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;il<st ��a ae�>� Contract A4irst Choice Roofing � iGss (888)871-9626 License#CCC1328591 13122 David Baker Road 6105 Memorial,Hwy,Suite E Riverview;FL 33579 Tampa,FL 33615 Date: 5 / Customer# A 5�� insured flame: "� t� �phone: t — tyy�— `J Job Address: � � d1 Nell phone: �•J�"' �"� � City: -� f,AN u iE`�11�1, State: 1' � Zip: Work phone: Email: t n�_ �VIAQ 4_7 Qsqn�— _Co-� Other Main Building #of Squares: -��„t D ached Building Reattach or spose tellite r Thed Roof Type: Reattach or Dispose Antenna Other(see notes)color: Reattach or Dispose Solar Panels utters Reattach or Dispose Other(see notes) Drip Edge Color: \Color: Upgrades(Not covered by insurance claim and are accepted financial responsibilities of homeowner.) Initial: i.La, �r�tdY k14 _ Cost$ 2. �� ai Cost$ insurance Estimate defines total scope of work,,unless noted in the Upgrade or Notes Section. ✓ e'" Materials and services may include,but are not limited to: Syr or&reaterkianufacturer Shingle Warranty PGRADE*New Ridge Vent Roof Ventilation System 3iNew yr"NO LEAK"Workmanship Warranty PGRADE*Re-nail of Decking as needed Plumbing.Vent Pipe Boots/Collars Vpr graded Underlayment' and Water in valleys(Peel and Stick) Remove all job related debris Wall Flashing and counter flashing per Insurance Claim Interior work per Insurance Claim Ad itional Terms/Notes ,.� Initial: Install and Payment Initial: r Replacement Cost Value$, c;2 c� Payment Today:$ *Replacement value(RCV)does NOT include " — supplemental checks requested for shortages from insurance company. " *Install date is contingent upon material availability from our suppliers,and prevailing weather conditions. This date is for the roof only,any other work will be scheduled after completion All rights.and obligations of the parties shall be subject to and governed,by the General.Specifications,Additional Terms/Notes (if applicable), and any subsequent modifications,which must be in writing and attached as Exhibit(s)duly accepted and signed by both parties. All work will be completed and billed.in accordance with the Insurance Estimate and this Installation Contract. l/we authorize direct payment of any benefits or proceeds,to AFCR for work performed by AFCR hereunder,and direct my/our insurance carrier to release any and all information requested by AFCR,its Representatives,or its Attorney.I/we authorize AFCR to deposit insurance checks'as payment for servlces rendered or to be rendered.In any event,I/we hereby agree to pay AFCR for the total replacement cost val and any supplemental funds approved by the insurance company. Authorize AgerrtPrint } ✓ CustomerSignature Date i "'I.a- / (7 Ck /?X) Authorized Agent signature pate CustomerSignature Date 9