13-14521 - Laserfiche WebLink

Browse Search

FOR OFFICE USE ONLY. I r�' (` Date Processed � � Neumann Construction, LLC Project Manager Assigned 24/7 Emergency Service Division Processing Representative 30427 Commerce Dr. . San Antonio, FL 33576 Insurance Company (813)782-9080 Neumann Job Number �y�y� �e (877)762-6350 www.nfoc.net Neumann Intake Number REPAIR AUTHORIZATION CBC 058155 I/We, , ("Owner/Insured") hereby request and authorize W.A. Neumann Co y�t�pn, LLC, and their employees/representatives to enter the premises located at: Street Address: ��L 5 �"Z � f; City: �pry^,t.t.� State:_ ��( Zip Code� ��'� ("Proqertv"), to perform the following scope of services, repairs, labor and/or work (collectively, "Work"): ❑ Emergency Services (circle): Water Extraction/Dry-Out Board-Up Tarp ❑ Structural Repairs ❑ Other: �� a �2 -� � I�/,� L Insurance Company: Claim Number: ,�� `� ("Owner's Insurance Companv"). �'✓ W.A. Neumann Construction, LLC shall perform all Work, as identified above, on the Property for the amount of the estimate agreed upon with the Owner and/or Owner's Insurance Company. Any supplements to the estimate for covered items will be paid by the Owner's Insurance Company Any work not covered by Owner's Insurance Company will be agreed to in the form of a change order,signed by the Owner and W.A. Neumann Construction, LLC prior to the commencement of such additional work. Payments for all Work perFormed under this Repair Authorization, including any additional work not related to the Owner's Insurance Company scope or estimate of repairs, is the sole responsibility of the Owner, regardless of insurance coverage. I/We hereby assign any and all interest in the proceeds from any payment from Owner's Insurance Company to W.A. Neumann Construction, LLC, and I/We further authorize and direct Owner's Insurance Company to issue payment directly to W.A. Neumann Construction, LLC for such Work, or, to�i ude W.A. Neumann Construction, LLC as an additional payee on the face of any payment draft for the Work performed on the Property If�y d�ient is made to the Owner, Owner agrees to immediately endorse same and furnish to W.A. Neumann Constructio �•J� � (OwneNlnsured Initials) n, LLC I/We understand that I am individually,jointly and severally, liable to W.A. Neumann Construction, LLC for full payment in connection with Work performed on the Property I/We acknowledge that this Repair Authorization and the Work required hereunder is subject to Florida's Construction Lien Law, and that should I/We fail to make full ent to W.A. Neumann Construction, LLC, as provided in this Repair Authorization,a lien will be placed on the Property (Owner/Insured Initials) I/We understand that I/we are solely responsible for the following expenses: (1)Any insurance deductible or non-recoverable depreciation in accordance with the Owner's Insurance Company; (2)Any and all repairs or work performed on the Property by W.A. Neumann Construction, LLC, which are not authorized by this Repair Authorization; (3) Any and all code upgrade items that are not covered under the Owner's Insurance Company; (4)Any and all additional work requested by any ch ge order; and(5)Emergency services, in the event that no insurance coverage is available for any repairs made to the Pro�erty__ � --- ---- - — --n , -(OwneF/lnsured-Initials)-------------— ---- I/We understand that should I/we choose to cancel this Repair Authorization prior to completion of the Work, I/we will remain responsible to pay W.A. Neumann Construction, LLC all actual expenses associated with W.A. Neumann Construction, LLC's performance of the Work, which includes any overhead and profit payments agreed to by the O�eye Insurance Company, regardless of the quantity or completeness of Work performed by W.A. Neumann Construction, LLC_ � �_(Owner/lnsured Initials) REMEDIES FOR NON-PAYMENT: W.A. Neumann Construction, LLC shall have all rights to payment and enforcement provided by Chapter 713, FLORIDA STATUTES, which is incorporated herein by this reference In the event it is necessary to collect any amount of money owed hereunder by referral to an attorney, collection agency, or court proceeding, it is agreed that the revailin such matter will reimburse the other party for its reasonable attorneys' fees and enforcement costs at al�l tribunalSl velsnalnld inralladispute resolution proceedings, including bankruptcy and post judgment collection, whether or not suit be brought. A service charge of 1.5%per month will be due on all invoices ten (10) days past due, along with all collection costs incurred. Work may be suspended or terminated by W.q. Neumann Construction, LLC if not paid in full ten (10) days after invoice or billing, In the event of termination by W.A. Neumann Construction, LLC as a result of delinquent payment or non-payment, W.A. Neumann Construction, LLC shall be entitled to compensation for lost profit and unabsorbed overhead for all Work not preformed W.A. Neumann Construction, LLC shall also be entitled to collection from the Owner/Insured of any monies withheld by a lien holder as party to a co-payee check as a result of default or delinquency by the Owner/Insured on a mortgage or other obligation on the property It is expressly understood that W.A. Neumann Construction, LLC pre-construction services including but not limited to estimating, site visits, planning, permitting and similar activities shall be payable at a minimum of 10% of total value of the estimated repairs if the Work is not perFormed by W.A. Neumann Construction, LLC SPECIAL NOTICE-INSURANCE CHECKS: W.A. Neumann Construction, LLC is agreeing to perform Work on the Property based solely upon Owner's agreement to make payment for the Work performed, as set forth in this Repair Authorization. Owner hereby agrees to assign or endorse any and all payment received from Owner's Insurance Company directly to W.A. Neumann Construction, LLC. Owner is responsible for Page 1 W.A, Neumann Construction, LLC-REPA/R AUTHOR/ZATION