Loading...
EL-12-2259Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 189314 Permit Number: EL -11 -12 -2259 Scheduled Inspection Date: April 17, 2013 Inspector: Devaney, Michael Owner: SCHROLL, PETER & SANDRA Job Address: 159 NW 109 Street Miami Shores, FL 33138- Project: <NONE> Contractor: ADT LLC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alarm Phone Number 305 - 751 -3616 Parcel Number 1121360030190 Building Department Comments BURGLAR ALARM Infractio Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments off-t/2- ze" April 16, 2013 For Inspections please call: (305)762.4949 Page 21 of 32 #c3/66WOK gA 61a1C‘31° \? \S\-W BU pDING PERMIT APPLICATION Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 7952204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit Type: Electrical JOB ADDRESS: /5-9 oil /99 (57/40-4t. City: Folio/Parcel #: Miami Shores County: C JIVE• NOV 29Z01Z FBC20(� C_& 2 °a Permit No. Master Permit No. Miami Dade Zip: (Q Is the Building Historically Designated: Yes Pamela, Flood Zone: OWNER: Name (Fee Simple Titleholder): J7e /0 el , Phone #:(gOS,J4/9S 4,' Address: ��jj/6 9 /yM/ /0 9 (�� �i' City: ////O'!7? / UY2O Zip: �3/�t7 Tenant/Lessee Name: Phone #: State:. Eivai1: CONTRACTOR: Company Name: T1- Address: /0,7gr , G't e/ City: State: Zip- Qualifier Name: .C�.��,�,: Phone #: rqPa9 Phone #: (9 x/0 °60 State Certification or Registration #: ( -F210 Certificate of Competency #: Contact Phone #:(9) ' — Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ 4.„ 90V Square/Linear Footage of Work: Type of Work: ClAddress Alteration Description of Work: ❑New ORepair /Replace ag /ar',' r,9-) //7 �J ,97a ee- ap iCpJ ❑Demolition **** Submittal Fee $ Scanning Fee $ Notary $ Double Fee $ :x*:K:K ** **:x*** *** ** * *** *: *Fees *** *** k:xx::x:x *:K*** *** :****x: *:a:: *** * ** ** *:x: **** Permit Fee $ Radon Fee $ Training/Education Fee $ Structural Review $ �cP e �'fa CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if a licable) Mortgage Lender's Address City State Zip Application is hereby made to commenced prior to the issua construction in this jurisdiction. WELLS, POOLS, FURNACES, btain a permit to do the work and installations as indicated. I certify that no work or installation has ce of a permit and that all work will be performed to meet the standards of all laws regulating I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I ce ify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating const ction and zoning. "WARNING TO a WNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS 0 YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CON ULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU ' NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a co y of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to att chment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which ccurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not he/win-ore I a re inspection fee will he charged. Signature er or Agent j The foregoing nstrument was a day of 14'1 , by who is pe onally known to me As ide NOTARY PUBLI Sign: Print: My Commission Expires: Signature 0 Contractor kno ledged, befor/4267/Y.5, this The foregoing instrument was acknowledged before me this �7ev day of // 20 , by /2'Y-it/el(' PG% y o27 r who has produced who is personally know to me or who has produced ication and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: "" MARIO HOYOS st: �.� *i MY COMMISSION # EE 097617 ISI'•11 � � Bonded Th EXPIRES: ru Notary aPublic Underwrttets * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * ** APPROVED BY 2 7 Lev .' r - (Revised 0/074, Plans Examiner Structural Review LeviseCI O6/ 10/7_000 a l0 V i'cd 3/15/09) Sign: �,�,� Print: dc�t" 1'U My Commission Expire ° eeptT�oy,� • 0' Zoning Clerk Miami -Dade My Home My Home mia "dada. py Show Me: [Property Information Search By: Select Item Ed Text only fgProperty Appraiser Tax Estimator Property Appraiser Tax Comparison Portability S.O.H. Calculator Summary Details: Folio No.: 11 -2130- 003-0190 Property: 159 NW 109 ST Mailing ddress: PETER T SCHROLL &W SANDRA F SCHROLL 159 NW 109 ST MIAMI HORES FL 33168-4316 Property Information: Primary Zone: 0800 SGL FAMILY - 1701 -1900 SQ CLUC: 0001 RESIDENTIAL - SINGLE FAMILY Beds/Baths: 3/2 Floors: 1 Living Units: 1 Adj Sq Footage: 1,496 Lot Size: 9,075 SQ FT Year Built: 1938 $50,000/ $110,834 MIAMI SHORES EXT PB City: 43-40 LOT 19 BLK 219 Legal LOT SIZE 75.000 X 121 Description: OR 15669 -0466 0992 1 COC 23652 -3957 07 20051 OR 23652 -3957 0705 00 Assessment Information: ear: 2012 2011 Land Value: $45,458 $45,458 :uilding Value: $115,376 .115,391 Market Value: $160,834 '. 160,849 ssessed Value: $160,834 $16084• Exemption Information: frear: 2012 2011 Homestead: $25,000 $25,000 2nd Homestead: YES YES Taxable Value Information: Page 1 of 2 frear: 2012 2011 Applied Applied 'Taxing Authority: Exemption/ Taxable Exemption/ Taxable Value: Value: Regional. $50,000/ $110,834 $50,000/ $110,849 County: $50,000/ $110,834 $50,000/ $110,849 City: $50,000/ $110,834 $50,000/ $110,849 School Board: $25,000/ $135,834 $25,0001 $135,849 Sale Information: Ic�io n��o hronnV ACTIVE TOOL: SELECT': Aerial Photography - 2012 0 mama. 112 ft My Home 1 Property Information 1 Property Taxes I My Neighborhood I Property Appraiser Home 1 Using Our Site 1 Phone Directory 1 Privacy 1 Disclaimer If you experience technical difficulties with the Property Information application, or wish to send us your comments, questions or suggestions please email us at Webmaster. Web Site © 2002 Miami -Dade County. All rights reserved. http://gisims2.miamidade.gov/myhome/propmap.asp Legend Property Boundary Selected Property Street a Highway Miami -Dade County Water 11/19/2012 A. Settlement State: ent (HUD-1) OMB Approval No. 2592-0265 fiix�52521637703 244615810 1. ®FHA 2.ORHS 3. riConv. Unins. 4. 1111 VA 5. E]Conv Ins. C. OTE: This :torn is flunishcd to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p,o.c.)" were paid outside the closing; they are shown here for informational purposes and are not included m the totals. 6. File Number 12027RAS 8. Mortgage Insurance Case Number FL0952521637703 kE1GN3I F E TKA71J; IMF-UM S1111ti rrilw' z1 Retirin ..._. ak z��"il`i'i,'sX'v ei�ii�N �Fe�r�y 3s e 14001.::': "l i tij1111.14 15,777.19 195 Adjustments for iterri9 106 Cityitown taxes 107i Caen 1.08 .:;;As* 110 = 012 tta''12/ 11/ / Q1 .-to `.:9/30/2011 to 415.51 603.28 403." 404.% 405 Attjustnaeuts for items paid by seller in advance 406. Lsi /t wn taxes to 407, County taxes . 11/8/2012 to 12/31/201 408_ Assessments 409. 11 /201 ::to 1/2013 415.50 334,795. ens 319,018.78 208 Misting loatl(s)'tak6 subject 0 ud�ic Tg Sr 207'' 208 209h 501; E bitss'ciel 51 ' a, vOt 503: Existing loatl(s):tak+ 504.' :'iii .15 tayy; W1 yLSF8RG4 505: Payoff of Seetihil mortgage 1oan <<:<.:••• .. ,Tfi 506: • 51:,1' 31,943.74 210. Citvvlllotviz tastes to 2I1. Cditityres : to 212; Assessments ':: 213' :•t, 214:::::; t, 215 216 17-;„:"k-<15:.: 218 - t 219.- :5 °'- ::.:.:.:,:;- :,.,.., .: ..::�•`. t, 220 Tot lAmopmCs Paid •,., by .4.10::/s— fofBorrowea rl l: oss amount` sue., .. y rower 302:3L s'arnount d.bytforborrQwerC1irie220) 303:.Cas i f 327,319.00 ,795.' 327,319.00 7,476.97 510.: Ciiy /tawiftax 511: Countvtai¢�, 12 :Ass smerts 5.13: 514.. 515. 516. 517: 518: 519. . . . 52QAtoi RedacAivi AniocuttDue , 312,948.58 312,948.58 6,070.20 o0S are O O y kitri e4filK", ,..,f314331.:i4a1:717', : -.0,... 7rm, LITT4r121- --viiiiii HUD-1 Line Number '..7 iril M1,747711- zala .. -4aiii;i5Rianni Charges That Cannot Increase Our origination charge #801 1111111111=1111.111111111111111111111111.1 Your credit or charge (points) the specific intcrest rate c osen #802 IIIIIIMIIIIIIIIIIIIIMIIIIIIIIIIMIIIIIIIII Your adjusted origination charges cbargcs #803 IIIIIIIIIIMIIIIIIIIIIIIIIIIIIIIIIIIIMIIIIIIIIMII Transfertaxes #1203 3 645.53 1111.1111111PMall A 07J;Ift, #804 AtigitiW 295.00 96.50 475.00 475.00 Credit report Tax scrvice #805 35.00 35.00 #806 79.00 79.00 Flood certification #807 26.00 26.00 Mortgage Insurance Premium for #902 5370.23 5,370.23 Tota Lase betaa-een 61:1„1, sit for Daily interest el:larger; liorrieowner'ir insurance #901 $ 28.87 /day 6,280.23 6 081.73 (198.50) or -3.1607 % 2,439.27 866,10 1.645,92 664.01 #903 Title services and Icnd&s title insurance Owner's title insurance #110I 3,600.00 500.00 2,994.00 1,194.00 #1 103 SURVEY' #1309 1,700.00 600.00 1,665.00 325.00 • Loan Terms Your Initial loan amount is Your Loart tan( is Your initial interest rate is Your initial muddy ninon:at owed for principal, interest, and any mortgage insurance is 312,240.00 30.00 years 3.375 % $ 1,697.20 includes tgl Principal interest Mortgage Insurance Can your. . . . , , . RIND. DYes,itcanrisetoamaximurnof %. The first change will be on and can change again every after Every change date, your interest rate can increase or decrease by %. Over the life of the loan, your interest rate is guaranteed to never be lower than % or hi than %. RiNo. EJ Yes, it can rise to a maximum of $ tZ No, 0 Yes, the first increase can be on and the monthly amount owed can rise to $ The maximum it can ever rise to is $ ENO. 0 Yes, your maximum prepayment penalty is $ (iNo.. CI Yes„ you have a balloon payment of $ 71: doe in years on • Even if you make popgun; on &wean your loan Even if you make payments on time, can your amount Owed for principal, interest, and mortgage assurance nse? Does your loin belie a pre ialty? DoeSytnnleanhaytanballntinpaymmatY;; • "ii,4i4 • • t • 8 escrt1a, Weer-int PaYMmats Total monthly amount owed itt. O You do not have a monthly escrow payment for items, such as property taxes and homeowner's insurance. You must pay these items directly yourself IR) You have an additional monthly escrow payment of $ TT7,$48.6$1: that results in a total initial monthly amount owed of $ 2,245:85 . This includes principal, interest, any mortgage insurance and any items checked below: Homeowner's insurance 1Property taxes 011ood insurance 0 Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form, please contact your lender. 0"•' File: 12027RA Previous editions are obsolete Page 3 of 3 02009 Display Systems, lac. (863) 763.5355 - Lew Gentealeel HUI U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT PAGE 2 iemnn`�iFll t�c�c "17r ui it itz,e• 1 : : Y o i ri oE'C Or Ct.- a •ints for Oat 's R01' Your adjusted orittination climes 1) from GFE #2 .0.o. sir 00 (fr om FE #3 .oc. s35.00 iti}b it • • •[+T :lf> :,. , 1 410.10I4 3 1(il-0)0]11) OM) 26 Rt1R '• :' MIST: . .c.$. -`.:il lTyrAtgi :,':,`.s'�.._..rt`s ipral °t t K, ia. ''77 ar'"v�ga li 11_E trt + ra Fay wa27 '7 '' ,< 1 6459 _ iu v ,li � € . r.., n ° 1, intft+}� t � . a: • t 1} ii.tY -�'�_ 1. #143. t1•i f "1[. 1 - flit 1 EIMENNEIIIMMirs `MIE0 i7"t M t�ts t } $ ••• • 1 k. . S '• ,,• .. 1,1..1: jt1a }ri L tuts tn'l Yt_ 12 03 I fro.: , • t t 1 14i. • w : _ p! 7 �1t',pF!. IEt- 1• ' K e r ∎ RellISMu at 11 a a • _ ;m+ iii' ri x7 F 11 .�,a s....:s ,F� ifFrs"'t,•_,�',•m .� w l�,z.-^2^�N "�.. ,v }' d"� d �e. cam' ...,�' :k?' 303: t'..: 7, r t ar OLD REPUBLIC NATIONALTITI -E INS. co. 4i.• DIMAS f00,C1kUnMeffiniRINSIMilibli I0 4011 tiaREMINMEMSAPAIIIIMI 'z 'I' oral Sett Cli eta I have carefully reviewed the HUD - 1 Settlement Statement and to the beat omy know e g NNan e disbursements made on my account or by me in this transaction. I further certify that 1 have 15,777.19 13,143.00 The HUD-1 Settlement Stataancnt which I have prepa ance with this statement. Borrower _ Borrower DATE: d11/8/2012 tint of all receipts an Statemen accurate account of this transaction. T have caused th SOVEREIGN TITLE & TRUST COMPANY Settlement Agent 11/8/2012 . to the United States on this or any other similar form. Penalties upon conviction can include a 1001 and Section 1010. Page 2 of 3 WARNING: It is a crime to knowingly make false fine and imprisonment. For details see. Title 18 U.S. C funds to be disbursed in accord- Seller Seller Date 12027RAS RESIDENTIAL SERVICES CONTRACT a 5 9-70 CONTRACT DATE CUSTOMER "ACCOUNT NQ ftIIi 11 n 11 11 5401UE02 hill 1 111 JOB NO LEAD SOURCE - •1 •11- 1 • ADT LLC dba ADT Security Services MDT") Office Address s 1 1 '7 - tea. ° Www.MyADT.com 800.ADT.ASAP® (800.238.2727) 1 B. AMOUNT OF EACH PAYMENT IS Customer Name (°Customer° or "I° or °me° or "my") �` APPLICABLE TAXES, FEES, FINES d, ° LATE CHARGE - PAYMENT IS DUE PURSUANT TO MY SELECTED BILLING FREQUENCY, PRIOR TO THE START OF SERVICE. MY FIRST BILUCHARGE WILL BE SENT /MADE SHORTLY AFTER MY SERVICE BEGINS. ADT MAY IMPOSE A ONE -TIME LATE CHARGE ON EACH PAYMENT THAT IS MORE THAN TEN (10) DAYS PAST DUE, UP TO THE MAXIMUM AMOUNT PERMITTED BY LAW, BUT IN NO EVENT WILL THIS AMOUNT EXCEED $5.00. Al (� 'h. '' �.a' r ,� y Premises' Address City( Tax Protected Telephone } - i� (T v p - ' -_P.- - C State (Qualified) *f ,.1 r - ' ZIP NOE Exempt No. Premises' Home ° '. ';'� ., r=',..�', .. ',_',`. '� �:`.� '. Traditional Tax Phone 0 Other Expire Date � , ! �. , LJ—I Home 0 Other (Non - Qualified) 0 Cell 0 Work 0 0 Cell 0 Work Alternate Telephone Alternate Telephone 1 �° ) f , '� 0 2 0 0 Fill in if billing address is the same Billing Address State City ZIP IF FAMILIARIZATION PERIOD IS REJECTED INITIAL HERE (see Paragraph 14 of the Terms and Conditions for explanation) EMAIL Commun'cations Authorization: I authorize ADT to provide me with information and updates about the security system products and services to the contact informat(pprovided by me. 1 may unsubscribe or opt out by emailing donotcontact@adt.com 888.DNC4ADT (888.362.4238). Initial here /, and new ADT and third -party or by calling Confirmation of Appointments: I authorize ADT to call me using an automated calling device to deliver a pre- recorded message to set/confirm appointments and provide other information and notices about the alarm system at the telephone number(s) provided by me. Initial here'- ' + EQUIPMENT TO REMAIN THE PROPERTY OF ADT. All equipment installed by ADT pursuant to this Contract shall be owned by ADT unless ADT has agreed to give me ownership of the equipment in a separate written agreement. ADT has the right upon termination of this Contract to remove or disable any or all of the equipment owned by ADT, in which case I will not be able to use the equipment for any purpose. See Paragraph 7 of the Terms and Conditions for more information. I acknowledge and agree to each of the following: (A) This Contract consists of six (6) pages. Before signing this Contract,1 have read, understand and agree to each and every term of this Contract, including but not limited to Paragraphs 5 and 18 of the Terms and Conditions. (B) The initial term of this Contract is three (3) years. (C) ADT is not a security consultant and cannot address all of my potential security needs. ADT has explained to me the full range of equipment and services that ADT can provide me. Additional equipment and services over those identified in this Contract are available and may be purchased from ADT at an additional cost to me. I have selected and purchased only the equipment and services identified in this Contract. (D) No alarm system can provide complete protection or guarantee prevention of loss or injury. Fires, floods, burglaries, robberies, medical problems and other incidents are unpredictable and cannot always be detected or prevented by an alarm system. Human error is always possible, and the response time of police, fire and medical emergency personnel is outside the control of ADT. ADT may not receive alarm signals if communications or power is interrupted for any reason. (E) ADT recommends that I manually test the alarm system monthly and any time I change telephone service, by calling 800.ADT.ASAP or by logging in to www.MyADT.com. (F) this Contract requires final approval by an ADT authorized manager before ADT may provide any equipment or services, and if approval is denied, then this Contract will be terminated, and ADT's only obligation will be to notify me of such termination and refund any amounts I paid in advance. ADT Representive 1 bi A? J y ( &j Rep. License No i y a9 ' , .f (If Required) Rep.°„i. ID No. iy i r Customer's Approval: Original Signature Required (Must match Customer Name in Section 1 above) X es:� -�' 111 IS M NOTICE OF CANCELLATION I, THE CUSTOMER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. I ACKNOWLEDGE BEING VERBALLY INFORMED OF MY RIGHT TO CANCEL AT THE TIME OF EXECUTION OF THIS CONTRACT AND RECEIPT OF THIS NOTICE. -, - •a - . . - ' . • . - . FINANCIAL DISCLOSURE STATEMENT THERE IS NO FINANCE CHARGE OR COST OF CREDIT (0% APR) ASSOCIATED WITH THIS CONTRACT. A. NUMBER OF PAYMENTS FOR THE INITIAL TERM 1S 36. 1 B. AMOUNT OF EACH PAYMENT IS TOTAL OF PAYMENTS FOR THE INITIAL (A. TIMES B.) (EXCLUSIVE OF ANY AND RATE INCREASES) p $ A�f S TERM IS �' APPLICABLE TAXES, FEES, FINES (TOTAL MONTHLY SERVICE CHARGE FROM BELOW) LATE CHARGE - PAYMENT IS DUE PURSUANT TO MY SELECTED BILLING FREQUENCY, PRIOR TO THE START OF SERVICE. MY FIRST BILUCHARGE WILL BE SENT /MADE SHORTLY AFTER MY SERVICE BEGINS. ADT MAY IMPOSE A ONE -TIME LATE CHARGE ON EACH PAYMENT THAT IS MORE THAN TEN (10) DAYS PAST DUE, UP TO THE MAXIMUM AMOUNT PERMITTED BY LAW, BUT IN NO EVENT WILL THIS AMOUNT EXCEED $5.00. PREPAYMENT - IF I PREPAY THE TOTAL OF PAYMENTS PRIOR TO THE END OF THE INITIAL TERM OF THIS CONTRACT, THERE IS NO PENALTY OR REFUND. SEE PARAGRAPHS 2, 7, 15 AND 19 OF THIS CONTRACT FOR ADDITIONAL INFORMATION ABOUT NONPAYMENT, DEFAULT AND ACCELERATION. 1 of 6 Customer Copy ©2012 ADT LLC dba ADT Security Services. All rights reserved. (09/12) PHONE OR OTHER INTERNET INTERFA RADIO, ETC. ( "NON - TRADITIONAL TELE MY PREMISES (THE BATTERY BACK-UPIi ELECTRONICS FAILURES SUCH AS A M( OF THE ALARM SYSTEM WITH MY NO DATA FORMAT AFTER ADT'S INITIAL R CMC. IF ADT DETERMINES IN ITS SOLD AS+FHE SOLE METHOD OF TRANSM METHOD OF COMMUNICATI BECOMES NON - COMPATIBLE, OR IF I C I USE AN ALTERNATE METHOD OF CO TRANSMISSION OF FIRE ALARM SIGNq ALARM OR OTHER STANDARDS OR C HAS A UNE -CUT FEATURE, IT MAY NO BE ABLE TO DOWNLOAD SYSTEM CH OR SERVICE. THE ALARM PANEL MAY HOOK DUE TO IMPROPER CONNECTIO TEST OF THE ALARM SYSTEM DOES N 19. CANCELLATION. A. ADT may, at any time, cancel this C (2) ADT cannot acquire or retain the fire or police department or other age recommendations to repair or replace. ADT's operating instructions for the al my premises after installation. If ADT c be supplied after the date of such ter other charges due. Additionally, ADT B. ADT may cancel this Contract upo communications service not suitable fo written notice from ADT, I will have to Contract, ADT may assess contract ter 20. ASSIGNMENT. I may not assign this any of its obligations under this Contr Important Terms and Conditions (continued) E -TYPE SERVICE OR RADIO SERVICE, INCLUDING CELLULAR OR PRIVATE PHONE SERVICE ")) INCLUDE THE LOSS OF NORMAL ELECTRICAL POWER TO FOR ADT'S ALARM PANEL DOES NOT POWER MY TELEPHONE SERVICE) AND ' )DEM MALFUNCTION. ADT WILL ONLY REVIEW THE INITIAL COMPATIBILITY - TRADITIONAL TELEPHONE SERVICE AT THE TIME OF INITIAL INSTALLATION. CHANGES IN MY TELEPHONE SERVICE'S IEW OF COMPATIBILITY COULD MAKE MY TELEPHONE SERVICE UNABLE TO TRANSMIT ALARM SIGNALS TO ADT'S DISCRETION THAT IT I5 COMPATIBLE, ADT WILL PERMIT ME TO USE MY NON - TRADITIONAL TELEPHONE ,SERVICE NG ALARM SIGNALS, ALTHOUGH I UNDERSTAND THAT ADT RECOMMENDS THAT I ALSO USE AN ADDITIONAL' N. IF ADT DETERMINES IN ITS SOLE DISCRETION THAT MY NON - TRADITIONAL TELEPHONE SERVICE 15 OR LATER ANGE TO ANOTHER NON - TRADITIONAL TELEPHONE SERVICE THAT IS NOT COMPATIBLE, THEN ADT REQUIRES THAT MUNICATION ACCEPTABLE TO ADT AS THE PRIMARY METHOD TO CONNECT THE ALARM SYSTEM TO ADT'S CMC. BY MEANS OTHER THAN A TRADITIONAL TELEPHONE LINE MAY NOT BE IN COMPLIANCE WITH APPLICABLE FIRE ES, AND IT IS SOLELY MY OBLIGATION TO COMPLY WITH SUCH STANDARDS AND CODES. IF THE ALARM SYSTEM BE ABLE TO DETECT IF MY NON - TRADITIONAL TELEPHONE SERVICE LINE IS CUT OR INTERRUPTED. ADT MAY NOT NGES OR PROVIDE CERTAIN AUXIUARY MONITORING SERVICES THROUGH A NON - TRADITIONAL TELEPHONE UNE E UNABLE TO SEIZE MY TELEPHONE LINE TO TRANSMIT AN ALARM SIGNAL IF ANOTHER CONNECTION IS OFF THE OR OTHERWISE. ADT RECOMMENDS THAT I TEST THE ALARM SYSTEM MONTHLY, EVEN THOUGH A SUCCESSFUL T GUARANTEE THAT ADT WILL RECEIVE ALARM SIGNALS FROM THE ALARM SYSTEM IN THE FUTURE. I III 11 it 1 5401UE02 Rl ntract at its option if: (1) ADT's CMC is destroyed or damaged so that it is impractical for ADT to continue service; ansmission connections or authorization to transmit signals between my premises and its CMC or the applicable cy, or between ADT's CMC and the applicable fire or police department or other agency; (3) I fail to follow ADT's ny defective parts of the system not covered under the Limited Warranty or, if purchased, QSP; (4) I fail to follow rm system; or (5) ADT determines that it is impractical to continue service due to the modification or alteration of ncels for any of the reasons stated immediately above, ADT will refund any advance payments made for services to ination, Tess any amounts still due for the installation of the equipment, for services already rendered and for any ill not assess contract termination charges, if any, as described in Paragraph 2 above. written notice to me if: (1) I fail to pay any monies when due under this Contract, (2) I change to a telephone/ alarm signal transmission or (3) I fail to comply with any other term or condition of this Contract. Upon receipt of (10) days to correct the deficiency. If I do not correct the deficiency in a timely manner, and ADT does cancel this ination charges, if any, as described in Paragraph 2 above. ontract without prior written consent from ADT. ADT does have the right to assign this Contract or to subcontract ct without my approval and without notice to me. 21. DELAYS. ADT HAS NO RESPONSIBI ITY OR LIABILITY TO ME OR ANY OTHER PERSON FOR DELAYS IN THE INSTALLATION OR REPAIR OF THE SYSTEM, REGARDLESS OF THE REASON. ADT HA NO RESPONSIBILITY OR LIABILITY FOR INTERRUPTIONS OF SERVICE OR ANY RESULTING CONSEQUENCES, WHETHER DUE TO STRIKE, RIOT, FLOOD, FIRE, ERRORISM, ACT OF GOD OR ANY OTHER CAUSE WITHIN OR BEYOND ADT'S CONTROL. IF THERE ARE SERVICE INTERRUPTIONS, ADT HAS NO OBLIGA ION TO SUPPLY ME WITH SUBSTITUTE SERVICES. 22. ELECTRONIC MEDIA; PERSONAL IN ORMATION. ADT may scan, image or otherwise convert this Contract into an electronic format of any nature. A copy of this Contract produced from s ch electronic format is legally equivalent to the original for any and all purposes, including litigation. ADT's receipt by fax of the Contract signed by me legally binds me and such fax copy is legally equivalent to the original for any and all purposes, including litigation. The personal information about me a d third parties that I provided to ADT is true and complete. I will notify ADT without delay of any change to this information. I consent to ADT's use of my personal information and that of third parties provided by me for the purpose of monitoring, setting up and administering my security services (incl ding credit approval, invoicing, collecting and providing information on new equipment or services). I have obtained the consent of the third parties, whose personal information I provided to ADT, to use such personal information for the administration of my account with ADT and as provided in this Contract. A T may collect (including my consent to record my telephone conversations with ADT's representatives), use, disclose and transfer my personal information, and that of third parties provided by me, to ADT's parents, affiliates, subsidiaries and successor corporations, any subcontractor or assignee of this Cont act or any applicable authority having jurisdiction that requests such information to administer alarm monitoring services or alarm system license, permi or similar programs. 23. PRIVACY POLICY. ADT maintains a online privacy policy at www.ADT.com/privacy that is applicable to the terms, conditions and obligations of the parties to this Contract. 24. ENTIRE AGREEMENT. THIS CONTR'' CT CONSTITUTES THE ENTIRE AGREEMENT BETWEEN THE PARTIES. I AM NOT RELYING ON ADT'S ADVICE OR ADVERTISEMENTS. ADT 15 NOT BOUND BY ANY REPRESENTATION, PROMISE, CONDITION, INDUCEMENT OR WARRANTY, EXPRESS OR IMPLIED, THAT IS NOT INCLUDED IN WRITING IN TH1• CONTRACT. THE TERMS AND CONDITIONS OF THIS CONTRACT APPLY AS PRINTED WITHOUT ALTERATION OR QUALIFICATION, UNLESS A CHANGE 5 APPROVED IN WRITING BY AN ADT AUTHORIZED REPRESENTATIVE. THE TERMS AND CONDITIONS OF THIS CONTRACT SHALL CONTROL AND GO . ERN EVEN IF THERE ARE OTHER DOCUMENTS WITH INCONSISTENT OR ADDITIONAL TERMS AND CONDITIONS. IF A COURT DETERMINES THAT ANY PRQ ISION OF THIS CONTRACT IS INVALID OR UNENFORCEABLE, THAT PROVISION SHALL BE DEEMED AMENDED AND ENFORCED TO THE MAXIMUM EXTEN" PERMITTED BY LAW. EACH AND EVERY OTHER PROVISION OF THIS CONTRACT SHALL CONTINUE TO BE VALID AND ENFORCEABLE. 25. License Information: AL Alabama = lectronic Security Board of Licensure, 7956 Vaughn Rd., Montgomery 36116, (334) 264-9388; AK 37950, 5520 Lake Otis Pkwy., Anchorage, AK 99507; AR E +0120041, Regulated by Arkansas Bd. of Private Investigators & Private Security Agencies, #1 State Police Plaza Dr., Little Rock 72209, (501) 618 -8600; AZ " OC 279591; CA AC07155, PP017232, 974443; alarm company operators are licensed and regulated by the Bureau of Security & Investigative Services, Q-pt. of Consumer Affairs, Sacramento, CA 95814; DC ECS902743; FL EF0001121; GA LVA205265, - 205326, - 205572, - 205679, - 205878, LVU405673, -004349 HI CT- 32297; 11124001792; LA F1639, F1407, F1640; MA 172C; MI 3601206258, 5103208 - 4182 Pier North Dr. Ste. D, Flint, MI 48504; MNTS650251; NC 753. P2, 7561P2, 7562P10, 7563P7, 7565P1, 7566P9 -Alarm Systems Licensing Bd., 1631 Midtown PI., Ste. 104, Raleigh, 27609 (919) 875 -3611; NM 374838; NV 0077105; NY 12000305615, Licensed by NYS Dept. of State; OH 50 -18 -0018; 50 -25 -0023; 50 -29 -0003; 50 -31 -0014; 50-48 -0008; 50.50 -0005; 50 -76 -0006; 5N -89 -0016, 53-89 -1726; OK 1995; OR 196560; PA Pennsylvania Home Improvement Contractor Registration Number: PA090797; RI 35683; TN ACC -1688, -1 89, -1690, -1691, -1692, -1693, -1694, -1695, -1696; TX B17944 -140 Heimer Rd. Ste. 100, San Antonio, TX 78232 - Texas Private Security Bureau, 5805 . Lamar Blvd., Austin 78752; UT 8289653; VA 11 -7348; 11 -7345; 11 -7354; WA ADTLLL881DO, 11824 N Creek Pkwy. #105, Bothell, WA 98011; WV 049758. MS 15019511 02012 ADT LLC dba ADT Security Servi es. All rights reserved. 6 of 6 (09/12) RESIDENTIAL SERVICES CONTRACT CONTRACT DATE U1 CUSTOMER ACCOUNT NO 11 11 111 1 i 11 1 5401 UEO2 i 11 JOB NO LEAD SOURCE - ••1 1 CI •1• 0 Check received for: 0 Installation: Check # Amount $ Check Confirmation # O Annual Service Charges Collected: Check # Amount $ Check Confirmation # I authorize ADT: 0 To withdraw all (1) Service Charges and (11) Contract Termination Charges (see Paragraph 2. Early Termination of this Contract) from my bank account p)To charge my credit/debit card for all (1) Service Charges and (ii) Contract Termination Charges (see Paragraph 2. Early Termination of this Contract): 0 Annually 0 Semi - Annually 0 Quarterly 0 Monthly Choose one: 0 Checking 0 Savings Name of Bank/Credit Union 'r.-. .., . ABA Routing Number Bank Account Number 'Installation 0 3 - = °: _(available over All/Recurring Service O Annually O Semi- 0 VISA 0 MasterCard Credit/Debit Card Number i 3 monthly $400 � credit/debit card payments only for telephone or field sales with Charges Annually O Quarterly 0 Discover ;,,:fins orders an installation of equal amounts with an installation price price over $1,500) OMonthly CYAMEX Expiration Date a i 1M Y Y ty t FYLa E �! Recurring Service Charge Amount $ Plus tax Recurring Service Charge Amount $ Plus tax Name as it appears on bank account I authorize ADT to debit my bank account for the amount of all Recurring and all Contract Termination Charges (see Paragraph 2. Early Termination indicated above. I may revoke this authorization only by notifying writing at least 10 business days before the scheduled debit If no service charges will be withdrawn monthly. Service Charges of this Contract) ADT and my bank in oval is filled above, Cardholder .Y "': s Name -I- bank account for the Charges (see Paragraph this authorization days before the monthly. amount of all 2. Early only by scheduled debit. If I am using a debit card, I authorize ADT to debit my Recurring Service Charges and all Contract Termination Termination of this Contract) indicated above. I may revoke notifying ADT and my bank in writing at least 10 business If no oval is filled above, my credit/debit card will be charged I authorize ADT to withdraw the amounts in this section from my bank account or credit card through an Automated Clearing House ("ACH"). These payments are for the equipment and services described in this Contract. This authorization will remain in effect until the termination date of this Contract or until I cancel it in writing, whichever occurs first. I also agree to notify ADT in writing of any changes in my account information at least 15 days prior to the next billing date. If a payment date falls on a weekend or holiday, payment may be executed on the next business day. Because this is an electronic transaction, these funds may be withdrawn from my account each month as early as the transaction date. If the date or amount of the withdrawal changes, or if Contract Termination Charges (see Paragraph 2. Early Termination of this Contract) apply, ADT will notify me at least 10 days prior to the payment being collected. If an ACH transaction is rejected for non - suffident funds (NSF), ADT may attempt to process the charge again within 30 days, and an NSF charge may apply. The origination of ACH transactions to my account must comply with the provisions of U.S. law. I am an authorized user of this credit card or bank account, and I will not dispute the payment with my credit card company or bank, so long as the amount corresponds to the terms indicated in this Contract. 0 To send me a bill: 0 Annually 0 Semi Annually _ Q'guarterly 0 Other " DOA Approval I If no oval is filled, ADT will send bill quarterly. Authorized Account Signature: °' , "-`_e - ' • 1 • 1 1 - . 1 • y 11 P. . Municipality Police Name Municipality Fire Name Municipality Medical Responder Name Patrol Name & Number Cross Street Job Type QNew Sale 0 Change Over 0 Upgrade 0 Resale Control Type 0 HW 41g,= F Permit Affiliation Member # Number Burglar Alarm: Comes 0 No Fire / Smoke: CLYes 0 No Two -Way Voice: 0 Yes No Cellular Model* i - 'rte y 0 Parallel 0 Standard Resale- Former Acct # Former CS # • 1 • •. 1 • • (-4-/ } This password must be issued to all users of the alarm system, including all people listed in Section 7. An optional, secondary password for service individuals, housekeepers, tenants, etc. is available upon request. A password must be no less than three (3) and no more than five (5) characters in length and may not contain any punctuation or spaces, offensive language or non - standard spelling. Customer may change passwords and contacts by going to www.MyADT.com or by calling ADT toll -free at 800.ADT.ASAP. - •2 11- • -5 y •1 These are the individuals who may be called in the event of an alarm. Because they may need to meet the authorities in response to an alarm, I will provide them access to my premises, the password, and the keypad code. By selecting the Yes designa on the right I am identifying which of these individuals may be called prior to notification of the authorities. a Customer /Emergency Contact #1 Ip / %+s 1/ O C O • 0 Print First/Last Name ' �' --) Phone �' 1� . ' "dome Cell Work Yes No 0 0 0 0 0 Phone Home Cell Work Yes No `J Customer/Emergency Contact #2 t ' r ,� ( 0 0, 0 0 Print First/Last Name �`'' Pf - Phone a ' Home Cell Work Yes No 0 0 0 0 0 ' Phone Home Cell Work Yes No Altemate/Emergency Only Contact, y; g , O O O O Print First/Last Name (. -�'f ° Phone �a 4� - (. 1 Home Cell Work Yes No 0 0 0 0 0 Phone Home Cell Work Yes No 3 of 6 ©2012 ADT LLC dba ADT Security Services. All rights reserved. (09112) IMPORTANT TERMS AND CONDITIONS 1. Payments; Term; Consumer Report 2. Early Termination of this Contract 3. Increases in Charges 4. Additional Charges and Offset Rights 5. Limitation of Liability 6. Other Party's Limitation 7. Ownership Installation 9. Limited Warranty 10. Extended Limited Warranty/ Quality Service Plan (QSP) 11. Warranty Exclusions 12. No Other Warranties 13. Alarm Monitoring and Notification Service 14. Familiarization Period 15. Failure to Pay Charges or Honor Contract 16. Smoke and Carbon Monoxide Detectors 17. Battery - Powered Devices 18. Communication Facilities 19. Cancellation 20. Assignment 21. Delays 11 II UII 1 11 i 5401UE02 �u of 22. Electronic Media; Personal Information 23. Privacy Policy 24. Entire Agreement 25. License Information 1. PAYMENTS; TERM; CONSUMER REPORT. All charges are payable in advance. The initial term of this Contract is three (3) years. ADT's alarm monitoring and notification services will begin wh n the equipment is installed, operational and communicating with ADT's Customer Monitoring Center ( "CMC "). This Contract will automatically renew, or successive thirty (30) -day terms unless terminated by either party in writing at least thirty (30) days before the end of the current term. If terminated, his Contract ends on the last day of the then - current term. If I would like to discuss my options before terminating service, I can call ADT at 800.327.4348. I authorize ADT to obtain a non - investigative consumer report, commonly referred to as a credit check or credit report, about me from a consumer rep rting agency at any time during the term. 2. EARLY TERMINATION OF THIS CONTRACT. I AGREE THAT THE CHARGES DUE UNDER THIS CONTRACT ARE BASED ON MY AGREEMENT TO RECEIVE AND PAY FOR THE SERVICES FOR THREE (3) FULL YEARS AND THAT ADT HAS REUED UPON MY AGREEMENT AND HAS INCURRED COSTS IN DECIDING TO ENTER INTO THIS CONTRACT. IF I CANCEL SERVICE OR OTHERWISE TERMINATE THIS CONTRACT DURING ITS INITIAL TERM, OR IF ADT CANCELS THIS CONTRACT DURING ITS INITIAL TERM FOR A REASON SET FORTH IN PARAGRAPH 19(B) BELOW, I WILL PAY ADT 75% OF THE TOTAL REMAINING MONTHLY CHARGES AS AN ALTERNATIVE TO ME HAVING TO PAY THE FULL REMAINING CHARGES. THIS AMOUNT IS A CONTRACT TERMINATION CHARGE AND I5 NOT A PENALTY. THE AMOUNT IS PAYABLE IMMEDIATELY IN FULL. NO CONTRACT TERMINATION CHARGES ARE DUE IF I TERMINATE, OR IF ADT CANCELS, DURING THE THIRTY (30) -DAY RENEWAL PERIOD(S). 3. INCREASES IN CHARGES. ADT has t e right to increase the annual service charge at any time after the first year. If I object in writing to the increase within thirty (30) days of receiving no, ice of the increase, and if ADT does not waive the increase, then I may terminate this Contract effective thirty (30) days after ADT's receipt of my written notice of termination. In this situation, 1 will not have to pay the contract termination charges described in Paragraph 2 above. 4. ADDITIONAL CHARGES AND OFFS RIGHTS. I agree to pay all construction/alarm use permit fees; all directly or indirectly imposed false alarm fines, fees or charges; all telephone or signal transmission company charges; and all other assessments, fees and charges related to the alarm system. I agree to pay a service charge if an ADT repre entative responds to a service call or alarm at my premises because I improperly followed operating instructions; failed to properly lock or dose a windo , door or other protected point; or improperly adjusted CCTV cameras, monitors or accessories. If ADT owes me money when this Contract ends, ADT h s the right to deduct from any refund owed me (A) service charges for thirty (30) days, if I fail to give the required written termination notice set forth in aragraph 1 above; (B) any contract termination charges that I may owe as set forth in Paragraph 2 above; and (C) any other additional charges, amounts r deposits that I owe ADT. If the amount of the deduction equals or exceeds the amount that ADT owes me or if ADT owes me a credit of five dollars ($!.00) or less, ADT will not be obligated to refund any amounts to me. 5. UMITATION OF UABIUTY. A. INSURANCE; WAIVER OF SUBROGATION. 1 AGREE THAT ADT IS NOT AN INSURER AND THAT ADT I5 NOT PROVIDING ME WITH INSURANCE OF ANY TYPE. THE AMOUNTS I PAY ADT ARE NOT INSURANCE PREMIUMS AND ARE NOT RELATED TO THE VALUE OF MY PROPERTY, ANYONE ELSE'S PROPERTY LOCATED IN MY PREMISES OR ANY RI OF LOSS AT MY PREMISES. INSTEAD, THE AMOUNTS ADT CHARGES ME ARE BASED SOLELY UPON THE VALUE OF THE EQUIPMENT AND SERVICES AD PROVIDES AND UPON THE LIMITED LIABIUTY ADT ASSUMES UNDER THIS CONTRACT. IF I WANT INSURANCE TO PROTECT AGAINST ANY RISK OF LOSS e., MY PREMISES,1 WILL PURCHASE IT. IN THE EVENT OF ANY LOSS, DAMAGE OR INJURY, 1 WILL LOOK EXCLUSIVELY TO MY INSURER AND NOT TO ADT TO, COMPENSATE ME OR ANYONE ELSE. I RELEASE AND WAIVE FOR MYSELF AND MY INSURER ALL SUBROGATION AND OTHER RIGHTS TO RECOVER AGAI ST ADT ARISING AS A RESULT OF THE PAYMENT OF ANY CLAIM FOR LOSS, DAMAGE OR INJURY. B. NO GUARANTEE; NO UABILITY. ADT 5 EQUIPMENT AND SERVICES DO NOT CAUSE AND CANNOT EUMINATE OCCURRENCES OF THE EVENTS THEY ARE INTENDED TO DETECT OR AVERT, INCL DING, BUT NOT LIMITED TO, FIRES, FLOODS, BURGLARIES, ROBBERIES AND MEDICAL PROBLEMS. OTHER THAN THE LIMITED WARRANTY AND /OR QU LITY SERVICE PLAN SET FORTH IN PARAGRAPHS 9 AND 10 BELOW, ADT MAKES NO GUARANTY OR WARRANTY, INCLUDING ANY IMPLIED WARRANTY e F MERCHANTABIUTY OR FITNESS FOR A PARTICULAR PURPOSE, THAT THE EQUIPMENT AND SERVICES PROVIDED WILL DETECT OR AVERT SUCH INCIDE' + + +- 5 OR THEIR CONSEQUENCES. ADT DOES NOT UNDERTAKE ANY RISK THAT I OR MY PROPERTY, OR THE PERSON OR PROPERTY OF OTHERS, MAY BE SUBJE ! TO INJURY OR LOSS IF SUCH AN EVENT OCCURS. THE ALLOCATION OF SUCH RISK REMAINS WITH ME, NOT ADT. I RELEASE, WAIVE, DISCHARGE AND PR + +' MISE NOT TO SUE OR BRING ANY CLAIM OF ANY TYPE AGAINST ADT FOR LOSS, DAMAGE OR INJURY RELATING IN ANY WAY TO THE EQUIPMENT OR 5 RVICES PROVIDED BY ADT. C. EXCLUSIVE REMEDY. IT I5 IMPRA FAILURE BY ADT TO PERFORM ANY OF OR INCIDENTAL DAMAGES, INCLUDING THE PROVISIONS OF THIS PARAGRAPH THE SERVICES AND /OR EQUIPMENT PR CHARGE OR $500, WHICHEVER IS GREA MAY AGREE TO ASSUME UABILITY BEY FORTH THE EXTENT OF ADT'S UABI D. APPUCATION. THE PROVISIONS OF EVEN IF DUE TO THE PERFORMANCE O OTHERWISE), STRICT LIABILITY, VIOLATI ON THE PART OF ADT, ITS AGENTS OR I E. INDEMNITY. IF ANY OTHER PERSON; RELATED TO THE EQUIPMENT OR SERVI SUCH CLAIMS AND LAWSUITS, INCLUDI AND DISTINCT FROM MY DUTY TO IND, REGARDLESS WHETHER ADT HAS BEEN F. TIME TO BRING CLAIM OR SUIT. NO THAT RESULTED IN THE LOSS, INJURY 0 CAL AND EXTREMELY DIFFICULT TO DETERMINE THE ACTUAL DAMAGES, IF ANY, THAT MAY RESULT FROM A 5 OBLIGATIONS. UNDER NO CIRCUMSTANCES WILL 1 ATTEMPT TO HOLD ADT LIABLE FOR ANY CONSEQUENTIAL WITHOUT LIMITATION, DAMAGES FOR PERSONAL INJURY OR DAMAGES TO PROPERTY. IF, NOTWITHSTANDING ADT IS FOUND LIABLE FOR LOSS, DAMAGE OR INJURY UNDER ANY LEGAL THEORY RELATING IN ANY WAY TO VIDED BY ADT, ADT'S UABILJTY TO ME SHALL BE LIMITED TO A SUM EQUAL TO 10% OF THE ANNUAL SERVICE ER. THIS AGREED -UPON AMOUNT IS NOT A PENALTY. RATHER, IT I5 MY SOLE REMEDY. UPON MY REQUEST, ADT ND WHAT I5 PROVIDED FOR IN THIS PARAGRAPH 5 BY ATTACHING AN AMENDMENT TO THIS CONTRACT SETTING AND THE ADDITIONAL CHARGES TO ME. HIS PARAGRAPH 5 APPLY NO MATTER HOW THE LOSS, DAMAGE, INJURY OR OTHER CONSEQUENCE OCCURS, NONPERFORMANCE BY ADT OF ITS OBLIGATIONS UNDER THIS CONTRACT OR FROM NEGUGENCE (ACTIVE OR N OF ANY APPLICABLE CONSUMER PROTECTION LAW OR ANY OTHER THEORY OF LIABILITY OR ALLEGED FAULT 5 EMPLOYEES. INCLUDING MY SUBROGATING INSURER, MAKES ANY CLAIM OR FILES ANY LAWSUIT AGAINST ADT IN ANY WAY ES PROVIDED BY ADT TO ME, I AGREE TO INDEMNIFY, DEFEND AND HOLD ADT HARMLESS FROM ANY AND ALL G THE PAYMENT OF ALL DAMAGES, EXPENSES, COSTS AND ATTORNEYS' FEES. MY DUTY TO DEFEND IS SEPARATE MNIFY AND HOLD HARMLESS AND ARISES UPON THE ASSERTION OF A CLAIM OR DEMAND AGAINST ADT AND FOUND UABLE OR WHETHER ADT HAS INCURRED ANY EXPENSE. UIT OR ACTION SHALL BE BROUGHT AGAINST ADT MORE THAN ONE (1) YEAR AFTER THE DATE OF THE INCIDENT DAMAGE, OR THE SHORTEST DURATION PERMITTED UNDER APPUCABLE LAW IF GREATER THAN ONE (1) YEAR. G. BENEFIT TO OTHERS. THE PROVISIONS OF THIS PARAGRAPH 5 SHALL APPLY TO AND BENEFIT ADT AND ITS AGENTS, EMPLOYEES, CONTRACTORS, SUBSIDIARIES, DEALERS, AFFIUATES, PARENTS (BOTH DIRECT AND INDIRECT), AFFINITY MARKETERS AND OTHER PARTNERS. 6. OTHER PARTY'S LIMITATION. IF 1 PI RCHASED EQUIPMENT OR SERVICES FROM ADT THROUGH ANOTHER BUSINESS OR PERSON, OR FROM ADT THROUGH A REFERRAL FROM ANOTHE BUSINESS OR PERSON, I AGREE THAT SUCH OTHER BUSINESS OR PERSON ACTS SOLELY AS AN INDEPENDENT CONTRACTOR AND HAS NO RESPONSI ILITY OR LIABILITY TO ME FOR THE PERFORMANCE OR NONPERFORMANCE OF THE EQUIPMENT OR SERVICES PROVIDED BY ADT. I ALSO AGREE AT ANY SUCH BUSINESS OR PERSON I5 ENTITLED TO THE SAME RIGHTS AS ADT UNDER THIS CONTRACT, INCLUDING PARAGRAPH 5. 7. OWNERSHIP. All equipment installe by ADT pursuant to this Contract shall be owned by ADT unless ADT has agreed to give me ownership of the equipment in a separate written agree ent. If there is existing, previously - installed equipment and it is my property, it shall remain my property. If any equipment is owned by ADT, ADT has a right upon termination of this Contract to remove, disable or abandon all or any of the equipment owned by ADT. If any equipment is disabled or re oved by ADT, I understand that I will not be able to use the equipment for any purpose. 1 will provide ADT access to ADT -owned equipment for removal,' nd ADT will have no obligation to repair or redecorate my premises after any such removal. I agree to pay any unpaid charges that I owe, even if ADT1 removes ADT -owned equipment. All ADT yard signs and window stickers provided to me at any time will remain the property of ADT and may be removed by ADT. If applicable, ADT will attempt to connect the existing, previously - installed alarm system to ADT's monitoring center. Prior to connection, ADT has the right to inspect my system and my premises to determine eligibility for Extended Limited Warranty/ Q5P coverage and may notify me of an required repair /replacement costs related to the existing alarm system, device(s) or connection. If I decline to pay such repair /replacement costs, ADT is not obligated to connect to the existing alarm system and may terminate this Contract without liability to ADT. If the existing alarm system is connected o ADT's monitoring center, ADT will have no liability for the maintenance, operation, non - operation, actuation, non - actuation or erroneous actuation o the existing alarm system, connection or device(s), and any repairs will be performed on a time and material basis by ADT, subject to available parts, excel) for repairs/replacements covered by Extended Limited Warranty /QSP coverage if such coverage is provided under this Contract. 8. INSTALLATION. In order for ADT to i stall and service the equipment listed on the second page of this Contract, I agree that: (A) I own the premises or have authority to authorize ADT to inst:II the alarm equipment at the premises; (B) I will make the premises available without interruption during ADT's normal working hours and will maintai the premises in a safe and sanitary condition suitable for work to be performed by ADT's representatives without jeopardizing their health or safety; (C) he installation will require drilling into various walls and other parts of the premises; (D) I will provide ADT with 110 AC electrical outlets for power equi o ment in locations designated by ADT; (E) 1 will make arrangements for lifting and replacing carpeting, if required, Terms and Conditions continue on accompanying sheets. 4 of 6 (09/12) RESIDENTIAL SERVICES CONTRACT CONTRACT DATE CUSTOMER ACCOUNT NO IU i 5401 UE02 IQ� JOB NO LEAD SOURCE f Section 2. Services to be Provided (continued) 0 Initial/Annual Recurring Municipal Fee billed separately (Subject to change based on local law) initial/ ^ nnua ; o Standard Monthly Service, Burglary Service includes: Customer Monitoring Center Signal Receiving and Notification Service for Burglary, Manual Fire and Manual Police Emergency Monthly Service Charge 0 Customer to obtain and pay for initial /annual municipal alarm use permit. Failure to obtain and provide ADT with the municipal alarm use permit registration number could result in no municipal fire/police response to an alarm from the premises and/or a fine. eno Standard Monthly Service, Fire/Smoke Detection Service includes: Customer Monitoring Center Signal Receiving and Notification Service for Fire, Manual Fire and Manual Police Emergency r { !'1t Municipal Electrical Permit Fee 0 Customer to obtain electrical permit ¢ �, $ / L ! O Carbon Monoxide 0 Flood 0 Low Temp $ Installation Price $ eb 0 Medical Alert $ Taxable Amount Safewatch Cellguard® $ t P A Non - Taxable Amount $ ",""'� O SecurityLink® $ Connection Fee $ *„""`°" "— . Extended Limited Warranty /Quality Service Plan (QSP) $ ! P\e'Th Admin Fee -"" $ O Guard Response Service Sales Tax on Installation* q O Monthly Recurring Municipal Fee (Subject to change based on local law) 0 Customer to obtain and pay for municipal alarm use permit $ Total Installation Charge* $ 6'1 k29 O Other $ Deposit Received $ , Total Monthly Service Charge $ 6.1 S Balance Due upon Installation* $ *If applicable sales tax not shown, it will be added to the first invoice, if not collected at the time of installation. •1 • •li'• • •' • �• COntrbl ot`1 eoso` e�C°` 1 �e 1 Op61- C,ep°'Jaa era + °pti,°`e� �c.#4, 4°a ,,,4`ae° Panel ` 9 dS) #4,0`4', 6. Cam .q.._ .R.. 1 ' rQaa\ `Sep9 a°�S ,cpp .,55. AS , ,Q.).opCaQJ�``apce '�� �i \ttg� Ne +6 C>�ape�' s6eape�' C.a�pe� Sake. °a LLB iP yr Pp�. \44 IPp� P‘ Comments Package Name: Includes: Foyer Living Room 1 r Family Room f �- Office r Dining Room Kitchen Laundry Room ,- e� i v Hallway Master Bedroom -- Master Bath — t L \ ,t i Bedroom 2 Bedroom 3 °° J`' Bath 2 Basement ~" \--C4-..- Garage Price Per Piece Totals E = Existing Equipment Estimated Installation Start Date 1 ( NOTES -) D., e" ©2012 ADT LLC dba ADT Security Services. All rights reserved. (09/12) Important Terms and Conditions (continued) for ADT's installation of floor mats or iring; (F) ADT may not be able to conceal any or all equipment or wiring; (G) ADT will not be liable for property amage, personal injury, illness or other Toss due to water intrusion, mold, fungi, wet or dry rot or bacteria that ay result from the installation services; and (H) my premises complies with all applicable codes, regulations and IAws and will continue to comply with all applicable codes, regulations and laws during the Initial term and any renewal terms of this Contract. 9. UMITED WARRANTY. During the fir wiring, and will make required mecha limited warranty is for my benefit only state where this Contract was signed m 10. EXTENDED UMITED WARRANTY /Q or QSP, ADT will repair or, at its option and tear or malfunction, excluding ba QSP (see Paragraph 11 below for exclus will commence on the date the alarm s The QSP will automatically renew for s least thirty (30) days before the end of working condition at the time I purcha 11 11 1 i 11 r 5401UE02 11111111 90 days after installation, ADT will repair or, at its option, replace any defective part of the alarm system, including ical adjustments, all at no charge to me. ADT will use new or functionally operative parts for replacements. This. nd may not be enforced by any other person. This limited warranty gives me specific legal rights. The laws of the y also give me additional rights. To order service, call 800.ADT.ASAP (800.238.2727). AUTY SERVICE PLAN (QSP). If I purchase ADT's Extended Limited Warranty, which is called the Quality Service Plan replace any part of the alarm system installed by ADT that requires repair or replacement due to ordinary wear eries. ADT will use new or functionally operative parts for replacements. If I require services excluded from the ons), then ADT will provide the services at its current labor rate for each service call. The QSP and the billing for it stem is installed, operational and communicating with ADT's CMC and will continue for the term of this Contract. ccessive thirty (30) -day terms at ADT's then - current QSP rate unless terminated by either party's written notice at he then - current term. If I purchase the QSP after the initial system installation, the alarm system must be in good e the QSP. To purchase the QSP, call 800.238.7085. 11. WARRANTY EXCLUSIONS. ADT pe '.rms warranty services only during normal working hours. IF I REQUEST ADT TO PERFORM WARRANTY SERVICES OUTSIDE NORMAL WORKING HOURS, I WILL PAY FOR THE SERVICES AT ADT'S THEN - CURRENT RATES FOR LABOR AND PARTS. THE LIMITED WARRANTY PROVIDED UNDER THIS CONTRACT AN», IF PURCHASED, THE QSP DO NOT APPLY IF ADT DETERMINES UPON INSPECTION THAT ANY OF THE FOLLOWING CONDITIONS CAUSED THE NEED FOR SE VICE: (A) damage resulting from accidents, theft, Acts of God, natural disasters, labor disputes, war, terrorism, civil strife, electrical surge, alterations or mi.use; (B) I fail to properly close or secure a door, window or other point protected by an alarm device; (C) I fail to properly follow the operating instructions; (D) trouble in a telephone line, use of non - traditional telephone line or service (including but not limited to DSL, ADSL, VoIP, etc.) or due to interruption f power; (E) repairs needed to window foil, security screens, exterior mounted devices (except for outdoor cameras installed by ADT) or PROM (Programma le Read Only Memory); (F) ordinary maintenance or wear and tear (not excluded from QSP); (G) alterations to my premises or failure of my premises to c mply with any applicable codes, regulations or laws; or (H) alterations or damage to the alarm system caused by me or by a cause beyond ADT's control ADT will not perform warranty services on any device not installed by ADT. Battery replacement is excluded from all warranties. 12. NO OTHER WARRANTIES. OTHER THAN THE UMITED WARRANTY PROVIDED UNDER THIS CONTRACT AND, IF PURCHASED, THE QSP, I AGREE THAT ADT MAKES NO GUARANTEE OR WARRANTY OF ANY KIND, INCLUDING ANY IMPUED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE, WITH RESPECT TO THE SER ICES ADT PERFORMS OR THE EQUIPMENT IT PROVIDES. MY EXCLUSIVE WARRANTY REMEDY IS SET FORTH IN PARAGRAPHS 9 AND 10 ABOVE. SOME STATES MAY NOT ALLOW THE PARTIES TO A CONTRACT TO OMIT THE LENGTH OF AN IMPLIED WARRANTY. THE LAWS OF THE STATE WHERE THIS CO RACT WAS SIGNED WILL DETERMINE WHETHER THESE UMITATIONS AND EXCLUSIONS APPLY. 13. ALARM MONITORING AND NOTIFI TION SERVICE. If I purchase service that includes response by police, fire department, guard, medical emergency notification or two -way voice monitori g services and such an alarm is received at ADT's CMC, ADT may, at its sole discretion, attempt to contact me and/ or anyone on my Emergency Contact Li to confirm that the alarm is not false. If ADT does not contact me and/or someone on my Emergency Contact List, or if ADT questions the response it receives upon such contact, then (A) ADT will attempt to notify the appropriate police department or fire department or, (B) if guard response service is provi ed and an alarm requires police response, ADT will attempt to dispatch a representative to make an investigation of the exterior of the premises from hi • or her vehicle and, upon evidence of a crime, ADT will attempt to notify the appropriate police department. If ADT provides supervisory alarm or trou•Ie alarm monitoring services (or if such services are actively programmed into the alarm system) and ADT's CMC receives an alarm, then ADT may attempt to notify my premises and /or the representative I designate. ADT may use an automated calling device to deliver such notification. If medical emergen notification services are provided, I agree that the very nature of such services, regardless of any delay, involves uncertainty, risk and possible serious inj ry, disability or death, for which I will not attempt to hold ADT responsible or liable; that the equipment furnished for medical emergency notification se ices is not foolproof and may experience signal transmission failures or delays for any number of reasons; and that the actual time required for med al emergency providers to arrive at my premises and/or to transport any person requiring medical attention is unpredictable with many contributing actors, including telephone network operation, distance, weather, road and traffic conditions, alarm equipment function and human factors both wit l in and outside of ADT's control. ADT's performance of, delay in performance of or failure to perform medical emergency notification services under t e Contract are subject to and controlled by Paragraph 5 of this Contract. The person(s) identified on my Emergency Contact List are authorized to act on m" behalf. I understand that the equipment ADT provides may not operate with other companies' alarm monitoring equipment and may prevent me from sing such equipment in the event I terminate my services. 1 understand that local laws, ordinances or policies may restrict ADT's ability to provide the alar monitoring and notification services described in this Contract and/or necessitate modified or additional services with additional charges to me. I unde and that ADT employs a number of industry- recognized measures to help reduce occurrences of false alarms. These measures include, but are not limited t•, implementation of default settings on alarm panels and various procedures at ADT's CMC to determine when and how to respond, if at all, to certai alarm events. I consent to ADT's use of these measures and agree that the alarm system has not been designed, programmed or installed pursuant to . ny law, code or rule that may be applicable to my particular premises, including, but not limited to, any code provisions of the National Fire Protecti•n Association or the International Residential Code. I understand that, upon receiving notification that an alarm signal has been received by ADT, the police department, fire department or other responding authority may forcibly enter my premises. I understand that ADT will never arrest or detain any person for any reason. 14. FAMILIARIZATION PERIOD. UNLESS I HAVE REJECTED THE FAMILIARIZATION PERIOD BY INITIALING THE APPROPRIATE LINE ON THE FIRST PAGE OF THIS CONTRACT (EXCEPT WHERE FAMILIAR! " TION IS REQUIRED BY LAW), I AGREE THAT, DURING A SEVEN (7) -DAY FAMILIARIZATION PERIOD, OR LONGER PERIOD IF REQUIRED BY LAW, THAT FSLLOWS COMPLETION OF THE INSTALLATION AND THE COMMUNICATIONS CONNECTION TO ADT'S CMC (AND DURING ANY APPLICABLE EXTENSIONS , ADT HAS NO OBLIGATION TO, AND WILL NOT, RESPOND TO ANY ALARM SIGNAL FROM MY PREMISES. I ALSO AGREE THAT DURING SUCH PERIOD AD HAS NO OBLIGATION TO, AND WILL NOT, NOTIFY ANY AUTHORITIES, ME OR MY DESIGNATED REPRESENTATIVE OR TAKE ANY OTHER ACTION WITH lirE ARD TO ANY ALARM SIGNAL ADT RECEIVES, EVEN IF DUE TO AN ACTUAL EMERGENCY 15. FAILURE TO PAY CHARGES OR HON • R CONTRACT. If I fail to make any payment when due or to honor any other term or condition of this Contract, ADT may stop providing the alarm mo itoring and notification services and repossess or disable the equipment without notice. I will grant ADT access to my premises and allow it to repossess o' disable the equipment. ADT has no liability if it stops providing the alarm monitoring and notification services and repossesses or disables the equipment. I DT is not required to redecorate or repair my premises as a result of repossessing or disabling the equipment. In addition to these remedies, ADT does rl.t waive, and retains the right to exercise, any other legal remedy, including the right to charge me a Tate fee for each month that a payment is not recei ed and /or interest on the unpaid amount and the right to report me to one or more consumer reporting agencies if I become delinquent on my account ( ore than 90 days without a payment). 16. SMOKE AND CARBON MONOXIDE D TECTORS. IF THE ALARM SYSTEM INCLUDES SMOKE AND /OR CARBON MONOXIDE DETECTORS, I AGREE THAT: (A) THE NUMBER AND PLACEMENT OF SU H DETECTORS MAY NOT FULFILL THE REQUIREMENTS OR RECOMMENDATIONS IN CODES, LAWS OR STANDARDS THAT APPLY IN MY JURISDICTION, IN UDING THE CODE PROVISIONS OF THE NATIONAL FIRE PROTECTION ASSOCIATION AND THE INTERNATIONAL RESIDENTIAL CODE; (B) I HAVE SOLE R SPONSIBIUTY FOR COMPLYING WITH ANY AND AU. CODES, LAWS AND STANDARDS THAT MAY APPLY TO THE INSTALLATION, PLACEMENT AND MAIN ENANCE OF THE ALARM SYSTEM; AND (C) ANY SMOKE AND /OR CARBON MONOXIDE DETECTORS DESCRIBED IN THIS CONTRACT ARE SUPPLEMENTAL D _ !CES ONLY AND ARE NOT INTENDED TO BE PART OF A PRIMARY FIRE ALARM OR CARBON MONOXIDE DETECTION SYSTEM. I understand that ADT's electric al smoke and carbon monoxide detectors, if installed in my premises, are designed to be connected to an electrical power source. THESE DETECTORS WILL ' OT OPERATE, THE ALARM WILL NOT SOUND AND THE ALARM SIGNAL WILL NOT BE TRANSMITTED WHEN: THE ELECTRICITY IS CUT OFF; THE BACK -UP ATTERY, IF INCLUDED AS PART OF THE SYSTEM, IS LOW OR DEAD; OR FIRE CUTS OFF THE ELECTRICITY BEFORE THE ALARM IS ACTIVATED, SOUNDS AND I5 TRANSMITTED. Connecting these detectors to a separate dedicated electrical circuit may increase their reliability, but even dedicated circuits can fail. I u derstand that these detectors all have limited useful lives, after which time they will not function. It is my sole responsibility to monitor and replace al detectors before or at the end of their useful lives. 17. BATTERY-POWERED DEVICES. I und' other detection sensors installed under BATTERY- POWERED DETECTION SENSO responsibility to maintain and replace t weekly to help maintain continued op all equipment. 18. COMMUNICATION FACILmES. (A) A or other company providing communica DIGITAL COMMUNICATOR. A digital co need for a dedicated telephone line an provided tome in connection with ADTr service marks or service names. These se to the same extent as ADT's liability in TRANSMISSION MODE IS NOT OPERATI ACQUIRE, TRANSMIT OR MAINTAIN AN OVER CERTAIN TELEPHONE SERVICES (I 5 of 6 rstand that all battery- powered motion detectors, smoke detectors, door and window contact transmitters and this Contract are not connected to the electrical system of my premises and require batteries to operate. THESE 5 WILL NOT OPERATE, AND THE ALARM WILL NOT SOUND, IF THE BATTERIES ARE LOW OR DEAD. It is my sole ese batteries. ADT recommends that I regularly inspect the sensors for dirt and dust buildup and test the sensors ration. ADT also recommends that I carefully read and follow the owner's manual, instructions and warnings for THORIZATION. I authorize ADT to request services, orders or equipment from a telephone company, wireless carrier ion facilities, signal transmission services or facilities under this Contract (referred to as "Telephone Company "). (B) municator, if installed under this Contract, uses traditional telephone lines for sending signals, which eliminates the the costs associated with such dedicated lines. (C) DERIVED LOCAL CHANNEL. The Telephone Company's services services may include Derived Local Channel service. Such service may be provided under the Telephone Company's ices include providing lines, signal paths, scanning and transmission. The Telephone Company's liability is limited aragraph 5 of this Contract. (D) ADT WILL NOT RECEIVE ALARM SIGNALS WHEN THE TELEPHONE UNE OR OTHER G OR HAS BEEN CUT, INTERFERED WITH OR 15 OTHERWISE DAMAGED, OR IF THE ALARM SYSTEM IS UNABLE TO LARM SIGNAL OVER MY TELEPHONE SERVICE FOR ANY REASON. OTHER POTENTIAL CAUSES OF SUCH A FAILURE CLUDING BUT NOT LIMITED TO SOME TYPES OF DSL, ADSL, VoIP, DIGITAL PHONE, INTERNET-PROTOCOL-BASED Terms and Conditions continue on accompanying sheets. (09/12) Notice to Building Official of Use of Private Provider Project Name: A ®C, Parcel Tax ID: f /c9/a622 /90 Services to be provided: Plans Review Inspections X Note: If the notice applies to either private plans review or private inspection services the Building Official may require, at his or her discretion, the private provider be used for both services pursuant to Section 553.791(2) Florida Statute. 1, , the fee owner, affirm I have entered into a contract with the Private Provider indicated below to conduct the services indicated above. Private Provider Firm: MTCI Private Provider Services Private Provider: Lester Triana Address: 97 N. E. 15`h Street, Homestead, Florida 33030 Telephone: (305) 246 -0696 Fax: (305) 242 - 3716 Email Address (Optional): mtc @mtcinspectors.com Florida License, Registration, or Certificate #: PE65707 I have elected to use one or more private providers to provide building code plans review and /or inspection services on the building that is the subject of the enclosed permit application, as authorized by s. 553.791, Florida Statutes. I understand that the local building official may not review the plans submitted or perform the required building inspections to determine compliance with the applicable codes, except to the extent specified in said law. Instead, plans review and/or required building inspections will be performed by licensed or certified personnel identified in the application. The law requires minimum insurance requirements for such personnel, but I understand that I may require more insurance to protect my interests. By executing this form, I acknowledge that I have made inquiry regarding the competence of the licensed or certified personnel and the level of their insurance and am satisfied that my interests are adequately protected. I agree to indemnify, defend, and hold harmless the local government, the local building official, and their building code enforcement personnel from any and all claims arising from my use of these licensed or certified personnel to perform building code inspection services with respect to the building that is the subject (Attie enclosed permit application. I understand the Building Official retains authority to review plans, make required inspections, and enforce the applicable codes within his or her charge pursuant to the standards established by s. 553.791, Florida Statutes. If I make any changes to the listed private providers or the services to be provided by those private providers, I shall, within I business day after any change, update this notice to reflect such changes. The building plans review and/or inspection services provided by the private provider is limited to building code compliance and does not include review for fire code, land use, environmental or other codes. 1 of 2 The following attachments are provide as required: 1. Qualification ,tatements and /or resumes < f the private provider and all duly authorized representatives. 2. Proof of insuran e for professional and comprehensive liability in the amount of $1 million per occurrence relati g to all services performed as a private provider, including tail coverage for a minimum of 5 y ars subsequent to the performance of building code inspection services. Individual Corporation Partnership Print Corporation Name Print Partnership Name By: By: (signature) (signature) (signature) Print ' Print Print Name •' / Z/, 021,- Name: Name: Address: /67 S l,/; 4./ Its: Its: ,,z;ei,i1 77, 0,' S— Address: Address: Tel epi}g,n y� to No.•ff _e ' Please use appropriate notary block. STATE OF COUNTY OFog Individual Telephone No. Before me, this c97 day of !f , 20 iersonally appeared ,92LZI who executed the foregoing i strument, and acknowledged before me that same was executed for the purpose therein expressed. Corporation Telephone No.: Before me, this day of ,20 , 1- personally appeared Personally known " ; or P of ,a corporation, on behalf of the state corporation, who executed the foregoing instrument and acknowledged before me that same was executed for the purposes therein expressed. Partnership Before me, this day of , 20__, personally appeared partner /agent on behalf of a partnership, who executed the foregoing instrument and acknowledged before me that sane was executed for the purposes therein expressed. oduced identification Type of identification produced Notary Public: NOTARY ST MP BELOW My commission expires: 0%. aaID! ,,,o IP 2 of 2 Print Name