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EL-12-1717} _ Miami Shores Village - Building Department AUG 2 7 2014 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 -� Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 )f Q -7Z , /)9 Permit NoA, 9 - 12 — 1-11") Master Permit No. Permit Type: Electrical OWNER: Name (Fee Simple Titleholder). ZJ k. 5---ZLkCg._Phone#: Address: I 16 5 dV E_ (0s ;" - City: �Ln " " CNI �NQA State: Tenant/Ussee Name: Phonek Email: JOB ADDRESS: 11 (05 City: Miami Shot Folio/Parcel#- — Z 4' ��WAW.e Sal Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: 007 Phonek qs�q Address: City: i o 1 Qualifier Name: W State Certification or Registration #: Contact Phone#: DESIGNER: Architect/Engineer: 'te: Zip: �Q_ k Certificate of Competency #: Email Address: �� ✓$ - Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: DAddress grAlteration ONew ORepairftplace ODemolition Submittal Fee $ Permit -- Scanning Fee $ !�!j Radon Fee $ DBPR $ Bond $ Notary $ r'__ I - Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ Poridim� C'�nnp:m� Nanic it .. ,y,hli�:hl� , 1 Bonding Company•s Address - City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Zi Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR 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 copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencer§ent must be posted at the job site for the first inspecti" which occurs se en ) days after the building permit is issed. 1 bsence of su posted notice, the inspection will not be approved and a reinsp ction fee will be charged. o V Owner or Agent The foregoing instrument was acknowledged before me this day of -;n 20 It by LZ )13 7Z— q6�( who is personally known to me or who has produced l" Ck— As identification and who did take an oath. NOTARY PUBLIC: �� ituuurHrtti��ii Sign: Print: O W My Commission Expires: wLr (Revised 07/10/07)(Revised 06110/2009)(Revised 3/15/09) S Contr for;. The foregoing instruent was ack tor before me this_, day of -.2 � / , 20 `, by GS C1- U i�0'A O ze who is personally known to me or who has produced rmn Z1* as identificatio t akP m NOTARY PUBLIC:'" "`' LUlSSEfTE CA£ MY COMMISSION #' EXPIRES: Na vemk Bonded Thru Notary Pu• Sign: Print: C My Commission Expires: Zoning Structural Review Clerk Control Post Permit Information Permit#: EL -9-12-1717 Status: Expired Permit Detail Permit #: EL -9-12-1717 Parcel#: 1122320280280 Status: EXPIRED Issued: 9/1812012 Applicant: ROBERT FOODY Phone: Contractor Name: GEORGE MANGINELLI1/10/13 Phone: Address 1165105 Street Miami Shores FL 33138-2505 Sub Permit Checklist Inspections List Type: Owner: Project Name: Exp Date: Company: Company: Electrical - Residential ROBERT FOODY 11/4/2013 ADT LLC Inspection Scheduled Requested Edit Type Date Time Date Time Review Electrical 518/2013 Not Requested NIA Page 1 of 1 https://bldg.mianiishoresvillage.com/cap/controlhost.aspx?cid=411 &&pid=f840b157-9515... 8/27/2014 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 Permit Type: Electrical OWNER: Name(Fee Simple Titleholder): 1 ( U I Address: 1 1 3_ i 5-�-� I City: JY) i 0 rY_\ 1 L<3 AAQY ? S State: Tenant/Ussee Name: Email: CEIVED MAY 08 �2013 Permit No. &—'q 12--(-717 Master Permit JOB ADDRESS: �\ S +f City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: (tol L/ CONTRACTOR: Company Name:l . L _ _Phone#: Q 514 214 t0 -9 L4 -7 Address: `U t I > I r City: I�N 1 C Y.N . Qualifier Name: CoQ tv State Certification or Registration Contact Phone#: DESIGNER: Architect/Engineer: Address: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑Address DAlteration ONew ORepair/Replace Description of Work: �uliiru'tial-Feed"--=_-- - Perm��ee$ Scanning Fee $ Radon Fee $ DBPR $ Bond $_ Notary $ TrainhWEducation Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ ODemolition —12 _ I • �' Bonding Compan%'. N mic � it ahhli�ahlc� __-- 1 Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR 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 copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. /it the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this day of , 20 _, by who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: Signature Con ctor The foregoing instrument was acknowl ged before this day of n , 20 —5 by who is personally known to me or who has produced identification and who did take an oath. NOTARYPUB . Sign: Print: My Commissiolr Structural Review (Revised 07/10/07)(Revised 06/10/2009)(R"ised 3/15/09) MARIA D. PEREZ y Publicpato-ot nn fission #fE:196 om Clerk Miami o es Village o 1 2 2 �o� SE Builink d +� artment '� p ------------------ l 10050 N.�E.2nd Avenue, Miami' Shores, Florida 33138 Tei: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PIi<ONE NtTMBER: (305). 762.4949 j. I! ,I BUILDING' I i Permit No. PERMIT'APPLICATION!'Master Permit No. FBC 20 l Ilii Permit Type: ELECTRICAL Owner's Narpe (dee Simple Titleholder) Phone # Owner's Address City /�%>� �� iz�'� State Zip c_—�/-Rr Tenant/Lesse� Name �' Phone # Email Job Address where the work isbem /j f /J g done) City Miami Shores Village County imi-Dadel Zip FOLIO / PARCEL # Is Building IIistorically Designated Contractor's Company Name A Contractor's (Address Itof..', Qualifier Name %7d2y-/�'''e,,eZ State Certificate or Registration No. Contact Phone ( % laeelh — Flood Zone i Phone # 1 . ®/D — ;D 3 Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ S 'a / 'qt�re Linear Footage Of Work: Type of Wo r: ❑Addition Alteration ❑Ne, ❑ Repair/Replace El Demolition Describe Work: Submittal Fed $ Permit Fee $lil CCF $ CO/CC $ Notary $_ Training/Education Fee $''' Technology Fee $ Scanning$ L Radon $ 1PB Bond $ ��---- Double Fee $II a Violation date: Structural Review. $ Ii Total Fee Now Due $ See Reverse side Bonding Company's Name (if applicable) Bonding Company's Address City State zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State zip 4 Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will'be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR 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 copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is suWt to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspeco which occurs seven (7) after the building permit is issued. In the absence of such posted notice, the inspection will not approved and ah -ins p io fee will be charged. Signature / Owner oy'Agenf® The foregoing ' ent was ac owledged beforewe this day of 204, by , who is personally known to me or who has produced As id ry �, �n o . Signature i Contractor The foregoing instrument was acknowledged before me this �c�• day of aby who is <ersonally kno me or who has produced as identification and who did take an oath. NOTARY PUBLIC: F' ! ' _ revCOWSSON#EE087617 �xpia�s; M8y 2s, gots NOTARY PUBLIC: Bonded Twu NoMy RMA underwr{tarci ;, Sign: Sign: Print: — &A1-7 7� Print: Z_44�z" My Commission Expires: My Commission Expires: APPROVED BY Plans Examiner Zoning Engineer (Revised 07/10/07XRevised 061102009) Clerk checked ENT O 'fib a Type of Loan A. Settlement. Statement (HUD -1) 1, Q FHA 2. ® RHS 3. Q Conv. Unins. 6. File id IWI 79.08.120: 7. Loan Number: "UP -1 page a of::3. 8, Mortgage Insurance Case Number: 4, VA :. ❑ Conv.Ins. NOTE: This form is furnished to give you a statement of actual settlement cats. Amounts paid to and DY me Sen,"29r,� t ". Items marked °(p.o.a)" were Pa id outside the dosing; they are shown here for infotmatlonal Purposes and are not fnclu totals. F. Name and Address of Lendor' D. Name and.Addrees of 180rrower E. Name and Address of Seller ROBERT F. FOODY CITY IST MORTGAGE.SERVICES, LLC LOUISE E. REECE 1165 NE 105 STREET 750 5. MAIN, SUITE 104 1428 BRICKELL. AVENUE, SUITE 304 MIAMI SHORES, E 33138 BOUNTIFUL, UT 84010 MIAMI,. FL 33131 if Property Location 65 NORTHEAST 105 STREET, AMI SHORES, FL 33138 )UNTY: MIAMI DADE ACEL ID: 11-22320280280 H. Settlement Agent SUNBELT TITLE AGENCY 15100 NW 67TH AVE, SUITE 110 MIAMI LAKES, FL 33014 Phone : (305) 364-1056 place of Settlement 15100 NW 67TH AVE, SUITE 110 MIAMI LAKES, FL 33014 K Summary o€ Seller's T 400. Gross Amounrt Due to Seiler M I. Settlement Date 08f30/lyac Disbursement Date 08/31/2012. 409 NonAdValoremTaxes{Pa9a) ��v.�evvrr....tr-.--I to 10/01/12 410. 412. 420. Gross Amount Due to Seller 500. Reductions In Amount Due to Selier 501. Excess De is 502. Settlement Cha es to Seller 503. Existin loans taken sub ect to 504. Pa off of First Morta e Loan to Bank Of America 505.' 506. Seller Paid Transfer Tax 507. 508. 509. Ad ustrnents for items un aid hy seller 510. Ci own Taxes County taxes (Unpaid) 2572.3100/yr 01/01/12 to 511. $63.57 $1,707.8 600,�cash Settlement to/�,ditje eller 345 063. 601.mount due to sell420 335 347 ....:_ .,Y,^tiller (line 520 J8120 HUD -1 (GFE) and HUD -1 Charaes Ghairgesfihat'Cannot Increase, HUD -1 Une Num Our orl n e # 801 Your credit or charge for the `specific interest rate chosen # 802 Your 401usted.origination.chames # 803 Transfer taxes # 1203 Charges That in Total Cannot Increase Vlore Than 10% HUD -1 Litre Number Government recordin # 1201 _ 69pralsal Fee # 804 Credit' R Fee # 808 Tax Service Fee --*806 Flood Certification # 807 Desk Review ralsai Fee to Rel # 808 Title Services - Lender's insurance # 1101 Owner's Title Insurance # 1103 Survey # 1302 Total Increase between OFR and HUD -1 Cha Charges That Can Change Initial deposit for your escrow account # 1001 Daily interest charges # 901 34.03 da Homeowner's Insurance # 903 Loan Terms Your initial loan amount is Your loan term is $310,500.00 30 years Your Initial Interest rate is 1 4 % 3of3 1111,10.1 HUD -1 Oood Faith HUD -1 Estimate _ 1384.47 $3,322.80 238.19 $34.03 $6,278.92 1848.00 Loan Number: 1200084971 $1,609.16 includes Your initial monthly amount owed for principal, interest X Principal and any mortgage insurance Is X Interest X Mortgage Insurance MV No. n Yes, it can rise to a maximum of %. The first change will be on and can change again Can your Interest rate rise? 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 higher than %. Even if you make payments on time, can your loan balance rise? � No. ❑Yes, it can rise to a maximum of $ Even If you make payments on time, can your monthly � No. ❑ Yes, the first increase can be on ___._.. _._.._ _. _.._... _._.. and the amount owed monthly amount owed can rise to $ _ _ _ . The maximum it can for principal, Interest and mortgage insurance rise? ever rise to is $ Does your loan have a prepayment penalty? 0 No. ❑ Yes, your maximum prepayment penalty is $ Does your loan have a balloon payment? Q No. ❑ Yes, you have a balloon payment of $ due in years on ❑ 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. You have an additional monthly escrow payment of $ _ 800.15 that results In a total initial monthly amount owed of $ 2,409.31 . ....._._......... 120241 -EA HUD -1 Page 2 of 3 . Settlement Char 1700. Total Real Estate Broker Fees $20995.00 Paid From Paid From Borrower's Funds Seller's Funds At Settlement At Settlement Division of Commission (line 700) as follows: 701. $10350,00 to Keil 299 Realty, Inc. 702. $10645.00 to Coldwell Banker Residential Real Estate/Coldwell Banker Residential Real Estate (incl $295 Broker Only Commission) 703, Commission 2aid at settlement $295,00 $20 700.00 704. 800. Items Payable In Connection with Loan 801. Our origination char $4,505.00 from GFE #1_L 802. Your credit or charge (points) for the specific interest rate chosen from GFE #2 ) 803. Your adjusted origination char es from GFE A ) 14,505,00 $04. Appraisal Fee to Nationwide Property & Appraisal Services PO $375.00 from GFE #3_L 805. Credit report to Premium Ci 1st Mortgage Services, LLC from GFE #3 ) _$13.00 806, Tax Service to City Ist Moq9age Services, LLC from GFE #3 ) $70.001 807, Flood Cert. Fee to , Corel22lf I City. 1st Mortgage Services, LLC from GFE #3 $13.001 808. Desk Review/Appraisal Fee to Refs to City 1st Mortgage Services, LLC $75.001 900. Items Required by Lender to Be Paid In Advance 901, Daily interest charges from 8/31/2012 to 9/1/2012 @ 34,0274/day City 1st Mona2e Services, LLC (from GFE #10) $34.03 902Mortgage Insurance Premium for 12 Month(s) MGIC/City 1st Mortgage Services, LLC (from GFE #3) $1.65 ,903, Homeowner's Insurance for 12 Month(s) Florida Family Insurance from GFE #11) $1,848.00 1904. Flood Ins. Premium for 12 Month(s) American Bankers Insurance 757.00 1905, Windstorm Insurance Premium to Citizens Property Insruance $3,671,00 1000.Reserves Deposited with Lender 1001. Initial deposit for your escrow account from GFE #9 $3322,80 1002, Hazard Ins. Reserve 3 Month(s) @ 154.00 per Month(s) City 1st Mortgage Services, LLC $462.00 1003. Mortgage Ins. Reserve @ 126.79 per Month(s) City 1st Mortgage Services, LLC 1004, County Property Taxes 12 Month(s) @ 276.90 per Month(s) City 1st Mork qage Services, LLC $3,322.80 1005. Flood Ins. Reserve 3 Month(s) @ 63.08 per Month(s) City 1st Mortgage Services, LLC $189.24 1006. Windstorm Insurance Reserves Month(s) @ 306.17 per Month(s) City 1st Mortgage Services, LLC $918.51 1007. Aggregate Accounting Adjustment to City 1st Mortgage Services, LLC $1,569.75 1100.Title Charges 1101. Title services and tender's title insurance to Sunbelt Title Agency from GFE #4 ) $1,152.50 $155.00 1102. Settlement or closing fee to Sunbelt Title Agency $495,00 $495.00 1103, Owner's title Insurance to Sunbelt Title 89ency from GFE #5 ) t1,800.00 1104. Lender's title insurance to Sunbelt Title Agency $617.50 1105. Lender's title policy limit $310,500.00 1106. Owner's title policy limit $345,000.00 1107. Asent's portion of the total title Insurance premium to Sunbelt Title Agency $1,692.25 1108, Underwriter's portion of the total title insurance premium to Title Resources Guaranty Company $725.25 1109. Abstract or Title Search to Sunbelt Title Agency $90.00 1110.Shipping and Handling Fee to Sunbelt Title Agency $50.00 1111. Wire Transfer and Handling Fee to Sunbelt Title Agency $30.00 11112, Release Tracking Fee to Sunbelt Title Agency $25.00 1200.6overnment Recording and Transfer Charges 1201. Government recordin2 charges from GFE #7_)_ $96,50 1202.Deed $1&50 Mortgage$78.00 Releases 18.50 118,50 1203. Transfer taxes from GFE 98 $3,777,75 1204. Cit /Coup tax/stamps Deed 12070.00 Mortgage $1707.75 1205. State tax/stamps Deed $ Mortgage $ 11206. 1300.Additional Settlement Charges 1301. Required services that you can shofor from GFE #6 $450,00 1302. Survey to Truel-ine Technologies, LLC 1303.Tax and Lien Search to ASAP Tax and Lien Search, Inc. 1304. Reimbursement for Re -occupancy Inspection to Kellogg Realty, Inc. $450,00 $135.00 $65,001 11305. 1 11400.Totat Settlement Charges (enter on lines 103, Section 3 and 502, Section K) s21f885-231 $21,568.50 if you have any questions about the settlement charges and loan terms listed on this form, please contact your lender. Settlement agent is not responsible for content of - - I- -- Ut In V@mi-Dade My. Home My Home Show Me: Property Information Search By: Select Item Text only 19 Property Aporaiser Tax Estimator Property Appraiser Tax Comparison 11 Portability S.O.H. Calculator Summary natmia. Folio No.: 280 PropW. 1165 NE 105 ST Mailing ROBERT F FOODY ddrew. INGLE FAMILY eds/Baths: 165 NE 105 ST MIAMI lours: SHORES FL iNng Units: 138-2126 Prnnarty Infnrmafinn- rimary Zone: 0800 SGL FAMILY - $56,982 1701-1900 SQ CLLIC: 0001 RESIDENTIAL - $155,877 INGLE FAMILY eds/Baths: 2 lours: 1 iNng Units: Value: d S Foote e: 1,511 Lot Size: 8 412.80 SQ FT ear Built: 1956 $93,710 MIAMI SHORES $50,000/ ESTATES PB 47-58 1/2 LOT 12 BLK 2 LOT egal IZE 76.480 X 110 OR Description: 19143-2159 06 2000 1 25657-4366 05 $93,710 71 OR 25657-4366 �COC $25,000/ 507 00 Aaaaaamnnf infnrmafinn- ear: 2012 Land Value: $56,982 Buildin Value: q$71,821 $98,895Market Value: $155,877 ssessed Value: $148,021 Exemption Information: Near: 1 2012 1 2011 H me $25,000 1 $25,000 d H me a d -YES I YES Taxable Value Infnrmatinn: ear: 2012 2011 e untndaarry Applied Applied Taxing Authority: Exemption/ Exemption/ Taxable Taxable Value: Value: Regional: $50,000/ $50,000/ $98,021 $93,710 County: $50,000/ $50,000/ $98,021 $93,710 City: $50,000/ $50,000/ $98,021 $93,710 School Board: $25,000/ $25,000/ $123,021 $118,710 Sale Information: Pagel of 2 Aerial Photography - 2009 0 - 110 ft My Home I Property Information I Property Taxes I My Neighborhood I Prooerty Appraiser Home I Using Our Site I Phone Dfrectoro I Privacy I 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 apo Stmt Highway Miami -Dade County Water 9/4/2012 Legend e untndaarry ov Selected Property apo Stmt Highway Miami -Dade County Water 9/4/2012 RESIDENTIAL SERVICES CONTRACT17UWIIuI�IIIIWIIIu�lllllll�llllllllllullllu 5401 UE00 CONTRACT�^ CUSTOMER JOB Ell LEAalin DATE ACCOUNT NO NO LEA Section• • ADT LLC dba ADT Security Services ("ADT') Customer Name (Customer" or "I" or "me" or "my") ffi a Addr TOTAL OF PAYMENTS FOR THE INITIAL TERM IS INITIAL TERM IS 36. Premises'VV Address (A. TIMES B.){EXCLUSIVE OF ANY APPLICABLE TAXES, FEES, FINES AND RATE INCREASES) LATE CHARGE - PAYMENT IS DUE PURSUANT TO MY SELECTED BILLING PREPAYMENT — IF I PREPAY THE ¢ . TOTAL OF PAYMENTS PRIOR TO 19 OF THIS CONTRACT FOR BE SENT/MADE SHORTLY AFTER MY SERVICE BEGINS. ADT MAY IMPOSE A THE END OF THE INITIAL TERM ADDITIONAL INFORMATION ONE-TIME LATE CHARGE ON EACH PAYMENT THAT IS MORE THAN TEN (10) OF THIS CONTRACT, THERE IS NO ABOUT NONPAYMENT, DEFAULT DAYS PAST DUE, UP TO THE MAXIMUM AMOUNT PERMITTED BY LAW, BUT IN PENALTY OR REFUND. AND ACCELERATION. NO EVENT WILL THIS AMOUNT EXCEED $5.00. tm 4,. CityState Zi m— Tax Exempt No. Tax Expire Date mYI]AII www.MyADT.com 1.800.ADT.ASAP® (1.800.238.2727) Protected Premises' O Traditional Phone O Other (Qualified) O Other (Non -Qualified) Telephone O Home O Cell O Work Alternate O Home O Cell O Work J AlternateL Telephone 1 Telephone21 O Fill in if billing address is the same Billing Address e III III ITI 11 1111111 ' m ZIP Citylil State r' - IF FAMILIARIZATION PERIOD IS REJECTED INITIAL HERE (see Paragraph 14 of the Terms and Conditions for explanation) �: 1 l ( - � ! C EMAIL Communications Authorization: I authorize AD . #o provide me with information and updates about the security system and new ADT and third -party products and services to the contact informati rif(iro'ided by me. I may unsubscribe or opt out by emailing donotcontact@adt.com or by calling 888.DNC4ADT (888.362.4238). Initial here Confirmation of Appointments: I authorize ADT•to call me using an automated calling device to deliver a pre-recorded message to set/confir , 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 1 will not be able to use the equipment for any purpose. See Paragraph 7 of the Terms and Conditions for more information. 1 acknowledge and agree to each of the following: (A) This Contract consists of six (6) pages. Before signing this Contract, I have read, understand and agree to each and every term of this Contract, including but not limited to Paragraphs 5 and 18 of the Terns 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 1.800.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 ADTs only obligation will be to notify me of such termination and refund any amounts I paid in advance. ADT Rep tative Rep. License No. Rep. "�"�J f/ - �✓ (✓ (If Required) ID No a f. Customgt's;Ap�proval: Origina nature Required (Must match Customer Name in Section 1 above) f I I/ J 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. • • be • •-• FINANCIAL DISCLOSURE STATEMENT THERE IS NO FINANCE CHARGE OR COST OF CREDIT (0% APR) ASSOCIATED WITH THIS CONTRACT. A. NUMBER OF .7 PAYMENTS FOR THEB, TOTAL OF PAYMENTS FOR THE INITIAL TERM IS INITIAL TERM IS 36. AMOUNT OF EACH PAYMENT IS (TOTAL MONTHLY SERVICE CHARGE FROM BELOW) (A. TIMES B.){EXCLUSIVE OF ANY APPLICABLE TAXES, FEES, FINES AND RATE INCREASES) LATE CHARGE - PAYMENT IS DUE PURSUANT TO MY SELECTED BILLING PREPAYMENT — IF I PREPAY THE SEE PARAGRAPHS 2, 7, 15 AND FREQUENCY, PRIOR TO THE START OF SERVICE. MY FIRST BIL'UCHARGE WILL TOTAL OF PAYMENTS PRIOR TO 19 OF THIS CONTRACT FOR BE SENT/MADE SHORTLY AFTER MY SERVICE BEGINS. ADT MAY IMPOSE A THE END OF THE INITIAL TERM ADDITIONAL INFORMATION ONE-TIME LATE CHARGE ON EACH PAYMENT THAT IS MORE THAN TEN (10) OF THIS CONTRACT, THERE IS NO ABOUT NONPAYMENT, DEFAULT DAYS PAST DUE, UP TO THE MAXIMUM AMOUNT PERMITTED BY LAW, BUT IN PENALTY OR REFUND. AND ACCELERATION. NO EVENT WILL THIS AMOUNT EXCEED $5.00. ©2012 ADT LLC dba ADT Security Services. 3 1 Of 6 Customer Copy All rights reserved. (06/12) Important Terms and Conditions (continued) Ilplp���l��llllll�ll�l��p�p � SOLE METHOD OF TRANSMITTING ALARM SIGNALS, ALTHOUGH 1 UNDERSTAND THAT ADT RECOMMENDS THAT 1 ` III�IIIII �Ij�Ul�l ALSO USE AN ADDITIONAL BACK-UP METHOD OF COMMUNICATION. IF ADT DETERMINES IN ITS SOLE DISCRETION W1 OEOO THAT MY NON-TRADITIONAL TELEPHONE SERVICE IS OR LATER BECOMES NON -COMPATIBLE, OR IF 1 CHANGE TO ANOTHER NON-TRADITIONAL TELEPHONE SERVICE THAT IS NOT COMPATIBLE, THEN ADT REQUIRES THAT 1 USE AN ALTERNATE METHOD OF COMMUNICATION ACCEPTABLE TO ADT AS THE PRIMARY METHOD TO CONNECT THE ALARM SYSTEM TO ADT'S CMG TRANSMISSION OF FIRE ALARM SIGNALS BY MEANS OTHER THAN A TRADITIONAL TELEPHONE LINE MAY NOT BE IN COMPLIANCE WITH APPLICABLE FIRE ALARM OR OTHER STANDARDS OR CODES, AND IT IS SOLELY MY OBLIGATION TO COMPLY WITH SUCH STANDARDS AND CODES. IF THE ALARM SYSTEM HAS A LINE -CUT FEATURE, IT MAY NOT BE ABLE TO DETECT IF MY NON-TRADMONAL TELEPHONE SERVICE LINE IS CUT OR INTERRUPTED. ADT MAY NOT BE ABLE TO DOWNLOAD SYSTEM CHANGES OR PROVIDE CERTAIN AUXILIARY MONITORING SERVICES THROUGH A NON-TRADITIONAL TELEPHONE LINE OR SERVICE. THE ALARM PANEL MAY BE UNABLE TO SEIZE MY TELEPHONE LINE TO TRANSMIT AN ALARM SIGNAL IF ANOTHER CONNECTION IS OFF THE HOOK DUE TO IMPROPER CONNECTION OR OTHERWISE. ADT RECOMMENDS THAT 1 TEST THE ALARM SYSTEM MONTHLY, EVEN THOUGH A SUCCESSFUL TEST OF THE ALARM SYSTEM DOES NOT GUARANTEE THAT ADT WILL RECEIVE ALARM SIGNALS FROM THE ALARM SYSTEM IN THE FUTURE. 19. CANCELLATION. A. ADT may, at any time, cancel this Contract at its option if: (1) ADT's CMC is destroyed or damaged so that it is impractical for ADT to continue service; (2) ADT cannot acquire or retain the transmission connections or authorization to transmit signals between my premises and its CMC or the applicable fire or police department or other agency, or between ADT's CMC and the applicable fire or police department or other agency; (3) I fail to follow ADT's recommendations to repair or replace any defective parts of the system not covered under the Limited Warranty or, if purchased, QSP, (4) 1 fail to follow ADT's operating instructions for the alarm system; or (5) ADT determines that it is impractical to continue service due to the modification or alteration of my premises after installation. If ADT cancels for any of the reasons stated immediately above, ADT will refund any advance payments made for services to be supplied after the date of such termination, less any amounts still due for the installation of the equipment, for services already rendered and for any other charges due. Additionally, ADT will not assess contract termination charges, if any, as described in Paragraph 2 above. B. ADT may cancel this Contract upon written notice to me if: (1) 1 fail to pay any monies when due under this Contract, (2) 1 change to a telephone/ communications service not suitable for alarm signal transmission or (3)1 fail to comply with any other term or condition of this Contract. Upon receipt of written notice from ADT, I will have ten (10) days to correct the deficiency. If I do not correct the deficiency in a timely manner, and ADT does cancel this Contract, ADT may assess contract termination charges, if any, as described in Paragraph 2 above. 20. ASSIGNMENT. I may not assign this Contract without prior written consent from ADT. ADT does have the right to assign this Contract or to subcontract any of its obligations under this Contract without my approval and without notice to me. 21. DELAYS. ADT HAS NO RESPONSIBILITY OR LIABILITY TO ME OR ANY OTHER PERSON FOR DELAYS IN THE INSTALLATION OR REPAIR OF THE SYSTEM, REGARDLESS OF THE REASON. ADT HAS NO RESPONSIBILITY OR LIABILITY FOR INTERRUPTIONS OF SERVICE OR ANY RESULTING CONSEQUENCES, WHETHER DUE TO STRIKE, RIOT, FLOOD, FIRE, TERRORISM, ACT OF GOD OR ANY OTHER CAUSE WITHIN OR BEYOND ADT'S CONTROL. IF THERE ARE SERVICE INTERRUPTIONS, ADT HAS NO OBLIGATION TO SUPPLY ME WITH SUBSTITUTE SERVICES. 22. ELECTRONIC MEDIA; PERSONAL INFORMATION. ADT may scan, image or otherwise convert this Contract into an electronic format of any nature. A copy of this Contract produced from such 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 and third parties that 1 provided to ADT is true and complete. 1 will notify ADT without delay of any change to this information. 1 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 (including 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. ADT 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 Contract or any applicable authority having jurisdiction that requests such information to administer alarm monitoring services or alarm system license, permit or similar programs. 23. PRIVACY POLICY. ADT maintains an 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 CONTRACT CONSTITUTES THE ENTIRE AGREEMENT BETWEEN THE PARTIES. I AM NOT RELYING ON ADT'S ADVICE OR ADVERTISEMENTS. ADT IS NOT BOUND BY ANY REPRESENTATION, PROMISE, CONDITION, INDUCEMENT OR WARRANTY, EXPRESS OR IMPLIED, THAT IS NOT INCLUDED IN WRITING IN THIS CONTRACT. THE TERMS AND CONDITIONS OF THIS CONTRACT APPLY AS PRINTED WITHOUT ALTERATION OR QUALIFICATION, UNLESS A CHANGE IS APPROVED IN WRITING BY AN ADT AUTHORIZED REPRESENTATIVE. THE TERMS AND CONDITIONS OF THIS CONTRACT SHALL CONTROL AND GOVERN EVEN IF THERE ARE OTHER DOCUMENTS WITH INCONSISTENT OR ADDITIONAL TERMS AND CONDITIONS. IF A COURT DETERMINES THAT ANY PROVISION OF THIS CONTRACT IS INVALID OR UNENFORCEABLE, THAT PROVISION SHALL BE DEEMED AMENDED AND ENFORCED TO THE MAXIMUM EXTENT PERMITTED BY LAW. EACH AND EVERY OTHER PROVISION OF THIS CONTRACT SHALL CONTINUE TO BE VALID AND ENFORCEABLE. 25. LICENSE INFORMATION. License numbers will be provided on a separate Rider. 02012 ADT LLC dba ADT Security Services. All rights reserved. 6 ®f 6 (06/12) RESIDENTIAL SERVICES CONTRACT Section. O Check received for. O Installation: Check # Amount O Annual Service Charges Collected: Check # Amount I authorize ADT: O To withdraw all (1) Service Charges and (fl) Contract Termination Charges Ifo charge my aedit/debit card for all (I) Service Charges and (ii) Contract (see Paragraph 2. Early Termination of this Contract) from my bank account: Termination Charges (see Paragraph 2. Early Termination of this Contract): O Annually O Semi -Annually O Quarterly O Monthly Q Installation O 3 monthly credit/debit card payments of equal amounts Choose one: O Checking O Savings (available only for telephone orders with an installation price over $400 or field sales with an installation price over $1,500) Name of Bank/Credit Union ®All/Recurring Service Charges O Annually O Semi -Annually O Quarterly 4WMonthly ABA Routing Number Bank Account Number VISA O MasterCard O Discover O AMEX 0 Credit/Debit Card Number E piration Date Recurring Service Charge Amount Plus tax M Y Name as it appears on bank account Recurring Service Charge Amount Plus tax Cardholder's MEMMINNEENEEMM Name I authorize ADT to debit my bank account for the amount of all Recurring Service Charges If I am using a debit card, I authorize ADT to debit my bank account for the amount of all and all Contract Termination Charges (see Paragraph 2. Early Termination of this Contract) Recurring Service Charges and all Contract Termination Charges (see Paragraph 2. Early indicated above. I may revoke this authorization only by notifying ADT and my bank in Termination of this Contract) indicated above. I may revoke this authorization only by writing at least 10 business days before the scheduled debit. If no oval is filled above, notifying ADT and my bank in writing at least 10 business days before the scheduled debit service charges will be withdrawn monthly. If no oval is filled above, my credit/debit card will be charged monthly. 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 -sufficient funds (NSF.) ADJ 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 the provisions of U.S. law. I am'o 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 c (responds to the terms indicated in Pis Contract O To send me a bill: O Annu rly O Semi -Annually O ua rly O Other DOA Approval If no oval is filled, ADT will send bill quarterly. Authorized Account Si natur :Z Section• and System Data Municipality ITTMMunicipality Police Name Fire Name Municipality Medical Patrol Name Responder Name &Number Cross Street Job Type (D*ew Sale O Change Over O Upgrade Control Type O HW (MRF Permit Affiliation Member # Number Burglar Alarm: i9PYes O No Fire / Smoke: O Yes W No Two -Way Voice: O Yes (7No Cellular Mod O Parallel 0 Standard Section• Password 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 1.800.ADT.ASAP. Section'T'Emergency Contact 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. y selecting the "Yes" dOijhation on the right I am identifying which of these individuals may be called prior to notification of the authorities. Customer/Emergency Contact #1/ f✓" / ^' � �k • No Print First/Last Name r A '!'' Phone o e C O O O 00 Phone Home Cell Work Yes No Customer/Emergency Contact #2 O O O O O Print First/Last Name Phone Home Cell Work Yes No O O O O O Phone Home Cell Work Yes No Alternate/Emergency Only Contact O O O O O Print First/Last Name Phone Home Cell Work Yes No O O O 00 Phone Home Cell Work Yes No 3 of 6 ©2012 ADT LLC dba ADT Security Services. All rights reserved. (06/12) 1. PAYMENTS; TERM; CONSUMER REPORT. All charges are payable in advance. The initial term of this Contract is three (3) years. ADrs alarm monitoring and notification services will begin when the equipment is installed, operational and communicating with ADTs Customer Monitoring Center ("CMC"). This Contract will automatically renew for 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, this 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. 1 authorize ADT to obtain a non -investigative consumer report, commonly referred to as a credit check or credit report, about me from a consumer reporting 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 RELIED 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 IS 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 the 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 notice of the increase, and if ADT does not waive the increase, then I may terminate this Contract effective thirty (30) days after ADrs receipt of my written notice of termination. In this situation, I will not have to pay the contract termination charges described in Paragraph 2 above. 4. ADDITIONAL CHARGES AND OFFSET 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 representative responds to a service call or alarm at my premises because I improperly followed operating instructions; failed to properly lock or close a window, door or other protected point, or improperly adjusted CCTV cameras, monitors or accessories. If ADT owes me money when this Contract ends, ADT has the right to deduct from any refund owed me (A) service charges for thirty (30) days, if I fall to give the required written termination notice set forth in Paragraph 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 or 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 ($5.00) or less, ADT will not be obligated to refund any amounts to me. S. LIMITATION OF LIABILITY. A. INSURANCE; WAIVER OF SUBROGATION. I AGREE THAT ADT IS NOT AN INSURER AND THAT ADT IS 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 RISK OF LOSS AT MY PREMISES. INSTEAD, THE AMOUNTS ADT CHARGES ME ARE BASED SOLELY UPON THE VALUE OF THE EQUIPMENT AND SERVICES ADT PROVIDES AND UPON THE LIMITED LIABILITY ADT ASSUMES UNDER THIS CONTRACT. IF I WANT INSURANCE TO PROTECT AGAINST ANY RISK OF LOSS AT MY PREMISES, I WILL PURCHASE IT. IN THE EVENT OF ANY LOSS, DAMAGE OR INJURY, I 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 AGAINST ADT ARISING AS A RESULT OF THE PAYMENT OF ANY CLAIM FOR LOSS, DAMAGE OR INJURY. B. NO GUARANTEE; NO LIABILITY. ADTS EQUIPMENT AND SERVICES DO NOT CAUSE AND CANNOT ELIMINATE OCCURRENCES OF THE EVENTS THEY ARE INTENDED TO DETECT OR AVERT, INCLUDING, BUT NOT LIMITED TO, FIRES, FLOODS, BURGLARIES, ROBBERIES AND MEDICAL PROBLEMS. OTHER THAN THE LIMITED WARRANTY AND/OR QUALITY SERVICE PLAN SET FORTH IN PARAGRAPHS 9 AND 10 BELOW, ADT MAKES NO GUARANTY OR WARRANTY, INCLUDING ANY IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PAR71CULAR PURPOSE, THAT THE EQUIPMENT AND SERVICES PROVIDED WILL DETECT OR AVERT SUCH INCIDENTS OR THEIR CONSEQUENCES. ADT DOES NOT UNDERTAKE ANY RISK THAT I OR MY PROPERTY, OR THE PERSON OR PROPERTY OF OTHERS, MAY BE SUBJECT TO INJURY OR LOSS IF SUCH AN EVENT OCCURS. THE ALLOCATION OF SUCH RISK REMAINS WITH ME, NOT ADT. I RELEASE, WAIVE, DISCHARGE AND PROMISE 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 SERVICES PROVIDED BY ADT. C. EXCLUSIVE REMEDY. IT IS IMPRACTICAL AND EXTREMELY DIFFICULT TO DETERMINE THE ACTUAL DAMAGES, IF ANY, THAT MAY RESULT FROM A FAILURE BY ADT TO PERFORM ANY OF ITS OBLIGATIONS. UNDER NO CIRCUMSTANCES WILL I ATTEMPT TO HOLD ADT LIABLE FOR ANY CONSEQUENTIAL OR INCIDENTAL DAMAGES, INCLUDING WITHOUT LIMITATION, DAMAGES FOR PERSONAL INJURY OR DAMAGES TO PROPERTY. IF, NOTWITHSTANDING THE PROVISIONS OF THIS PARAGRAPH 5, ADT IS FOUND LIABLE FOR LOSS, DAMAGE OR INJURY UNDER ANY LEGAL THEORY RELATING IN ANY WAY TO THE SERVICES AND/OR EQUIPMENT PROVIDED BY ADT, ADTS LIABILITY TO ME SHALL BE LIMITED TO A SUM EQUAL TO 10% OF THE ANNUAL SERVICE CHARGE OR $500, WHICHEVER IS GREATER. THIS AGREED-UPON AMOUNT IS NOT A PENALTY. RATHER, IT IS MY SOLE REMEDY. UPON MY REQUEST, ADT MAY AGREE TO ASSUME LIABILITY BEYOND WHAT IS PROVIDED FOR IN THIS PARAGRAPH 5 BY ATTACHING AN AMENDMENT TO THIS CONTRACT SETTING FORTH THE EXTENT OF ADTS LIABILITY AND THE ADDITIONAL CHARGES TO ME. D. APPLICATION. THE PROVISIONS OF THIS PARAGRAPH 5 APPLY NO MATTER HOW THE LOSS, DAMAGE, INJURY OR OTHER CONSEQUENCE OCCURS, EVEN IF DUE TO THE PERFORMANCE OR NONPERFORMANCE BY ADT OF ITS OBLIGATIONS UNDER THIS CONTRACT OR FROM NEGLIGENCE (ACTIVE OR OTHERWISE), STRICT LIABILITY, VIOLATION OF ANY APPLICABLE CONSUMER PROTECTION LAW OR ANY OTHER THEORY OF LIABILITY OR ALLEGED FAULT ON THE PART OF ADT, ITS AGENTS OR ITS EMPLOYEES. E. INDEMNITY. IF ANY OTHER PERSON, INCLUDING MY SUBROGATING INSURER, MAKES ANY CLAIM OR FILES ANY LAWSUIT AGAINST ADT IN ANYWAY RELATED TO THE EQUIPMENT OR SERVICES PROVIDED BY ADT TO ME, I AGREE TO INDEMNIFY, DEFEND AND HOLD ADT HARMLESS FROM ANY AND ALL SUCH CLAIMS AND LAWSUITS, INCLUDING THE PAYMENT OF ALL DAMAGES, EXPENSES, COSTS AND ATTORNEYS' FEES. MY DUTY TO DEFEND IS SEPARATE AND DISTINCT FROM MY DUTY TO INDEMNIFY AND HOLD HARMLESS AND ARISES UPON THE ASSERTION OF A CLAIM OR DEMAND AGAINST ADT AND REGARDLESS WHETHER ADT HAS BEEN FOUND LIABLE OR WHETHER ADT HAS INCURRED ANY EXPENSE. F. TIME TO BRING CLAIM OR SUIT. NO SUITOR ACTION SHALL BE BROUGHT AGAINST ADT MORE THAN ONE (1) YEAR AFTER THE DATE OF THE INCIDENT THAT RESULTED IN THE LOSS, INJURY OR DAMAGE, OR THE SHORTEST DURATION PERMITTED UNDER APPLICABLE LAW IF GREATER THAN ONE (1) YEAR. G. BENEFIT TO OTHERS. THE PROVISIONS OF THIS PARAGRAPH S SHALL APPLY TO AND BENEFIT ADT AND ITS AGENTS, EMPLOYEES, CONTRACTORS, SUBSIDIARIES, DEALERS, AFFILIATES, PARENTS (BOTH DIRECT AND INDIRECT), AFFINITY MARKETERS AND OTHER PARTNERS. 6. OTHER PARTY'S LIMITATION. IF I PURCHASED EQUIPMENT OR SERVICES FROM ADT THROUGH ANOTHER BUSINESS OR PERSON, OR FROM ADT THROUGH A REFERRAL FROM ANOTHER BUSINESS OR PERSON, I AGREE THAT SUCH OTHER BUSINESS OR PERSON ACTS SOLELY AS AN INDEPENDENT CONTRACTOR AND HAS NO RESPONSIBILITY OR LIABILITY TO ME FOR THE PERFORMANCE OR NONPERFORMANCE OF THE EQUIPMENT OR SERVICES PROVIDED BY ADT. I ALSO AGREE THAT ANY SUCH BUSINESS OR PERSON IS ENTITLED TO THE SAME RIGHTS AS ADT UNDER THIS CONTRACT. INCLUDING PARAGRAPH S. 7. OWNERSHIP 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, disable or abandon all or any of the equipment owned by ADT. If the equipment is disabled or removed by ADT, I understand that I will not be able to use the equipment for any purpose nor will the alarm system be able to function locally or be monitored by another service provider. I will provide ADT access to the equipment for removal, and 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 ADT removes the 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. 8. INSTALLATION. In order for ADT to install 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 install the alarm equipment at the premises, (B) I will make the premises available without interruption during ADrs normal working hours and will maintain the premises in a safe and sanitary condition suitable for work to be performed by ADTs representatives without jeopardizing their health or safety; (C) the 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 equipment in locations designated by ADT, (E) I will make arrangements for lifting and replacing carpeting, if required, for ADT's installation of floor mats or wiring; (F) ADT may not be able to conceal any or all equipment or wiring; (G) ADT will not be liable for property damage, personal injury, illness or other loss due to water intrusion, mold, fungi, wet or dry rot or bacteria that may result from the installation services, and (H) my premises complies with all applicable codes, regulations and laws and will continue to comply with all applicable codes, regulations and laws during the Initial term and any renewal terms of this Contract. 9. LIMITED WARRANTY. During the first 90 days after installation, ADT will repair or, at its option, replace any defective part of the alarm system, including wiring, and will make required mechanical adjustments, all at no charge to me. ADT will use new or functionally operative parts for replacements. This limited warranty is for my benefit only and may not be enforced by any other person. This limited warranty gives me specific legal rights. The laws of 4of 6 Terms and Conditions continue on accompanying sheets. (06/12) IMPORTANT TERMS AND CONDITIONS Ilplp��lll��l��l�llpil,��l�np IPmen Consumer Report 11:Wa Exclusions = 2. Early Te%n o this Contract 12No Warranties 5401 UEOO 3. Increases in Charges 13. Alarm Monitoring and Notification Service 4. Additional Charges and Offset Rights 14. Familiarization Period 5. Limitation of Liability 6. Other Party's Limitation 15. Failure to Pay Charges or Honor Contract 16. Smoke and Carbon Monoxide Detectors 22. Electronic Media; Personal Information 7. Ownership 17. Battery -Powered Devices 23. Privacy Policy 24. Entire Agreement 8. Installation 9. Limited Warranty 18. Communication Facilities 19. Cancellation 25. License Information 10. Extended Limited Warranty/ 20. Assignment Quality Service Plan (QSP) 21. Delays 1. PAYMENTS; TERM; CONSUMER REPORT. All charges are payable in advance. The initial term of this Contract is three (3) years. ADrs alarm monitoring and notification services will begin when the equipment is installed, operational and communicating with ADTs Customer Monitoring Center ("CMC"). This Contract will automatically renew for 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, this 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. 1 authorize ADT to obtain a non -investigative consumer report, commonly referred to as a credit check or credit report, about me from a consumer reporting 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 RELIED 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 IS 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 the 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 notice of the increase, and if ADT does not waive the increase, then I may terminate this Contract effective thirty (30) days after ADrs receipt of my written notice of termination. In this situation, I will not have to pay the contract termination charges described in Paragraph 2 above. 4. ADDITIONAL CHARGES AND OFFSET 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 representative responds to a service call or alarm at my premises because I improperly followed operating instructions; failed to properly lock or close a window, door or other protected point, or improperly adjusted CCTV cameras, monitors or accessories. If ADT owes me money when this Contract ends, ADT has the right to deduct from any refund owed me (A) service charges for thirty (30) days, if I fall to give the required written termination notice set forth in Paragraph 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 or 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 ($5.00) or less, ADT will not be obligated to refund any amounts to me. S. LIMITATION OF LIABILITY. A. INSURANCE; WAIVER OF SUBROGATION. I AGREE THAT ADT IS NOT AN INSURER AND THAT ADT IS 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 RISK OF LOSS AT MY PREMISES. INSTEAD, THE AMOUNTS ADT CHARGES ME ARE BASED SOLELY UPON THE VALUE OF THE EQUIPMENT AND SERVICES ADT PROVIDES AND UPON THE LIMITED LIABILITY ADT ASSUMES UNDER THIS CONTRACT. IF I WANT INSURANCE TO PROTECT AGAINST ANY RISK OF LOSS AT MY PREMISES, I WILL PURCHASE IT. IN THE EVENT OF ANY LOSS, DAMAGE OR INJURY, I 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 AGAINST ADT ARISING AS A RESULT OF THE PAYMENT OF ANY CLAIM FOR LOSS, DAMAGE OR INJURY. B. NO GUARANTEE; NO LIABILITY. ADTS EQUIPMENT AND SERVICES DO NOT CAUSE AND CANNOT ELIMINATE OCCURRENCES OF THE EVENTS THEY ARE INTENDED TO DETECT OR AVERT, INCLUDING, BUT NOT LIMITED TO, FIRES, FLOODS, BURGLARIES, ROBBERIES AND MEDICAL PROBLEMS. OTHER THAN THE LIMITED WARRANTY AND/OR QUALITY SERVICE PLAN SET FORTH IN PARAGRAPHS 9 AND 10 BELOW, ADT MAKES NO GUARANTY OR WARRANTY, INCLUDING ANY IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PAR71CULAR PURPOSE, THAT THE EQUIPMENT AND SERVICES PROVIDED WILL DETECT OR AVERT SUCH INCIDENTS OR THEIR CONSEQUENCES. ADT DOES NOT UNDERTAKE ANY RISK THAT I OR MY PROPERTY, OR THE PERSON OR PROPERTY OF OTHERS, MAY BE SUBJECT TO INJURY OR LOSS IF SUCH AN EVENT OCCURS. THE ALLOCATION OF SUCH RISK REMAINS WITH ME, NOT ADT. I RELEASE, WAIVE, DISCHARGE AND PROMISE 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 SERVICES PROVIDED BY ADT. C. EXCLUSIVE REMEDY. IT IS IMPRACTICAL AND EXTREMELY DIFFICULT TO DETERMINE THE ACTUAL DAMAGES, IF ANY, THAT MAY RESULT FROM A FAILURE BY ADT TO PERFORM ANY OF ITS OBLIGATIONS. UNDER NO CIRCUMSTANCES WILL I ATTEMPT TO HOLD ADT LIABLE FOR ANY CONSEQUENTIAL OR INCIDENTAL DAMAGES, INCLUDING WITHOUT LIMITATION, DAMAGES FOR PERSONAL INJURY OR DAMAGES TO PROPERTY. IF, NOTWITHSTANDING THE PROVISIONS OF THIS PARAGRAPH 5, ADT IS FOUND LIABLE FOR LOSS, DAMAGE OR INJURY UNDER ANY LEGAL THEORY RELATING IN ANY WAY TO THE SERVICES AND/OR EQUIPMENT PROVIDED BY ADT, ADTS LIABILITY TO ME SHALL BE LIMITED TO A SUM EQUAL TO 10% OF THE ANNUAL SERVICE CHARGE OR $500, WHICHEVER IS GREATER. THIS AGREED-UPON AMOUNT IS NOT A PENALTY. RATHER, IT IS MY SOLE REMEDY. UPON MY REQUEST, ADT MAY AGREE TO ASSUME LIABILITY BEYOND WHAT IS PROVIDED FOR IN THIS PARAGRAPH 5 BY ATTACHING AN AMENDMENT TO THIS CONTRACT SETTING FORTH THE EXTENT OF ADTS LIABILITY AND THE ADDITIONAL CHARGES TO ME. D. APPLICATION. THE PROVISIONS OF THIS PARAGRAPH 5 APPLY NO MATTER HOW THE LOSS, DAMAGE, INJURY OR OTHER CONSEQUENCE OCCURS, EVEN IF DUE TO THE PERFORMANCE OR NONPERFORMANCE BY ADT OF ITS OBLIGATIONS UNDER THIS CONTRACT OR FROM NEGLIGENCE (ACTIVE OR OTHERWISE), STRICT LIABILITY, VIOLATION OF ANY APPLICABLE CONSUMER PROTECTION LAW OR ANY OTHER THEORY OF LIABILITY OR ALLEGED FAULT ON THE PART OF ADT, ITS AGENTS OR ITS EMPLOYEES. E. INDEMNITY. IF ANY OTHER PERSON, INCLUDING MY SUBROGATING INSURER, MAKES ANY CLAIM OR FILES ANY LAWSUIT AGAINST ADT IN ANYWAY RELATED TO THE EQUIPMENT OR SERVICES PROVIDED BY ADT TO ME, I AGREE TO INDEMNIFY, DEFEND AND HOLD ADT HARMLESS FROM ANY AND ALL SUCH CLAIMS AND LAWSUITS, INCLUDING THE PAYMENT OF ALL DAMAGES, EXPENSES, COSTS AND ATTORNEYS' FEES. MY DUTY TO DEFEND IS SEPARATE AND DISTINCT FROM MY DUTY TO INDEMNIFY AND HOLD HARMLESS AND ARISES UPON THE ASSERTION OF A CLAIM OR DEMAND AGAINST ADT AND REGARDLESS WHETHER ADT HAS BEEN FOUND LIABLE OR WHETHER ADT HAS INCURRED ANY EXPENSE. F. TIME TO BRING CLAIM OR SUIT. NO SUITOR ACTION SHALL BE BROUGHT AGAINST ADT MORE THAN ONE (1) YEAR AFTER THE DATE OF THE INCIDENT THAT RESULTED IN THE LOSS, INJURY OR DAMAGE, OR THE SHORTEST DURATION PERMITTED UNDER APPLICABLE LAW IF GREATER THAN ONE (1) YEAR. G. BENEFIT TO OTHERS. THE PROVISIONS OF THIS PARAGRAPH S SHALL APPLY TO AND BENEFIT ADT AND ITS AGENTS, EMPLOYEES, CONTRACTORS, SUBSIDIARIES, DEALERS, AFFILIATES, PARENTS (BOTH DIRECT AND INDIRECT), AFFINITY MARKETERS AND OTHER PARTNERS. 6. OTHER PARTY'S LIMITATION. IF I PURCHASED EQUIPMENT OR SERVICES FROM ADT THROUGH ANOTHER BUSINESS OR PERSON, OR FROM ADT THROUGH A REFERRAL FROM ANOTHER BUSINESS OR PERSON, I AGREE THAT SUCH OTHER BUSINESS OR PERSON ACTS SOLELY AS AN INDEPENDENT CONTRACTOR AND HAS NO RESPONSIBILITY OR LIABILITY TO ME FOR THE PERFORMANCE OR NONPERFORMANCE OF THE EQUIPMENT OR SERVICES PROVIDED BY ADT. I ALSO AGREE THAT ANY SUCH BUSINESS OR PERSON IS ENTITLED TO THE SAME RIGHTS AS ADT UNDER THIS CONTRACT. INCLUDING PARAGRAPH S. 7. OWNERSHIP 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, disable or abandon all or any of the equipment owned by ADT. If the equipment is disabled or removed by ADT, I understand that I will not be able to use the equipment for any purpose nor will the alarm system be able to function locally or be monitored by another service provider. I will provide ADT access to the equipment for removal, and 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 ADT removes the 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. 8. INSTALLATION. In order for ADT to install 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 install the alarm equipment at the premises, (B) I will make the premises available without interruption during ADrs normal working hours and will maintain the premises in a safe and sanitary condition suitable for work to be performed by ADTs representatives without jeopardizing their health or safety; (C) the 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 equipment in locations designated by ADT, (E) I will make arrangements for lifting and replacing carpeting, if required, for ADT's installation of floor mats or wiring; (F) ADT may not be able to conceal any or all equipment or wiring; (G) ADT will not be liable for property damage, personal injury, illness or other loss due to water intrusion, mold, fungi, wet or dry rot or bacteria that may result from the installation services, and (H) my premises complies with all applicable codes, regulations and laws and will continue to comply with all applicable codes, regulations and laws during the Initial term and any renewal terms of this Contract. 9. LIMITED WARRANTY. During the first 90 days after installation, ADT will repair or, at its option, replace any defective part of the alarm system, including wiring, and will make required mechanical adjustments, all at no charge to me. ADT will use new or functionally operative parts for replacements. This limited warranty is for my benefit only and may not be enforced by any other person. This limited warranty gives me specific legal rights. The laws of 4of 6 Terms and Conditions continue on accompanying sheets. (06/12)