EL-11-1113 4 +i( Miami Shores Village �'f y p /f � 1- ILII ..
10050 N.E.2nd Avenue NE a
•'•• `" Miami Shores,FL 33138-0000 �- f, I1Yorlc Gle rfica# AJA*
%j
Phone: (305)795-2204 ,.. A*PC?NED
�y �' `Tt2 't1 Expiration: 12/24/2011
Project Address Parcel Number Applicant
53 NE 102 Street 1132060131660
Miami Shores, FL 33138- Block: Lot: LYDIA AMADOR
Owner Information Address Phone Cell
LYDIA AMADOR 53 NE 102 Street
MIAMI SHORES FL 33138-2322
Contractor(s) Phone Cell Phone $ 200.00
Valuation:
ADT SECURITY SERVICES, INC (786)331-3967
Total Sq Feet: 0
Type of Work:ALARM Available Inspections:
Additional Info: Inspection Type:
Classification:Residential
Scanning: 1
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
Invoice# EL-6-11-41247
DBPR Fee $2.00 06/20/2011 Check#: 126142 $50.00 $58.60
DCA Fee $2.00
Education Surcharge $0.20 07/05/2011 Check#: 126746 $58.60 $0.00
Permit Fee-Additions/Alterations $100.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $108.60
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the above-named contractor to do the work stated.
July 05,2011
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
July 05,2011 1
a
Miami Shores Village =�23
Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax: (305)756.8972
INSPECTION'S PHONE NUMBER: (305)762.4949FBC 20 (L
BUILDING Permit No.
PERMIT APPLICATION Master Permit No.
Permit Type: Electrical
JOB ADDRESS: S�3 4/,0:' /O.2- Ste;
City: Miami Shores / County: Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated:Yes / NO Flood Zone:
OWNER:Name(Fee Simple Titleholder): LYaI,Q Ql�YJ0.�p/. Phone#:
Address: ,,,,��✓`3 Nr /0,2 HJT.
City: f?vingn � 10 State: �L Zip: 33/3dP
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name:
Address: O 7 tri-
City:1W 'lo_ State: Zip:
Qualifier Name: / Phone#:
State Certification or Registration#: Certificate of Competency#:
Contact Phone#: Email Address:
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: OAddress ❑A ration ONew ORepair/Replace ❑Demolition
Description of Work: fGW �v�'
Submittal Fee$ Permit Fee$ bl,O 1&940 CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$ `,C) 3
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
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) pidy7after the building permit is issued. In the absence of such posted notice, the
inspection will n approved and a reinspecti n e will be charged.
Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this 13 The foregoing instrument was acknowled ed before me this
day of ,201-q,by L��`l C� &> '� ' , day of Qi ,20�by
who is personally known to me or who has produced who is pl, rsonally known to me or who has prod ed
DL-- As identification and who did take an oath. as identification and who did take an oath.
NOTARY P NOTARY PUBLIC:
Sign. Sign:
Print: 1 Print: L as61,iGS
BLES
M Commission Expires: m A �YN�®LA M Commission Expires: JULIO Y PUBLIC My p � Y P NOTARY PUBLIC
Notary Public,State of Florida
Commission#EE 167448 STATE OF FLORIDA
My comm.expires Feb.7,2016Comm#FF007936
' e
� � �xxxxxxxxxx xxxxxx4�017
APPROVED BY ��- L���P� P ans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
a
^� ADT Aiways ,Thero-
Important Electrical Permit Information
Dear Customer,
Our records indicate the permit for the installation of the alarm system has not had the required
inspection.To resolve the issue we need to renewed the permit and an electrical inspection is
needed in order to close the permit record with the city.
The electrical inspectors from the municipality conduct inspections between the hours
of 8:00 am and 4:00 pm, Monday thru Friday,excluding holidays.ADT Security Services can not
schedule a specific time. You may attempt to obtain a time by calling the municipality directly
the day of the inspection before 8am
According to the South Florida Code, any work that does not have a final inspection is
"presumed and deemed unsafe". This matter requires your immediate attention. If a final
inspection is not completed the municipality will require additional fees. Or they can place a
violation on your property.
Thank you in advance for your cooperation in this matter.
o" ifastto
Lscastro(a)-adt.com
ADT SECURITY
10785 Marks Way
Miramar FL 33025
(954)266-5137
4
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 No.
PERMIT APPLICATION Master Permit No.
FBC 20 1 D
Permit Type: Electrical
OWNER:Name(Fee Simple Titleholder): Phone#:
Address: .S,4 A�e /0A 5;7r7-
City: State: Zip:
Tenant/Lessee Name: Phone#:
Email:
JOB ADDRESS: Alo
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR:Company Name: d t `le Phone#:
Address: /078 ' x' a% - y/
City: Q/1 State: T G Zip: 3 r
Qualifier Name: Go ne Phone#: 9.1� ��. L7
State Certification or Registration#: �04�>/��� Certificate of Competency#:
Contact Phone#:9��/sLL�'.s�7✓'' Email Address:
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑Address ❑A-lter 'on ❑New ❑Repair/Replace ❑Demolition
Description of Work: e-oc e_fi ;
x��xx�x�xx��xx��������xx�xxx���x��xxx�xFees�xxxx����xxx���xx�xxxx�x�x��x�:�:xx�xxx��x�xx�
Submittal Fee$ Permit Fee$ l®��®G CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$
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
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. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of ,20_,by day of ,20/%3by +
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign: "
Print: Print:
My Commission Expires: My Corns
' MAMA 0 PFREI
Notary Public• SIaj,� )F fl@ 5
air My Comm.Expires May i'• 001
�:x��xx°��xx°�x°�xxxm�x�xx°aa�:xxx�xxx°xa��xxx�xxa����°xx��°x�:x�:x:t<:iax°x:xxx°xx°�x°x�xx�x �>klt�'Is ��x<����' �� �� �����'x���xx
APPROVED BY �� �ll�-� Plans Examiner Zoning
Structural Review Clerk
(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
Miami Shores Village
JUN 2 0 REr`0
Building Dpartment
e
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax:(305) 756.8972
BUILDING t ermit No.
PERMIT APPLICATION Master Permit No.
FBC 20G4
Permit Type: Electrical �� 1 ��� 3y
Owner's Name(Fee Simple Titleholder)_ LIMA ftM 9DDR- Phone 11
Owner's Address 53 N e /a;Z ,i"ef*
cityPILfnti Skzo-)4s State FL Zip—33 09
Tenant/Lessee Name Phone t# _.
E-MAIL:
Job Address(where the work is being done)
Citv Miami Shores Village _County Miami-Dade zip—
FOLIO/
ip_FOLIO/PARCEL# i/ - 320( — 0l,3 - (o&0
Is Building Historically Designated YES NO y� '0�
Contractor's Company Name DT
ti1w-rsKeca.1 �d#`CS Phon_e#
�Contractor's address /07Y-6-
Citv p 'ama
r State Zip
/� _ 3Da
Qualifier Name GeV.-I�C Phone#9 -a�(Q(Q-��7 _
State Certificate or Registration No.&F19DD//a- Certificate of Competency No.
E-MAIL: OJrin 0&td- (!P a A-t-• CDYn
Architect1 'ngineer's Name(if applicable) Phone#
Value of Work For this Permit$ . Square/Linear Footage Of Work: _
Type of Work: ❑Addition []Alteration ❑New ❑ Repair/Replace ❑ Demolition
Describe Work: /nstamvy h, of bumta,(- a*,L 'L
xic 9:xxxxxiexxxac acxaF ntxic xi ':xx xxF ac icxx xxxic rr.ie''°Feesziczxicxx xx rxzir r.xisxxiex xxxacxicxx>Y*xae 9rx xr.xxF iexic iex
Submittal Fee S Permit Fee$ 'e�40 CCF$ CO/CC
Notary$ Training/Education Fee$ Technology Fee$
Scanning$ Radon$ DP13R$ Zoning$
Bond$ Code Enforcement$ _ Double Fee$
Structural Review.$ 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 —
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no wurk 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. 1 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 certif, 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 :hal a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose proper•tj,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 (?) ays after the building permit is issued. In the absence of such posted notice, the
inspection will not proved and a reinspe to .fee will be charged.
Signature 7� CG Signature _ — --- --- ---
Owner or AgentCo ractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this((
day of Q ,20[�_,by I J Al"M'C�l�r- day of Q ULe ,20(�,by
who is personally known to me or who h swin
roduced who is personally known to me or who has produced _
As i 15,0yoas identification and who did take an oath.
NOTARY PUBLIC: Stab of Florida NOTARY PUBLIC:
sengartenion EED934612/2015
Sign: Sign .*
Print/V � �6305 '� /� Pri t: =o1°Rr°oaf Notary Public State of
is rinidad
o` My Commission DD945622
My Commission Expires: LJ — — N y omml r of rvo� Expires 12/10/2013
xxxxxxxxxrxxxxTr�rxrrrrxrxYxr>;>rrxxrrrrxxxrxxxxxxxxxxxxxxxxxxxrrx�xxxnxxrxxxxx •x• xxxxxxx
APPLICATION APPROVED BY: ��/ ���/�' L� ,ZZ Plans Examiner
Engineer
Zoning
(Revised 02/09/06)
s
t
Show Me:
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Search By:
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Property Appraiser Tax Estimator r=A
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Comparison
Portability S.O.H.Calculator
Summary Details: 2� _ k HE 114 D 81
Folio No.: 11-3206-013-1660 �
Property: 53 NE 102 ST
Mailing LYDIA AMADOR
Address: 53 NE 102
tJ`
SHORES FLT MIAMIi
33138-2322
• �.� ,.
Property Information: �.
Primary Zone
1000 SINGLE FAMILY "W 101ST ST
RESIDENCE
CLUC: 0001 RESIDENTIAL- +
SINGLE FAMILY
Beds/Baths: 3/2
Floors: 1
Livin Units: 1
Ad'Sq Footage: 2,043 Aerial Photography-2009 0 112 ft
Lot Size. 8,475 SO FT
Year Built 1949
MIAMI SHORES SEC 1
MD PB 10-70 LOT 17& My Home I Property Information I Property Taxes
Legal1/2 OF LOT 18 BLK 12 1 My Neighborhood I Property Appraiser
Description LOT SIZE 75 000 X 113
COC 2453-4695 06
2004 1 OR 22453-4695
.060400
Assessment Information: ` -�
Year: 2010 2009 If you experience technical difficulties with the Property Information application,
Land Value: $76,109 $85,186 or wish to send us your comments,questions or suggestions
Building Value: $155,589 $166,315 please email us at Webmaster.
Market Value: $231,698 $251,501
Assessed Value: $231,698 $251,501
Exemption Information: Web Site
C 2002 Miami-Dade County
Year: 2010 2009 All rights reseried
Homestead $25,000 $25,000
'nil iium steau_ YES YES
Taxable Value Information:
Year: 2010 1 2009
Applied Applied
http://gisims2.miamidade.gov/myhome/propmap.asp 6/15001 1
I _
cin nein, i 50.O�:i:!! 1
r-
I ?U
SEC.C.D01
1.5yo
d — $50,000/
City: $181,698 $201,501
School Board: $25,000/ $25,000/
$206,698 $226,501
Sale Information:
ale Date: 6/2004
ale Amount: $365,000
ale O/R: 2453-4695
Sales
Qualification Sales which are qualified
Description:
View Additional Sales
Additional Information:
Click here to._see_more info.._rm_aton for this
ro ert
Community Development District
Community Redevelopment Area
Empowerment Zone
Enterprise Zone
oning Land Use
Urban Development Boundary
oning
Non-Ad Valorem Assessments
Environmental Considerations
littp://gisims2.tniainidade.gov/myiioine/propinap.asp 6/15/2011
DOCUMENT APPROVED COPY CustNo-169812734 JobNo-01
RESIDENTIAL SERVICES CONTRACT
up5104UEll
CONTRACT DATE / TOWN NO: CUSTOMER NO: JOB NO: LEAD SOURCE: C�om�,)s�
SeCtI01-1to
ControlPan ►'
Model:�
AREA �� e
Package: Comments
F,�Lb Includes: mo 60%-
Foyer
SFoyer
Living Room p
Family Room -Office - - -- --
Dining Room -- —.
Kitchen
A....Nle—�-vd/�
Laundry Room
HelWay
Master Bedroom -- - - - - -
Master Bath
AAA,Bedroom 2 - -- - -- -._ M b--haa ..
Bedroom 3
Bedroom 4 - •- -
- - _
GBed
room 5 . .. . ...
Bath 2Lo
Bath 3 __ - •.. A�(�� .
Attic
Basement
Garage
Totals '
E=Existing Equipment
b P' 9. J 1 Ige-
2 of 6
02011 ADT Security Services,Inc(01/11)
DOCUMENT APPROVED COPY CustNo-169812734 JobNo-01
RESIDENTIAL SERVICES CONMACT
5104UEl l
CONTiACT DATE: 1!! L TOwri NO: CUSTOMER NO: JOB NO: LEAD SOURCE:
Section
ADT Security Services,Inc.(ADT) Customer NameA�L L ( 1 b
("We"or'Us'or'Our")Office Address ('You'or'Your') 55
Address 53 NC
t g s ,� cityM«�,�► S Affinity Name&No.
M� � '33030�� State/Trp Tax Exempt No.
� v-11- s A , Protected Pn:mises'Telephone Fax Expire.Date
T1-8;0�'ADT-ASAPI
1'0�v ❑Traditional Phone ❑Other(Qualified) ❑Other(Non-Qualified)Tel: C
1-10-238-2727 Alternate Te'ephone 1 �v- a 9 q 0 99'-f (Circle one)Ho /Cell! ork w/ext.
IF FAMILIARIZATION PE Alternate Te.ephone 2 (Circle one)Home/Cell/work wl ext.
REJECTED INITIAL HERE EMAIL rw1 (P P,ritp04 CTO
Communications Authorization:You hereby authorize ADT to furnish information and/or updates regarding your security system and new ADT and/or
third products and services available to ADT customer;to the contact information provided by you.You may unsubseibe or opt-out by emailing
Confirmation of Appoir►imerpts:You hereby expressly authorize ADT to call you using an automated calling device to deliver a prerecorded message to
a re
m Ownershi : ❑Customer-Owned ADT-CMmed
Section 2. • be. P,,rovided
to Gat Monthly
lner Service dbring Center rgI ftmly �� Cwftucdon Pemdt Fee 1 f 1 C
Notifiratlap Service for Bwglay,planted Fire,and Poke ftwgmq l G Other
❑Standard Monthly Service,HreJSmoke Demon Installation Price
Service i CustomMordioring Center Signalaril
Taxable Amount
❑Carbon Monoxide ❑Flood ❑Low T _! Non-Taxable Amount
❑ I Alert r Connection Fee
Sal watch et sales Tax on inswwft-
13sxmiww Total bxstalhdon Charp- L?
Limited WamqMwft Service Nan n C(— Rgosk Rec W
Gupon Installation'
Monthly Recurring Municipal Fee"led to dwW based on local lain
❑
to and for muni alarm use *If applicable sales tax not shown,k will be added to your first invoice.
dom w— 16
Total pEft Se ChaMe X G �� T �� " t r •
❑IniliaUAnnual Recurring Municipal Fee-baled separately X—PEstimated
�� �j U NQ —Id
❑ " to drange based on local laww) Estimated Start pate `✓ :1-+�-t P"
Gistomer to obtain and forpinitiallanmral municipal alarm use
a�m use permit registration rtYour fWlwe to obtain�wn6er oW ADT It I your m pal i
tarsi resuh in no muni Bret
ora Completion Date
YOU ACKNOWLEDGE AND ADMIT THAT.(1)WE HAVE EXPLAINED TO YOU THE FULL RANGE OF EQUIPMENT AND SERVICES AVAILABLE TO YOU;(2)
ADDITIONAL EQUIPMENT AND SERVICES OVER THAT DESCRIBED HEREIN ARE AVAILABLE AND MAY BE OBTAINED FROM LIS AT AN ADDITIONAL COST
TO YOU,(3)YOU HAVE CHOSEN AND HAVE CONTRACTED FOR ONLY THE EQUIPMENT AND THE SERVICES DESCRIBED IN THIS CONTRACT;(4)THE INITIAL
TERM OF THIS CONTRACT iS FOR THREE(3)YEARS;AND(S)YOU SHOULD MANUALLY TEST YOUR SYSTEM MONTHLY WITH ADT AS WELL AS UPON
ANY CHANGE TO THE TELEPHONE SERVICE iN YOUR PREMISES TO CONFIRM PROPER TELEPHONE UNE SEIZURE AND THAT SIGNAL TRANSMISSION IS
FUNCTIONING PROPERLY BY CALLING ADT AT 1400-ADT-ASAP(AND FOLLOW THE PROMPTS).WE ARE NOT A SECURITY CONSULTANT.
YOU ACKNOWLEDGE AND ADMIT THAT BEFORE SIGNING you HAVE READ THE FRONT AND BACK OF THIS PAGE IN ADDITION TO THE ATTACHED PAGES
WHICH CONVM IMPORTANT TWO AND CONDITIONS FOR THIS CONTRACT:YOU STATE THAT YOU UNDER 'AND ALLTHE TERMS AND CONDITIONS OF
THIS CONTRACTT,INCLUDING.BUT NOT LIMITED TI,PARAGRAPHS S,6.7 8,9,10 AND 22.YOU ARE AWARE OF THE FOLLOWING:NO ALARM SYSTEM CAN
GUARANTEE PREVENTION OF LOSS,HUMAN ERROR iS ALWAYS POSSIBLE;WE� NOT OT RECEIVE ALARM SIGNALS IF THE TELEPHONE LINE OR OTHER ALARM
THIS CONTRACT REQUIRES FINAL APPROVAL OF AN ADT AU"HORiZED MANAGER BEFORE ANY MAY BE PROVIDED.IF APPROVALS
DENIED.THIS CONTRACT WILL BE TERMINATED AND O VLY OBUGXnON TO YOU WILL BE TO NOTIFY YOU OF SUCH TERMMIATION AND ROiJND ANY
AMOUNTS PAID IN ADVANCE.
T Re IDO OVl DATE
s-49-f
Rep.License No.( Required): O Is re Required
NOTICE OF CANCELLATION
YOU, THE CUSTOMER, MAY CANCEL THIS TRANSACTION AT ANY TiME PRIOR TO MIDNIGHT OF THE THIRD
BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN
EXPLANATION OF THIS RIGHT.
1 of 6 Central Storage Copy 02011 ADT Security Services,Inc.(01/11)