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18C-073 (6) 777 BRIDGE RD BP-2020-0129 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 18C-073 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:window replaced BUILDING PERMIT Permit# BP-2020-0129 Proiect# JS-2020-000207 Est.Cost: $4900.00 Fee:$40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: LOWES HOME CENTERS INC 049918 Lot Size(sq.ft.): 23391.72 Owner: LUCEY MARGARET L&KELLY ANSALDO Zoning: URB000)/ Applicant. LOWES HOME CENTERS INC AT: 777 BRIDGE RD Applicant Address: Phone: Insitrance: 282 RUSSELL ST (413) 588-0270 Liability HADLEYMA01035 ISSUED ON:8/1/2019 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL 4 REPLACEMENT WINDOWS POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Deaartment Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeTvne: Date Paid: Amount: Building 8/1/2019 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner e r6uilf Department use only �r City of Northa ptan Status of Permit: Building Depa men EC E I V �ut/Dr eway Permit r ,sr F 212 Main Street septi Availability Room 10 Watei Well kvailability Northampton, MA 01C160JUL 3 1 20 Io E ots of Structural Plans phone 413-587-1240 F x 413-587-1272 Plot/S to Pla is peri APPLICATION TO CONSTRUCT,ALTER, N ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 42P-a�O—1,91 1.1 Property Address. This section to be complette�d by office —]- 7-7 �jr d9e- 17 Map (9� Lot 0-"7 15 Unit N[o RT u A lh P',ti/' V Zone Overlay District �O Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: �„ WL'�l �-7-7 M(OG-c R r� Name( rint) Current Mailing Addres 1 Telephone Signature 2.2 Authorized Agent: CVaLt /A(nj �DDO L�c✓�S �L�n �oa��5vl��� a �. Name(Print) Current Mailing Address: `fly- Z-7Z- 7g ') 1 Signature Telephone SECTION 3 -ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building D (a)Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total = 0 +2 + 3 +4+5) ou Check Number 3Z 7-Ory This Section For Official Use Only Building Permit Numb r: Date Issued: Signature: �" " 2O)9 Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage % Open Space Footage % (Lotarea minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DON'T KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DON'T KNOW 0 YES 0 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO Q DON'T KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained Q Date Issued: C. Do any signs exist on the property? YES Q NO O IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO Q IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading, excavation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO O IF YES, then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [0 Siding [p] Other[0] Brief Description of Proposed c� � I Work: I cyja l U-A Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a. If New house and or addition to existing housing, complete the following: a. Use of building : One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No . I. Septic Tank City Sewer Private well City water Supply SECTION 7a -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date I, L--�� 4V&-,e C e 5 as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print Name o� Signature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License HGOer: M (�k J" �d( N C ! G� l License Number 6r - E A- �.�►�►P�.,�, Mel i Z_ 29_ 7-d Address Expiration Date C(( i- X85-7�t 6 t Sig re Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ CVA.,f5 how- ( I(S 6$� Company Name Registration Number (C) )U CawP� Gy 9 WW resu l e� (v I-7 — c 1 Address L( Expiration Date Telephone ` _7- 72-y�'. SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152,§25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buil ing permit. Signed Affidavit Attached Yes....... D No...... ❑ City of Northampton ,�t;Tt7it� �5 rl �S Massachusetts DEPARTMENT OF BUILDING INSPECTIONS y, �.r r 212 Main Street • Municipal Building -- Northampton, MA 01060 AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes. Prior to performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC"). M.G.L. Chapter 142A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building'be done by registered contractors. Note:If the homeowner has contracted with a corporation or LLC,that entity must be registered Type of Work: Est. Cost: Address of Work: Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law(explain): _Job under$1,000.00 _Owner obtaining own permit(explain): Building not owner-occupied Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply for a building permit as the agent of the owner: Date Contractor Name HIC Registration No. OR: Notwithstanding the above notice, I hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature City of Northampton r Massachusetts DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 Massachusetts Residential Building Code Section 110.R5.1.2 Homeowner: Person (s) who own a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Section 110.R5.1.3.1 Any homeowner performing work for which a building permit is required shall be exempt from the licensing provisions of 780 CMR 110.R5, provided that if a homeowner engages a person(s) for hire to do such work, then such homeowner shall act as supervisor. Such homeowner shall submit to the Building Official, on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s) you hire to perform work for you under this permit. City of Northampton Massachusetts . E DEPARTMENT OF BUILDING INSPECTIONS ". , 212 Main Street *Municipal Building ry Northampton, MA 01060 Debris Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. The debris from construction work being performed at: -7--? (�A i DC-6- /�­() (Please print house number and street name) Is to be disposed of at: VAS - y -e py-,+W,our-' RD 7W o ' N�� .P ti, /,' aloe (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) Sig ure of Permit Applica wner Date If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. The Commonwealth of Massachusetts r Department of Industrial Accidents I Congress Street,Suite 100 Boston, MA 02114-2017 www mass.gov/dia NVorkers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. kl)plicant Information Please Print Le��ihh Name (Business/Organization/Individual): L-OL-E 7 �(0MC CEN ra 0- S Address: NC900 CO wg� R)L.v f? City/State/Zip:(/Vloa(^V: lel M<.- Phone #: «` Z7Z-q-7 Are you an employer?Check the appropriate box: Type of project(required): I.[3 1 am a employer with employees(full and/or part-time).* 7. ❑New Construction 2.❑1 am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.❑I am a homeowner doing all work myself[No workers'comp.insurance required.]' 10E] Building addition 4.❑1 am a homeowner and will be hiring contractors to conduct all work on my property. 1 will ensure that all contractors either have workers'compensation insurance or are sole I LE]❑ Electrical repairs or additions proprietors with no employees. 12.[]Plumbing repairs or additions > am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.: 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,`1(4),and we have no employees.[No workers'comp.insurance required.] Any applicant that checks box#I must also till out the section below showing their workers'compensation policy information. t liomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the polio'and joh cite information. Insurance Company Name: N �M7I(- 5e(1�vt P(7 5 d 1 -�_N r r Policy#or Self-ins.Lic.#: w 2� (� Expiration Date: Job Site Address: '771 `A(DG,6 "`tom City/State/Zip:✓b r4j-,.,P IL,1, D� Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u er the pains and penalties of perjury that the information provided above is true and correct. Sip-nature: �—, Date: Phone#: u(') —Z7 Z -261, -)1 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. ( its/"I own Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other ( ontact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 02-23-15 www.mass.gov/dia i F ONTRACTfr I(( MASSACHUSETTS SERVICES SOLUTIONS INSTALLED SALES CONTRACT ",bYEE '�}i r+,�.. :.=>FiLSENf �;, NUrdE#.if CUS1041ER r%r. STREET AUURESS STREET ADDRt:5S l E _..... ..........._ ZIP C;PTY STATE Ztr l is .�'H tr-iE TELEPHONE DATE .__�� LOWS S HCHdE CENTER'a.LtC'S MA HtC NO. tAHfiAB case+ tlANt< L t_rE1NC ,r,_s:%ca.ly a quote for the merthax&se and sw mcos printed Wow Ths becomes an agreement upon payment- Utx>n payment.ttpe enter agr�rrx�nt,'rrmJeuSirxt the=,pr,,;,ifw^�Ity aomp#att;¢f pages aI Vs+s i ehxumead.€he Terns and Conditions mcludetd with Iter;document and any other acidanda and attachments hereto.shalt be raferred to heram as thls'Contrad' z PLEASE?.READ ALL TERMS AND CONDITIONS ON THE REVERSE SIDE OF THIS PAGE AND FOLLOWING PAGES BEFORE SIGNING 4 S i.,.i.l 6N':;PFEr ATY'RESS (;try STATE iiP I—- f F { ) i NOTICE TO CUSTOMER–PRICE CALCULATIONS: In order to properly perform the installation of certain Goods,the Contract Price may include more Goods than actually will be installed based on the measured square footage of the Project Area.As a result, the parties agree that the lump-sum Price mated in this Contract is calculated upon bath the value of estimated Goods required to fulfill the Contract(including waste),which rnay exceed the actual sktuare foDtaga of the Project Area,and the labor which may be estimated based on the amount of Goods required to fulfill the Contract(including waste>. s Ry signing this Contract below,Customer acknowledges receipt of this notice and agrees and understands that the Price includes these costs which may rjot be refunded once the Installation Services are performed. i Are permits required for this installation?: ( '] Yes [ ] Na Contract Tota{ L......... ------- _L-*applicable tax included NOTICE TO CUSTOMER: Federal law requires Lowe's to provide you with the pamplet Renovate Right. By signing this Contract, Customer acknowledges having received a copy of this pamphlet before work began informing Customer of the potential risk of the lead hazard exposure tram renovation activity to be performed in Customer's dwelling unit. NOTE: if rotted wood is discovered during installation additional charges will apply.You will be givers a quote and a change order roust be completed and signed by the customer for any additional charges. _T Customer must initial. Aw� .t rk�x material;sat sl�ecit .r.Is not ate.hr(jed in this contract.Any changes or additions will be.at an additional charge for the material and labor _.... -— .. ...._.. �_ _- ----- _.............. f HOTO RELEASE. Customer grants to Lowe's and Lowe's employees and independent contractors ttte right to take photographs of the Premises where E Itstallation Services will be performed and all work performed at the Premises related to this Contract, and irrevocably grants to Lowe's all right, title,and ifitetest in and to the photographs for use in ali markets and media,worldwide.in perpetuity.Customer authorizes Lowe's to copyright, use and publish the photographs in print andlor electronically.and agrees that Lowe's may use such photographs for any lawful purpose,inclUding,but not limited to,marketing, advertising,rtising publicity, Illustration training and Web content.By initialing here Customer agrees to the foregoing._' [Cu tomer to Initial to the left) j Work is to commence upon reasonable availability of Contractor and/or any special order or customer made Good(s)which is anticipated to be ------- ..___._.[fill in date). Estimated completion date is [fill in date). $aid estimated substantial completion date is not of the essence. A statement of any contingencies that would materially change said estimated,'substantial dornpletion date is as follows. __ __.__..___....................____ _._ .... __-... ........ (if applicable,insert a statement of such contingencies). IF THE CONTRACT TOTAL. IS$1.0010.00 OR LESS Customer must pay in full. COMPLETE THIS SECTION ONLY_WHEN THE.CONTRACT TOTAL EXCEEDS$1.000 00 ({1)L3'postt S e to be paid upon signing contract.Any deposit collected at the time this Contract is signed will not exceed one-third (V3)of the contract price and (`)P ayinrrt 3f $, ...... __ ._—._ to be collected upon or after the corinlencer lent of work.IANe authorize Lowe's to do one of the following(check appropriate box!7,0o"'t ` j( ) Charge mytour credit card for the amount of the payment indicated above upon or after the commencement of work. ! or I ( 1)Deposit my/our cheek for the amount of the payment indicated above upon or after the commencement of work:and i L i'l?F'inal payment of$100.00 to be Maid upon completion of the installation and both parties'satisfaction. t t�DTI E REGARDING ARBITRATION AGREEMENT FOR CLAIM . VER£0 8Y M.G.L.c.142A i L§3.°JE'S AND 4)'o^vNE R HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT LOWE'S HAS A DISPUTE CONCERNING THIS CONTRACT. THAT 0WE'S MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY OF THE EXECUTIVE 'OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE OWNER SHALL BE REQUIRED TO SUBMIT TO SUCH ARBITRATION AS 'PROVIDED IN M,G.L c 1 i1A.THE SIGNATURES OF THE�-ART.(.E S� APPLY ONLY TO THE AGREEMENT OF T_HE PA_RTW TOAs TkRNATIVE DISPU I , i R SOLUTION INITIATES BY LQ PURSUANT TO M G L c 142Qc THE Q�ttJ.E12.MAYBE PERMITTEt)TQ INITIATE ALTERNATIVE ED SPLIT RESO TIt�N EVEN WHERE THIS SECTION IS.NS2T.$EPARAT�LY_SIGt_�Et3,,,BY THEPARTIES. If customer has a complaint which cannot be resolved Informally, the:, hoe l I r,r _.., l C nntractnr I aw rM G I c 142Ad may nrnvide Costumer with the rinht Ica request arbitration throuall a private arbitration orporam aooroved by the Director i } _.__ i i i __.�.,- _....� _ -�--, i a ._. ____.� ..___..._._..�.. _. _r i # MASSACHUSETTS SERVICES SOLUTIONS INSTALLEC} SAES C©NTRACT � r .._ _� ..._�.. _ _ _._____..� [ t i s;'.- 1_ ..�. tEPRE SEh�Ca.T!4L � NUFASE^E i CUSTCtfJiER _ 4 r713F .t� STf2F E-i AC7i Rf. 5 STrtF""ApC'Ftc�S .— __.— _s t rTY STALE 21P CIT c >,T Lfr' .. ..e..........w..,� ...,..�.n. _...�.,�..,�.,...�. � .._.,,.. �: ,� ..... Fr�EF�Nf3:"fE i E t Pti'�NE a ,- , s' y � �i C)ATG LCi L h7t)R£ C,Cl3 i Ei2S,LLC;S hiA HIC NO,; a-0f388ft t ____ ____.__ �•.._.. :;hail tt { This is rxaty a quode?car Fhf;marchsradise ar?d services printeC tse!ow. Ttais be?momas an agraanu9nt ur�'are paynuana. tlEc;ri payment,the antirn agrmermanL�nrkufinry rtra s;xa;�„�aliy cc*mrriet:>d ptr;;u,nt tbrs i Mxaia»�nt�then Terms and C,aSndeteons inr�;trdt!d wefts this rlocumen7 and any othrzr addfFnda and ararx,rrsenis nr:ralo,shall ba raterrexa to heraln as this"Ctmtrati' L%LE.ASE READ A3_l TER°:".S ANf7 f:f)Nn(TtC?NS ON TME REVERSE S3DE aF TtaiS PAGE ANp FOLLOWING PAGES BEFGRE SIGNING. t .,��_m��...m.-.......--.--.._ ........�....._..._ .......�. ti.:Y�!.Ilitlflyd STREET Af)nRE`=[= t'�ITY 57.i+TE '!P - .... ... , ." a d - - 1 , }—i- — --��. _._.,� -._ .� �� . AHOTC)RELEkSE_Customer grants tra Lpwe`s:.and Lpwe's emplpyees anti independenk tpntraCiprs the right to take'phptpgraphs pf the Premises when, i lhsialtatipn Services will be performed and all wprk performed at tree Premises related tp ibis Conirack,and irrevpt,ably grants tp Lprre's all right: title orad iaterist ir+and in the photpgraphs for use in all markets and media,wprldwide,in perpetuity.Customer authorizes Lowes tp copyright,use and publish the '> ptaGtsagraptas In prirat andlpr electrpnicatiy,and agrees that Lowe`s may use such photographs for any lawful purppsc.including,but not timrted tp,markr;tiny, j �idvertising, tnrblicaty:illusiratipn.training enc#�'Veb content.By iniflaiing here.Customer agrees tp the foregping. _..... ......._(Customer tp initietl to the lift(. j__: __.��..�,�._..w.....__._,.,_...._.�..._m,..._�..... __._ .. ... Contract Total Rre permits required fc�r this instaNBti�f77: ( ,�)Yes ( ] �� *applicable tax included �� �� r { _,. __...w.._ _� � ._...__..._.. J t40TtCE TO Ct15TOMER: Federal taw requires Lowe's to provide you with the pamplet Renovate Right. t3y signing this Contract. Customer acknowledges having received a copy of this pamphlet before work began infprming Customer of the potential risk of the lead hazard exposure from renovatirn activtty to be periprtned in Customer's dwelling unit. NOTE: If rotted wand is discovered during installation additional charges will apply. You will be given a quote and a change order must be catnpleted and signed by the customer for any additional charges ' w.....___... Customer must initial. r'�s;��„art, ., r.�ttari,�l tt,, .>krt c..,.e_;i;�rti)t trac.le�<;�d ir7 ibrs rr�rztr.0:a. Arty E:hen�ac..;or adt3iti��r<s wAl ae+iaf:an aCteiittc}n;ai a:harrars fC�;the material and lakzar i _ •.--------wAiVER OF LIEN and ONE YEAR WARRANTY{TO BE SIGNER t�Y INSTAI.I.ER} i 'he„_� .r3..�-t,Ir+s!al!er8nd.peraett?rrt Contractor,�Tar<Ing Veen employed by the Customer who signed the Certificate of Garrpteron below do beret}y certify that the work far tnrs�ra,act +� .e^r t+as bee+^rampieied in a workmanlike manner and to the Customers Satisfiaction. Ir.consideration of the recetpt ofi one dollar and ether goad a?td•ratua6le cans!deration,a;Td �int t'c a;��rr-�tt�ry�y applirahla Eaw,t hEr�bv waicre and r�rnqui5h ail#l0ns and a91 rrgh[s and claims afi liens which 1,tiTe under5lgned,now!nave er rra3y herea`ier have for Inbar cr rY+at?rialy irx s �d<grad#,:ether rattily the t al w•ark performed and materials furnished,if stay,by any athti}r party ar faartips apart thn order cs`the un€te€signed,have bc�n E,,Iky;gala`ar.Flmh�:,!r e 3Lr„+K,:,�,aar..t,io cause the prrxr,pt release of any mechan;c s!!en[s}which may tie filed«igainst iha Custrmer s premises ray any subeaniractor.taperer.mechanic or material su;:prier +r t= t;�t to fee such a lien through a'Qrk related to the Customer s Gantract with Lowe"s.in addition to any warranties provided by law or specafaed elsewhere.!nciudtng the 3s ot�aF"s 1�C�tr<T�t..f�t.awes,the uraders+gned,further warrants that all work Famished for this project shall be free from detects either in material or workrTaanshtp.!`any de#acts in rr dter!ai er .t:•<!':tanstai a,rani!bE distxavered in tie waric furnished ar material used during fire course of the work or within arae year from the bate of the Genificate of%amptetian,the urde-signrd agrees i to r�,#a;ve c t±)rrEct such defective warts or material,free from all expense to Lowe's and the Customer ua a manner satsfa�r'n7+to the Gustcmer. I I(�rirr±r re„e,r»nt teat l have.g+ven Customer the aptSon of retaining soma ar al!of the surplus materials or having some nr ail of sur.,h surt)4rs materals rerraved front the Cutin liar's I +�:=rr>s:as i!f!a;T,i.,au3n tta t're per#nrmance al the w=ork required far this project,I,the undersigned InstaCterflndependent Gontractar,da hereby certify that t have campGed witta ail raquirL!f<en;s u`'he !LE1'?Renta .'�Tn,Re!)air.and Painting t"�nxfram Rule("If�tRPP Rule";.4G C.f=.R,sec.7�5.$Q et seq.,ar any applicable state?awe or program regulating lead-based pa!rai s,jte work.pr:.sctit;es i:aY ,t as cc�7,paance wltta nit mtarmatian did r ballon,notice requirements and work.practice standards in perfo[ming the wank required far tt=is prefect.1 CaRi`<y fhat I have prc�v!�ed,rata t.. me:watt,aG<toc:ur,:entation required to ue supplied under the IRRPP Rule or state program.shall retain al!recprds required by law,and kava attached la this daeum�nt c)r;,as t � cll ',.�rte:Ords r�,qu+red to be retained by the IRRPP Rule or applicable state program. Srgnr>•d orad dcrliveraci tfT!s .day of_..._... _.__._._..._..._� _.__.._.._ ..._._._._._...,_... r I �„�______ t5eatl _____.___.___.�_��..._._..._...................._�__.� ! "fit:)!It;r Print Name I CERTIFICATE OF COMPLETION t ! fh?Custrnner,certify that the Installerrslltxlependent Contractors or their sub-cbntractars,have famished all Goods artdtor services,that installation,.repairs orad aiteraians or improvements ! ��, a insta}latien services'}have br3en asmp�ted es set fettle in mytour ixantract with Los4�s,and treat I have taeen offered the apportunshp to request treat Lovra's allow rite io retain same or al's al � a y unused.rBceipted surplus materials rather tftan have sixth sur�us materials remain the property of Iowa's. i TERMS AND CONDITIONS 1."LOWE'S"DEFINED.Within this Contract(as defined on the front page of the Contract),the term"Lowe's-shali refer to Lowe's Home Centers. LLC,a Nofth Carnfina limited liability company, 21GENER%L DESCRIPTION.By executing this Contract,Customer and Lowe's agree that 1)Lowe's shall provide Customer the goods and/or materials (the"Goods"),2)Lowe's shall procure on Customer's behalf,the services to install the Goods(the"Installation Services')in or on the premises identified on the face of this Contract(the'Premises")and 3)Customer shall pay Lowe's the lump-sum Contract Total stated on the face of this Contract(the ,Price")af id according to the provisions of the'Contract Documents'.The Installation Services shall be performed in the specific rooms or areas of the, Premises identified on the face of this Contract(*'Project Area").The"Contract Documents"shall consist of(1)the face of this Contract,(2)these Terms and Conditions.(3)the applicable portions(s)of Lowe's receipt and(4)any attached sketches,materials lists,floor plans,and/or specification sheets and other addenda or attachments hereto.The Contract Documents do not include any correspondence,advertisements,estimates or other documents that are not attached. 3. INSTALLATION SERVICES. Customer authorizes Lowe's on Customer's behalf to (a) arrange for the Installation Services to be performed by an independent contractor(the"Installer")(licensed when legally required),(b)issue a work order to the Installer to perform the Installation Services,(c)have the Installer's work inspected.should Lowe's in its discretion choose to do so(it being agreed that Lowe's has no obligation to do so),and(d)pay the Installer after completion of the work and after receipt of a certificate,signed and dated by Customer,that the work has been satisfactorily completed(the"Certificate of C.oniplotion'*).Customer understands that Lowe's will rely upon the Certificate of Completion in paying the Installer for the InstaliatiOn Services.Customer agrees that the Installation Services do not Include architectural/engineering services or structural changes to the Premises or any other services beyond the ordinary and routine installation of the Goods as specifically provided in the Contract.Customer is responsible,at Customer's cost,for providing any necessary architecturallengineering services or structural changes to the Premises or any other services not specifically identified in this Contract. 4. GOODS. Lowe's will arrange for delivery of the Goods to the Premises,Customer agrees that title to goods does not pass to Customer until installed in Customer's home,building,or on Customer's property.Customer agrees Contract is being offered for the total Price(per below).Customer further agrees any surplus materials upon completion of the Installation Services are not the property of customer and,it instructed by Lowe's,such surplus material,;shall be returned to Lowe's by the Installer.Upon request from Customer at the time of job completion,Lowe's,in its discretion,will allow all or Part of unused,recelptea surplus materials to be retained by the Customer. 5. PRICE. The Price covers the Goods, Installation Services,and applicable taxes.The Price assumes sound existing substructures.Superstructure and ociints of attachments. The Price shalt be increased by the cost and reasonable profit to Lowe's of having to provide additional Goods and/or Installation Services is a result of defective substructures,superstructures,or points of attachments or the existence of any other Undisclosed Condition(per below). In the event of an Undisclosed Condition or the foregoing,Customer will execute a change order or a new replacement contract upon Lowe's request, 6.PAYMENT.If the Price is$1,000,00 or less,payment of the Price by Customer to Lowe's is due in full upon execution of this Contract. If the Price is over S1,000.00,Customer agrees to pay Lowe's according to the payment schedule set forth in this Contract. 1 7,LICENSES,PERMITS,SAFETY RULES,BUILDING CODES,ZONING ORDINANCES,AND OTHER LAWS. The Installer shall be solely responsible to Customer for obtaining any and all licenses,registrations and certifications which are legally required to perform the Installation Services.The Installer shall also be solely responsible to Customer for the Installation Services being performed in compliance with all applicable safety rules and all existing 1 uuilding codes.zoning ordinances and other laws.Lowe's shall be responsible to Customer for obtaining building permits which are legally required to perform the Installation Services where Lowe's is legally required to obtain such permits,Where Installer is required to obtain Such permits then Installer oe responsible to Customer for obtaining such permits.Customers who secure their own building permits will be precluded from claiming against certain state guaranty funds relating to home improvements.Neither the Installer nor Lowe's shall be responsible for any pre-existing violations of safety rules.building codes,zoning ordinances or other laws and shall not be required to address or correct same.If prior to the completion of work a change occurs to any applicable safety rule.building code,zoning ordinance or other law which requires additional Goods and/or'Installation Services to perform this Contract,Customer agrees to pay Lowe's the cost and reasonable profit for such additional Goods and Installation Services and to execute a resulting change order or new replacement contract as requested by Lowe's.No additional work will be performed under this Contract due to any change to any i applicable safety rule.building code,zoning ordinance or other law that occurs after the completion of work, 8.CUSTOMER'S WARRANTY AGAINST VIOLATIONS OF EASEMENTS,COVENANTS,AND THIRD PARTY RIGHTS. Customer warrants that 1 performance of Installation Services will not violate any existing real property easements,covenants,homeowner's association rules or rights of third p,)rttcs-holding an interest in the real property being improved. 9. UNDISCLOSED CONDITIONS IN PREMISES. If any defect, weakness or dangerous condition including, but in no way limited to, mold, mildew, rot, asnestos or infestation('Undisclosed Condition')is discovered or identified in the Premises'structure,substructure,superstructure or points of attachment at any time prior to commencement or completion of the Installation Services,Customer must remedy the Undisclosed Condition at Customer's sole cost and exoense and to Lowe's sole satisfaction. If Customer refuses to permit inspection of the Premises as set forth below.Lowe's may terminate or rescind i llnt,,Contract without remedy or recourse by,or further obligation to,Customer,except as expressly provided below, If Customer and Lowe's disagree as to whether an Undisclosed Condition exists. Lowe's may in its sole discretion obtain the services of an inspector to inspect the Premises at Lowe's sole cost and expense,and if Lowe's chooses to do so,such inspector's report shall be final and conclusive as to whether an Undisclosed Condition exists, In the event of any Undisclosed Condition that Customer does not remedy to Lowe's sole satisfaction, or any failure by Customer to perform any other obligation of Customer under this Contract,then at Lowe's option(i)Lowe's may rescind this Contract and return the Price to Customer without further cost or obligation by either Customer or Lowe's if Lowe's notifies Customer of its election to rescind this Contract prior to the earlier of delivery of the Goods and the, Installer beginning performance of the Installation Services, or(4) Lowe's may terminate this Contract without remedy or recourse by.or further obligation to Customer,except as expressly provided below if Lowe's notifies Customer of its election to terminate this Contract after the earlier of delivery I of the Goods and the Installer beginning performance of the Installation Services. In the event that Lowe's terminates this Contract as provided in this Section, then Customer may return the Goods(other than Goods that have been "Custom-made") in their original, unopened condition, to Lowe's for a refund or credit. Any such return must be made within thirty(30)days after Lowe's terminates this Contract. Customer will be charged a 15%restocking fee on any such returns. Goods not in their original, unopened condition,and custom-made goods. may not be returned, "Custom-made"goods include I goods that have been uniquely altered.color-matched,shaped,sized,cut or otherwise designed or filled to accommodate the requirements of a particular space or environment. Examples of custom-made goods include, but are not limited to, cabinets, countertops, floor and wall coverings, and window treatments. If Lowe's terminates this Contract as provided herein,Lowe's shall have no obligation to refund any portion of the Price(except as expressly provided herein) and shall have, no obligation to restore the Premises to their original condition, Notwithstanding the foregoing, and alternative to rescinding or terminating this Contract as described above, upon discovery or identification of any Undisclosed Condition in the Premises. Lowe's may in I!rniteo circumstances and markets, and in Lowe's sole discretion, authorize the commencement or continuation of Installation Services Upon Lowe's ieceipt of Customer's written agreement (to be furnished to Customer by Lowe's) to release and hold harmless Lowe's and Installer from any and all kability arising out of or related to the Undisclosed Condition and Customer's remedy of Undisclosed Condition. 10.CUSTOMER'S RESPONSIBILITIES:Customer agrees to pay Lowe's according to these Terms and Conditions.Customer agrees to facilitate the location of utility lines.Customer is responsible for identifying property lines.Customer agrees to ensure that work area is free of verrnin and pre-existing physical or environmental hazards,and building/zoning code violations.Customer agrees to provide the Installer with access to work areas during working hours and to provide access to sanitary facilities or to pay the rental costs for such facilities.Customer agrees to ensure that any security system at the Premises will not interfere with performance of the Installation Services.Customer agrees to provide power to,as applicable,climate control in,the work areas.Customer agrees not to allow unattended minors at the Promises while the Installer is present.Customer agrees to control and keep pets away from, work areas,Customer agrees to keep posted permits on display at all times.Customer agrees that if Customer or anyone Customer controls interferes with or delays performance of the Installation Services,Customer may be subject to transportation1storage charges or other resulting charges. Customer agrees not to assign or transfer this Contract.Customer agrees that any claim against Lowe's or the Installer under this Contract should be made to Lowe's within thirty(30)calendar days of the date Customer first becomes aware of a problem.(Lowe's will attempt resolution of any clatm(s) within sixty(60)calendar days of receiving Customer's notice.)CUSTOMER ASSUMES THE RISK AND THE FULL LIABILITY OF PHYSICALLY ASSISTING WITH DELIVERY OF THE GOODS OR WITH PERFOMANCE OF THE INSTALLATION SERVICES. 11.MANUFACTURER WARRANTY FOR GOODS, Customer is entitled to any warranty provided by a manufacturer of the Goods sold under this TERMS AND CONDITIONS 1."LOWE'S*DEFINED.Within this Contract(as defined on the front page of the Contract),the term"Lowe's"shall refer to Lowe's Home Centers. LLC,a North Carolina limited liability company. .2-.GENERAL DESCRIPTION.By executing this Contract,Customer and Lowe's agree that 1)Lowe's shall provide Customer the goods and/or materials Rhe'Goods-),2)Lowe's shall procure on Customer's behalf,the services to install the Goods(the"Installation Services")in or on the premises identified on the face of this Contract(the'Premises')and 3)Customer shall pay Lowe's the lump-sum Contract Total stated on the face of this Contract(the "Price")and according to the provisions of the'Contract Documents".The Installation Services shall be performed in the specific rooms or areas of the Premises identified on the face of this Contract('Project Area").The"Contract Documents"shall consist of(1)the face of this Contract,(2)these Terms :and Conditions,(3)the applicable portions(s)of Lowe's receipt and(4)any attached sketches,materials lists,floor plans,and/or specification sheets and ollic,addenda or attachments hereto.The Contract Documents do not include any correspondence,advertisements,estimates or other documents that are,riot attached. 3, INSTALLATION SERVICES. Customer authorizes Lowe's on Customer's behalf to (a) arrange for the Installation Services to be performed by an i independent contractor(the"Installer")(licensed when legally required),(b)issue a work order to the Installer to perform the Installation Services,(c)have the Installer's work inspected,should Lowe's in its discretion choose to do so(it being agreed that Lowe's has no obligation to do so),and(d)pay the Installer after completion of the work and after receipt of a certificate,signed and dated by Customer,that the work has been satisfactorily completed(the"Certificate of Completion").Customer understands that Lowe's will rely upon the,Certificate of Completion in paying the Installer for the Installation Services.CUStUrner agrees that the Installation Services do not include architecturallengineering services or structural changes to the Premises or any other services beyond the ordinary and routine installation of the Goods as specifically provided in the Contract.Customer is responsible,at Customer's cost,for providing any necessary architecturatlengineering services or structural changes to the Premises or any other services not specifically identified in this Contract. 4. GOODS. Lowe's will arrange for delivery of the Goods to the Premises.Customer agrees that title to goods does not pass to Customer until installed it'i Customer's home,bui!ding,or on Customer's property.Customer agrees Contract is being offered for the total Price(per below).Customer further agrees any surplus materials upon completion of the Installation Services are not the property of customer arid,it instructed by Lowe's,such surplus natenia:s shall be returned to Lowe's by the Installer.Upon request from Customer at the time of job completion,Lowe's,in its discretion,will allow all or part of unused,receipted surplus materials to be retained by the Customer. 5. PRICE. The Price covers the Goods, Installation Services,and applicable taxes,The Price assumes sound existing substructures, superstructure and points of attachments. The Price shall be increased by the cost and reasonable profit to Lowe's of having to provide additional Goods and/or Installation Serwres as a result of defective substructures,superstructures.or points of attachments or the existence of any other Undisclosed Condition.(per below) in the event of an Undisclosed Condition or the foregoing,Customer will execute a change order or a new replacement contract upon Lowe's request, 6.PAYMENT.If the Price is 51,000.00 or less,payment of the Price by Customer to Lowe's is due in full upon execution of this Contract.If the Price is over 51.000.00,Customer agrees to pay Lowe's according to the payment schedule set forth in this Contract. 7,LICENSES,PERMITS,SAFETY RULES,BUILDING CODES,ZONING ORDINANCES,AND OTHER LAWS. The Installer shall be solely responsible 1,,)C�-istomer for obtaining any and all licenses,registrations and certifications which are legally required to perform the Installation Services,The Installer shall also be solely responsible to Customer for the Installation Services being performed in compliance with all applicable safety rules and all existing building codes,zoning ordinances and other laws. Lowe's shall be responsible to Customer for obtaining building permits which are legally required to perform the Installation Services where Lowe's is legally required to obtain such permits,Where Installer is required to obtain such permits then Installer will be responsible to Customer for obtaining such permits,Customers who secure their own building permits will be precluded from claiming against certain state guaranty funds relating to home improvements.Neither the Installer nor Lowe's shall be responsible for any pre-existing violations of safety ,n;le s building codes,zoning ordinances or other laws and shall not be required to address or correct same If prior to the completion of work a change tctrs to any applicable safety rule,building code,zoning ordinance or other law which requires additional Goods and/or Installation Services to perform this Contract,Customer agrees to pay Lowe's the cost and reasonable profit for such additional Goods and Installation Services and to execute a resullin'g, chanr )e order or new replacement contract as requested by Lowe's.No additional work will be performed tinder this Contract due to any change to any opplicablo Safety rule,building code,zoning ordinance or other law that occurs after the completion of work. 8,CUSTOMER'S WARRANTY AGAINST VIOLATIONS OF EASEMENTS,COVENANTS,AND THIRD PARTY RIGHTS. Customer warrants that performance of Installation Services will not violate any existing real property easements,covenants,homeowner's association rules or rights of third parties holding an interest in the real property being improved, 9. UNDISCLOSED CONDITIONS IN PREMISES. If any defect,weakness or dangerous condition including, but in no way limited to. mold, mildew, rot. asbestos or infestation("Undisclosed Condition")is discovered or identified in the Premises'structure,substructure,superstructure or points of attachment at any lime prior to commencei-rierit or completion of the Installation Services, Customer must remedy the Undisclosed Condition at Custarner's sole cost and expense and to Lowe's sole satisfaction, If Customer refuses to permit inspection of the Premises as set forth below,Lowe's may terminate or rescind 'his Contract without remedy or recourse by,or further obligation to,Customer,except as expressly provided below. If Customer and Lowe's disagree as to whother an Undisclosed Condition exists, Lowe's may in its sole discretion obtain the services of an inspector to inspect the Premises at Lowe's sole cost and expense.and if Lowe's chooses to do so,such inspector's report shall be final and conclusive as to whether an Undisclosed Condition exists. In the c,,vf?nt of any Undisclosed Condition that Customer does not remedy to Lowe's sole satisfaction. or any failure by Customer to perform any other obligation of Customer tinder this Contract,then at Lowe's option(i)Lowe's may rescind this Contract and return the Price to Customer without further cost or obligation by either Customer or Lowe's if Lowe's notifies Customer of its election to rescind this Contract prior to the earlier of delivery of the Goods and the Installer beginning performance of the Installation Services, or(ir) Lowe's may terminate this Contract without remedy or recourse by,or further obligation to Customer,except as expressly provided below if Lowe's notifies Customer of its election to terminate this Contract after the earlier of delivery of the Goods and the Installer beginning performance of the Installation Services, In the event that Lowe's terminates this Contract as provided in this Section. then Customer may return the Goods (other than Goods that have been 'custom-made")in their original, unopened condition. to Lowe's for a i refund or credit. Any such return must be made within thirty(30)days after Lowe's terminates this Contract. Customer will be charged a 15°',,restocking fee on any such returns. Goods not in their original, unopened condition,and custom-made goods,may not be returned. -Custom-made"goods include goods that have been uniquely altered,color-matched,shaped,sized,cut or otherwise designed or fitted to accommodate the requirements of a particular space or environment. Examples of custom-made goods include, but are not limited to, cabinets, countertops, floor and wall coverings, and window treatments_ If Lowe's terminates this Contract as provided herein, Lowe's shall have no obligation to refund any portion of the Price(except as expressly provided herein) and shall have no obligation to restore the Premises to their original condition. Notwithstanding the foregoing. and alternative to rescinding or terminating this Contract as described above, upon discovery or identification of any Undisclosed Condition in the Premises, Lowe's may in limited circumstances and markets, and in Lowe's sole discretion, authorize the commencement or continuation of installation. Services upon Lowe's eceipt of Customer's written agreement (to be furnished to Customer by Lowe's) to release and hold harmicss Lowe's and Installer from any and ai; liability arising out of or related to the Undisclosed Condition and Customers remedy of Undisclosed Condition, 10.CUSTOMER'S RESPONSIBILITIES:Customer agrees to pay Lowe's according to these Terms and Conditions.Customer agrees to facilitate the locallon of utility lines Customer is responsible for identifying property lines.Customer agrees to ensure that work area is free of vermin and pre-existing physical or environmental hazards,and buildingfzoning code violations.Customer agrees to provide the Installer with access to work areas during working hours and to provide access to sanitary facilities or to pay the rental costs for such facilities.Customer agrees to ensure that any security system at the, Premises will riot interfere with performance of the Installation Services.Customer agrees to provide power to,as applicable,climate control in,the work i areas. Customer agrees not to allow unattended minors at the Premises while the Installer is present.Customer agrees to control and keep pets away from work areas.Customer agrees to keep posted permits on display at all times.Customer agrees that if Customer or anyone Customer controls interferes with or delays performance of the Installation Services,Customer may be subject to transportation/storage charges or other resulting charges. Customer agrees not to assign or transfer this Contract.Customer agrees that any claim against Lowe's or the Installer under this Contract should be made to Lowe's within thirty(30)calendar days of the date Customer first becomes aware of a problem.(Lowe's will attempt resolution of any clairnis) w;thin r,;xty(60)calendar days of receiving Customer's notice,)CUSTOMER ASSUMES THE RISK AND THE FULL LIABILITY OF PHYSICALLY ASSISTING WITH DELIVERY OF THE GOODS OR WITH PERFOMANCE OF THE INSTALtATION-SERVICES. 11.MANUFACTURER WARRANTY FOR GOODS. Customer is entitled to anv warranty nrovided by a manufacturer of the('nrirls Cnlrt tinripr this NOTICE OF RIGHT TO CANCEL (enter date of transaction) (Date) You may CANCEL this transaction, without any Penalty or Obligation, within THREE BUSINESS DAYS from the above date. If you cancel, any property traded in, any payments made by you under the contract or sale, and any negotiable instrument executed by you will be returned within TEN BUSINESS DAYS following receipt by the seller of your cancellation notice, and any security interest arising out of the transaction will be cancelled. If you cancel, you must make available to the seller at your residence, in substantially as good condition as when received, any goods delivered to you tinder this contract or sale, or you may if you wish, comply with the instructions of the seller regarding the return shipment of the goods at the seller's expense and risk. If you do make the goods available to the seller and the seller does not pick them up within 20 days of the date of your notice of cancellation, you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the seller, or if you agree to return the goods to the seller and fail to do so, then you remain liable for performance of all obligations under the contract. To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice or any other written notice, or send a telegram, to [Name of seller] at— NOT LATER [Address of seller's place of business] THAN MIDNIGHT OF [Enter date 3 business days after transaction date above(or longer as required [Date].........----'by applicable law);include Saturdays but not Sundays and Federal Holidays.; I HEREBY CANCEL THIS TRANSACTION. (Date) (Buyer's Signature) ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND CERTIFICATION On this day of (year), each of you hereby acknowledges receipt of two (2) copies of the foregoing Notice of Right to Cancel; each of you who is a party to the Contract hereby acknowledges receipt of one (1) copy of the fully executed and dated Contract Number (SEAL) (SEAL) (Witness) NOTE: Each Customer who is a party to the Contract must sign above. Item#90993 Rev(12i13) JOS FOLDER .',,OPY ,y CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT 8ErNEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the puihcy(ies)must have ADDITIONAL INSURED provisions or be endorsed.It , SUBROGATION IS WAIVED.subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this ' certificate clues not conter rights to the certificate holder in lieu of such endorsemeni(s). CONTACT «=NGDJC:ER NA1fE. � A, Ri•,k ',aq iV iGC`,r Sc.)u13t, Llc., �F }fE- ._.... Fes. ;«jai=;ttr vc Office fAY NaE.11- CE86) ibdlilz� - 1111 ti'Iztr,:);x)litan Avenae•, Suite 400 E•Mt�l C h.«r int to NC 2W04 US.A c, PC55 2 1NSURERISt AFFORDING COVERAGE NAIL 6 INSURED NSWIERAt,r-tt Ameri£an Assurdme Cumpanp 2€,344 (Orioanie'.. Inc• NsuReRe ti.ltrz,na3�u«lion fire Ins Co oP aittsbur-gh 1944, a+-I its st�sidi,rx It•s --- llltJll IY'«Ne's BoulevarA NSURERC: -. H,rmt,shirc Instlrartce takapany 13841 .•r>:;rxt•n=illi: NC. 2.811` [#,A NSVRER0 NSVR£R L NSURER F: COVERAGES CERTIFICATE NUMBER:570075483114 REVISION NUMBER: THIS 15 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE If;;URED NAMEDABOVE FOR THE POLICY PERIOD NDICATEO Nt3T4NITHSTANDiNG ANY REOUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 4b?ilcm THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS Or SUCf I POLICIES LIMITS,SHOWN MAY HAVE BEEN REDUCED BY PAID CV,IMS Limits shown are as requested PotIc Ex t.TR TYPE Or INSURANCE W ) POLICY NUMDER M .. 'YYYY M '•YYY LIMITS COMMERCIAL GENERAL UABILITY Y y Self-Insured 04/01/2019 04101/2020 EpC>«CX,e;;;Rr1ChC..E .i:M4-M•+d�_ i I !:^•_:R F'H"M«`a tinct:>c:n.+r£+Y.r tt�JJ UFO C JCP IArtw FER,1,ONALS kJ I%:VR,' LIVsrA"P1,1tSPERGENFRA_AGGREC IF © FR • Txv t' O a AUT.FMOGII_E Lrlr#_itU rY OCA 4993101 , 011201904/01f202.0 cnuslyFaslrucLELla;r M0011 AOS IES :L;1P"tr___._, _..._.._ .. R r�ArrY A:;tO CA 4993103 04/01/2019 04101/2020 FnrrtllY ams z •of5:y,7 :CI'EDLiEIt NA N 4a c c:'Av APdt(Jo CA 4993102 04!01,12019 04/011,2020Won VA u UMBRELLAUAB K L"EI277620S 04/01120194,1011707v SIR applies per p«.)liC.y tt'.r s & condi ions EXCESS U48777 T x ;L4., ....€ <•s'Sr S1!},tIGCJ,f)(It7 F.I C;.I., WORKERS COMPENSATION AND wc01 1716174/01,!7671 04/0111020 20 X nFRSTATUTE Tt+. 4 EMPLOYERS'LIABILITY Y;N AOS R :. 'ACHACrAZENT SZ,i10t3,i)t70 t_ER+a£r,+ssERLxc,u�,:;7 °� NIA SIR applies, per policy ter ns. & condi ions r1116"d.ory In NN) :Ar3:R5E ER L WLU`"E. fr2.(iw.ow. rsretnlbVWe ;r Sl.ono,oon 'a ;ace"N WC kw, 3 04/01,,201904'r3)-:'i)t3 tt ( 1 11 t,r d m S I}u.i.(t o AOS Li. 0--­­ I , « « ,.,I i,.v S • -: •IR App1 ies per, pot icy ter as & condi fans EL I)1,<a r s.r ;mI, Lt SCRIPTION OF OPERATIONS I LOCATIONS;VEWLES(ACORD 101.Aada-ul Rsmsrts SChodule,msY 1.sttatha a mon space is MQUaid) 1� "Mm" C."C."Iwral IiA,IIity poIir.Y is self-2«ewlre(I. �'=* 4r CERTIFICATE HOLDER CANCELLATION r SHOULD ANY OF THE A8OV£ OESCRIBEO POLICIES BE CANCELLED BEFORE THE EIPIRATION DATE THFRFOF, NOTICE MtL BE DELIVERED IN ACCORDANCE KITH THE POLICY PROVISIONS i_th v'5 Comj)AlIke,a, Inc, AUTNORIZEDREPRESENIATIVE anef its s )sr cti,«rr+CS 1000 i.£mes Blvd, Mooresville Nc. ?8117-85:'0 USA f 01988-2015 ACORD CORPORATION.All rights reserved. ACORD 26(2016103) The ACORD dame and IOgD are registered marks at ACORD %4 1 � �t<=xrx•r rr r�� l( Office of corsumerAff,irs&Business Regulation; HOME IMPROVEiMEN> �'ONTRACTOR TYPE:individual Registration Expiration 159137 04/03/2020 MARK JODOIN Di 61AJODOIN HOME IMPROVEMENT MARK.S.JODOIN 1,JONES DR EASTHAMPTON,MA 01027 Undersecre"la'y Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Construction St1pirvisor CS-049918 Expires: 12129/202 MARK S.lODOIN 15 JONES DR EASTHAMPTON MA 01027 Commissioner "" DATE(MWDDIYYW) ACcaRV CERTIFICATE OF LIABILITY INSURANCE 48/21/2018 THIS iLRTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THtS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED,the policy()es)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER ONTA T — tw„a; Mahe Praulx _-- iNSURANCE CENTER OF NEW ENGLAND P (413j754-7106„ I r .Na _ mproulx@icne.com 1474$UFFIEQST _._ iNSURER(S)AFFORDING COVERAGE __.._ NAIC# AGAWAMMA 01001 INS INSURED IURERA: AIM MUTUAL INS CO 33758 NER 8: MARK JOOOINSUR INSuRRERC: - JODOIN HOME IMPROVEMGMT INS ._ __o:-_- _._ - -15 JONES DRIVE 1NsuRERE —._- .. EASTHAMPTON MA 01027 INSURERF: COVERAGES CERTIFICATE NUMBER: 305784 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THi5 DED BY THE POLICIES DESCRIBED HEREIN iS SUBJECT TO ALL THE TERMS, CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFOR EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. (NSR AODL SU POLICY EFF POLICY EXP UMTS POLICY NUMBER TYPE OF INSURANCE MR?D M D COMMERCIAL GENERAL LIABILITYEACH OCCURRENCE ' G7=t0 fF1=-NTED "" '�� CLAstvh;•MADE 0 OCCUR PREMISES cc Ea ourrence5 MED EXP(An one person) __... ... N/A PERSONAL&_ADV INJURY.__ S _...._.- -----.-- - —""-- GENERAL AGGREGATE S _. GEN'L AGGREGATE LIMIT APPLIES PER: "� PRODUCTS-COMPlOPA66 S POLICY Cl JOT 0 LOC $ -— OTHER: COIiBIN D SINGLE LIM y ALrrptIIOBILE t lAattltY Ea accident) _......_. BODILY INJURY(Per pewon) $ ANY AUTO BODILY INJURY(Per accident) $ _. ALL UTOS NEDAUTTOSSCHEDULEn NIA --- -- DAMAG NON-OWNED PROPERTYS (Par eaidenn HIRED AUTOS AUTOS $ r UMBRELLAUAS OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS MADE NIA AGGREGATE -...._- $.._._ DED I RETENTION S I WORKERS COMPENSATION X PANTE ER. I AND EMPLOYERS'LIABILITY Y t N E.L.EACH ACCIDENT $ 504,444 A �ANYpROPRISTOWPARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDED? N!A NIA WA AWC4g074296i3201$A 08131/2018 0$�31�2019 E.I.DISEASE-EA EMPLOYEE 1 $44,444 (Mandatory in NH) {itas,describe under EJ_DISEASE-POLICY LIMIT $ X44,444 i DESCRIPTION OF OPERATIONS betrnu NiA DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may he attached it MOM aptce b required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daffy by accessing the proof of Coverage-Coverage Verification Search tool at wwrw.mass.govflwd!workers-compensationlinvestirg ationst. Sete proprietor has not elected coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Lowes Companies Inc any and all subsidiaries Mal Code A3ESS AUTHORaED REPResew nvei Mooresville NC 28117 Daniel M.Crow iey,CPCU,Vice President-Residual Market-WCRIBMA O 1988-201:4 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD JODOHOM-01 MPR4UL _ DATE(MM1DDlYYYY) R CERTIFICATE OF LIA131LITY INSURANCE 06118/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY ANA CONFERS NO RIGNTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW- THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. _ IMPORTANT: N the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the paticy,certain policies may require an endorsement A statement an this Certificate dose not confer ri hts to the Certificate holder in lieu of such endorsements. CONTACT PRODUCER insurance Center of New England,Inc Aco,N►m Eq800)243-8134---.— _{ Lr.�413�731-9539 I OTO Suffield Street qa ...__ — Agawam,MA 01401 _— _— —---- — iNBUR02t91 AFEDROINo.coVr"aE 17370.__.. — _ 14SURERA.Nautilus.insuranceCo__ a_Commerce.tnsurance Cam.QanY_.. _ J34764_ INSURED ' Jodoin Home improvement i INS --- clo Mark S 3odain -..---- 137 Porter Lake Drive Longmeadow,MA 01106-1246 - -- - INSURER F: OVERAGES CERTIFICATE NUMBER: REVISION NUMBER- _ THIS 13 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE IN NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _—. _ _-._—_. _-TADDLSU9Ak --_._._. POLICY NUEkBER — POLICY EEE POUCY EXP — UNITS INSR TYPE OF INSURANCE 1,000,000 A X C MERCIALGENERALLIABILITY ! EACHOCCURIZENGE_ $ .._ ._..-- -' � X ;NN006433 06126/2010 06128/2010 kIEMI F GE Oi EONca�r enter)_ 100'a0� CLAIMS-MADE X OCCUR _. .S ---- _ _ j ti1E9 EXP..(My one penwn) 1,000,000 _PERSONAL 8 ADV INJURY 2,000,000 ..._ —_ .. I GENERAL AGGREGATE r S _ GEN'L AGGREGATE LIMIT APPLIES PER. _ ^.- -, 0 I j PRODUCTS .COMPIOF ALiG_$ ._ 2,000,000 POLICY JECT L. -LOC � � — TH �-- COMBINED SINGLE LIMIT 1,000,00() AUTOMOSILe LIABILITY 4RFJ989 a3I26I2018 i73I261201$ BODILY INJURY�(PrsonZ�3 ANY AUTO _ 1 X — — _ OyyNEp [ SCHEDULED BODILY INJLUR .{Per_accida i S AUTOS ONLY X:AUTOS pAMAGE PROPERTY) H� ���� i I (Per acc�deltit.. E XJ AISRl%ONLY UMBRELLA LIAS s OCCUR i _EACH OCCURRENCE f� —._.._-___.— . EXCESS LIAR I CWMS-MADE; __.._.._.._.. DED ' RETENTIONS ' � j PER i 0TH- s _ VIORKERS COMPENSATION —. i AND EMPLOYERS'UAaiLriY Y!N, ' i E.L EACH ACCIDENT .._.. S —.... .-.. i ANY PROPRIETORIPARTNERIEXECUTNE N!A _ EMPL OFfiCER/MEMBEREXCLUDEO? I ! E_l.,-DISEASE-.EA_ OYEE_S. If yes.describe under E.L DISEASE-POLICY LIMIT,3 DESCRIPTION OF OPERATIONS belflw DESCRlP710R OF OPERATIONS i LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more spaCa is required) Vendor#97828 L.owe's Companies Ind.and any and all subsidiaries are named as additional insured as respects to General Liability and Auto Liability per Mass Business Auto Forms CA0001 and MM9911 an applicable Mass.State Laws as per written contract only. CERTIFiC TE HOLDER CANCELLATION - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL. BE DELIVERED IN Lowe's Companies Inc. ACCORDANCE WITH THE POUCY PROVISIONS. and any and all subsidiaries Mail Code A3ESS AUTKO(MD REPRESENTATIVE 1400 Lowe's Blvd Mooresville,NC 28117 ACORD 25{2016103) 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD