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12-023 (8) 6 COUNTRY WAY BP-2021-1412 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 12-023 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-2021-1412 Project# JS-2021-000527 Est.Cost: $9000.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: LOWES HOME CENTERS INC 049918 Lot size(sq.ft.): 25613.28 Owner: KOWAL WILLIAM J&ARLENE C Zoning: Applicant: LOWES HOME CENTERS INC AT: 6 COUNTRY WAY Applicant Address: Phone: Insurance: 10001,OWES BLVD (413) 272-8931 () WC MOORESVI LLENC28117 ISSUED ON:6/1/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL 9 REPLACEMENT WINDOWS POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. tinilding Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department 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. s Certificate of Occupancy Signature: 01 • y9 . FeeType: Date Paid: Amount: Building 6/1/2021 0:00:00 $40.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner 1/' ;)� c, / The Commonwealth of Mas chusetts r <4 4,,',�,t;� 4. Board of Building Regulations a andards? FOR•G;,': �0 MUNICIPALITY 1: , Massachusetts State Building Cade?T� �� ei USE , Building Permit Application To Construct,Repair,�a{t,'dlte,` Demo!' a ,Revised Mar?011 One-or Two-Family Dwelling 4-7QQ6bi, This Section For Official Use Only Aso% Building ermit Number: 6 P"Al, / 112_ Date A:,....,lied: ev 5 /� ifQ 5 /l 6-/,20Z I Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers i.G co 1 t-j1'2' A uz 3 1.1 a Is this an accepted street?yes no Map Number Parce mber 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard j Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) ' 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP 2.1 O ner'of Record H.�I-ehe LC.<, 161 I Ptor-fLtc€, /1.14 v l 0 G e Name(Print) City,State,ZIP G cvtin,LA, wciti 413-a50-1424 cie I-en-t. )C.(0-v.1 I P tl.cg'A-, No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK (check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work'-: N{r►+o v.e 4- to 41.41 I/ ® '1., 'et(fat"'C . /V o el ,'+,.Likes; ) C In 4t,+5 -° SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 1, V o v 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (I-3VAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fe�s:l Check No.Hi eck Amount:k Amount: 6.Total Project Cost: $ S/ 0 Jb 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) ok-tct MJ N(C J ))Q t , iI License Number Expiration Date Name of CSL Holder 11 List CSL Type(see below) I 7Z D(L No.and Street Type Description �� ���� Unrestricted(Buildings up to 35,000 cu.ft.) e 7}k 4 �� / R Restricted 1&2 Family Dwelling City/Town.State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 4-i-)--)1-*(i7/ -iuc)l4. ipprr'hO. as&Sn•1,t I Insulation Telephone Email address r.r+ D I Demolition 5.2 Registered Home Improvement Contractor(MC) d (t4t-005( / o —17- I (v4-.04 C e h , S H1C Registration Number Expiration Date HIC Company Name or HIC Registrant Name - f 10 t!-N ( "�� OC/�v C�✓ �Y7��7nk✓. ltr��� ( Lbw .�+� No.and Street Email address 4 ,.r1,v.'lle, A/C 1/7 k-I11) -Ftsy3/ City/Town,State,ZIP Telephone SECTION 6: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 building permit. Signed Affidavit Attached? Yes ❑ 11 1- 0 SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S 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. Print Owner's Name(Electronic Signature) Date SECTION 7b: OWNERS OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accu •to to the best of my knowledge and understanding. • ()VIA 1Mtl 5,44 `a Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at www.mass.£ov/oca Information on the Construction Supervisor License can be found at ttwv.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" The Commonwealth of Massachusetts ;'*== Department of Industrial Accidents =a 1 Congress Street,Suite 100 C Boston,MA 02114-2017 ,,sr° www.mass oov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information jJ Please Print Legibly Name(Business/Organization/Individual): V"r'l #5 K0 C I) S Address: I CUU ►S City/State/Zip: v''t Ju r-E.5(1'1 I e Ac•}mil ) Phone#: Are you an employer?Check the appropriate box: Type of project(required): l.❑I am a employer with employees(full and/or part-time)." 7. El New construction 2.0 I am a sole proprietor or partnership and have no employees working forme in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 3.0I am a homeowner doing all work myself.[No workers'comp.insurance required.) 9. ❑Demolition 10❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.E Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5,!I am a general contractor and I have hired the sub-contractors listed on the attached sheet 13.0Roof repairs These sub-contractors have employees and have workers'comp.insurance t 6.0 We are a corporation and its officers have exercisedtheir right of exemption per MGL c. 14.El Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] `Any applicant that checks box#1 must also Ell out the section below showing their workers'compensation policy information. t Homeowners 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.polity number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information.Insurance Company Name: Q f.6j).( L7 P- /1' C Policy#or Self-ins.Lic.#: LLLd 1 G17 K ) I O 5 Expiration Date: `( -L Job Site Address: 6 Cot.r divot. City/State/Zip: (DI.','Ct, M� C>t 6C z 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 certxfy under the pains and penalties of perjury that the information provided above is true and correct .gnature: i Date: s'-XL(—01.( Phone#: �1--�7rt- I� 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.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ewrnl!;,� The City of Northampton � _ `` Building Department Yr. 212 Main Street %/°° rED.10;1`s Northampton, Massachusetts 01060 Phone (413) 587-1240 Fax (413) 587-1272 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVAT ION PROJECTS) In accordance with the provisions of MGL c40, s54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c 111, s150A. The debris will be disposed of in: Lel A5 Location of Facility /1-• ( 6vyi y i)(' 4" / 'S V`1 US . The debris will be transported by: Name of Hauler 1 i4j 60'‘4,Q 6141 if I,ki.") tt.i 4tt-. (7 Signature of Applicant: Date: —d"`I `‘)" 1 • City of Northampton S r Massachusetts i;� � i DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building yJti, �s �•.. w. Northampton, MA 01060 y4.• HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT • I, (insert full legal name), born — (insert month, ►•y,year), herelnj depose and state the following: 1. I am se- -ing a building permit pursuant to the homeowners'exemption to the permit requirements of the Massachu .s State Building Code, codified at 780 CMR 110.RS.1.3.1, in e'onnection with a project or work on a par • land to which I hold legal title. 2. I am not engaged in, a the project or work for which I am seekin the aforementioned homeowners' exemption, does not involve . e field erection of manufactured buil►. gs constructed in accordance with 780 CMR 110.R3. 3. I qualifyy under the State Building Code ••finition bf"homeo er"as defined at 780 CMR 110.R5.1.2: Person(s) who owns a parcel of land on hich he/s - resides or intends to reside, on which there is, or is intended to be, a one-or two- .• 'y :welling, attached or detached structures accessory to such use and/or farm structures. A •: .son who constructs more than one home in a two-year period shall not be considered a ham- • , er. 4. I do not hold a valid Massachusetts constructio supervision •nse and, except to the extent that I qualify for and will abide by the Massachusetts 'tate Building Code quirements for the supervision of the project or work on my parcel, I am not e ;aged in construction sup- • Sion in connection with any project or work involving construction, reconstruction, alteration, rep, • removal or demolition involving any activity regulated by any p ovision of the Massachusetts State But •ing Code. 5. If I engage any other person or perso s for hire in connection with the aforementione• project or work on my parcel,I acknowledge that I am equired to and will act as the supervisor for said project or work. Signed under the pains and penalties of.•-rjury on this day of , 20_. (Signature) ♦ � ACC)R CERTIFICATE OF LIABILITY INSURANCE DATE(MM/ D/YYYY) 03/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 BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed_ IfSUBROGATION 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 CONTACT NAME: Marsh USA Inc. PHONE FAX —� 100 North Tryon Street,Suite 3600 (A/C.No.Ext): IA/C,No) Charlotte,NC 28202 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# CN102776519-Lowes-SI-21-22 INSURER A:National Union Fire Ins Co.of Pittsburgh PA 19445 IN oREDe's Companies,Inc. INSURER B:Interstate Fire&Casualty Co 22829 and subsidiaries INSURER C:AIU Insurance Co 19399 1000 Lowe's Boulevard INSURER o:New Hampshire Insurance Company 23841 Mooresville,NC 28117 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-004976909-08 REVISION NUMBER: 10 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 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. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MMIDD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 CLAIMS-MADE OCCUR Self Insured-See below DAMAGE PREMISESO(Ea occurrence) -$ MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ A AUTOMOBILE LIABILITY CA7030892 (AOS) 04/01/2021 04/01/2022 COMBINED SINGLE LIMIT $ 5,000,000 (Ea accident) A X ANY AUTO CA7030891 (MA) 04/01/2021 04/01/2022 BODILY INJURY(Per person) $ A owNED ONLY SCHEDULED CA7030893 (VA) 04/01/2021 04/01/2022 BODILY INJURY(Per accident) $ AUTOSHIRED NON-OWNED PROPERTY DAMAGE -$ AUTOS ONLY _ AUTOS ONLY (Per accident) B X UMBRELLA LIAB X OCCUR USZ00024220 04/01/2021 04/01/2022 EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTIONS $ C WORKERS COMPENSATION WC016393105(AOS) 04/01/2021 04/01/2022 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER p Y/N WC016393104 (ND,WA WI,WY) 04/01/2021 04/01/2022 2,000,000 ANYPROPRILIOR/PARTNER/LXLCU I IVE E.L.EACH ACCIDENT $ OFFICER/MLMBEREXCLUDED? n N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE,$ 2,000,000 If yes,describe under 2,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Excess Workers'Compensation XWC1647266 (FL) 04/01/2021 04/01/2022 (WC per statute) 3,000,000 A Excess Workers'Compensation XWC1647265 (AOS) 04/01/2021 04/01/2022 (WC per statute) 3,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS(VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Commercial General Liability policy Is Self-Insured,effective 4/12021 to 4/1/2022. CERTIFICATE HOLDER CANCELLATION Lowe's Companies,Inc.and Subsidaries SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1000 Lowe's Blvd. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Mooresville,NC 28117 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN102776519 LOC#: Charlotte ACORO ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Marsh USA Inc. Lowe's Companies,Inc and subsidiaries POLICY NUMBER 1000 Lowe's Boulevard Mooresville,NC 28117 CARRIER NAIL CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance TX Employers XS Indemnity Policy Number EP0000016700 Career:Nath American Specialty Policy Effective Date:01-Apr-2021 Policy Expiration Date:01-Apr-2022 Lints:$8,000,000 Each Occurrence/$35,000,000 Aggregate XS TX Employers XS Indemnity(Excess) Policy Number XCB3095 Carrier:Evanston Insurance Company Policy Effective Date:01-Apr-2021 Policy Expiration Date:01-Apr-2022 Lints:$15,000,000 Each Occurrence/$35,000,000 Aggregate XS Workers'Compensation and Excess Workers'Compensation policies include a self-insured retention of$2,000,000. General Liability:The insured is self insured for$10,000,000 each occurrence for the period of 4/1/2021 to 411/2022. The Automobile Liability policy evidenced above is subject to additional self-insured retentions excess of limits shown for venous penis covered. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Ac a® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYW) 07/27/2020 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 BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 CONTNAME: mane Marie Proulx HUB INTERNATIONAL NEW ENGLAND LLC (tile No.Ext): (413)750 7106 FAX No): E-MAIL P ADDRESS: marie. roulx hubintemational.com 600 LONGWATER DRIVE INSURER(S)AFFORDING COVERAGE NAIC# NORWELL MA 02061 INSURER A: AIM MUTUAL INS CO 33758 INSURED INSURER B: MARK JODOIN INSURER C: JODOIN HOME IMPROVEMENT INSURER D: 15 JONES DRIVE INSURER E: EASTHAMPTON MA 01027 INSURER F COVERAGES CERTIFICATE NUMBER: 557741 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 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP/Y LIMITS LTRINSD WVD POLICY NUMBER (MMIDDIYYYY) IMM/DDYYYI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGE RENTE $ CLAIMS-MADE OCCUR PREMISESO(Ea occur ence) $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS-COMP/OPAGG $ OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) _ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $ _ _ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X STATUTEPER EOTH AND EMPLOYERS'LIABILITY A OFFICER/MEMBER R//MEMBER EXCLUDED? R ECUTIVE E.L.EACH ACCIDENT $ 500,000 N/A N/A N/A AW040070296132020A 08/31/2020 08/31/2021 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it more space is 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 daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/Iwd/workers-compensation/investigations/. Sole 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 Lowes Companies Inc and any and all subsidiaries ACCORDANCE WITH THE POLICY PROVISIONS. Mail Code A3ESS 1000 Lowes Blvd AUTHORIZED REPRESENTATIVE Mooresville NC 28117 -'• Daniel M.Crow)ey,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD • • JODOHOM-01 MPROULX ,d►coRO CERTIFICATE OF LIABILITY INSURANCE DAT/23/2020 D/YYYY) 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 BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or 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 CONTACT NAME: HUB International New England LLC 1070 Suffield Street iA°No,Eat):(800)243-8134 iNC,No):(413)731-9539 Agawam,MA 01001 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Nautilus Insurance Co 17370 INSURED INSURER B Commerce Insurance Company 34754 Jodoin Home Improvement INSURER C: c/o Mark S Jodoin 137 Porter Lake Drive INSURER D: Longmeadow,MA 01 1 0 6-1 246 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 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 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. INSR AWL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY ( M/DD/YYYY) LIMITS A X COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR NN1119917 6/26/2020 6/26/2021 DAMAGE TO RENTED 100,000 X PREMISES(Ea occurrencei $ MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER' GENERAL AGGREGATE $ 2'000'000 POLICY PELT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: COMBINED SINGLE LIMIT 1,000,000 B AUTOMOBILE LIABILITY (Ea accident) ANY AUTO X RPJ989 3/26/2020 3/26/2021 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOSp ONLY X AUTOS yy p BODILY INJURY(Per accident) $ X ADTOS ONLY X AUTOS ONNLY PeaHde DAMAGE ( coi $ $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER AND EMPLOYERS'LIABILITY Y/N STATUTEH- ER OFFICERR/MEMBER EXCLUDED?PROPRIETOR/PARTNER/EXECUTIVE N/A E.L EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS t LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Vendor#97826 Lowe's Companies Inc.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. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Lowe's Companies Inc. THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN p ACCORDANCE WITH THE POLICY PROVISIONS. and any and all subsidiaries Mail Code A3ESS 1000 Lowe's Blvd AUTHORIZED REPRESENTATIVE Mooresville,NC 28117 ^t �„' ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Office of Cor-coner AffMrs&Bs RI HOME IMPROVEMENT,*;,..114Tri ACTOR TYPE:irefiv4.1Lfal gegistfatioll Evairplion 1b9137 04;03r4020 MAHK JODON • 114391,110D0114 'IPF1OVEMENT MARK S .1000114 11:1 JONES DR aSTHAMP1ON. UnciertnoreXy Cornrinonweitri ot Massachusetts Divisor,of Piontssional Licenore Board of Buildfng Rngulatia as and Standards -7,,mstt Uctient Suirrrsor CS-049918 Expires 12/291202 MARK S JODOIN 15 JONES DR . EASTHAMPTON PilA 01027 ' Comrnissioner 1 • 1 8 /4", V . • ice cef Consumer Affairs&Business Reguiation 4!.• HOME IMPROVEMENT CONTRACTOR TYPE. individual -• Registration gxpitation /59137 04/03/2022 MARK. ODO IN D/B/A J•DOIN HOME IMPAO'VEIVIENT MARK S JODOIN 15 JON DR EASTH PION, MA 01027 Undersecretari Office HOME IMPROVEMENTCONTRAC Regulation TYPE:Burnie eat Card st.53L i i n 148688 10117:2021 LOW ES HOME CENTERS,LW GI.1ri1STOPHER MIt31E 100Q LOWES BLVD MO VICE COMPLIANCE NC 28117 Undersecretary — n X htips ��=c.'.my:i;ense r36rtrstTkiaiV,a nx_ � E"..r-.;- 1-' - - Tit Search... P' • 4 <,cnot.Wcik'crc__entral(N,t3 4SearchK4 = ' _ t'<.,:._ File 'atilt Veen Faventes n I Hold me Oecfe YnY6ma10 Hea*o Mn,tftierFO,Motafofleno w.i4lxxmm aM�M'rbwrw MYJ-oa1rs Public Safety 1 1a .,� ;41. CO Mass. Licensee Details_._.... _.... _ __......... IMnwgapbk ddamraane $s' OwNaas ___-- MARK SJOIx31N ?(?weer Name: hoarse Address Information eesmamesd1 &ate. MA Zipcoee. 0102T ouanry Unties Staten Wens..Immnnatim r License No CS-049918 Loense rope Conslruclgn 6u 0000w PrdE5ston: b 2°2Mq LKen5es Dale 01 Last Renewal. 12116r1020 1ss:se Date ActNe 010 Eepe oe Date 1229RC22 license Status Ac1Ne 'stays Dale 1r19/2021 Sec00dan License Type' 0o 1S Business As maws vnan2e R00Sen'. L,Cenaa Renews, Mrezawaidtat Information NO FrertgYNI1Q a1f0¢matgn..:::. ..... No AVaaape P0;t1?!10%lS...................................._........._......_...._.._.._.._.......i ammonite 9 ��' -: ter- e. $i„ + arym •. 1 �t Or LOWE'I .........E MASSACHUSETTS SERVICES SOLUTIONS INSTALLED SALES CONTRACT LOWE'S AUTHORIZED REPRESENTATIVE SALES ID DATE L1STOMER NAME Dan Flaherty 2054066 5/14/202 Arlene Kowal STORE NO. STREET ADDRESS STREET ADDRESS 1916 6 country way 6 Country Way. CITY STATE ZIP CRY STATE Hadley ma 01035 Florence MA 01062 TE'I..EPHONE, TEl.taPHHNE 4133253625 4132501424 EMAIL EMAIL daniel.flaherty@store.lowes.com arlene.kowal@gmail.com LOWE'S CONTRACTOR LICENSE# LOWE'S REPRESENTATIVE LICENSE# CREDIT/DEBIT i I CC t ARD tTITT CARD #L9t ct(home improvementc:,nvacwr},fk3S194 NA (If Applicable This is only a quote for the merchandise and services printed below; Lowe's does not offer services to paint, seal or stain fences. This becomes an agreement upon payment and issuance of a Lowe's receipt, upon pay-ment,the entire agreement, including the specifically completed pages of this document, the Terms and Conditions included with this document and any other addenda and attachments hereto,shall be referred to herein as this"Contract."PLEASE READ THIS ENTIRE DOCUMENT, INCLUDING THE "NOTICES," "TERMS AND CONDITIONS," AND "ADDENDUM" CONTAINED WITHIN THIS CONTRACT ON THE FOLLOWING PAGES BEFORE SIGNING. INS TAI.I.ATION STREET ADDRESS CITY ",I A 1 E /IP 6 country way Florence MA 01062 MERCHANDISE AND INSTALLATION SUMMARY(I.E.ITEM NUMBERS,COLORS,DIMENSIONS,CONSIDERATIONS): Removal of five windows. Installation of five Pella 250 series vinyl replacement windows, double hung, white/white, full screens, 8x8 grids between the glass, 3/4 contoured - white/white. comfort locks - white, dual pane glass, argon filled, Low-E. foam filled frames. new exterior stops. CONTRACT TOTAL $4 912.00 (INCLUDING TAX) Work is to commence upon reasonable availability of Contractor and/or any special order or customer made Good(s) which is anticipated to be 07/13/2021 [fill in date]. Estimated completion date is 08/13/2021 [fill in date]. COVID-19 has affected manufacturers and labor markets, with the production of fence, deck and generator material experiencing significant delays and installation start dates that are at least four(4)months away in most cases. Please also note that weather can delay start dates for these and other exterior categories, particularly in colder climates. Rev.03/02/2021 1 r ` LOWERS SERVICES CONTINUATION OF MATERIALS AND WORK TO BE PERFORMED (I.E. ITEM NUMBERS,COLORS, DIMENSIONS, CONSIDERATIONS): 1 ( ( 1 Rev.03/02/2021 2 NO110E5 LEAD SAFE INFORMATION. Federal and applicable state laws require that You be provided with a lead hazard information pamphlet such las the Renovate Right: Important Lead Hazard Information for Families, Child Care Providers and Schools. By signing this Contract,You acknowledge having received a copy of this information pamphlet before work began informing You of the potential risk of the lead hazard exposure from renovation activity performed in Your dwelling unit or facility. A copy of the pamphlet is available at the following website: www.lowes.corn/EPARRP. For more information see: https://www.epa.gov/lead/lead-renovation-repair-and-painting-program. NOTICE OF ARBITRATION AGREEMENT: This Contract provides that all claims by Customer or Lowe's will be resolved by BINDING ARBITRATION. Customer and Lowe's GIVE UP THE RIGHT TO GO TO COURT to enforce this Contract (EXCEPT for matters that may be taken to SMALL CLAIMS COURT). Lowe's and Customer's rights will be determined by a NEUTRAL ARBITRATOR and NOT a judge or jury. Lowe's and Customer are entitled to a FAIR HEARING. But the arbitration procedures are SIMPLER AND MORE LIMITED THAN RULES APPLICABLE IN COURT. Arbitrator decisions are as enforceable as any court order and are subject to VERY LIMITED REVIEW BY A COURT. FOR MORE DETAILS: Review the section titled ARBITRATION AGREEMENT, WAIVER OF JURY TRIAL AND WAIVER OF CLASS ACTION ADJUDICATION found in the Terms and Conditions of this Contract. NOTICE REGARDING ARBITRATION AGREEMENT FOR CLAIMS COVERED BY M.G.L. c. 142A: LOWE'S AND OWNER HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT LOWE'S HAS A DISPUTE CONCERNING THIS CONTRACT, THAT LOWE'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.142A. THE SIGNATURES OF THE PARTIES BELOW APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE RESOLUTION INITIATED BY LOWES, PURSUANT TO M.G.L. c. 142A. THE OWNER MAY BE PERMITTED TO INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THIS SECTION IS NOT SEPARATELY SIGNED BY THE PARTIES. If customer has a complaint which cannot be resolved informally, the home Improvement Contractor Law (M.G.L. c. 142A) may provide Customer with the right to request arbitration through a private arbitration program approved by the Director of the Office of Consumer Affairs and Business Regulation, as an alternative to court action. The same right is not afforded to Lowe's unless this Notice is signed and dated by Lowe's and Customer. All claims by Customer or Lowe's concerning this Contract which cannot be resolved informally, and which are not covered by M.G.L. c142A or subject to the jurisdiction of a small claims court, shall be resolved by binding arbitration as set forth in the Terms and Conditions. 05/13/2021 By: Date: Lowe's Authorized Representative ilti e edWg 05/14/2021 By: Date: Customer PRICE CALCULATIONS. If this Contract includes Goods and related Installation Services sold by unit of measurement, such as per square foot, the Price may include more Goods than the actual measurements of Your project area. The Price includes the total amount of Goods required by Lowe's to fulfill the Contract (including surplus materials and overages) (together the "Estimated Product") and the Installation Services required based upon this total amount of Goods. For instance, a 120 square foot room may require 140 square feet of carpet to properly match the carpet seams, pattern, or unique room characteristics, and the Price would include Installation Services based upon the 140 square feet of carpet.The total amount of Estimated Product is based upon the total Goods recommended by the Installer, based on the Installer's assessment of unique characteristics of Your project. If any usable Goods are left over, Lowe's may, at its discretion, initiate a Price adjustment. Lowe's will not adjust the Contract Price for the related Installation Services. By signing this Contract,You acknowledge You are aware of Your project area measurements and the amount of Estimated Product, and that the Estimated Product may exceed Your actual project area. If Your project includes the installation of flooring materials, by signing this Contract You further acknowledge having received a completed Flooring Detail Diagram (the "Diagram") prior to execution of this Contract. Upon request, Lowe's can provide You with additional copies of the Diagram, which identifies the square footage of Your project area and the square footage of the Estimated Goods. PHOTO RELEASE. By signing this Contract, You grant to Lowe's, its representatives, and Installer the right to take and use photographs,videos,or other representations of the Premises before and after the Installation Services and all work performed at the Premises related to this Contract(the"Content"). Lowe's irrevocably keeps all rights(including the copyright),title, and interest in the Content for use in all markets and media, worldwide, in perpetuity. Lowe's can use the Content, in any form or medium, internally for any purpose(e.g., customer service, planning, and claims. NOTICE REGARDING PAYMENT SCHEDULE. If the Contract Price is$1,000 or less, payment of the Price by Customer to Lowe's is due in full upon execution of this Contract. If the Contract Price exceeds $1,000, Customer shall use the following payment schedule: (1) Deposit of $ $1,637.00 [enter 1/3 of the contract Price] to be paid upon signing this Contact. Any deposit collected at the time this Contract is signed will not exceed one-third (1/3)of the Contract Price; Rev.03/02/2021 3 (2) Payment of $ $3,275.00 [enter 2/3 of the contract Price minus $100] to be collected upon or after the commencement of work. Customer authorizes Lowe's to charge Customer's credit card, or deposit Customer's check, for the amount of the payment indicated in this section anytime upon or after the commencement of the work; and (3) Final payment of$100 to be paid upon completion of the Installation Services to both parties'satisfaction. NOTICE OF CUSTOMER'S RIGHT TO CANCEL. If this is a "door-to-door sale" as defined by 16 C.F.R. § 429.0(a), or if this Contract is signed by Customer at a place other than the address of the seller as set forth in M.G.L. c. 93 § 48, You, the Customer, may cancel this Contract at any time prior to midnight of the third business day after the date of this transaction. See the notice of cancellation form sent as an attachment to this Contract for an explanation of this right. By executing this Contract, Customer acknowledges receipt of two(2) completed copies of the Notice of Right to Cancel form and certifies Lowe's has informed Customer orally of his or her right to cancel. NOTICE TO CUSTOMER. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Lowe's Home Centers, LLC EXECUTED ON 14 , DAY OF May 2021 LOWE'S AUTHORIZED REPRESENTATIVE SIGNATURE OWNER'S SIGNATURE %C5-0)„,,„,NH-,00N.A Ill* Customer acknowledges receipt of a true copy of this contract which was completely filled in prior to Customer's execution hereof. Rev.03/02/2021 4 CMS A`1 CO1 TIO LoweV Installation Contract defines what You can expect in Your installation experience with Lowe's,what Lowe's expects in return, and how You and Lowe's will resolve any differences. It is a legal agreement. By signing this Contract, clicking "I agree," or by accepting Goods or Installation Services You are agreeing to be bound by this Contract. IF YOU DO NOT AGREE TO ALL OF THE TERMS OF THIS CONTRACT, YOU MUST NOT SIGN THIS CONTRACT, CLICK "I AGREE", OR ACCEPT THE GOODS OR INSTALLATION SERVICES. 1. COMMON DEFINITIONS. Capitalized terms used in this Contract will either have the following stated meanings or will be defined throughout the Contract. a) "Contract" means Lowe's Installation Contract and includes (a)any applicable State Addendum, (b)these Terms and Conditions, (c)any documents expressly referencing and made a part of this Contract, e.g., fully executed Change Orders,or incorporated by reference in the Contract(d)the cover page,the Merchandise and Installation Summary, and Notices, and (e) any sketches, materials lists, floor plans, or specification sheets provided by Lowe's. If there is any inconsistency between these documents, the first document to appear in this definition shall take precedence; i.e., any State Addendum shall take precedence, whether supplementing or modifying, over any conflicting provision of these Terms and Conditions, and so on. The Contract does not include any correspondence, advertisements, quotes,or estimates. The Contract is the entire agreement between You and Lowe's concerning the Goods and Installation Services. The Contract replaces and supersedes all earlier written agreements and all oral agreements, whether earlier or at the same time as this Contract, concerning the Goods and related Installation Services. b) "You","Your(s)", and"Customer"all mean the person executing this Contract to purchase Installation Services. c) "Goods" means the physical items You are purchasing in connection with the Installation Services. A list of the Goods appears on the Merchandise and Installation Summary. d) "Installation Services"means the work, labor, and other services necessary to install the Goods. Some examples of Installation Services include delivery, handling, return, and selection and placement of Goods. e) "Installer" means the independent contractor Lowe's arranges to perform the Installation Services. Installer will be licensed when legally required, and will direct, control, and perform the Installation Services directly or through its employees, agents, and subcontractors using tools and equipment Installer provides. Lowe's does not employ Installer, its employees, or its agents or subcontractors. f) "Lowe's" means Lowe's Home Centers, LLC, a North Carolina Limited Liability Company located at 1605 Curtis Bridge Road,Wilkesboro, NC 28697. Lowe's Employer Identification Number is 56-0748358. g) "Premises" means the Installation Address You identify where the Installation Services will occur. h) "Price"means the Contract Total stated on the Merchandise and Installation Summary and is the complete payment due for the Goods and Installation Services. 2. SCOPE. This Contract is between You and Lowe's for the purchase of Goods and Installation Services. Lowe's does not perform Installation Services, but arranges for Installer to do so directly or through Installer's employees, agents, or subcontractors. Installer is an independent contractor and is not under the supervision or control of Lowe's. Installation Services do not include architectural or engineering services. Installer will complete Installation Services, subject to any changes, in substantial conformance with the Merchandise and Installation Summary. Lowe's reserves the right to terminate or rescind this Contract if Lowe's decides that any portion of the job is beyond the scope of the Installation Services that Lowe's originally contemplated. 3. EACLUSIONS. Neither Lowe's nor Installer is responsible for start or finish delays resulting from events beyond their control including but not limited to:Change Orders,acts of nature,governmental actions, manufacturing or delivery delays or damage to merchandise caused by third parties,labor strikes or unrest,Your credit or financing,any incorrect information You provide, legal encumbrances on Your property, Your property's nonconformance with zoning requirements or building code requirements, hidden or unforeseen physical or hazardous conditions (including but not limited to, environmental hazards such as mold, asbestos,lead paint, unsound structures or points of attachment)at the Premises,or Your noncompliance with this Agreement. None of these delays will constitute a breach of this Contract by Lowe's or Installer. Lowe's reserves the right to terminate this Contract and/or require Installer to discontinue Installation Services given any of the conditions listed above. 4. PRICING. The Price includes most applicable taxes, permit fees, and other costs reasonably known to Lowe's at the time You sign the Contract. When the initial Price does not include all applicable charges,for example, if You order online, Lowe's will contact You to obtain further payment. If Lowe's requests an increase in the Price after You sign the Contract You will have the opportunity to cancel any unperformed portion of the Contract and receive a refund for that portion. The Price includes only those Goods and Installation services necessary to complete this Contract. 5. GOODS.Title to Goods does not pass to Customer and remain the property of Lowe's until Goods are installed in Customer's home, building, or on Customer's property. Customer agrees Contract is being offered for the total Price. Customer further agrees any surplus materials upon completion of the Installation Services are not the property of customer and, if instructed by Lowe's, such surplus materials shall be returned to Lowe's by the Installer. Upon request from Customer at the time of job completion, Lowe's, in its discretion, may allow all or part of the unused, receipted surplus materials to be retained by the Customer. Rev.03/02/2021 5 6. PAYMENT.You must pay the Price in full upon execution of this Contract. Payment for any Change Order or replacement contract is due at the time of that Change Order or replacement contract. • 7. • LICENSES. PERMITS. AND OTHER REGULATORY REQUIREMENTS Installer will obtain any and all licenses, registrations, certifications, and permits ("Local Requirements") necessary to perform the Installation Services at the Premises, unless otherwise required by law or where Lowe's elects to use a third-party service. You agree to pay any fees associated with the Local Requirements and to cooperate in any required inspection or permitting process.The Installer, and not Lowe's, is responsible for performing the Installation Services in compliance with applicable safety rules, building codes, zoning ordinances, and other regulations ("Local Regulations"). You are responsible for any violations of the Local Regulations that exist at the time of Your signing this Contract. This Contract creates no obligation to correct these pre- existing violations. Any change in the Local Regulations may require a Change Order, and may result in an increase in the Price. Neither Lowe's nor Installer will perform any additional work after completion of the Installation Services due to changes in the Local Regulations. 8. UNDISCLOSED CONDITIONS. You represent that there are no defects, weaknesses or dangerous conditions, some examples of which are mold, mildew, rot, asbestos, and infestation, in the Premises'structure, substructure, superstructure, or points of attachment("Undisclosed Condition"). Lowe's has formulated the Price based on this representation. If Lowe's discovers an Undisclosed Condition before completing the Installation Services,You must remedy the Undisclosed Condition at Your sole cost and expense to Lowe's satisfaction. If You disagree that an Undisclosed Condition exists, then Lowe's can hire an inspector to inspect the Premises, and the inspector's report will be final and conclusive as to the existence of an Undisclosed Condition. If You refuse to permit an inspection or if You fail to remedy the Undisclosed Condition to Lowe's satisfaction then Lowe's may terminate or rescind this Contract. If terminated or rescinded, Lowe's has no obligation to return the Premises to the original condition. If Lowe's terminates or rescinds the contract before delivering Goods or beginning the Installation Services, then Lowe's will return the Price to You without further costs or obligation to You or Lowe's. If Lowe's terminates or rescinds the contract after delivering Goods or beginning the Installation Services,title of the Goods passes to Customer upon contract termination and Lowe's has no obligation to return any portion of the Price to You except for in exchange for Goods You validly return.You will have thirty(30)days from any termination or rescission to return any standard Goods in the original, unopened condition for refund or credit. 9. RETURNS. Returns of Goods are subject to Lowe's standard return policies at time of purchase. The return period for Goods purchased in connection with this contract begins upon completion of the project. Lowe's return policy is available at www.lowes.com/returns. Custom and special-order Goods may be subject to a restocking fee if returned. Custom Goods include Goods altered, color-matched, shaped, sized, cut, or otherwise designed or fitted to accommodate the requirements of a particular space or environment. Some examples of custom Goods are cabinets, countertops, floor and wall coverings, and window treatments. 10. CHANGES AND CHANGE ORDERS. Lowe's, at Your request, may arrange for the Installer to perform additional work, subject to a Change Order and additional amounts payable by You to Lowe's.Any changes to Installation Services or Goods, e.g., a substitution of materials or an expansion of the scope of the work, will require You and Lowe's to sign a written document that clearly defines the scope of the change, any difference in the Price, and new start or finish dates where applicable("Change Order").Change Orders are only binding on Lowe's if signed by both You and Lowe's and will become part of this Contract once signed. 11. YOUR WARRANTY TO LOWE'S AGAINST VIOLATIONS OF EASEMENTS.COVENANTS.AND THIRD PARTY RIGHTS. You warrant that performance of Installation Services will not violate any existing real property easement, covenant, historic district regulations, homeowner's association rule or rights of third parties holding an interest in the Premises or otherwise, and that You have the rights and authority to enter into this Contract. 12. CUSTOMER RESPONSIBILITIES.You agree: (1) To Pay only Lowe's. You agree to pay Lowe's and only Lowe's for any Goods and Installation Services, even if Installer provides a new Contract or Change Order for your review and signature. Installer may collect payment on Lowe's behalf, but you agree not to pay the Installer separately or directly. This Contract is solely between you and Lowe's. (2) To Locate Lines and Hazards. Before Installer begins Installation Services, You will identify and mark the location of utility lines,for example electrical, plumbing,and gas lines,and property lines that could impact the Installation Services. (3) To Ensure Compliance with Smoke Alarm and Carbon Monoxide Detector Requirements. Prior to the start of the Installation Services, You will ensure the Premises have all necessary carbon monoxide detectors and smoke alarms ("Detectors") needed for the Installer to obtain the necessary permits and complete the Installation Services. You are solely responsible for the proper number, placement, type, functioning, operation, installation, testing, as per the manufacturers'specifications, and maintenance of any Detectors required by Local Regulations. Failure to meet Federal, state or local Detector requirements, if any,will be considered an Undisclosed Condition. (4) To Provide a Safe and Proper Working Environment. Before and during the Installation Services,You will ensure that work areas are free of vermin, pre-existing physical or environmental hazards, and violations of Local Regulations. You will allow the Installer to have access to work areas and restrooms. You will provide climate control, where applicable, and electricity to the work areas. You agree not to allow unattended minors at the Premises during the Installation Services. You agree to control and keep pets away from work areas.You agree to keep posted permits on display at all Rev.03/02/2021 6 times. If You or someone You control interferes with the Installation Services, Lowe's may charge You for storage, transportation, or other resulting charges. (5) To Sign the Certificate of Completion. Once the Installation Services are complete, You agree that You will sign a Certificate of Completion upon a request from Lowe's. (6) Not to Assign or Transfer this Contract. You cannot give Your rights under this Contract to anyone else. (7) To Promptly Notify Lowe's of a Claim. If you have a claim that is in any way related to this Contract, You must make that claim to Lowe's within thirty (30) calendar days of when you knew or should have known of a problem. Lowe's will attempt resolution of any claim(s)within sixty(60) calendar days of receiving Your notice. (8) That You Are Responsible If You Choose to Help. YOU ASSUME THE RISK AND THE FULL LIABILITY OF PHYSICALLY ASSISTING WITH DELIVERY OF THE GOODS OR WITH PERFORMANCE OF THE INSTALLATION SERVICES. 13. JVIMUFACTURER WARRANTY FOR GOODS. You are entitled to any warranty provided by a manufacturer of the Goods installed under this Contract. Lowe's will provide You with any manufacturer consumer warranty information accompanying the Goods, and You may also obtain such information by contacting Lowe's. LOWE'S DOES NOT WARRANT THE GOODS AND EXPRESSLY DISCLAIMS ALL WARRANTIES. EXPRESSED OR IMPLIED. INCLUDING WITHOUT LIMITATION THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE, 14. LOWE'S LIMITED WARRANTY FOR INSTALLATION SERVICES. Lowe's warrants that the Installer will perform the Installation Services in a good and workmanlike manner. Lowe's warranty for Installation Services extends for a period of one year(two years for roof replacement)from the earlier of(i)the date You sign the Certificate of Completion or(ii)the date that Lowe's determines that thelnstallation Services have been completed, or for such greater period as required by an extended warranty, if any, or byapplicable law governing consumer warranties for workmanship(the"Warranty Period")._ LOWE'S WARRANTY THAT THEINSTALLER WILL PERFORM THE INSTALLATION SERVICES IN A GOOD AND WORKMANLIKE MANNER DOES NOTCOVER.AND LOWE'S IS NOT RESPONSIBLE FOR.ANY DEFECT IN SUCH JNSTALLATION SERVICES DUE TO (11 AN UNDISCLOSED CONDITION OR OTHER PRE-EXISTING PHYSICAL OR ENVIRONMENTAL HAZARD.OR(21 ABUSE. MISUSE.NEGLECT.OR IMPROPER CLEANING. LOWE'S WARRANTY FOR INSTALLATION SERVICES IS IN LIEU OF ANY OTHER WARRANTY. EXPRESS OR IMPLIED.INCLUDING WITHOUT LIMITATION ANY IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE, 15. LIMITATION OF LIABILITY. For any claim related to this Contract,You can only seek recourse from Lowe's or the Installer; no parent or affiliate of Lowe's shall have any liability under this Contract. You must give Lowe's written notice within the Warranty Period of any warranty claim. Your only remedy for a warranty claim is either (i) for Lowe's to have the Installation Services performed again, including any necessary repair and replacement of Goods, to correct the defective Installation Services, or(ii)a refund of all or part of the Price. Lowe's has absolute discretion to choose between these two options.YOU SHALL HAVE NO OTHER REMEDY FOR A WARRANTY CLAIM,INCLUDING WITHOUT LIMITATION REMEDY FOR LOSS OR DAMAGE CAUSED BY NORMAL WEAR AND TEAR, LOSS OR DAMAGE WHICH HAS NOT BEEN REASONABLY MITIGATED, OR LOSS OR DAMAGE CAUSED BY ACTS OF GOD. IN NO EVENT SHALL LOWE'S BE LIABLE FOR INDIRECT, PUNITIVE, CONSEQUENTIAL OR INCIDENTAL DAMAGES (SUCH AS, WITHOUT LIMITATION, LOST PROFITS, LOST SALES, COSTS ASSOCIATED WITH PROJECT DELAYS, AND INJURIES TO PERSONS OR PROPERTY), EVEN WHERE LOWE'S HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. WHERE, DUE TO OPERATION OF LAW, SUCH DAMAGES CANNOT BE EXCLUDED, THEY ARE EXPRESSLY LIMITED IN AMOUNT TO THE PURCHASE PRICE. For warranty claims, You agree to prepare the Premises and the work area in the manner described in the section titled "Customer Responsibilities." 16. ARBITRATION AGREEMENT.WAIVER OF JURY TRIAL.AND WAIVER OF CLASS ACTION RIGHTS. Lowe's wants to keep You as customer, and Lowe's resolves most questions and complaints informally. If You have a question or complaint, contact Your Lowe's salesperson first or the manager of the Lowe's store that fulfilled Your order.All claims by You, Your agents, insureds or assigns, or Lowe's related to this Contract,which You and Lowe's cannot resolve informally shall proceed to binding arbitration conducted by a single arbitrator under the current applicable rules,procedures,and protocols of JAMS,Inc.("JAMS') (wwww.iamsadr.com)or the American Arbitration Association("AAA")(wv w.adr.oro).You agree that if either JAMS or AAA is unable or unwilling to arbitrate the matter,You and Lowe's will agree upon a single arbitrator with a nationally recognized arbitration firm to arbitrate the matter.Claims subject to binding arbitration include: (1) all claims in any way related to the signing of this arbitration agreement, the validity or scope of this arbitration agreement, or any attempt to set aside this arbitration agreement; (2) all federal or state law claims relating in any way to this Contract (including this arbitration agreement), the information You gave Lowe's before entering into this Contract,and any past agreement or agreements between You and Lowe's; (3) all counterclaims, cross-claims, and third-party claims; (4) all common law claims of any kind including claims based upon alleged product defect, contract, tort, fraud, or other intentional torts; (5) all claims based upon a violation of any state or federal constitution, statute, or regulation; (6) all claims asserted by Lowe's against You, including claims for money damages to collect any sum Lowe's claims Rev.03/02/2021 7 You owe; (7) all claims asserted by You individually against Lowe's or any of Lowe's employees, agents, directors, officers, shareholders, managers, members, parent company, or affiliated entities (collectively the "related third parties") or the Installer, including claims for money damages and/or equitable or injunctive relief; (8) all claims asserted on Your behalf by another person; (9)all claims asserted by or on behalf of You as a private attorney general against Lowe's, related third parties or the Installer; (10) all claims arising from or relating directly or indirectly to the disclosure by Lowe's, related third parties or the Installer of any non-public personal information about You; and (11) all other claims related to this Contract whether or not set forth above. If the dispute falls within the jurisdiction of a small claims court the claimant may, at its option, choose to arbitrate or file a small claims action.Any appeal of a judgment from a small claims court shall be resolved by arbitration as provided by this Contract. Binding arbitration means that You waive: (1)any right to a jury trial; (2)any right to bring a lawsuit in a court(other than a small claims court as described above); and (3) any right to seek relief in any other way. An arbitrator will decide any claim not decided by a small claims court. You agree that binding arbitration provides a simple, cost effective method to resolve disputes quickly. You agree that (1) You cannot pursue a class action lawsuit or class action arbitration of any type, (2) no one can pursue a class action lawsuit or class action arbitration of any type on Your behalf, and (3) a Court or arbitrator(s) cannot order class action proceedings under this Contract.You further agree that there shall be no joinder of parties, except for joinder of parties to the transaction covered by this Contract. By agreeing to binding arbitration You and Lowe's waive any right to bring or participate in a class action lawsuit or class action arbitration regarding any claim. Jiow Arbitration Works: Lowe's may demand arbitration by sending written notice to You at the address listed in this Contract. You may demand arbitration by sending written notice to Lowe's at the following address: Mail code NB6LG, P.O. Box 1000, Mooresville, NC 28115. The arbitration shall occur in the city or county of the Premises. Lowe's shall pay the filing, administrative, hearing, and arbitrator's fees associated with the arbitration. You are not required to reimburse Lowe's for these expenses even if Lowe's wins the arbitration. Unless the arbitrator's award or controlling law specifically provides otherwise, You and Lowe's are each responsible for their own attorneys'fees and other expenses, such as witness and expert witness fees. Either party may request that the arbitrator provide a written explanation of the award, consistent with the then current rules, procedures, and protocols of the arbitration entity selected by the parties. Any court having jurisdiction may receive and enforce the arbitrator's award. If You fail to pay Lowe's in accordance with this Contract,You agree that Lowe's can recover its reasonable attorneys'fees as provided by N.C. Gen. Stat. Section 6-21.2 or other controlling law. The parties agree that this arbitration agreement is made in connection with a transaction involving interstate commerce and that the Federal Arbitration Act, 9 U.S.C. Sections 1-16 (as amended) ("FAA"), governs. If for any reason the Federal Arbitration Act does not apply,then the laws of the State of North Carolina shall govern this arbitration agreement. 17. GOVERNING LAW AND SEVERABILITY. North Carolina law shall govern and guide the interpretation of this Contract, without regard to the choice of law rules of any state,except that the FAA governs the ARBITRATION AGREEMENT,WAIVER OF JURY TRIAL AND WAIVER OF CLASS ACTION RIGHTS. Should an arbitrator, court, or other interpreting entity determine that a provision of this Contract is contrary to an applicable law, such unlawful provision shall be ineffective without invalidating the other provisions,which shall remain in full force and effect. 18. CREDIT CARD/ FINANCED TRANSACTIONS. If You use credit or obtain a loan to pay some or all of the Price, then the total cost of Your purchase will depend on the terms of Your credit or loan and applicable law. Credit and loans often include interest charges,finance charges, or fees.You are subject to Your creditor's or lender's terms and conditions. Lowe's is NOT a party to Your cardholder agreement,financing agreement, or other lending agreement. 19. WAIVER OF LIENS. Before Lowe's pays the Installer on Your behalf, Lowe's will require the Installer to fully and unconditionally relinquish, waive, and release any and all liens. Installer's lien waiver will include waivers for itself, its subcontractors,and its materialmen and suppliers of all mechanic's liens, materialman's liens,and other liens in the Premises related to this Contract, to the extent permitted by law. In addition, Lowe's fully and unconditionally waives and releases any and all such liens in the Premises it may have or acquire in the future as a result of this Contract. 20. COUNTERPARTS AND AMENDMENT. You and Lowe's may execute this Contract in one or more counterparts, each of which when executed and delivered or transmitted by facsimile, e-mail or other electronic means, shall be an original and all of which taken together shall constitute one and the same instrument.A facsimile or electronic signature is deemed an original signature for all purposes under this Contract. No modifications or additions to this Contract are valid unless signed by both You and Lowe's. 21. QUESTIONS OR CONCERNS. You should speak to the Lowe's Salesperson or the manager of the Lowe's store assigned your order regarding routine matters like scheduling, changes to Your order, or any concerns You have about this Contract, the Goods, or the Installation Services. If you still have questions or concerns please contact Customer Care at 1-800-445-6937. Rev.03/02/2021 8 <: } \ `rid•\ y: "'° , a _ •cv For.Installation Services performed in the Commonwealth of Massachusetts, the terms and conditions of this Massachusetts Addendum ("State Addendum") are made a part of the Lowe's Installation Contract and supplement the Contract's Terms and Conditions ("Terms and Conditions") between You and Lowe's. To the extent there is a conflict between the Terms and Conditions and this State Addendum, the State Addendum shall prevail. All capitalized terms used but not otherwise defined in this State Addendum shall have the meaning ascribed to them in the Terms and Conditions. 1. MASSACHUSETTS LICENSES AND CERTIFICATIONS: Contractor license number(s)and certifications held by or on behalf of Lowe's Home Centers, LLC: #148688 (home improvement contractor) and 35194. License number(s) and certifications may be subject to change in accordance with local or state government processes. For the most current listing of license numbers and certifications held by or on behalf of Lowe's Home Centers, LLC, please visit http://www.lowes.comtlicensenumbers. 2. FEDERAL TAX IDENTIFICATION NUMBER: Lowe's Federal Identification Number(FEIN) is 56-0748358. 3. OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATION: All home improvement contractors and subcontractors must be registered by the Office of Consumer Affairs and Business Regulation ("OCABR"). Inquiries about a contractor or subcontractor relating to a registration should be directed to the OCABR Director of Home Improvement Contractor Registration at 1000 Washington Street, Suite 710, Boston, MA 02118; (617)973-8787; (888) 283-3757; or http://www.mass.gov/ocabr/. 4. REQUIRED PERMITS: Lowe's or the Installer is obligated to inform You of any and all permits necessary to complete the Installation Services contemplated in this Contract, and it is the obligation of Lowe's or the Installer to obtain said permits. Homeowners who secure their own building permits are automatically excluded from all Guaranty Fund provisions of the Home Improvement Contractor Law(M.G.L. c. 142A). 5. PAYMENT SCHEDULE: 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 Contract Price is over$1,000.00 (a) Customer agrees to pay Lowe's according to the payment schedule set forth in this Contract, and (b)in accordance with M.G.L.c. 142A§2(a), any deposit collected at the time this Contract is signed will not exceed one-third(1/3)of the Contract Price,and no final payment will be demanded until the completion of the Installation Services to both parties'satisfaction. By executing this Contract, Customer authorizes Lowe's'to charge Customer's credit card, or deposit Customer's check,as set forth in this Contract's payment schedule. Payment for a new replacement contract is payable according to these Terms and Conditions. Payment for any change order is due at the time of that change order. 6. WARRANTIES: Massachusetts General Laws 142A, Section 2(a)(8) requires that this contract include a notice disclosing all warranties and rights of Customer under this agreement. Except as provided elsewhere in this agreement, Contractor makes no express warranty. Customer waives, renounces, and disclaims all implied warranties of fitness for purpose, merchantability, habitability and good construction. Rev.03/02/2021 9 MASSACHUSETTS NOTICE OF RIGHT TO CANCEL1 05/14/2021 Execution Date Three (3) Days After Execution Date (not counting Sundays and Federal Holidays) You may CANCEL this transaction,without any Penalty or Obligation,within THREE(3) BUSINESS DAYS from the above date(Execution 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 (10) 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 under 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 twenty(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 Lowe's,at 6 country way Hadley ma 01035 (LOWE'S STORE ADDRESS) or by email at daniel.flaherty@store.lowes.com (PSE EMAIL),NOT LATER THAN MIDNIGHT OF the 3'd day after execution date ensuring Saturday is considered a business day while Sundays and federal holidays are not. Notice of Cancellation: I HEREBY CANCEL THIS TRANSACTION. Arlene Kowal 4132501424 (Customer's Printed Name) (Customer's Phone Number) (Today's Date) (Customers signature) 1 This Notice only applies if this Contract is a"door-to-door sale"as defined by 16 C.F.R.§429.0(a),or if this Contract is signed by Customer at a place other than the address of the seller as set forth in M.G.L.c.93§48. Rev.03/02/2021 11 Rev.03/02/2021 12 MASSACHUSETTS NOTICE OF RIGHT TO CANCEL2 05/14/2021 Execution Date Three(3) Days After Execution Date (not counting Sundays and Federal Holidays) You may CANCEL this transaction,without any Penalty or Obligation,within THREE (3) BUSINESS DAYS from the above date(Execution 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 (10) 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 under 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 twenty(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 Lowe's, at 6 country way Hadley ma 01035 (LOWE'S STORE ADDRESS) or by email at daniel.flaherty@store.lowes.com (PSE EMAIL),NOT LATER THAN MIDNIGHT OF the 3rd day after execution date ensuring Saturday is considered a business day while Sundays and federal holidays are not. Notice of Cancellation: I HEREBY CANCEL THIS TRANSACTION. Arlene Kowal 4132501424 (Customer's Printed Name) (Customer's Phone Number) (Today's Date) (Customer's signature) 2 This Notice only applies if this Contract is a"door-to-door sale"as defined by 16 C.F.R.§429.0(a),or if this Contract is signed by Customer at a place other than the address of the seller as set forth in M.G.L.c.93§48. Rev.03/02/2021 13