WORK AUTHORIZATION
(Restoration/Reconstruction)
1. RESTORATION AND RECONSTRUCTION - _______________________ (“Contractor"), is
requested and authorized to: (i) perform any and all emergency construction and/or emergency restoration services at
the property address identified below; and, (ii) remove and store any and all items, personal property and/or fixtures
that Contractor believes need to be relocated and stored at a different location.
2. INSURANCE - If the damage to the Homeowner's property is covered by a policy of insurance, the
Homeowner hereby authorizes and directs the insurance company listed below to issue payment directly to Contractor
for any and all labor, services and materials provided by Contractor which is covered by the policy of insurance. If for
any reason whatsoever payment is delivered to the Homeowner, the Homeowner hereby agrees to immediately tender
the payment and/or make full payment to Contractor. In the event that collection and/or legal proceedings must be
instituted to recover any amount due ___________________, ___________________ shall be entitled to recover
interest at the rate of _______ percent (_____%) per annum from and after the date payment is due, together with any
costs of collection, including reasonable attorney's fees.
The Homeowner(s) fully agree and understand as follows:
(i) That they are personally responsible for any and all deductible, depreciation and/or any other charges, costs or
fees not covered by a policy of insurance;
(ii) That Contractor has been retained to provide labor, services and materials to the Homeowner and not for any
insurance company, adjuster and/or agent; and,
(iii) That in most cases the cause of the damage is not covered by a policy of insurance and must be paid for by the
property owner (for example, if a faucet breaks and floods a home, in most cases the property owner is
responsible to pay for the faucet).
3. WARRANTY AND LIMITATIONS - THE LIABILITY OF CONTRACTOR IS EXPRESSLY
LIMITED TO THE TOTAL AMOUNT OF THE SERVICES AUTHORIZED HEREIN AND IN NO EVENT
SHALL CONTRACTOR, ITS AGENTS OR ASSIGNS, BE LIABLE FOR ANY DIRECT, INDIRECT,
SPECIAL, INCIDENTAL OR CONSEQUENTIAL DAMAGES RESULTING IN ANY MANNER
WHATSOEVER, INCLUDING, BUT NOT LIMITED TO, LOSS OF TIME, INCONVENIENCE, INJURY,
LOSS OR DAMAGE TO PERSON OR PROPERTY, LOSS OF PROFITS, LIABILITIES OF THE
HOMEOWNER TO THIRD PERSONS OR ANY OTHER MATTERS NOT SPECIFICALLY STATED,
WHETHER BASED ON CONTRACT, TORT OR ANY OTHER LEGAL THEORY. THERE ARE NO
COVENANTS, REPRESENTATIONS, WARRANTIES, AGREEMENTS, OR CONDITIONS, EITHER
EXPRESSED OR IMPLIED, WHICH IN ANY WAY AFFECT, OR ARE A PART OF, OR RELATE TO THIS
AGREEMENT, EXCEPT FOR THOSE EXPRESSLY SET FORTH HEREIN.
4. MEDIATION/ARBITRATION - If any dispute(s) arise(s) between Homeowner and Contractor as to the
meaning or interpretation of any provision of this Agreement or, if any dispute(s)/claim(s) arise(s) hereunder and
Contractor and Homeowner are unable between themselves, the dispute shall be submitted to mediation to the
________________ under the Rules then in effect. If, after mediation, the dispute has not been resolved, it should be
submitted to binding arbitration under the _______________ (to be conducted under the Association(s) then existing
rules relating to arbitration).
5. MOLD – Mold may typically be found anywhere that water is found, whether in a basement, kitchen or
bathroom. Some types of mold have been shown to have adverse health effects on people. Contractor makes neither
any express nor implied warranties concerning mold in the home, whether presently or in the future. Homeowner
hereby agrees that Contractor shall not be responsible for, and hereby waives and releases Contractor from any claims,
damages, actions, costs or other liabilities, whether direct or indirect, that may be caused by, resulting from, or relating
to, mold, or by some other agent, that may or may not be associated with defects in construction, including but not
limited to, property damage, personal injury, loss of income, emotional distress, anxiety, embarrassment, humiliation,
mental anguish, death, loss of use, loss of value, and any adverse health effect, or any other effect on Homeowner
and/or Homeowner’s family, friends or invitees. ANY IMPLIED WARRANTIES, INCLUDING ANY
IMPLIED WARRANTY OF WORKMANLIKE CONSTRUCTION, IMPLIED WARRANTY OF
HABITABILITY, OR IMPLIED WARRANTY OF FITNESS F