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HomeMy WebLinkAbout13-3415 Supreme CourI9 WWR 0 20074243 C Y Jer DKM Court of Commonyjeas vili Cover Shut F or P rolholwlaq Use Ott y: r p C UMBERLAND ,, Courih- Docket No: 13 3 is [vliTe m The information collected on this form is used solely for court administration purposes. This form does not supplement or replace the filing and service ofpleadings or other papers as required by laiv or rules of court. Commencement of Action: S 0 Complaint ❑ Writ of Summons ❑ Petition E ❑ Transfer from Another Jurisdiction ❑ Declaration of Takin C Lead Plaintiff's Name: Lead Defendant's Name: T'' STATE FARM FIRE & CASUALTY LORI SMITH PONDER I 0 Are money damages requested? ® Yes ❑ No Dollar Amount Requested: ® within arbitration limits N (check one) ❑ outside arbitration limits A Is this a Class Action Suit? ❑ Yes Cad No Is this an NWJ Appeal? 13 Yes Cad No Name of Plaintiff /Appellant's Attorney: Benjamin W. Lawrence,209032 ❑ Check here if you have no attorney (are a Self- Represented [Pro Sel Litigant) Nature of the Case Place an "X" to the left of the ONE case category that most accurately describes your PRIMARY CASE. If you are making more than one type of claim, check the one that you consider most important. TORT (do not include Mass Tort) CONTRACT (do not include Judgments) CIVIL APPEALS ❑ Intentional ❑ Buyer Protection Administrative Agencies ❑ Malicious Prosecution ❑ Debt Collection: Credit Card ❑ Board of Assessment ❑ Motor Vehicle ❑ Debt Collection: Other ❑ Board of Elections ❑ Nuisance ❑ Dept. of Transportation S ❑ Premises Liability ❑ Statutory Appeal: Other E ❑ Product Liability (does not include [] Employment Dispute Mass tort) Discrimination C ❑ Slander /Libel/Defamation ❑ Employment Dispute: Other ❑ Zoning Board '1' — .41' Other: ❑ Other: I � l53 l d E3 0 Other: N MASS TORT ❑ Asbestos B ❑ Tobacco REAL PROPERTY MISCELLANEOUS • Toxic Tort - DES ❑ Ejectment ❑ Common Law /Statutory Arbitration • Toxic Tort — Implant ❑ Eminent Domain/Condemnation ❑ Declaratory Judgment • Toxic Waste ❑ Ground Rent ❑ Mandamus ❑ Other: ❑ Landlord/Tenant Dispute ❑ Non - Domestic Relations ❑ Mortgage Foreclosure: Residential Retraining Order ❑ Mortgage Foreclosure: Commercial ❑ Quo Waranto ❑ Partition ❑ Replevin PROFESSIONAL LIABILITY ❑ Quiet Title ❑ Other: ❑ Dental ❑ Other: ❑ Legal ❑ Medical ❑ Other Professional: Updated 1/1/2011 NOTICE Pennsylvania Rule of Civil Procedure 205.5. (Cover Sheet) provides, in part: Rule 205.5. Cover Sheet (a)(1) This rule shall apply to all actions governed by the rules of civil procedure except the following: (i) actions pursuant to the Protection from Abuse Act, Rules 1901 et seq. (ii) actions for support, Rules 1910.1 et seq. (iii) actions for custody, partial custody and visitation of minor children, Rules 1915.1 et seq. (iv) actions for divorce or annulment of marriage, Rules 1920.1 et seq. (v) actions in domestic relations generally, including paternity actions, Rules 1930.1 et seq. (vi) voluntary mediation in custody actions, Rules 1940.1 et seq. (2) At the commencement of any action, the party initiating the action shall complete the cover sheet set forth in subdivision (e) and file it with the prothonotary. (b) The prothonotary shall not accept a filing commencing an action without a completed cover sheet. (c) The prothonotary shall assist a party appearing pro se in the completion of the form. (d) A judicial district which has implemented an electronic filing system pursuant to Rule 205.4 and has promulgated those procedures pursuant to Rule 239.9 shall be exempt from the provisions of this rule. (e) The Court Administrator of Pennsylvania, in conjunction with the Civil Procedural Rules Committee, shall design and publish the cover sheet. The latest version of the form shall be published on the website of the Administrative Office of Pennsylvania Courts at www.pacourts.us. Ql1 �t 7 2 � C 1 "i -:' _ rr -C� W < =? Ci . ®r ; IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION STATE FARM FIRE & CASUALTY 6 Plaintiff No: 1 3 3415 �'�►'� Term vs. COMPLAINT IN CIVIL ACTION LORI SMITH PONDER AKA LORI PONDER Defendant FILED ON BEHALF OF Plaintiff COUNSEL OF RECORD OF THIS PARTY: Benjamin W. Lawrence,209032 WELTMAN, WEINBERG & REIS CO., L.P.A. 325 CHESTNUT STREET SUITE 501 PHILADELPHIA, PA 19106 -2614 215- 599 -1500 FAX: 215- 599 -1505 20074243 C Y Jer DKM Q 4 103 s P'N 'A'rry IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION STATE FARM FIRE & CASUALTY U Plaintiff VS. Civil Action No LORI SMITH PONDER AKA LORI PONDER Defendant COMPLAINT AND NOTICE TO DEFEND You have been sued in court. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this complaint and notice are served, by entering a written appearance personally or by an attorney and filing in writing with the court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the court without further notice for any money claimed in the complaint or for any other claim or relief requested by the plaintiff. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. LAWYER REFERRAL SERVICE CUMBERLAND COUNTY BAR ASSOCIATION 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 (717) 249 -3166 WELTMAN, WEINBERG & REIS CO., L.P.A. BY: Benjamin W. Lawrence, Esquire Attorney for Plaintiff(s) Pa. Identification No. 209032 325 Chestnut Street, Suite 501 Philadelphia, PA 19106 Phone: 215.599.1500 Fax: 215.599.1505 File #20074243 } STATE FARM FIRE & CASUALTY CO. } Court of Common Pleas } Cumberland County } } vs. } } LORI SMITH PONDER } NO. CIVIL ACTION — COMPLAINT 1. Plaintiff is a business organization licensed and authorized to conduct business in the State of Illinois with a place of business located at P.O. Box 2371, Bloomington, Illinois 61702. 2. Defendant is an adult individual who at all times pertinent resided at 905 2 ND Avenue, Altoona, Pennsylvania 16602. 3. At all times pertinent hereto, State Farm agreed to insure the property of its insured located at 804 Coolidge Street, New Cumberland, Pennsylvania, hereinafter "the Property ", pursuant to a policy of insurance. 4. At all times pertinent hereto, Defendant was a tenant at the Property. 5. On or about August 1, 2012, after the lease ended pursuant to the terms of the Lease Agreement, the Plaintiff Insured discovered damage to the property caused by the negligent, careless, reckless and /or intentional actions of the Defendant. 6. In particular Defendant did negligently, carelessly, recklessly and /or intentionally cause damage to the Plaintiff's Insured's real and /or personal property. 7. As a direct and proximate result of Defendant's negligence, carelessness, recklessness and /or intentional acts, the State Farm Insured's property sustained property damage in the amount of $8,066.65. Attached as Exhibit 1 is a copy of those document which Plaintiff intends to introduce into evidence at the arbitration of this matter. 8. Pursuant to the insurance policy issued by State Farm and as a result of the aforesaid payment, State Farm became subrogated to the claim of its Insured against Defendant. WHEREFORE, Plaintiff demands Judgment against Defendant in the amount of $8,066.65 plus interest and costs. WELTMAN, WEINBERG & REIS, CO., L.P.A. Benjamin W. Lawrence, Esquire PA I. D. # 209032 325 Chestnut Street Suite 501 Philadelphia, PA 19106 (215) 599 -1500 WWR #09288995 EXHIBIT 1 fu ' RENTAL AGREEMENT THIS AGREEMENT dated 9/7 /2011, is by and between Deb Hetrick, LANDLORD; and Lori Ponder, TENANT w /co- signor guarantor Fiore A. Pizzino, for rental of the property located at: 804 Coolidge Street, new Cumberland, PA 17070, Boro/Township of New Cumberland, County of Cumberland, Pennsylvania, under the following terms and conditions: TERM: TENANT AGREES TO LEASE THIS DWELLING FOR A FIXED TERM OF One Year plus 23 days, BEGINNING ON 9/7/2011, AND ENDING ON 9/30/2012. RENT: TENANTS AGREE TO RENT THIS DWELLING FOR THE SUM OF $12703.00 DOLLARS PER TERM, PAYABLE MONTHLY_ THE RENT IS $995.00 DOLLARS PER MONTH. MONTHLY RENT IS DUE BY THE 1ST (FIRST) DAY OF EACH MONTH. A LATE CHARGE OF (ten) 10% (99.50) WILL BE CHARGED FOR LATE PAYMENT AFTER THE 1 ST DAY OF EACH MONTH. AFTER THE 1ST DAY OF EACH MONTH, TENANT IS TO PAY AN ADDITIONAL $5.00 PER DAY UNTIL RENT IS RECEIVED IN OFFICE. IF PAYMENT IS NOT RECEIVED BY THE 10TH DAY OF THE MONTH DUE, EVICTION PROCEEDINGS WILL BE STARTED, ALL COSTS TO BE PAID BY TENANT. If tenant must be posted for eviction by landlord /owner!agent, then tenant agrees to pay a $50.00 posting fee to landlord. Monthly rent is to be made payable by direct deposit, certified check or money order to: Deb Hetrick at 82 Cherrywood Drive, Williamsville, NY 14221 LANDLORD ACKNOWLEDGES RECEIPT OF $995.00 Security deposit; received October 2011 Rent $995.00; Pro -rated September Rent $763.00 (23 Days) is due to Landlord /Owner on or before October 1, 2011. TENANT AGREES TO PAY $50.00 TO LANDLORD FOR ANY BOUNCED CHECK OR CHECK RETURNED FOR INSUFFICIENT FUNDS, IN ADDITION TO LATE FEES. AFTER THE FIRST CHECK BOUNCE INCIDENT _(if any), ), ALL REMAINING RENTAL PAYMENTS MUST BE MADE BY CASHIER CHECK. CERTIFIED CHECK OR MONEY ORDER. SERVICE REQUESTS: ALL CALLS SHALL BE DIRECTED TO LANDLORD OWNER DEB HETRICK AT 717 - 979 -5198 OR THE NEIGHBOR (Number to be provided by landlord) AS DIRECTED BY DEB HETRICK, or only if you are unable to reach THE LANDLORD OWNER within 48 hours call MIKE BENNETT 24/7 AT 645 -8072. IF YOU RECEIVE NO RETURN PHONE CALL WITHIN 48 HOURS OF YOUR REQUEST FOR SERVICE OR YOUR PROBLEM IS NOT BEING ADDRESSED PLEASE CALL DAN TEDESCO 717 - 903 -9830. DEPOSITS: TENANT AGREES TO DEPOSIT WITH THE LANDLORD THE SUM OF $995.00 (received 9/612011) PAYABLE BEFORE TENANT OCCUPIES THE PREMISES. LANDLORD MAY WITHHOLD FROM THESE DEPOSITS ONLY WHAT IS REASONABLY NECESSARY TO COVER THE FOLLOWING TENANT DEFAULTS: 1)DAMAGES TO THE DWELLING; 2)EXTRAORDINARY CLEANING COSTS FOLLOWING TENANT'S DEPARTURE; 3)UNPAID RENT AND VARIOUS OTHER ACCRUED AND UNPAID CHARGES. DEPOSIT SHALL BE HELD AT Owner's Bank. PAGE 1 OF 12 TENANTS INITIALS RENTAL AGREEMENT 60 DAY NOTICE: SIXTY (60) DAYS NOTICE IS REQUIRED PRIOR TO VACATING OF THE PROPERTY EITHER AT THE END OF THE LEASE OR AT ANY WRITTEN OR UNWRITTEN EXTENSION OF THE LEASE. BREAKING OF LEASE RESULTS W A MINIMUM OF FORFEITURE OF DEPOSIT. IF THE PROPERTY CANNOT BE SHOWN WITH A MAXIMUM 24 HOUR NOTICE, THEN THE 60 DAY NOTICE DOES NOT TAKE EFFECT. REFUND OF TENANT'S DEPOSIT: WITHIN THIRTY (30) DAYS AFTER TENANT HAS MOVED OUT COMPLETELY, LANDLORD SHALL PROVIDE A WRITTEN ACCOUNTING OF THE DISPOSITION OF THE TENANT'S DEPOSITS AND SHALL AT THE SAME TIME RETURN ALL DEPOSITS REMAINING IF TENANT HAS PROVIDED A FORWARDING ADDRESS WITHIN TEN (10) DAYS AND RETURNED ALL KEYS. INTEREST ON SECURITY DEPOSIT (RESIDENTIAL ONLY): BEGINNING WITH THE THIRD YEAR OF OCCUPANCY, THE DEPOSIT SHALL EARN INTEREST AT THE PREVAILING PASSBOOK RATE. TENANT AGREES TO ALLOW INTEREST TO ACCUMULATE IN THE ACCOUNT AND AGREES THAT LANDLORD WILL NOT NEED TO DISBURSE SUCH MONEYS ON A YEARLY BASIS. UTILITIES /TENANT MAINTENANCE: TENANT TO PAY FOR: Oil Heat, HVAC Maintenance /cleaning, Electric, Water, Sewer/Trash (Please pay extra $50 /MO owner will bill to tenant for difference), Repairs for damage caused by tenant's action or neglect, lawn care, snow removal, maintenance on appliances, Snowlice removal: tenant; Lawn Care: Tenant. MINOR MAINTENANCE TENANT TO PAY FOR MINOR MAINTENANCE ITEMS COSTING LESS THAN $100.00 INCLUDING BUT NOT LIMITED TO FAUCET REPAIRS, MINOR PLUMBING REPAIRS, STOVE BURNERS AND ALL LIGHT BULBS (INCLUDING FLUORESCENT LIGHT BULBS & EXTERIOR ILLUMINATION IF APPLICABLE)_ IF TENANT IS RESPONSIBLE FOR APPLYING DE- ICER, REMOVING SNOW AND /OR ICE FROM THEIR OWN SIDEWALK, STEPS, PATIOS, DECKS, PARKING LOTS, FRONT SIDEWALKS IT MUST BE DONE ON AN AS NEEDED BASIS. Grass: tenant; Shrubs: tenant; Leaves: tenant; Snow lice: tenant. LANDLORD PAYS: Real EstateTaxes, Owner's Liability Insurance. OCCUPANT: THE NUMBER OF OCCUPANTS IS LIMITED TO Three ONLY THE FOLLOWING PERSON(S) MAY LIVE IN THIS DWELLING: Lori Ponder Breeanna Ponder, Bryan Ponder. NO ONE ELSE MAY LIVE THERE WITHOUT LANDLORD'S PRIOR WRITTEN PERMISSION. ADDITIONAL PERSONS = $100.00 PER MONTH PER PERSON. SUBLETTING, TRANSFER & ASSIGNMENT: TENANT SHALL NOT TRANSFER SUBLET THE ENTIRE PREMISES OR ANY PART OF THE PREMISES OR THIS LEASE, NOR SHALL THEY ASSIGN THIS AGREEMENT TO ANYONE ELSE WITHOUT FIRST OBTAINING THE LANDLORD'S PRIOR WRITTEN PERMISSION /CONSENT. BEFORE TRANSFERRING OR SUBLETTING TENANT MUST FIRST: 1) MAKE A WRITTEN REQUEST TO LANDLORD /OWNER/MANAGEMENT. SUBMIT, ON LANDLORD'S RENTAL APPLICATION, INFORMATION ON THE NEW TENANTS, AND 3) PAY A PROCESSING FEE OF $150.00 TO LANDLORD /OWNER OR MANAGEMENT. APPLIANCES: APPLIANCES IN THE DWELLING: RANGE: Yes - Electric, DISHWASHER: Yes; DISPOSAL: Yes; REFRIGERATOR: Yes; WASHER: Yes; DRYER: Yes; MICROWAVE: Yes. IF TENANT WISHES TO USE THESE APPLIANCES, TENANT AGREES TO ASSUME ALL RESPONSIBILITY FOR CARE AND MAINTENANCE, PAGE 2 OF 12 TENANTS INITIALS RENTAL AGREEMENT TENANT INSPECTION: TENANT HAS INSPECTED THE DWELLING AND ITS CONTENTS AND AGREES THAT THEY ARE IN SATISFACTORY ORDER, AS ARE THE ELECTRICAL, PLUMBING, AND HEATING SYSTEMS. TENANT HAS RECEIVED INVENTORY AND INSPECTION FORM AND WILL RETURN TO OFFICE IN 30 DAYS. VEHICLES: TENANT AGREES TO KEEP A MAXIMUM OF Two VEHICLE(S) ON THE PREMISES. Description of Vehicle(s): 2000 Gold Ford Taurus 2002 Black Harley Sportster 1200 VEHICLE(S) MUST BE OPERABLE AND CURRENTLY LICENSED /INSPECTED. TENANT AGREES TO PARK THEIR VEHICLE(S) IN ASSIGNED SPACE(S) AND TO KEEP THE SPACE CLEAN OF OIL DRIPPINGS. TENANT AGREES TO ADVISE THEIR VISITORS ABOUT PARKING AND TO TAKE RESPONSIBILITY FOR WHERE THEIR VISITORS PARK. ONLY THOSE MOTORCYCLES WHICH HAVE EXHAUST MUFFLING COMPARABLE TO THAT OF A PASSENGER CAR ARE ALLOWED. ONLY THOSE SELF- PROPELLED RECREATIONAL VEHICLES WHICH ARE USED FOR REGULAR PERSONAL TRANSPORTATION ARE ALLOWED. TENANT AGREES NOT TO PARK BOATS, RECREATIONAL TRAILERS, UTILITY TRAILERS, AND THE LIKE ON THE PREMISES WITHOUT FIRST OBTAINING LANDLORD'S PRIOR WRITTEN PERMISSION. TENANT AGREES NOT TO REPAIR THEIR VEHICLE(S) ON THE PREMISES IF SUCH REPAIRS WILL TAKE LONGER THAN A SINGLE DAY UNLESS THE VEHICLE IS KEPT IN AN ENCLOSED GARAGE. PARKING FOR THIS PROPERTY LOCATED: On street, off street, carport. NOTIFICATION OF SERIOUS BUILDING PROBLEMS: TENANT AGREES TO NOTIFY THE LANDLORD IMMEDIATELY UPON FIRST DISCOVERING ANY SIGNS OF SERIOUS BUILDING PROBLEMS SUCH AS A CRACK IN THE FOUNDATION, A TILTING PORCH, A CRACK IN THE PLASTER OR STUCCO, MOISTURE IN THE CEILING, BUCKLING SHEETROCK OR SIDING, A LEAKY ROOF, A SPONGY FLOOR, A LEAKY WATER HEATER OR TERMITE ACTIVITY. REASONABLE TIME FOR REPAIRS: UPON BEING NOTIFIED BY TENANT THAT THERE IS SOME BUILDING DEFECT WHICH IS HAZARDOUS TO LIFE, HEALTH OR SAFETY, OWNER SHALL UNDERTAKE REPAIRS AS SOON AS POSSIBLE. SHOULD THERE BE A DELAY OF MORE THAN SEVENTY TWO (72) HOURS IN MAKING THE REPAIR OR REPAIRS, DUE TO A DIFFICULTY IN SCHEDULING THE WORK OR OBTAINING PARTS OR FOR ANY OTHER REASON BEYOND THE LANDLORD'S CONTROL, LANDLORD AGREES TO KEEP TENANT INFORMED ABOUT THE PROCESS OF THE WORK. WINDOWS: EXCEPT FOR THOSE WINDOWS WHICH ARE NOTED IN WRITING AS BEING CRACKED OR BROKEN WHEN TENANT MOVES IN, TENANT AGREES TO BE RESPONSIBLE FOR ANY WINDOWS WHICH BECOME CRACKED OR BROKEN IN THEIR DWELLING WHILE TENANT LIVES THERE. TENANT TO MAINTAIN/REPLACE ALL WINDOW COVERINGS PROVIDED BY LANDLORD. IF NOT PROVIDED, TENANT AGREES TO PROVIDE AND INSTALL AT LEAST WHITE PULL DOWN SHADES AT TENANT EXPENSE. PAGE 3 OF 12 TENANTS INITIALS RENTAL AGREEMENT DAMAGE: TENANT AGREES TO PAY FOR REPAIRS OF ALL DAMAGE WHICH TENANT OR THEIR GUEST(S) HAVE CAUSED. DRAIN STOPPAGES: AS OF THE DATE OF THIS AGREEMENT, LANDLORD WARRANTS THAT THE DWELLING'S SEWAGE DRAINS ARE IN GOOD WORKING ORDER AND THAT SEWAGE DRAINS WILL ACCEPT THE NORMAL HOUSEHOLD WASTE FOR WHICH THEY WERE DESIGNED. SEWAGE DRAINS WILL NOT ACCEPT THINGS SUCH AS PAPER DIAPERS, SANITARY NAPKINS, PAPER TOWELS, TAMPONS, CHILDREN'S TOYS, WADS OF TOILET PAPER, BALLS OF HAIR, GREASE, OIL, PAINT PRODUCTS, TABLE SCRAPS, CLOTHING, RAGS, SAND, DIRT, ROCKS, OR NEWSPAPERS. TENANT AGREES TO PAY FOR CLEARING THE PIPES OF ANY AND ALL STOPPAGES EXCEPT THOSE WHICH THE PLUMBER, WHO IS CALLED TO CLEAR THE STOPPAGE, WILL ATTEST IN WRITING WERE CAUSED BY DEFECTIVE PLUMBING, TREE ROOTS, OR ACTS OF GOD. TRASH: TENANT AGREES TO DISPOSE OF THEIR ORDINARY HOUSEHOLD TRASH BY PLACING IT INTO PROPER RECEPTACLES. TENANT AGREES TO DISPOSE OF THEIR EXTRAORDINARY HOUSEHOLD TRASH SUCH AS CHRISTMAS TREES, DAMAGED FURNITURE, BROKEN APPLIANCES, AND THE LIKE, BY COMPACTING IT SO THAT IT WILL FIT INSIDE THEIR TRASH RECEPTACLE OR BY HAULING IT TO THE DUMP THEMSELVES OR BY PAYING SOMEONE ELSE TO HAUL IT AWAY. TENANT AGREES TO PROVIDE TRASH RECEPTACLES (CANS) AS NEEDED. BUG /INSECT CONTROL IS THE RESPONSIBILITY OF THE TENANT. ACCESS: LANDLORD RECOGNIZES THAT TENANT HAS A RIGHT TO PRIVACY. AT CERTAIN TIMES, HOWEVER, OWNER, LANDLORD, THEIR EMPLOYEES, OR AGENTS MAY HAVE TO GAIN ACCESS TO THE TENANT'S DWELLING FOR PURPOSES OF SHOWING IT TO PROSPECTIVE TENANTS, PURCHASERS, LENDERS, OR OTHERS OR FOR REPAIRS, INSPECTION, OR MAINTENANCE. WHEN SEEKING ACCESS UNDER ORDINARY CIRCUMSTANCES, OWNER /LANDLORD WILL SCHEDULE ENTRY BETWEEN THE HOURS OF 8AM & 6PM, MONDAY THROUGH SATURDAY, EXCEPT HOLIDAYS AND OWNERILANDLORD WILL PROVIDE TENANT A MAXIMUM 24 HOURS NOTICE. IN EMERGENCIES THERE WILL BE NO NOTICE. OWNER /LANDLORD MAY DISPLAY FOR SALE /SOLD OR FOR RENT SIGNS AND MAY CONTINUE TO MARKET PROPERTY FOR SALE DURING THIS LEASE PERIOD. IF OWNER DECIDES TO SELL THIS PROPERTY TO TENANT, TENANT AGREES TO PURCHASE IT THROUGH M C WALKER REALTY. OWNER AGREES TO PAY A SALES COMMISSION TO M. C. WALKER REALTY OF 7% UNLESS OTHERWISE AGREED TO IN WRITING. TELEPHONE: IF AND WHEN TENANT INSTALLS TELEPHONE IN THEIR DWELLING, TENANT WILL FURNISH LANDLORD WITH THE NUMBER WITHIN FIVE CALENDAR DAYS. 4 OF 12 TENANT INITIALS RENTAL. AGREEMENT PEACE AND QUIET: TENANT DESIRES THE QUIET ENJOYMENT OF THEIR OWN DWELLING, AND THEIR NEIGHBORS DESIRE THE SAME_ TENANT AGREES TO REFRAIN FROM MAKING NOISES AND DISTURBANCES AND TO KEEP DOWN THE VOLUME OF THEIR MUSIC AND BROADCAST PROGRAMS AT ALL TIMES SO AS NOT TO DISTURB OTHER PEOPLES' PEACE AND QUIET, BUSINESS USE: TENANT AGREES TO USE THIS DWELLING AS THEIR PERSONAL RESIDENCE. TENANT AGREES TO CONDUCT NO BUSINESS ON THE PREMISES WITHOUT FIRST OBTAINING LANDLORD'S WRITTEN PERMISSION. INSURANCE: LANDLORD HAS OBTAINED INSURANCE TO COVER FIRE DAMAGE r TO THE BUILDING ITSELF, LANDLORD'S INSURANCE DOES NOT COVER TENANT'S POSSESSIONS OR TENANTS NEGLIGENCE, TENANT SHALL OBTAIN A TENANT'S INSURANCE POLICY TO COVER DAMAGE TO OR LOSS OF TENANT'S OWN POSSESSIONS, AS WELL AS LOSSES RESULTING FROM TENANT'S NEGLIGENCE. TENANT AGREES TO PROVIDE LANDLORD WITH EVIDENCE OF SUCH A POLICY WITHIN TWO WEEKS FROM THE DATE OF THIS AGREEMENT. INSURANCE CONSIDERATIONS: TENANT AGREES THAT TENANT WILL DO NOTHING TO THE PREMISES NOR KEEP ANYTHING ON THE PREMISES WHICH WILL RESULT IN AN INCREASE OR CANCELLATION IN THE LANDLORD'S INSURANCE POLICY OR AN INCREASE IN HAZARD OF THE PREMISES. NEITHER WILL THE TENANT ALLOW ANYONE ELSE TO DO SO. FIRE: NO RIGHTS OF STORAGE ARE GIVEN BY THIS LEASE, AND THE LANDLORD SHALL NOT BE LIABLE FOR ANY LOSS OF PROPERTY BY FIRE, THEFT, BURGLARY AND OTHERWISE FROM SAID PREMISES OR BUILDING, NOR FOR ANY ACCIDENTAL DAMAGE TO PERSONS OR PROPERTY IN OR ABOUT THE RENTED PREMISES OR BUILDING BY ANY CAUSE. THE TENANT HEREBY AGREES TO MAKE NO CLAIM FOR ANY SUCH LOSS OR DAMAGE. TENANT ACKNOWLEDGES THAT THE TENANT HAS BEEN ADVISED OF THE TENANTS OBLIGATION TO OBTAIN INSURANCE. LOCKS: THE TENANT ACKNOWLEDGES THAT THE TENANT HAS BEEN ADVISED THAT THE EXISTING LOCKS ON THE RENTAL UNIT HAVE NOT BEEN CHANGED AND THAT PERSONS OTHER THAN THE LANDLORD AND THE TENANT MAY HAVE KEYS TO THE PREMISES. TENANT ACKNOWLEDGES THAT TENANT HAS BEEN ADVISED OF TENANT'S RIGHT TO HAVE THE LOCKS CHANGED AND THAT SUCH CHANGE WILL BE MADE BY THE LANDLORD UPON REQUEST AT THE TENANT'S EXPENSE. TENANT TO BE RESPONSIBLE FOR RETURNING LOCKS TO ORIGINAL LOCK SYSTEM IF IT IS A MASTER LOCK SYSTEM FOR THE BUILDING. 5 OF 12 TENANT INITIALS -' RENTAL AGREEMENT RETURN OF DEPOSIT: SECURITY AND DAMAGE DEPOSITS AND ANY OTHER DEPOSITS MADE BY TENANT MAY BE CREDITED TO THE LANDLORD'S OPERATING ACCOUNT, RETURN OF THESE DEPOSITS IS SUBJECT TO THE FOLLOWING PROVISIONS: a) THE FULL TERM OF THE LEASE HAS EXPIRED. b) FORMAL WRITTEN NOTICE OF INTENT TO VACATE HAS BEEN RECEIVED BY THE LANDLORD OR HIS AGENT A FULL 60 DAYS PRIOR TO THE FIRST OF THE MONTH OF SAID VACATING. c) NO DAMAGE TO PROPERTY BEYOND NORMAL WEAR AND TEAR IS EVIDENT. SUCH EVIDENCE SHALL BE BY A COMPARISON OF PRESENT CONDITIONS TO HOUSE CONDITION REPORT PRESENTED BY THE TENANT UPON OCCUPANCY. d) THE ENTIRE DWELLING, INCLUDING RANGE, REFRIGERATOR, BATHROOM, CLOSETS, AND CUPBOARDS ARE CLEAN, AND THE REFRIGERATOR, IS DEFROSTED. e) NO UNPAID LATE CHARGES OR DELINQUENT RENTS REMAIN OUTSTANDING. fl ALL KEYS ARE RETURNED. g) TENANT PROVIDES WRITTEN EVIDENCE OF FULL PAYMENT OF ALL MUNICIPAL AND OR COUNTY CHARGES, SUCH AS, BUT NOT LIMITED TO TRASH, WATER AND SEWAGE. h) ALL DEBRIS, RUBBISH, AND GARBAGE IS PLACED IN APPROPRIATE CANS OR HAULED AWAY. 1) FORWARDING ADDRESS HAS BEEN MAILED TO LANDLORD OR HIS AGENT. ONCE ALL OF THESE CONDITIONS HAVE BEEN MET TO THE SATISFACTION OF THE LANDLORD, AND ANY COSTS OF LABOR AND MATERIALS FOR CLEANING AND REPAIRS HAVE BEEN DEDUCTED, ALONG WITH LATE CHARGES FOR RENTS RECEIVED, THE BALANCE OF DEPOSITS WILL BE RETURNED BY CHECK ADDRESSED JOINTLY TO ALL PERSONS WHO SIGN THIS AGREEMENT. THE LANDLORD HAS 30 DAYS AFTER THE TENANT VACATES THE PREMISES FOR TERMINATION OF THIS AGREEMENT TO IMPOSE A CLAIM AGAINST THE TENANT'S DEPOSITS. PAGE 6 OF 12 TENANT INITIALS , RENTAL AGREEMENT LAWFUL USE: TENANT AGREES THAT THEY WILL NOT THEMSELVES ENGAGE IN ANY ILLEGAL ACTIVITIES ON THE PREMISES, NOR WILL TENANT ALLOW OTHERS TO ENGAGE IN ANY ILLEGAL ACTIVITIES ON THE PREMISES. VACATING: WHEN TENANT VACATES, CARPETS ARE TO BE CLEANED BY A PROFESSIONAL CLEANER, NOT A RENTED MACHINE. WHEN TENANT VACATES, THE SAME AMOUNT OF OIL IS TO BE LEFT WITH THE PROPERTY AS WHEN THE LEASE STARTED. TENANT WILL REMOVE ALL RUBBISH AND GARBAGE, AND WILL CLEAN THE PREMISES AND TO THE STANDARD OF THE OWNER /LANDLOR OR THEIR DESIGNATED REPRESENTATIVE, AND WILL INSURE THAT ALL APPLIANCES, ELECTRICAL AND PLUMBING SYSTEMS ARE IN GOOD WORKING ORDER PRIOR TO VACATING THE PREMISES, AND TO RETURN ALL KEYS TO THE LANDLORD OR REAL ESTATE AGENT PRIOR TO MIDNIGHT ON THE FINAL DAY OF OCCUPANCY. CONDITION: THE DWELLING AND ALL OF THE FURNISHINGS AND APPLIANCES THEREIN ARE ACCEPTED AS IN GOOD CONDITION, PROVIDED, HOWEVER, THAT IF TENANT SHALL FIND ANYTHING NOT IN GOOD CONDITION, OR THAT THE INVENTORY IN THE HOUSE CONDITION REPORT IS INCORRECT IN ANY WAY, A WRITTEN STATEMENT OF ANY OBJECTIONS SHALL BE DELIVERED TO THE LANDLORD WITHIN THREE (3) DAYS AFTER TAKING POSSESSION. OTHERWISE, IT WILL BE PRESUMED THAT INVENTORY IS CORRECT. THE TENANT AGREES NOT TO PERMIT THE PREMISES, INCLUDING WOODWORK, FLOORS AND WALLS, OR ANY FURNISHINGS, FIXTURES, OR APPLIANCES ON THE PREMISES TO BE DAMAGED OR DEPRECIATED IN ANY MANNER, AND AGREES TO PAY FOR ANY LOSS, BREAKAGE OR DAMAGE. TENANT SPECIFICALLY AGREES THAT NO TACKS, NAILS, OR SCREWS WILL BE DRIVEN INTO THE PLASTER WALLS OR WOODWORK, EXCEPT FOR NORMAL HOUSEHOLD PICTURES AND MIRRORS. PETS: Yes. TENANT AGREES TO KEEP ONE CAT, PET OR OTHER ANIMAL UNLESS IT HAS BEEN AGREED TO IN WRITING BY THE LANDLORD AND AN ADDITIONAL DEPOSIT OF $250 refundable (OF WHICH 0 IS NON - REFUNDABLE) HAS BEEN PAID AND ADDITIONAL RENT HAS BEEN AGREED TO. TENANT AGREES TO NOT USE ANY PART OF THE PREMISES FOR ANY UNLAWFUL OR IMMORAL PURPOSE; NOR PLAY MUSICAL INSTRUMENTS OR RADIO, TAPES, RECORDS, CD'S, OR TELEVISION SETS BEFORE 8AM OR AFTER 10PM LOUDLY ENOUGH TO DISTURB NEIGHBORS, OR TO VIOLATE ANY REGULATIONS OF THE BOARD OF HEALTH, CITY OR COUNTY ORDINANCES, OR ANY STATE LAWS. IF APPLICABLE SEE ATTACHED PET ADDENDUM. INVENTORY: THE FOLLOWING PERSONAL PROPERTY IS INVENTORIED AS PROPERTY OF THE LANDLORD /OWNER: Range, refrigerator, washer, dryer, microwave, garden tools, dispose< PAGE 7 OF 12 TENANT INITIALS RENTAL AGREEMENT RULES AND REGULATIONS: LANDLORD'S EXISTING RULES AND REGULATIONS ARE PART OF THIS AGREEMENT. LANDLORD MAY ADOPT OTHER RULES AND REGULATIONS AT A LATER TIME PROVIDED THEY HAVE LEGITIMATE PURPOSE AND DO NOT MODIFY TENANT'S RIGHTS SUBSTANTIALLY. TENANT AGREES: a) TO REPLACE OR REPAIR ALL BROKEN OR DAMAGED GLASS, SCREENS, LOCKS, PLASTER, FLOORING, AND WOOD AT THE EXPENSE OF TENANT AND TO THE SATISFACTION OF LANDLORD OR REAL ESTATE AGENT. b) TO KEEP RADIATORS, RANGES, STOVES, WATER AND GAS PIPES, AND ALL OTHER WATER, GAS, PLUMBING AND ELECTRICAL APPLIANCES AND FIXTURES IN GOOD AND SUBSTANTIAL REPAIR AND CLEAN CONDITION, REASONABLE WEAR AND TEAR EXCEPTED. c) TO PAY FOR THE COST OF ANNUAL CLEANING OF HEATING AND COOLING SYSTEMS. d) TO KEEP THE GUTTERS AND DOWNSPOUTS CLEANED AND CLEAR OF LEAVES, NEEDLES AND OTHER DEBRIS. e) TO UNSTOP AND CLEAR ALL WASTE PIPES. f) TO MAKE NO ALTERATIONS, ADDITIONS, OR IMPROVEMENTS TO THE PROPERTY WITHOUT THE WRITTEN CONSENT OF THE LANDLORD, AND THAT ANY SUCH ALTERATIONS, ADDITIONS AND IMPROVEMENTS TO THE PROPERTY TO REMAIN UPON THE TERMINATION OF THIS LEASE. g) TO NOT INSTALL ON THE PROPERTY ANY HEATING OR AIR CONDITIONING UNIT (A /C FILTER IS TO BE CLEANED BY TENANT), WASHING MACHINE OR ANTENNAE OF ANY KIND WITHOUT WRITTEN CONSENT OF THE LANDLORD. h) TO REPLACE ALL FAUCET WASHERS AS NECESSARY 1) TO KEEP ALL DOORS AND WINDOWS CLOSED DURING RAIN OR SNOW. j) TO NOT KEEP ANY EXPLOSIVES OR ANY INFLAMMABLE FLUIDS OR MATERIAL OF ANY KIND ON THE PROPERTY. k) TO NOT AFFIX OR SUSPEND ANY SIGNS, ADVERTISEMENTS, OR NOTICES UPON OR FROM ANY PART OF THE PROPERTY WITHOUT THE WRITTEN CONSENT OF THE LANDLORD. 1) TO OBTAIN WRITTEN PERMISSION FOR ANY CHANGES TO STRUCTURE OR PAINTING. m) TENANT TO KEEP PROPERTY PROPERLY HEATED. n) TENANT TO BE RESPONSIBLE FOR MAINTAINING SMOKER DETECTORS AT ALL TIMES. o) TO NOT AFFIX ANY KIND OF ADHESIVE TO WALLS OR CABINETS (i.e. CONTACT PAPER). p) TO PAY FOR ANY DAMAGE DONE BY WIND, RAIN OR SNOW CAUSED BY LEAVING WINDOWS OPEN, BY OVERFLOW OF WATER OR STOPPAGE OF WATER PIPES, OR DETERIORATION OF LAWNS AND LANDSCAPING AS A RESULT OF NEGLECT OR ABUSE. PAGE 8 OF 12 TENANT INITIALS RENTAL AGREEMENT MISCELLANEOUS: MARK WALKER IS A PENNSYLVANIA LICENSED REAL ESTATE BROKER. LANDLORD HAS THE RIGHT TO HAVE WORK DONE AT ANY TIME AT THE PROPERTY. BUSINESS TENANTS ARE RESPONSIBLE FOR HANDICAP ACCESSIBILITY COMPLIANCE IF REQUIRED. RADON TESTING IS WAIVED. PARKING: On street, off street, carport COMMON USE AREAS: None STORAGE: In unit, yard shed, carport shed RECYCLING: New Cumberland Boro HOLDING OVERJT IS FURTHER AGREED THAT THE TERMS AND CONDITIONS OF THIS AGREEMENT AND LEASE SHALL IN NO WAY BE CHANGED OR ALTERED EXCEPT IN WRITING SIGNED BY ALL PERSONS SIGNING THIS AGREEMENT; AND IF THE TENANT SHALL CONTINUE IN POSSESSION OF THE PREMISES AFTER THE EXPIRATION OF THE LEASE TERM, AT THE OPTION OF THE LANDLORD, SUCH HOLDING OVER MAY BE HELD AND DEEMED A RENEWAL OF THIS AGREEMENT FOR ANOTHER LIKE TERM, THE SAME AS THOUGH A NEW AGREEMENT OF LEASING, IDENTICAL WITH THIS ONE, HAD BEEN EXECUTED AND DELIVERED BY ALL PERSONS SIGNING THIS AGREEMENT FOR A LIKE TERM. NON - WAIVER: SHOULD LANDLORD WAIVE HIS RIGHTS TO ENFORCE ANY BREACH OF THIS AGREEMENT, THAT WAIVER SHALL BE CONSIDERED TEMPORARY AND NOT A CONTINUING WAIVER OF ANY LATER BREACH. ALTHOUGH LANDLORD MAY KNOW WHEN ACCEPTING RENT THAT TENANT IS VIOLATING ONE OR MORE OF THIS AGREEMENT'S CONDITIONS, LANDLORD IN ACCEPTING THE RENT IS IN NO WAY WAIVING HIS RIGHT TO ENFORCE THE BREACH. ENTIRE AGREEMENT: AS WRITTEN, THIS AGREEMENT CONSTITUTES THE ENTIRE AGREEMENT BETWEEN THE TENANT AND LANDLORD. TENANT AND LANDLORD HAVE MADE NO FURTHER PROMISES OF ANY KIND TO ONE ANOTHER, NOR HAVE TENANT AND LANDLORD REACHED ANY OTHER UNDERSTANDING, EITHER VERBAL OR WRITTEN. CONSEQUENCES: VIOLATION OF ANY PART OF THIS AGREEMENT OR NONPAYMENT OF RENT WHEN DUE SHALL BE CAUSE FOR EVICTION UNDER APPROPRIATE SECTIONS OF THE APPLICABLE CODE. CO- SIGNERIGUARANTOR: THE CO- SIGNOR GUARANTOR AGREEMENT IS ATTACHED AND HEREBY MADE A PART OF THIS RENTAL AGREEMENT. h PAGE 9 OF 12 TENANT INITIALS RENTAL AGREEMENT THE FOLLOWING PROPERTY RULES AND REGULATIONS ARE HEREBY MADE A PART OF THE RENTAL AGREEMENT: 1) REQUEST ASSISTANCE FROM THE LANDLORD FOR INSTRUCTION AND HELP REGARDING THE OPERATION AND CARE OF EACH APPLIANCE OR ANY PHYSICAL PART OF THE PREMISES INCLUDING DOORS, WINDOWS, LIGHTS, PLUMBING, FLOORS, WALLS, AND THE APPLIANCES. 2) PATIOS, BALCONIES AND WINDOWS MAY BE DECORATED WITH PLANTERS HANGING BASKETS AND LAWN FURNITURE. DO NOT USE PATIOS OR BALCONIES FOR STORAGE. 3) PROVIDE OWN LIGHT BULBS (OF PROPER SIZE), FUSES AND STARTERS, 4) USE TRASH CONTAINERS PROPERLY. KEEP HALLWAYS, WALKS, AND LAWNS FREE OF PERSONAL ITEMS, PAPERS AND TRASH. 5) CONSERVE ENERGY AND ASSURE SAFETY BY NOT INSTALLING ADDITIONAL APPLIANCES OR EQUIPMENT OTHER THAN NORMAL HOME ITEMS, PRIOR PERMISSION OF THE LANDLORD MUST BE OBTAINED. 6) COMPLY WITH ALL LAWS OF THE VARIOUS GOVERNMENTS CONTROLLING THE PROPERTY. E) ALL ROOMS ARE TO BE CARPETED EXCEPT KITCHEN AND BATH ABOVE THE FIRST FLOOR, WHERE APPLICABLE. 8) NO ADDITIONAL SAFETY /SECURITY LOCKS ARE TO BE INSTALLED WITHOUT WRITTEN PERMISSION FROM MANAGEMENT. NO LOCKS MAY BE CHANGED WITHOUT WRITTEN PERMISSION. 9) UNDER NO CIRCUMSTANCES ARE ANY SUPPLEMENTARY HEATING DEVICES PERMITTED IN ANY APARTMENT OR HOUSE. SUPPLEMENTARY HEATING DEVICES INCLUDE: KEROSENE HEATERS, WOOD STOVES, SPACE HEATERS, GAS HEATERS ELECTRIC HEATERS, CAMP HEATERS, ETC. THESE HEATING DEVICES AND THEIR FUEL CONSTITUTE A GRAVE FIRE HAZARD. ANY USE OF ANY SUCH DEVICE WILL BE IN DIRECT VIOLATION OF THIS LEASE. STORAGE OF ANY FLAMMABLE SUBSTANCES IN THIS APARTMENT OR HOUSE IS PROHIBITED. 10) PLAYING OF RADIOS, STEREOS, TV OR MUSICAL INSTRUMENTS LOUDLY BETWEEN THE HOURS OF 1JPM AND BAM IS PROHIBITED. AT NO TIME MAY ANY NOISE BE AUDIBLE OUTSIDE OF THE APARTMENT /HOUSEIPREMISES. 11) ONLY STANDARD PICTURE HANGERS MAY BE USED FOR HANGING PICTURES, MIRRORS: ETC. NO ADHESIVE HANGERS MAY BE USED. 12) THE USE OF WATER FROM THE PREMISES FOR THE PURPOSE OF WASHING CARS IS PERMITTED. MAINTENANCE AND /OR REPAIRS OF ANY VEHICLE FOR ANY REASON ON THE PREMISES IS PROHIBITED. ALL VEHICLES MUST BE PROPERLY INSPECTED, MAINTAINED AND LICENSED. 13) WATER BEDS ARE PERMITTED ONLY WITH PROPER INSURANCE VERIFICATION PROVIDED TO THE MANAGEMENT /LANDLORD ANNUALLY AND AT THE SIGNING OF THIS AGREEMENT. 14) THE PREMISES IS TO BE USED SOLELY AS A RESIDENTIAL DWELLING UNIT, AND MAY NOT BE USED FOR ANY BUSINESS PURPOSES. THE TENANT AGREES NOT TO UTILIZE THE APARTMENT OR HOUSE TO CONDUCT ANY BUSINESS OR TO HOUSE ANY BUSINESS OF ANY SIZE, FOR ANY PURPOSE, FOR PROFIT OR OTHERWISE. TENANT INITIALS PAGE 10 OF 12 RENTAL AGREEMENT 15) TENANT WILL COMPLY WITH ANY ADDITIONS TO THESE RULES ENACTED BY THE LANDLORD. VIOLATION OF THE LEASE OR ANY OF THE RULES OR GUIDELINES OF THE LEASE AND THE RENTAL PROPERTY SHALL BE SUFFICIENT CAUSE FOR TERMINATION OR EVICTION AT THE OPTION OF THE LANDLORD /MANAGEMENT. 16) CARPETS MUST BE PROFESSIONALLY SHAMPOOEDICLEANED UPON MOVEOUT AND RECEIPT PROVIDED TO MANAGEMENT. INDEMNIFICATION CLAUSE: TENANT AGREES TO BE RESPONSIBLE FOR AND TO RELIEVE AND HEREBY RELIEVES LANDLORD FROM ALL LIABILITY BY REASON OF ANY INJURY OR DAMAGE TO ANY PERSON OR PROPERTY IN THE RENTED PREMISES OR ANY PART OR PORTION OF THE BUILDING OF WHICH THE RENTED PREMISES IS A PART, CAUSE BY ANY FIRE, BREAKAGE OR LEAKAGE IN ANY PART OR PORTION OF THE RENTED PREMISES, OR FROM WATER, RAIN OR SNOW THAT MAY LEAK INTO, ISSUE OR FLOW FROM ANY PART OF SAID PREMISES, OR OF THE BUILDING OF WHICH THE RENTED PREMISES IS A PART, WHETHER SUCH BREAKAGE, LEAKAGE, INJURY, OR DAMAGE BE CAUSED BY OR RESULT FROM THE NEGLIGENCE OF LANDLORD OR HIS AGENTS OR CONTRACTORS OR ANY PERSON WHATSOEVER. POSSESSION: WALKER REALTY, AGENTS, LANDLORD AND /OR OWNER ARE HEREBY RELEASED FROM ALL LIABILITY FOR FAILURE OF ANY PREVIOUS TENANT(S) TO VACATE IN A TIMELY MANNER, LEAD WARNING: DISCLOSURE FOR TARGET HOUSING RENTALS AND LEASING INFORMATION ON LEAD BASED PAINT AND /OR LEAD BASED PAINT HAZARDS. HOUSING BUILT BEFORE 1978 MAY CONTAIN LEAD -BASED PAINT. LEAD FROM PAINT, PAINT CHIPS, AND DUST CAN POSE HEALTH HAZARDS IF NOT MANAGED PROPERLY. LEAD EXPOSURE IS ESPECIALLY HARMFUL TO YOUNG CHILDREN AND PREGNANT WOMEN. BEFORE RENTING PRE -1978 HOUSING, LANDLORDS /LESSORS MUST DISCLOSE THE PRESENCE OF KNOWN LEAD -BASED PAINT AND /OR LEAD -BASED PAINT HAZARDS IN THE DWELLING. TENANTS /LESSEES MUST ALSO RECEIVE A FEDERALLY APPROVED PAMPHLET ON LEAD POISONING PREVENTION. LESSOR'S I LANDLORD'S DISCLOSURE: PRESENCE OF LEAD -BASED PAINT AND /OR LEAD BASED PAINT HAZARDS (check A or B below) A) KNOWN LEAD -BASED PAINT AND /OR LEAD -BASED PAINT HAZARDS ARE PRESENT IN THE HOUSING (EXPLAIN) X B) LESSOR /LANDLORD HAS NO KNOWLEDGE OF LEAD -BASED PAINT AND /OR LEAD -BASED PAINT HAZARDS IN THE HOUSING. RECORDS AND REPORTS AVAILABLE TO THE LESSOR (check C or D below) C) LESSOR /LANDLORD HAS PROVIDED THE LESSEE/TENANT WITH ALL AVAILABLE RECORDS AND REPORTS PERTAINING TO LEAD -BASED PAINT HAZARDS IN THE HOUSING (list documents here) X D) LESSOR HAS NO REPORTS OR RECORDS PERTAINING TO LEAD - BASED PAINT AND /OR LEAD BASED PAINT HAZARDS IN THE HOUSING. LESSEE'S /TENANT'S ACKNOWLEDGEMENT LESSE/TENANT HAS RECEIVED ALL COPIES OF ALL INFORMATION LISTED ABOVE _X LESSE /TENANT HAS RECEIVED THE PAMPHLET "PROTECT YOUR FAMILY FROM LEAD IN YOUR HOME' TENANT INITIALS 11 OF 12 RENTAL AGREEMENT SPECIAL NOTE: SHOULD TENANT PURCHASE A HOME THROUGH WALKER REALTY, TENANT MAY GIVE A 60 DAY NOTICE TO VACATE ON ANY OF THE FOLLOWING DATES- FEB 1, MARCH 1, APRIL 1, MAY 1, JUNE 1, ,JULY 1, AUG 1, SEPTEMBER 1. (Walker Realty or Walker Properties must still be managing this property) X DOES NOT DOES APPLY TO THIS LEASE LEASE RENEWAL A) TENANT RESPONSIBILITIES: NO LESS THAN 60 DAYS PRIOR TO THE EXPIRATION OF THIS LEASE, THE TENANT AGREES TO NOTIFY THE LANDLORD ANDIOR WALKER REALTY IN WRITING REGARDING THE TENANT'S INTENTIONS TO REMAIN IN OR TO VACATE THE PROPERTY AT THE EXPIRATION OF THE LEASE, B) LAND LORDIOWN ERANALKER REALTY UPON RECEIPT OF SUCH NOTICE MAY: 1) DECIDE NOT TO RENEW LEASE. 2) MAY DECIDE TO RENEW LEASE FOR TERM AND AMOUNT TO BE DETERMINED. 3) MAY TAKE NO ACTION, THIS WOULD ALLOW AUTOMATIC RENEWAL FOR TERM AND AMOUNT IDENTICAL TO CURRENT LEASE. NOTICE WAIVER SHOULD THE TENANT DEFAULT IN THIS LEASE, THE LANDLORD DOES NOT NEED TO GIVE AN ADVANCE NOTICE REQUIRING TENANT TO VACATE THE PREMISES. NOTICE TO PARTIES: WHEN SIGNED, THIS AGREEMENT IS A BINDING CONTRACT. RETURN BY FACSIMILE TRANSMISSION (FAX) OF THIS RENTAL AGREEMENT, AND ALL ADDENDA, BEARING THE SIGNATURES OF ALL PARTIES, CONSTITUTES ACCEPTANCE OF THIS AGREEMENT, PARTIES TO THIS AGREEMENT ARE ADVISED TO CONSULT AN ATTORNEY BEFORE SIGNING IF THEY DESIRE LEGAL ADVICE. ACKNOWLEDGMENT: TENANT HEREBY ACKNOWLEDGES THAT TENANT HAS READ THIS AGREEMENT, UNDERSTANDS IT AGREES TO IT AND HAS BEEN GIVEN A COPY OF IT. ATTACHED ADDENDUMS AND NOTICES ARE HEREBY MADE A PART OF THIS AGREEMENT. SMOKING OF ANY TYPE IN THIS UNIT OR ANYWHERE ON THE PREMISES IS NOT PERMITTED. $500 WILL BE CHARGED AS A RESIDENTIAL RECOVERY FEE UPON DISCOVERY OF ANY SMOKING IN THE RESIDENCE OR ANY PET ODOR. $250.00 WILL BE CHARGED AS A GROUNDS RECOVERY FEE FOR ANY CIGARETTEITOBACCO BUT CLEAN UP OR PET CLEANUP INCLUDING DAMAGED GRASS~ AREAS. t,.' TENANT R K LANDLORD /OWNER BROKER WITNESS 12 OF 12 CO- SIGNOR GUARANTOR AGREEMENT ATTACHED BUYER'S AGENCY AGREEMENT ATTACHED: TENANT AGREES TO USE WALKER REALTY AS BUYER AGENT (MICHAEL BENNETT) FOR THIS PROPERTY (OR ANY OTHER PROPERTY) BUT SPECIFICALLY IF THIS OWNER DECIDES TO SELL THIS PROPERTY OUTRIGHT OR BY SALES AGREEMENT ANDiOR RENT TO OWN IN THE FUTURE. PROCEDURt TO JBREA,.K THE 'LE A SE Property Address: Lease date: notify the Landlord €3wner. bc kl; Forward a check to the landlord /owner equal to one mouth rent: as a lease te� fee. Fifty (50 %) of your security deposit is to be forfeited as a lease termination fee. Landlord will begin to re -rent and market the property to prospective tenants. Tenant(s) must continue to pay rent until the property s re- rented-When you are out of property contact landlord for disposition of remainder of the security deposit. All tenant paid utilities must remain on active states is your name until new tenan t tames over. Terra Date Date Landlord /Owner Date Witness = : Broker Date Addendum to the lease agreement dated w `t M,, for the property at — between U,. , _ .Landlord and the Tenart(s) It is hereby ageed that regarding Washers, Dryers and portable Air Conditioners: These items generally are no €!included in our leases. Please be aware that if you would life any of these items, and it is permitted by the law dlord'ov-•ner; t at the purchase, instailation arid. ;eventual removal is totally at tenant expense. This also applies if any of these appliances are pre - existing in your unit. i If so, you may use the appliance, but you would be responsible for any repairs. X Tenant at J E'`ti ✓ D2is Landlord Witness f ,,.ness UTILITIES A N SERv ICE � d- and - - La GlOr' T ^n3a2 n`1�C t �a� �O: ti "e c aa`g S if' i' '� Property as 1 3°SSeu °CW a se i not niarked &s 7e;I7J �i7C1 L�j iYtc" dTSulvra, iit is it c Z s OiS v that service. Lan diory is not responsible for loss 7t ser V_�Cc if in �C;': }_';ec r: :?: 11i stances d Landlord Tenant Landlord Tenant PaSS pads pays pays G G Cooking Gras; 7 Lsectricity +, , u G Cable Te eviss:U- :?eat. - - 0 _ � Plot Wafer - G Ol d Watt - rash Removal �,i Lr.: E s'.f �.:- ' "«. �•' •� ° ,'- y� V Sewage Eees', G ti Seever Ma intenance G G G _ L awn and 5ht�uhbery i. are G e � e 0 Heater - Maintenance ConLract Comments: GUARANTY AGREEMENT PROPERTY: DATE OF LEASE AGREEMENT: LANDLORDIOWNER: - TENANT(t): GUARANTORS }• a � :.., � � �; v,� ;. TERM ©F ;LEASE• . ° =2 START DATE: ENO DATE: ti..Y'i'`',u DO HE EB -P,3 f RL-SFONSIBLE TO THE LANDLORD FOR I HE T RUE- AND) Fri: 3 PERFORMANCE OF THE ABOVE REFERENCED LEASE AGRcE =.y,IE,NT ON PART Or } -T r r v ;, iv . MEIN OF AL L SUMS DUE TO LANDLORD By T t: i�tiN : , .u, W . r OTHER TENANT RESPONSIBILITIES BUT NOT LIM T E-D � T E� LI;KE UTILITIES AND MINOR MAINTENANCE ITEMS, ETC. GUARt "' N; v AGREEMENT SHALL, ,REMAIN IN EFFECT THROUGHOUT THE TERV OF THE I�cASE AGREEMENT, NOTWITHSTANDING AIRY .' E - �CRE.'.SE O I RErNEWAL�OF THE LEASE AGREEMENT. ~` ,.f NESS TENANT }61 rc� 1: irN E TENA N T WITNESS GUARANTORS Y' 'TN SS BROKER �''� t - (r1 - �[}s�r t'. NLE SS LANDL�;RD /OV�N LE T Id.W1411)IiINFULL I_.Et- M', as• r by nN [estridad ao se by. mcmn - r oF!i}z Fer +a,yicuai:, rs ;rdalic� Of RPAiTvPS+ (P.4Ri. . PROPERTY - L kNDLOR { TENANT(S) — DATE OF LEASE x `- I- Allowanate of Pei(s): Lmid!ord agrees that the pegs) des: ribed in Paragraph 7 map be permitted on the Property- `lenaim nlay sot have any other pet(s) on gay part of the Property w.ti ouC Landlord's wa t: "er: pernniesibn. 2. Location of Pet(s): Pet(si r>i:l be kept inside the Pscf erYv_ at all times, except wv en cm a lea5ih m otherw :se restrained by and under the full control of Tenant. Exceptions: _ �- ?. Tenaut's Duties: Tenani n.ill clean up after the pet(s) in any area of the Properi.,� including conttnon areas. 4. Loss or Dautage_ Tenant is - esRmsible for any less or damage caused by the rtit(si. Tenart agt'ees that Landlord Y.ea s no r sraasibilih, for any carnage, injury or utisance caused by the pegs). 5. Removal of Pet(s): if Landlord deter that.the pet(s) is annoying, bothersome, Orin any way a nutsance to ott=ers, L.andlors will aofi`y Tenant in writing and Tenant will remove the pets) immediately from the Property. All oUter terms and conditions of this lease wiil Terrain ir: E61 force and effect: Tenant's failure to remove 8u pet(s) ,rern the Property will be grounds for eviction- 5. Additional Fees/Charges: A. 0 Tenant will pa as a Pet Deposit in addition to Other deposits requires by the Lease. 1. The Pet Deposii ;s subject to the same prcvissior.s as the Security Deposit as outlined in tine Lease. '. 2. Any ?ant of (lie Properly or any eommop areas fouled by the pet(s) 'milt be professionally cleaned and treated upon: termination of ft, fi ease. This will include carpet cleaning, hcatmcnt for flea infestation, or any other;reatment ss deenned necessary by Landlord in order to return the Property to the condition as exisled at tcke start of tale Lease. The cost o` One cleaning and//or in_atment will be deducted from the Pet Deposit - 3. if damage cat: ed by the pet(s) exceeds the amount of the Pet Deposit, additional costs must be paid by Tenaui irrrznediataly upon demand by Landiord- B. 0 T tll dditional S monthly cent, / sfu X ab i. — -- - -- 7. Description of Pet(s): itz'•. i tlmbar of Pet(s) A. Typa of Animal — rw' 11re�d Natae cf Pe_,� _ ' <g Weight License Number (if applicable) Spayed/aeutered? `es a No Declawed? G `',es o B. Type of Animal Breed -- Name of Pet,_______. Color _ ___ License Number (if applicable) Spa?ed /neuterad? D Yas 0 No Declawed7 Cl Yes No C. Type of Animal_, Breed _ Name of 1'et Age Wei ;ht Colo: _ _ License Number (if applicable) Spayedtreutered? 11 Yes 1- 1 loo Declawed? O `;es 0 No D. Type of Animal_, _ Breed 1 Larne of Pet — Age _ Vveisht . Color License Number (if applicable) - Spayediireutered? D Yes 11 No Declawed? 0 yes u No 8. NOTIM Guide/Suppert Animals Pei ;asylvania law makes it illegal for a landlord to icfuse to rent property or otherwise discriminate against any person on the basis Of the uie of a guide a_ ;MA-i because of blindness or deafness, or use of a support animal because of a physicai hmldic or because the user is a handler o. trainer of support or guide animals. 9. NOTICE. Dsugemtts M)gs Pennsylvania late rttakes ii a st:tnmary offense foq harboring a "dangerous dog." Lender no circumstances is a "dangerous dog" per mitteci on the Propel w. A db2 is considered dangerous under P.S. §459 - 502 - A(a) xvinere: A. '171e dog bas done one or more of the follarving: 1. Inflicted severe injury on a human being without provocation on public or piivate property. 2. Killed or inflict-_t severe injury on a domestic animal without provocation while Orr his owner's property. 3. Attacked a human 1 1 , ei ng without provocation. 4. Been used in a �omnlE55ion of a crime. B. The dog has cilia or boil;: of the following: I. A history of ettackiang hurnan beings and/or domestic animals without provocation. 2. A propensity tc ::tack !,.tman beings and/ordotnestic animals without provocation. A propensity to attack maybe proven by a single ii:c er:t of the conduct described in paragraph A_ l), (2), (3), or (4). f All other terms and cnnditJcris of Use Tease remain unchanged and in full force and effect. - �C f' � € '�� C �g li ti �iiITvLS6_ _ _— ......._ TENANT =' — ?` DATE — WiTNESS- -_—___ — TENANT DATE—___ TENANT �_. - ---. DATE_ —. kFITNES'S _, LAN )LORD _ _ DA7V_ .. -. i WITNESS LANDLORD OT Pennsylvania Association of W(1Pt [ li Fi P El 'NSl VAN1A ASSXUATttA' Or RFAT TOM r999 CONES. L ;1IfrE -LAO . r. 5'E n tCEh C -TL• !T �?- S •y� 1w Were NrT6E le hrvmi'.aa •- . N9'. \'ttlti ov uAU()N . ltiliiatl) t A)!) wrrnln) snnlwu) rta ,lyauxtcrnneglowptwrnw, slwo- er ltaduulint p<tad :Liw• i 1�t1 L.l s �t (3A U�� -a_. -� c7 1 /h•'.:r IweL3HVVindge hdlEuYroNe,lywa wxrcdm lb -w-, tYil t tti) (�,$..1'Uttf M1ICU,iYEUY,I tle 1 !)) J" with slU ' - imAto of all Woo iadl sted I)ett)w . I TYI'6 Or +1T3$'T RAS[ If:1S (Pitocwits/I ter at wtuklag lew,r} .... , -. - .. _»_.__ ... .... t , n wtu ce oa to. drote(s} Property nd t+r tht+ nndvrd {a) exiv.niCd trPlgtn rty Addtea5 � (_a 2 (1 r h«s paaaledESo l4et the t'nfpraty ,mdawert rr ��) tap o! _ . - r eferred 17AfG RAI'17tJ ItIitNJCITON Ma'R10I) Tell nt 1s hereby advia exist ie1, t or rn +ncl tile Prope<Ey ill au �Mnid�rnay havr. l te1 tia _ rtcr _ vwr her in as "Mold ") "lay urirrs, allergic midlor respiratory Coping Or ALLAVAILAe1. 13T ESTRRCoRTBwW.dA[vea'edtni�a�'T w,tauriyn r n �� . but not Ihllited to, physictrl U problems, yerutl; o in L:ause ht:alih effect" including, Slrfi6tiq'IrBlWttiTHOQ3 ARt1S1R.T8nP7rtII fTiSlTS. rcacticils or other p particularly in peYsnns with ilrtml.lrte systerFr i Ltl) lttyfoN - wsprrzUoN crrmr)rrc;;ttivelr y.w,w1 F"lli l or1'3014 t Irat ihr. e . n u, 1> rl,o lkupert. ier�Fxelod tar n+>iou t,y :f ucerdia! )unpmGM r "• r' . rhildreFl a.urf/ar elderly Persons. +� WAtvr n.,T� •• • rv° : its that Tenant deems ner:essary or `Pi:nant acknowledges and accr)pGS the possibility of, and rick assrx:iatcriwiill, the presence of Mold. "E'enant agrtes to conduct all insl)ectini)cs, p)iar to ctosiltt3, it — desifal)le to drtenninr; tht; exle letemlirle L le pr s nos of Motd rt heiicliytlianTi shall — iii, if ally, he 'fulant's reeponuibility to leseutstion frr)ar the landl c n rhil] slid wan'aais I.hnt 'l.'c iant l lo t a fe i lla, Pl` sence al' Mold ial, or around the Peopelly, our has walker Realty anti agents Tog; P the Pro ett or ifs Terlanf rrlied on the a to lanldldete n£i tatiort r olicet ling the Press t c of Mold in the in tPe Py)pe•dy as a btsla JIM "easing l J libbers. b and a revs to arse t full responsibility far, and assuffw a roes to r ep j*tstlautackuowledg's s well as their that 11111 11111Y result frorn Mold in,t o a or OTT. d• a P %CttV. l' rant hnteb k the lVdiord, M. C, `Nallser Realty respective uffirers, mnployatss, ageu#s, heirs, cxei'i, adult rwiso} tbntePano>7ot nay incur as a Flal"inless froth any (f (finaord c Peaxnt u uderstanris that the _......_S lilt of the Presctica of Mold in, on or around the Prop rty. _ . __. .._._....... __.. - .. .... _._...... _. _.. prod) isgsanriregresr ntationsmade- tn. tlnskZeiGFiseart: amRtenel)ndnreur°ntfnrl.andlort o enter into the contract to cent the Propet'ty to Tenant. Tenant herel)y acknowledges reading this discloswc turd rslease and is aware of the condition set n1)nnt's chcu)sing prior,.it,) the execution oFthis dot:ument > Barth 'I7tis riiscIosurE rth tllerrnl, '1'Cna111 h beet! t ivon the oppollunity t0 diSCLtt6 dOeltmP.t)t Wt discley re otllr r icpresvIt'attva of T anti with iLLll krtawtedge of its s i g n ificalrcc. wid release is exrxutecl.vutuntnrily inntlnus cc),wcr'ning lx)vsibli iteatule tulcnudu�tt 11rl�irtu r svu 72c;a1 l state lttokrt's Fond ttle)tts art: trot qualttled to laaptet Property Ill mot P n ol, racou.mrxt St4ntts or Bete) to t ) t 1 „ ! � t t j 5a letr issues. TI)e P upose of tibia disc loyut•e is to t)ot fe)tnn is cnr 11 due ddtgeuce regarding tltts'inatter. ..._ gate rmwt { tenant - ' The Future Hume Buyer's Addendum This Futw -e home buyer's Addendum to the rental agreement dated Between Tenxn l And Lan.dlord/Ov,Tie F i Is hereby made a part of the rental agreement for the property: ICI. C. `vV 4 It ' s Main v i - allt�_ R °a y business is Home Sales (rcp reseriting �-a�;-ers and set "_Y_s. Th :etorL n Li v, Initiated a prog;a__.:o encourage te; a:,ts to hecorxe I oneoxvners by parchasiiLg M. C. Walker Realty. For the renta.oeatior1: i k> a , ;, . The credit paY alnle at settlement 'lo be: r `= w reia �. The followi 4 re_'q uirements must be met in order to receive the rent '_'�-`bate: t j .Men ar' purchas s t1Le t ;-� M. r' w e i :- v �� propem,, tenan ag, es t o usek. C. tt� u __. __ Me �. 2) M. C. W'alker Realty must be the selling agent fOr the proper_v beir:g o b i~e L =ug= . 3 L t . V"aiker Rea.Ity:mt;st receive tlae real estate fee /co:I'inission paypblc at sv.:__�1fa 4) Tenant.-Buyer must si a buyer agency e ploy t ^n it =; ti;� M C :; u :ter Rtait< i✓' a n1 :;leiZ� �-.• - _raC wi M. C . - - designated as the Buyer's Agent for the home pturcl?ase. Tenant Sip a :� :re � T enant Sig.n.ature Landlord/O `r`A State Farm HETRICK. STEPHEN 38 -1685 -366 Main Level Main Level DESCRIPTION QUANTI'T'Y UNIT COST RCV DEPREC. ACV Haul debris - per pickup truck load - 1.00 EA 122.07 122.07 122.07 including dump fees General clean - up 4.00 HR 29.68 D 118.72 118.72 Content Manipulation charge - per 1.00 HR 27.66 D 27.66 27.66 hour Verv_Jeii' contents remain in the home Added labor below as outlined: Drywaller 4 hr needed 1.39 hr provided Drywall Installer / Finisher - per hour 2.61 HR 54.27 D 141.64 141.64 Total: Main Level 410.09 0.00 410.09 ~� r Living Room Height: 8' ia 500.00 SIB Walls 218.25 SF Ceiling .b 1 +�� A r 718?5 SF Walls & Ceiling 218.25 SF Floor 64.17 LF Ceil. Perimeter 62.17 LF Floor Perimeter irn Missing Wall - Goes to Floor 2' X 6 Opens into HALL Subroom: CLOSET (1) Height: 8' T 97.33 SF Walls 9.04 SF Ceiling 106.38 SF Walls & Ceiling 9.04 SF Floor l 12.17 LF Ceil. Perimeter 12.17 LF Floor Perimeter x DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Floor protection - self- adhesive plastic 227.29 SF 0.42 95.46 95.46 film Drywall patch / small repair. ready for 1.00 EA 40.37 40.37 40.37 paint Date: 8/29/2012 4:26 PM Page: 5 State Farm HETRICK, STEPHEN 38 -1685 -366 CONTINUED - Living Room DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Seal /prime then paint the surface area 4.00 SF 0.63 2.52 2.52 (2 coats) Paint the walls - one coat 597.33 SF 0.40 238.93 (79.64) 159.29 Screen and coat wood floor 227.29 SF 1.21 275.02 (137,51) 137.51 Add for dustless floor sanding 227.29 SF 1.00 227.29 227.29 Clean floor 227.29 SF 0.29 D 65.91 65.91 Totals: hiving Room 945.50 217,15 728-35 -+- 3' T T Bedroom 1 Height: 8' - o- 1 ms 40167 SF Walls 135.67 SF Ceiling 7 06d 538.33 SF Walls & Ceiling 135.67 SF Floor T T 52.00 LF Ceil. Perimeter 50.00 LF Floor Perimeter 1 . t L - ea oom Missing Wall - Goes to Floor 2' X 6' R" Opens into HALL Subroom: ROOM3 (1) Height: 8' T 132.00 SF Walls 14.64 SF Ceiling M . 146.64 SF Walls & Ceiling 14.64 SF Floor ©_ N 16.50 LF Ceil. Perimeter 16.50 LF Floor Perimeter Dedru m 1 2� 11 r DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV R &R Interior door unit - Standard 1.00 EA 146.30 146.30 (7.32) 138.98 grade Detach &. Reset Door knob - interior - 1.00 EA 20.95 D 20.95 20.95 Standard grade Paint door slab only - 2 coats (per side) 1.00 EA 20.10 20.10 20.10 Date: 8/29/'20'12 4:26 PM Page: 6 State Farm HETRICK, STEPHEN 38 -1.68S -366 CONTINUED - Bedroom 1 DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Screen and coat wood floor 150.31 SF 1.21 181.88 (90.94) 90.94 Add for dustless floor sanding 150.31 SF 1.00 150.31 15031 Clean floor 150.31 SF 0.29D 43.59 43.59 Totals: Bedroom 1 563.13 98.26 464.87 { H al l Height: S' o r Tm = wxoom 123.33 SF Walls 21.49 SF Ceiling 144.82 SF Walls & Ceiling 21.49 SF Floor � 20.83 LF Ceil. Perimeter 14.33 LF Floor Perimeter PM Bedroom 2 Missing «'all - Goes to Floor 2' X 6' 8" Opens into LIVING Missing Wall - Goes to Floor 2' 6 X 6' 8" Opens into DINING ROOM Missing Wall - Goes to Floor 2' X 6' 8" Opens into BEDROOM DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Paint door slab only - 2 coat, (per side) 1.00 EA 20.10 20.10 20.10 Screen and coat wood floor 21.49 SF 1.21 26.00 (13.00) 13.00 Add for dustless floor sanding 21.49 SF 1.00 21.49 21.49 Clean floor 21.49 SF 0.29 D 6.23 6.23 Totals: Hall 73.82 13.00 60.82 Date: 8/29;2012 4:26 PM Page: 7 State Farm HETRICK, STEPHEN 38 -1685 -366 l `! Bedroom 2 Height: 8' -4 Eli 349.33 SF Walls 119.17 SF Ceiling ~ T 468.51 SF Walls & Ceiling 119.17 SF Floor 43.67 LF Ceil. Perimeter 43.67 LF Floor Perimeter :14'6` [4'V i DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Detach & Reset Mirror - 1/4" Plate 10.00 SF 5.64 D 56.40 56.40 glass Finish Carpenter - per hour 1.00 HR 62.65 D 62.65 6165 Ahove two items to repair broken frarne to wall mounted mirror Screen and coat wood floor 119.17 SF 1.21 144.20 (72.10) 72.10 Add for dustless floor sanding 119.17 SF 1.00 119.17 119.17 Clean floor 119.17 SF 0.29 D 34.56 34.56 Totals: Bedroom 2 416.98 72.10 344.88 ` Dining Room Height: 8' W 295.33 SF Walls 85.78 SF Ceiling 381.12 SF Walls & Ceiling 85.78 SF Floor 39.00 LF Ceil. Perimeter 36.50 LF Floor Perimeter Missing Wall - Goes to Floor 2' 6" X 6' 8 Opens into HALL DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Screen and coat wood floor 85.78 SF 1.21 103.79 (51.90) 51.89 Add for dustless floor sanding 85.78 SF 1.00 85. 85.78 Totals: Dining Room 189.57 51.90 137.67 Date: 8/291'2012 4:26 PM Page: 8 State Farm HETRICK, STEPHEN 38 -1.685 -366 - -1 Height: 8' Bathroom b Bathroom :°� r4 251.82 SF Walls 51.59 SF Ceiling j 303.41 SF Walls & Ceiling 51.59 SF Floor 31.48 LF Ceil. Perimeter 31.48 LF Floor Perimeter " hedrbam 2 DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Detach & Reset Interior door unit 1.00 EA 55.18 55.18 55.18 R &R Door opening (jamb & casing) - 1.00 EA 92.28 9 2.2 8 9128 Lip to 32 "wide - paint grade Paint door /window trim & jamb - 2 1.00 EA 19.86 19.86 (6.62) 13.24 coats (per side) Totals: Bathroom 167.32 6.62 160.70 Kitchen 0.00 SF Walls 0.00 SF Ceiling 0.00 SF Walls & Ceiling 0.00 SF Floor 0.00 SF Short Wall 0.00 LF Floor Perimeter 0.00 SF Long Wall 0.00 LF Ceil. Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Rear entry area: R&R Storm door assembly - Standard 1.00 EA 177.51 177.51 (44.38) 133.13 grade R &R Exterior door slab - insulated 1.00 EA 342.21 342.21 (102.66) 239.55 metal or wood - High grade Detach & Reset Door lockset - 1.00 EA 20.95 D 20.95 20.95 exterior - Standard grade Prime & paint door slab only - 2.00 EA 30.75 61.50 (20.50) 41.00 exterior (per side) R&R Interior door unit 1.00 EA 153.45 153.45 (7.67) 145.78 Detach & Reset Door knob - interior - 1.00 EA 20.95 D 20.95 20.95 Standard grade Paint door slab only - 2 coat, (per side) 1.00 EA 20.10 20.10 20.10 Cabinet drawer repair: Date: 8/29/2012 4:26 PM Page: 9 State Farm HETRICK, STEPHEN 38 -1.685 -366 CONTINUED - Kitchen DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV R &R Cabinet drawer front - Standard 0.98 SF 16.97 16.64 16.64 grade Carpenter - Finish, Trim / Cabinet - 2.00 HR 62.65 D 125.30 125.30 per hour Actual repair above should he to detach & reset the drawer face to a new drainer; l do not have an entry for a drmver only (no face). Please advise andforward docutnentation if the repair exceeds the above two entries. Detach & Reset Cabinet knob or pull - 12.00 EA 1.74 20.88 20.88 Standard grade Seal & paint cabinetry - lower - faces 8.00 LF 13.67 109.36 109.36 only Ahove to paint the left lower eahinets where the drawer is being repaired Totals: Kitchen 1,068.85 175.21 893.64 Exterior 0.00 SF Walls 0.00 SF Ceiling 0.00 SF Walls & Ceiling 0.00 SF Floor 0.00 SF Short Wall 0.00 LF Floor Perimeter 0.00 SF Long Wall 0.00 LF Ceil, Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV R &R Rural mailbox 1.00 EA 45.52 D 45.52 (11.38) 34.14 R&R Mailbox post - wood 1.00 EA 66.30 D 66.30 (16.58) 49.72 Includes: Mailbox post and installation labor. Quality: 4 "x 4 "solid cedar post and mounting arm and a drive in steel anchor. Totals: Exterior 111.82 27.96 83.86 Area Totals: Main Level 2,151.82 SF Walls 65.5.64 SF Ceiling 2,807.45 SF Walls and Ceiling 655.64 SF Floor 726.68 Total Area 266.81 LF Floor Perimeter 655.64 Floor Area 141.79 Exterior Perimeter 279.81 LF Ceil. Perimeter 1,276.08 Exterior Wall Area of Walls 2,151.82 Interior Wall Area Total: Main Level 3,947.08 662.20 3,284.88 Date: 8/29/'2012 4:26 PM Page: 10 State Farm HETRICK, STEPHEN 38 -1685 -366 Basement 1- 1 0- 7 " Bedroom Height: 8' T 9 1 288.00 SF Walls 80.16 SF Ceiling '` er1£ln 368.16 SF Walls & Ceiling 80.16 SF Floor �II 2 V 2' 1.1" 36.00 LF Ceil. Perimeter 36.00 LF Floor Perimeter 1 DE SCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Reglaze window, 1- 9 sf 1.00 EA 50.36 D 50.36 50.36 Drywall patch / small repair, ready for 1.00 EA 4037 40.37 40.37 paint Seal /prime then paint the surface area 4.00 SF 0.63 2.52 2.52 (2 coats) Paint the walls - one coat 288.00 SF 0.40 115.20 (38.40) 76.80 Totals: Bedroom 208.45 38.40 170.05 E' 4" } {t' 1" Laundry Height: 8' � 7,.. 189.61 SF Walls 25.13 SF Ceiling - = r 214.74 SF Walls & Ceiling 25.13 SF Floor 23.70 LF Ceil. Perimeter 23.70 LF Floor Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Detach & Reset Door knob - interior - 1.00 EA 20.95 D 20.95 20.95 Standard grade R&R Interior door - lauan/mahogany - 1.00 EA 86.72 86.72 (4.34) 8238 slab only Paint door slab only - 2 coats (per side) 3.00 EA 20.10 60.30 (20.10) 40.20 Above for bath sides of'laundry door and basement 1st floor entry door (basement .side). Totals: Laundry 167.97 24.44 143.53 Date: 8/29/2012 4:26 PM Page: 11 State Farm HETRICK, STEPHEN 38 -1685 -366 Basement Height: 8' 371.33 SF Walls 202.57 SF Ceiling 573.90 SF Walls & Ceiling 202.57 SF Floor 46.42 LF Ceil. Perimeter 46.42 LF Floor Perimeter Z Subroom: OFFSET (1) Height: 8' 226.27 SF Walls 98.66 SF Ceiling � 324.93 SF Walls & Ceiling 98.66 SF Floor 33.28 LF Ceil. Perimeter 27.28 LF Floor Perimeter Missing Wall - Goes to Floor 6' X 6' 8" Opens into Exterior Missing Wall 21'7" X 8' Opens into BASEMENT Z 1 1 ° Subroom: H V A C (2) Height: 8' T 133.61 SF Walls 15.40 SF Ceiling 149.01 SF Walls & Ceiling 15.40 SF Floor ri . � 16.70 LF Ceil. Perimeter 16.70 LF Floor Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV No related damage - water leak - also affected doonvoy to hedroo :n Totals: Basement 0.00 0.00 0.00 Area Totals: Basement 1,208.82 SF Walls 421.92 SF Ceiling 1,630.74 SF Walls and Ceiling 421.92 SF Floor 464.81 Total Area 150.10 LF Floor Perimeter 421.92 Floor Area 99.20 Exterior Perimeter 156.10 LF Ced. Perimeter 852.81 Exterior Wall Area of Walls 1,208.82 Interior Wall Area Total: Basement 376.42 62.84 313.58 Line Item Subtotals: 38 -168S -366 4,32350 725.04 3,598.46 Date: 8/29/2012 4:26 PM Page: 12 State Farm HETRICK, STEPHEN 38 -1685 -366 Adjustments for Base Service Charges Adjustment Carpenter - Finish, Trim/Cabinet 12530 Drywall Installer/Finisher 217.08 Wood Flooring Installer 125.40 Painter 49.58 Total Adjustments for Base Service Charges: 567.36 LINE ITEM TOTA LS: 38 -168S -366 4,890.86 725.04 4,165.82 Grand Total Areas: 3,360.63 SF Walls 1,077.56 SF Ceiling 4,438.19 SF Walls and Ceiling 1,077.56 SF Floor 416.91 LF Floor Perimeter 435.91 LF Ceil. Perimeter 1,077.56 Floor Area 1,191.49 Total Area 3,360.63 Interior Wall Area 2,128.89 Exterior Wall Area 240.99 Exterior Perimeter of Walls Date: $/29/2012 4:26 PM Page: 13 Basement — ._____._._.._ -_ 10' 7" Bedroom .44' .q a,! ... 1. t 14'9' I IVAC - (2Y� v> Offset (11 21' 7" v v Ba erit J L;c 15' 3 25 4,,: B3sem2nf Date: 8/29/2012 4:26 PM Page: 14 Main Level 1$'11" T T' 11' 4" 12' FE- Ruon...E 2' 7 Bedcoam..l. Closet t � L.Mm Raam \\ 2 , 1 Bathroom t v i 12'11" 1 13, ' _ T t Qinina Room- Damage path (furniture drac c e) on wood floor . 11'7 ... ` r Main te�� Date: 8/29/2012 4:26 PM Page: 15 State Farm HETRICK, STEPHEN 38 -1.68S -366 Insured: HETRICK, STEPHEN Estimate: 38 -1685 -366 Property: 804 Coolidge St Claim Number: 38168S366 New Cumberind, PA 17070 -1427 Policy Number: 98- 130- W531-4 Home: (716) 255 -5727 Price List: PAHA9F AUG 12 Type of Loss: Other Restoration/Service/Remodel Deductible: $1,000.00 F Factored In, D_ Do Not Apply Date of Loss: 811/2012 Date Inspected: 8//3/2012 Summary for Dwelling Line Item Total 4,890.86 Material Sales Tax @ 6.000 1 1 ' 0 x 1,148.20 68.89 Subtotal 4,959.75 General Contractor Overhead (a 10.0% x 4,959.75 495.98 General Contractor Profit 10.0% x 4,959.75 495.98 Cleaning Sales Tax (a; 6.000% x 322.81 19.37 Replacement Cost Value (Including General Contractor Overhead and Profit) 5,971.08 Less Depreciation (Including Taxes) (741.19) Less General Contractor Overhead & Profit on Recoverable & Non - recoverable Depreciation (148.24) Less Deductible (1,000.00) Net Actual Cash Value Payment $4,081.65 Maximum Additional Amounts Available If Incurred: Total Line Item Depreciation (Including Taxes) 741.19 General Contractor O &P on Depreciation 148.24 Total Maximum Additional Amount Available If Incurred 889.43 Total Amount of Claim If Incurred $4,971.08 Smith, Lori (800) 406 -8543 x 2002292 ALL AMOUNTS PAYABLE ARE SUBJECT TO THE TERMS, CONDITIONS AND LIMITS OF YOUR POLICY. Date: 8/29/2012 4:26 PM Page: 3 StateFarm Explanation of Building Replacement Cost Benefits owl Rental Dwelling Policy Dwelling To: Name: HETRICK, STEPHEN Address: 804 Coolidge St City: New Cumberind State /Zip: PA, 17070 -1427 Insured: HETRICK, STEPHEN Claim Number: 38168S366 Date of Loss: 8/1 /2012 Cause of Loss: OTHER Your insurance policy provides replacement cost coverage for some or all of the loss or damage to your dwelling or structures. Replacement cost coverage pays the actual and necessary cost of repair or replacement, without a deduction for depreciation, subject to your policy's limit of liability. To receive replacement cost benefits you must: 1. Complete the actual repair or replacement of the damaged part of the property within a reasonable time frame after the loss. 2. Confirm completion of repair or replacement by submitting invoices, receipts or other documentation to your agent or claim office. Until these requirements have been satisfied, our payment(s) to you will be for the actual cash value of the damaged part of the property, which may include a deduction for depreciation. Without waiving the above requirements, we will consider paying replacement cost benefits prior to actual repair or replacement if we determine repair or replacement costs will be incurred because repairs are substantially underway or you present a signed contract acceptable to us. The estimate to repair or replace your damaged property is $5,971.08. The enclosed claim payment to you of $4,081.65 is for the actual cash value of the damaged property at the time of loss, less any deductible that may apply. We determined the actual cash value by deducting depreciation from the estimated repair or replacement cost. Our estimate details the depreciation applied to your loss. Based on our estimate, the additional amount available to you for replacement cost benefits (recoverable depreciation) is $889.43. If you cannot have the repairs completed for the repair /replacement cost estimated, please contact your claim representative prior to beginning repairs. All policy provisions apply to your claim. Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or a statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties. Date: 8/29/2012 4:26 PM 123976.5 03 -24 -2010 Page: 4 State Farm HETRICK, STEPHEN 38-1.685 -366 Main Level Main Level DESCRIPTION QUANTI'T'Y UNIT COST RCV DEPREC. ACV Haul debris - per pickup truck load - 1.00 EA 122.07 122.07 122.07 including dump fees General clean - up 4.00 HR 29.68 D 118.72 118.72 Content Manipulation charge - per 1.00 HR 27.66 D 27.66 27.66 hour Verti ft contents remain in the home Added labor below as outlined: Drywaller 4 hr needed 1.39 hr provided Drywall Installer / Finisher - per hour 2.61 HR 54.27 D 141.64 141.64 Total: Main Level 410.09 0.00 410.09 F -g --- Living Room Height: 8' 10 500.00 SF Walls 218.25 SF Ceiling T ur3xfla� 1 r 718.25 Sr- Walls & Ceiling 218.25 SF Floor - -► -rz' z-. ty 64.17 LF Ceil. Perimeter 62.17 LF Floor Perimeter HIM ii. Roa Missing Wall - Goes to Floor 2' X 6' 8" Opens into HALL Subroom: CLOSET (1) Height: 8' T 97.33 SF Walls 9.04 SF Ceiling t 106.38 SF Walls & Ceiling 9.04 SF Floor I ' N 12.17 LF Ceil. Perimeter 12.17 LF Floor Perimeter 1 x. DESCRIPTIO QUANTITY UNIT COST RCV DEPREC. ACV Floor protection - self - adhesive plastic 227.29 SF 0.42 95.46 95.46 film Drywall patch 1 small repair, ready for 1.00 EA 40.37 40.37 40.37 paint Date: 8/29/2012 4 :26 PM Page: 5 State Faim HETRICK, STEPHEN 38 -1685 -366 CONTINUED - Living Room DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Seal /prime then paint the surface area 4.00 SF 0.63 2.52 2.52 (2 coats) Paint the walls - one coat 597.33 SF 0.40 238.93 (79.64) 159.29 Screen and coat wood floor 227.29 SF 1.21 275.02 (137.51) 137.51 Add for dustless floor sanding 227.29 SF t.00 227.29 227.29 Clean floor 227.29 SF 0.29 D 65.91 65.91 Totals: Living Room 945.50 217.15 72835 ..a...3 2 1. Bedroom 1 Height: 8' a s,, -1 402.67 SF Walls 135.67 SF Ceiling Z . t 538.33 SF Walls & Ceiling 135.67 SF Floor 52.00 LF Ceil. Perimeter 50.00 LF Floor Perimeter DOM 1 D, Missing Wall - Goes to Floor 2' X 6' 8 Opens into HALL 1"A Subroom: ROO M3 (1) Height: 8' T - � 132.00 SF Walls 14.64 SF Ceiling i i V 146.64 SF Walls & Ceiling 14.64 SF Floor ©_ N" 16.50 LF Ceil. Perimeter 16.50 LF Floor Perimeter sy Bedroom 1 2 11 + DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV R&R Interior door unit - Standard 1.00 EA 146.30 146.30 (7.32) 138.98 grade Detach & Reset Door knob - interior - 1.00 EA 20.95 D 20.95 20.95 Standard grade Paint door slab only - 2 coats (per side) 1.00 EA 20.10 20.10 20.10 Date: 8/29;2012 4:26 PM Page: 6 State Farm HETRICK, STEPHEN 38 -1685 -366 CONTINUED - Bedroom I DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Screen and coat wood floor 150.31 SF 1.21 181.88 (90.94) 90.94 Add for dustless floor sanding 150.31 SF 1.00 150.31 150.31 Clean floor 150.31 SF 0.29 D 43.59 43.59 Totals: Bedroom 1 563.13 98.26 464.87 2 { Hall Height: 8' 123.33 SF Walls 21.49 SF Ceiling _ N 144.82 SF Walls & Ceiling 21.49 SF Floor ��- 20.83 LF Ceil. Perimeter 14.33 LF Floor Perimeter l no doom 2 Missing Wall - Goes to Floor 2' X 6' 8 Opens into LIVING Missing Wall - Goes to Floor 2' 6 X 6' 8" Opens into DINING Missing Wall - Goes to Floor 2' X 6' 8" Opens into BEDROOM DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Paint door slab only - 2 coats (per side) 1.00 EA 20.10 20.10 20.10 Screen and coat wood floor 21.49 SF 1.21 26.00 (13.00) 13.00 Add for dustless floor sanding 21.49 SF 1.00 21.49 21.49 Clean floor 21.49 SF 0.29 D 6.23 6.23 Totals: Hall 73.82 13.00 60.82 Date: 8/29/2012 4:26 PM Page: 7 State Farm HETRICK, STEPHEN 38 -1685 -366 Bedroom 2 Height: 8' 1 �. -tU 1t Eli 349.33 SF Walls 119.17 SF Ceiling L ~ T pmt 468.51 SF Walls & Ceiling 119.17 SF Floor 43.67 LF Ceil. Perimeter 43.67 LF Floor Perimeter F DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Detach & Reset Mirror - 1/4" plate 10.00 SF 5.64 D 56.40 56.40 glass Finish Carpenter - per hour 1.00 HR 62.65 D 62.65 62.65 Above two iterns to repair broken frmne to wall mounted rnirror Screen and coat wood floor 119.17 SF 1.21 144.20 (72.10) 72.10 Add for dustless floor sanding 119.17 SF 1.00 119.17 119.17 Clean floor 119.17 SF 0.29 D 34.56 34.56 Totals: Bedroom 2 416.98 72.10 344.88 "'- Dining Room Height: 8' N 295.33 SF Walls 85.78 SF Ceiling B 381.12 SF Walls & Ceiling 85.78 SF Floor T 39.00 LF Ceil. Perimeter 36.50 LF Floor Perimeter zo r. Missing Wall - Goes to Floor 2' 6" X 6' 8" Opens into HALL DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Screen and coat wood floor 85.78 SF 1.21 103.79 (51.90) 51.89 Add for dustless floor sanding 85.78 SF 1.00 85.78 85.78 Totals: Dining Room 189.57 51.90 137.67 Date: 8/29/2012 4:26 PM Page: 8 State Farm HETRICK, STEPHEN 38 -1.685 -366 Bathroom Height: 8' r T r - 7 «, c4 251.82 SF Walls 51.59 SF Ceiling L 303.41 SF Walls & Ceiling 51.59 SF Floor 31.48 LF Ceil. Perimeter 31.48 LF Floor Perimeter Bedroom 2 DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Detach & Reset Interior door unit 1.00 EA 55.18 55.18 55.18 R&R Door opening (jamb & casing) - 1.00 EA 92.28 92.28 92.28 up to 32 "wide - paint grade Paint door /window trim & j amb - 2 1.00 EA 19.86 19.86 (6.62) 13.24 coats (per side) Totals: Bathroom 167.32 6.62 160.70 Kitchen 0.00 SF Walls 0.00 SF Ceiling 0.00 SF Walls & Ceiling 0.00 SF Floor 0.00 SF Short Wall 0.00 LF Floor Perimeter 0.00 SF Long Wall 0.00 LF Ceil. Perimeter DE SCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Rear entry area: R&R. Storm door assembly - Standard 1.00 EA 177.51 177.51 (44.38) 133.13 grade R &R Exterior door slab - insulated 1.00 EA 342.21 34121 (102.66) 239.55 metal or wood - High grade Detach & Reset Door lockset - 1.00 EA 20.95 D 20.95 20.95 exterior - Standard grade Prime & paint door slab only - 2.00 EA 30.75 61.50 (20.50) 41.00 exterior (per side) R &R Interior door unit 1.00 EA 153.45 153.45 (7.67) 145.78 Detach & Reset Door knob - interior - 1.00 EA 20.95 D 20.95 20.95 Standard grade Paint door slab only - 2 coats (per side) 1.00 EA 20.10 20.10 20.10 Cabinet drawer repair: Date: 8/291'2012 4:26 PM Page: 9 State Farm HETRICK, STEPHEN 38 -1685 -366 CONTTNUED - Kitchen DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV R &R Cabinet drawer front - Standard 0.98 SF 16.97 16.64 16.64 grade Carpenter - Finish, Trim / Cabinet - 2.00 I-IR 62.65 D 125.30 125.30 per hour Actual repair above should he to detach & reset the drawer face to a new drawer; I do not have an entry fi)r a drawer only (no fact). Please advise and forward documentation if the repair exceeds the above two entries. Detach & Reset Cabinet knob or pull - 12.00 EA 1.74 20.88 20.88 Standard grade Seal & paint cabinetry - lower - faces 8.00 LF 13.67 109.36 109.36 only Ahove to paint the left lower cabinets where the drawer is being repaired Totals: Kitchen 1,068.85 175.21 893.64 Exterior 0.00 SF Walls 0.00 SF Ceiling 0.00 SF Walls & Ceiling 0.00 SF Floor 0.00 SF Short Wall 0.00 LF Floor Perimeter 0.00 SF Long Wall 0.00 LF Ceil. Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV R&:R Rural mailbox 1.00 EA 45.52 D 45.52 (11.38) 34.14 R&R Mailbox post - wood 1.00 EA 66.30 D 66.30 (16.58) 49.72 Includes: Mailbox post and installation labor. Quality: 4 "x 4 "solid cedar post and mounting arm and a drive in steel anchor. Totals: Exterior 111.82 27.96 83.86 Area Totals: Main Level 2,151.82 SF Walls 655.64 SF Ceiling 2,807.45 SF Walls and Ceiling 655.64 SF Floor 726.68 Total Area 266.81 LF Floor Perimeter 655.64 Floor Area 141.79 Exterior Perimeter 279.81 LF Ceil. Perimeter 1,276.08 Exterior Wall Area of Walls 2,151.82 Interior Wall Area Total: Main Level 3,947.08 662.20 3,284.88 Date: 8/291'20 t 2 4:26 PM Page: 10 State Farm HETRICK, STEPHEN 38 -1685 -366 Basement 0- 7" Bedroom Height: 8' 288.00 SF Walls 80.16 SF Ceiling errinr 368.16 SF Walls & Ceiling 80.16 SF Floor 2 6" Z 1. t 36.00 LF Ceil. Perimeter 36.00 LF Floor Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Reglaze window, 1 - 9 sf 1.00 EA 50.36D 50.36 50.36 Drywall patch / small repair, ready for 1.00 EA 40.37 40.37 40.37 paint Seal/prime then paint the surface area 4.00 SF 0.63 2.52 2.52 (2 coats) Paint the walls - one coat 288.00 SF 0.40 115.20 (38.40) 76.80 Totals: Bedroom 208.45 38.40 170.05 E' 4 .. , �, Laundn Height: 8' eases 189.61 SF Walls 25.13 SF Ceiling 214.74 SF Walls & Ceiling 25.13 SF Floor 23.70 LF Ceil. Perimeter 23.70 LF Floor Perimeter m DESCRIPTION Q UANTITY UNIT COST RCV DEPREC. ACV Detach & Reset Door knob - interior - 1.00 EA 20.95 D 20.95 20.95 Standard grade R&R Interior door - lauan/mahogany - 1.00 EA 86.72 86.72 (4.34) 82.38 slab only Paint door slab only - 2 coat, (per side) 3.00 EA 20.10 60.30 (20.10) 40.20 Ahove for bath sides nf'laundn) door and hasernent Istflovr entnv door (basement side). Totals: Laundry 167.97 24.44 143.53 Date: 8/29/'2012 4:26 PM Page: 11 State Farm HETRICK, STEPHEN 38- 1.685 -366 ° 2 " He z� r.+� $asement ht: 8' b m 371.33 SF Walls 202.57 SF Ceiling 573.90 SF Walls & Ceiling 202.57 SF Floor 46.42 LF Ceil. Perimeter 46.42 LF Floor Perimeter Sub room: OFFSET (1) Height: 8' 'a 226.27 SF Walls 98.66 SF Ceiling 324.93 SF Walls & Ceiling 98.66 SF Floor 33.28 LF Ceil. Perimeter 27.28 LF Floor Perimeter Missing Wall - Goes to Floor 6' X 6' 8" Opens into Exterior Missing Wall 21'7" X 8' Opens into BASEMENT 2' 11" Subroom: HVAC ( 2) Height: 8' T. 133.61 SF Walls 15.40 SF Ceiling 149.01 SF Walls & Ceiling 15.40 SF Floor 16.70 LF Ceil. Perimeter 16.70 LF Floor Perimeter DESCRIPTION Q UANTITY UNIT COST RCV DEPREC. ACV No related damage - water leak - also ajftcted doonvay to hedroom Totals: Basement 0.00 0.00 0.00 Area Totals: Basement 1,208.82 SF Walls 421.92 SF Ceiling 1,630.74 SF Walls and Ceiling 421.92 SF Floor 464.81 Total Area 150.10 LF Floor Perimeter 421.92 Floor Area 99.20 Exterior Perimeter 156.10 LF Ceil. Perimeter 852.81 Exterior Wall Area of Walls 1,208.82 Interior Wall Area Total: Basement 376.42 62.84 313.58 Line Item Subtotals: 38 -168S -366 4,32350 725.04 3,598.46 Date: 8/29'2012 4:26 PM Page: 12 State Farm HETRICK, STEPHEN 38 -1685 -366 Adjustments for Ease Service Charges Adjustment Carpenter - Finish, Trim/Cabinet 125.30 Drywall Installer/Finisher 217.08 Wood Flooring Installer 125.40 Painter 99.58 Total Adjustments for Base Service Charges: 567.36 LINE ITEM TOTALS: 38 -1 685 -366 4,890.86 725.04 4,165.82 Grand Total Areas: 3,360.63 SF Walls 1,077.56 SF Ceiling 4,438.19 SF Walls and Ceiling 1,077.56 SF Floor 416.91 LF Floor Perimeter 435.91 LF Ceil. Perimeter 1,077.56 Floor Area 1,191.49 Total Area 3,360.63 Interior Wall Area 2,128.89 Exterior Wall Area 240.99 Exterior Perimeter of Walls Date: 8/29.2012 4:26 PM Page: 13 Basement 10' 7" -- - - -� — 9 1 11 1, Bedroom - to _.. L 14'. 9' IiVAC - [2'I' � M to Offset�(1) 21' T' a Bastment M 25: 4,... �1 Ba"mont Date: 8/29/2012 4:26 PM Page: 14 Main Level 14'11" T 2' 7` M R. sort...El F 8' 2" 2 , 7„ Bedroom. 1. Closet t 2' 1 V — l.lainn Roan \\ Bathroom a' 12'lV 7 , 2 " j 13' 1 7:' LI Qinina Room- - - - 1' N ti. Damage path (f rniture dr e) on wood floor 11 , 7 , ; . Main Lev -! Date: 8/29/2012 4:26 PM Page: 15 From: Lori T Smith Sent: Wednesday, August 29, 2012 2:19 PM To: Lori T Smith Subject: 381685366 « ... OLE_Obj ... >> Claim Rep Draft HETRICK. STEPHEN 38 -168S -366 Insured: HETRICK, STEPHEN Estimate: 38 -1685 -366 Property: 804 Coolidge St Claim Number: 38168S366 New Cumberind, PA 17070 -1427 Policy Number: 98- BO- W531 -4 Home: (716) 255 -5727 Price List: PAHA9F_ALJG12 Type of Loss: Other Restoration/Service/Remodel Deductible: $1,000.00 F = Factored In, D = Do Not Apply Date of Loss: 8/1/2012 Date Inspected: 8/3/2012 Summary for Dwelling Lune Item Total 4,890.86 Material Sales Tax @ 6.000% x 1,14820 68.89 Subtotal 4,959.75 General Contractor Overhead @ 10.0% x 4,959.75 495.98 General Contractor Profit @ 10.0% x 4,959.75 49598 Cleaning Sales Tax @ 6.000% x 322.81 19.37 Replacement Cost Value (Including General Contractor Overhead and Profit) 5,971.08 Less Depreciation (Including Taxes) (741.19) Less General Contractor Overhead & Profit on Recoverable & Non - recoverable Depreciation (148.24) Less Deductible (1,000.00) Net Actual Cash Value Payment $4,081.65 Maximum Additional Amounts Available If Incurred: Total Line Item Depreciation (Including Taxes) 741.19 General Contractor O &P on Depreciation 148.24 Total Maximum Additional Amount Available If Incurred 889.43 Total Amount of Claim If Incurred $4,971.08 Smith, Lori (800) 406 -8543 x 2002292 ALL AMOUNTS PAYABLE ARE SUBJECT TO THE TERMS, CONDITIONS AND LIMITS OF YOUR POLICY. 8/29/2012 5:41 PM Page: 2 5tateFarm C W Explanation of Building Replacement Cost Benefits . Rental Dwelling Policy Dwelling To: Name: HETRICK, STEPHEN Address: 804 Coolidge St City: New Cumberind State /Zip: PA, 17070 -1427 Insured: HETRICK, STEPHEN Claim Number: 381685366 Date of Loss: 8/1/2012 Cause of Loss: OTHER Your insurance policy provides replacement cost coverage for some or all of the loss or damage to your dwelling or structures. Replacement cost coverage pays the actual and necessary cost of repair or replacement, without a deduction for depreciation, subject to your policy's limit of liability. To receive replacement cost benefits you must: 1. Complete the actual repair or replacement of the damaged part of the property within a reasonable time frame after the loss. 2. Confirm completion of repair or replacement by submitting invoices, receipts or other documentation to your agent or claim office. Until these requirements have been satisfied, our payment(s) to you will be for the actual cash value of the damaged part of the property, which may include a deduction for depreciation. Without waiving the above requirements, we will consider paying replacement cost benefits prior to actual repair or replacement if we determine repair or replacement costs will be incurred because repairs are substantially under way or you present a signed contract acceptable to us. The estimate to repair or replace your damaged property is $5,971.08. The enclosed claim payment to you of $4,081.65 is for the actual cash value of the damaged property at the time of loss, less any deductible that may apply. We determined the actual cash value by deducting depredation from the estimated repair or replacement cost. Our estimate details the depreciation applied to your loss_ Based on our estimate, the additional amount available to you for replacement cost benefits (recoverable depreciation) is $889.43. If you cannot have the repairs completed for the repair /replacement cost estimated, please contact your claim representative prior to beginning repairs. All policy provisions apply to your claim. Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or a statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties. Date: 8/29/20125:41 PM 123976.5 03 -24 -2010 Page: 3 Claim Rep Draft HETRICK. STEPHEN 38 -168S -366 Main Level Main Level DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 55. Haul debris - per pickup truck 1.00 EA 122.07 122.07 122.07 Ioad - including dump fees 57. General clean - up 4.00 HR 29.68 D 118.72 118.72 59. Content Manipulation charge - 1.00 HR 27.66 D 27.66 27.66 per hour Very few contents remain in the home Added labor below as outlined: Drywaller 4 hr needed 1.39 hr provided 60. Drywall Installer i Finisher - per 2.61 HR 54.27 D 141.64 141.64 hour Total: Main Level 410.09 0.00 410.09 z s F- �' • Living Room Height: 8' 500.00 SF Walls 218.25 SF Ceiling T N ` �• R-» 718.25 SF Walls & Ceiling 218.25 SF Floor IT r - n 64.17 LF Ceil. Perimeter 62.17 LF Floor Perimeter 1blissing Wall - Goes to Floor 2' X 6' 8 Opens into HALL S ubroom: CLOSET (1) Height: 8' T 97.33 SF Walls 9.04 SF Ceiling = t 106.38 SF Walls & Ceiling 9.04 SF Floor 12.17 LF Ceil. Perimeter 12.17 LF Floor Perimeter «0 2' 11" J DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 58. Floor protection - self - adhesive 227.29 SF 0.42 95.46 95.46 plastic film 13. Drywall patch / small repair, 1.00 EA 4037 40.37 4037 ready for paint 8/29/2012 5:41 PM Page: 4 Claim Rep Draft HETRICK. STEPHEN 38 -1685 -366 CONTINUED - Living Room DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 14. Seal/prime then paint the surface 4.00 SF 0.63 2.52 2.52 area (2 coats) 15. Paint the walls - one coat 597.33 SF 0.40 238.93 (79.64) 159.29 1. Screen and coat wood floor 227.29 SF 1.21 275.02 (137.51) 137.51 8_ Add for dustless floor sanding 22729 SF 1.00 22729 227.29 16. Clean floor 227.29 SF 029 D 65.91 65.91 Totals: Living Room 945.50 217.15 728.35 I 6'8' -}- 3 -Y 2" Bedroom 1 Height: 8' s ' s" m3 m 402.67 SF Walls 135.67 SF Ceiling 7" Bedroom 1 T t 538.33 SF Walls & Ceiling 135.67 SF Floor T m = 52.00 LF Ceil_ Perimeter 50.00 LF Floor Perimeter rn u� u 11 1 Bathroom Missing Wall - Goes to Floor 2' X 6' 8 Opens into HALL 3' 1 Sabroom: ROON4'I3 (1) Height: 8' T 132.00 SF Walls 14.64 SF Ceiling i I46.64 SF Walls & Ceiling 14.64 SF Floor 16.50 LF Ceil. Perimeter 16.50 LF Floor Perimeter N Bedroom 7 DESCRIPTI QUANTITY UNIT COST RCV DEPREC. ACV 31. R &R Interior door unit - Standard 1.00 EA 146.30 146.30 (7.32) 138.98 grade 56. Detach & Reset Door knob - 1.00 EA 20.95 D 20.95 20.95 interior - Standard grade 32. Paint door slab only - 2 coats (per 1.00 EA 20.10 20.10 20.10 side) 8/29/2012 5:41 PM Page: 5 Claim Rep Draft HETRICK. STEPHEN 38 -1685 -366 CONTINUED - Bedroom 1 DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 7. Screen and coat wood floor 150.31 SF 1.21 181.88 (90.94) 90.94 9. Add for dustless floor sanding 15031 SF 1.00 150.31 150.31 17. Clean floor 150.31 SF 0.29 D 43.59 43.59 Totals: Bedroom 1 563.13 98.26 464.87 1 Hall Height: 8' r T eaYh►ocxn 12333 SF Walls 21.49 SF Ceiling N i� I Him ` 144.82 SF Walls & Ceiling 21.49 SF Floor I 20.83 LF Ceil. Perimeter 14.33 LF Floor Perimeter E,2 N )0411 9edrmm 2 Missing Wall - Goes to Floor 2' X 6' 8" Opens into LIVING ROOM Missing Wall - Goes to Floor 2' 6 X 6' 8 Opens into DINING ROOM Missing Wall - Goes to Floor 2'X 6' 8" Opens into BEDROOM - 1 D ESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 33. Paint door slab only - 2 coats (per 1.00 EA 20.10 20.10 20.10 side) 4. Screen and coat wood floor 21.49 SF 1.21 26.00 (13.00) 13.00 10. Add for dustless floor sanding 21.49 SF 1.00 21.49 21.49 18. Clean floor 21.49 SF 0.29 D 6.23 6.23 Totals: Hall 73.82 13.00 60.82 8/29;2012 5:41 PM Page: 6 Claim Rep Draft HETRICK. STEPHEN 38 -1685 -366 B edroom 2 Height: $' �IKell 349.33 SF Walls 119.17 SF Ceiling T Oedr m 2 I 468.51 SF Walls & Ceiling 119.17 SF Floor 43.67 LF Ceil. Perimeter 43.67 LF Floor Perimeter 1 F4'6" 1 F4'1" 4 DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 46. Detach & Reset Mirror - 1/4" 10.00 SF 5.64 D 56.40 56.40 plate glass 47. Finish Carpenter - per hour 1.00 HR 62.6.5 D 62.65 62.65 Above two items to repair broken frame to wall mounted mirror 3. Screen and coat wood floor 119.17 SF 1.21 144.20 (72.10) 7110 11. Add for dustless floor sanding 119.17 SF 1.00 119.17 119.17 19. Clean floor 119.17 SF 029 D 34.56 34.56 Totals: Bedroom 2 416.98 72.10 344.88 7.,...,.. 8�._._Q 7' `" Dining Room Height: 8' 7' 295.33 SF Walls 85.78 SF Ceiling T 1 „f„ a 381.12 SF Walls & Ceiling 85.78 SF Floor vedma 39.00 LF Ceil. Perimeter 36.50 LF Floor Perimeter ti 1'9" 12'1 Missing Wall - Goes to Floor 2 X 6' 8" Opens into HALL DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 2. Screen and coat wood floor 85.78 SF 1.21 103.79 (51.90) 51.89 12. Add for dustless floor sanding 85.78 SF 1.00 85.78 85.78 Totals: Dining Room 189.57 51.90 137.67 8/29/2012 5:41 PM Page: 7 Claim Rep Draft HETRICK. STEPHEN 38 -1685 -366 Bathroom Height: 8' m T 11' 1" o> _eat r+ 251.82 SF Wails 51.59 SF Ceiling L 303.41 SF Walls & Ceiling 51.59 SF Floor � .� 10' 11" 31.48 LF Ceil. Perimeter 31.48 LF Floor Perimeter I Bedroom a 2 DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 45. Detach & Reset Interior door unit 1.00 EA 5.5.18 55.18 55.18 30. R &R Door opening (jamb & 1.00 EA 92.28 92.28 92.28 casing) - up to 32 "wide - paint grade 29. Paint door/ trim & jamb - 1.00 EA 19.86 19.86 (6.62) 13.24 2 coats (per side) Totals: Bathroom 167.32 6.62 160.70 Kitchen 0.00 SF Walls 0.00 SF Ceiling 0.00 SF Walls & Ceiling 0.00 SF Floor 0.00 SF Short Wall 0.00 LF Floor Perimeter 0.00 SF Long Wall 0.00 LF Cell. Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Rear entry area: 24. R &R Storm door assembly - 1.00 EA 177.51 177.51 (44.38) 133.13 Standard grade 21. R&R Exterior door slab - 1.00 EA 342.21 342.21 (102.66) 239.55 insulated metal or wood - High grade 42. Detach & Reset Door lockset - 1.00 EA 20.95 D 20.95 20.95 exterior - Standard grade 43. Prime & paint door slab only - 2.00 EA 30.75 61.50 (20.50) 41.00 exterior (per side) 22. R &R Interior door emit 1.00 EA 153.45 153.45 (7.67) 145.78 41. Detach & Reset Doorknob - 1.00 EA 20.95 D 20.95 20.95 interior - Standard grade 44. Paint door slab only - 2 coats (per 1.00 EA 20.10 20.10 20.10 side) 8/29/2012 5:41 PM Page: 8 Claim Rep Draft HETRICK_ STEPHEN 38 -1685 -366 CONTINUED - Kitchen DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Cabinet drawer repair: 28. R &R Cabinet drawer front - 0.98 SF 16.97 16.64 16.64 Standard grade 25. Carpenter - Finish, Trim / Cabinet 100 HR 62.65 D 125.30 12530 - per hour Actual repair above should be to detach & reset the drawer face to a new drawer; I do not have an entry for a drawer only (no face). Please advise and forward documentation if the repair exceeds the above two entries. 26. Detach & Reset Cabinet knob or 12.00 EA 1.74 20.88 20.88 pull - Standard grade 27. Seal & paint cabinetry - lower - 8.00 LF 13.67 109.36 109.36 faces only Above to paint the left lower cabinets where the drawer is being repaired Totals: Kitchen 1,068.85 175.21 893.64 Exterior 0.00 SF Walls 0.00 SF Ceiling 0.00 SF Walls & Ceiling 0.00 SF Floor 0.00 SF Short Wall 0.00 LF Floor Perimeter 0.00 SF Long Wall 0.00 LF Cell. Perimeter DESCRIPTION Q UANTITY UNIT COST RCV DEPREC. ACV 34. R &R Rural mailbox 1.00 EA 45.52 D 45.52 (11.38) 34.14 35. R &R Mailbox post - wood 1.00 EA 66.30 D 66.30 (16.58) 49.72 Includes: Mailbox post and installation labor. Quality: 4 "x 4 "solid cedar post and mounting arm and a drive in steel anchor. Totals: Exterior 111.82 27.96 83.86 Area Totals: Main Level 2,151.82 SF Falls 655.64 SF Ceiling 2,807.45 SF Walls and Ceiling 655.64 SF Floor 726.68 Total Area 266.81 LF Floor Perimeter 655.64 Floor Area 141.79 Exterior Perimeter 279.81 LF Cell. Perimeter 1,276.08 Exterior Wall Area of Walls 2,151.82 Interior Wall Area 8/29/2012 5 :41 PM Page: 9 Claim Rep Draft HETRICK. STEPHEN 38 -1685 -366 Total: Main Level 3,947.08 662.20 3,284.88 Basement E- 1 0' 7" Bedroom Height: 8' T 9' 11„ 288.00 SF Walls 80.16 SF Ceiling '+ War" 368.16 SF Walls & Ceiling 80.16 SF Floor oo �0 2' 6" 2' 11` 36.00 LF Ceil. Perimeter 36.00 LF Floor Perimeter 11 -V DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 48. Reglaze window, 1 - 9 sf 1.00 EA 50.36 D 50.36 5036 49. Drywall patch / small repair, 1.00 EA 40.37 4037 40.37 ready for paint 50. Seal/prime then paint the surface 4.00 SF 0.63 2.52 2.52 area (2 coats) 51. Paint the walls - one coat 288.00 SF 0.40 115.20 (38.40) 76.80 Totals: Bedroom 208.45 38.40 170.05 Laundry Height: 8' �� 4�� -+4' 1.. � easel 51 ----- i � g° T 189.61 SF Walls 25.13 SF Ceiling 214.74 SF Walls & Ceiling 25.13 SF Floor 23.70 LF Ceil. Perimeter 23.70 LF Floor Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 52. Detach & Reset Door knob - 1.00 EA 20.9.5 D 20.95 20.95 interior - Standard grade 53. R &R Interior door - 1.00 EA 86.72 86.72 (4.34) 82.38 lauan/mahogany - slab only 54. Paint door slab only - 2 coats (per 3.00 EA 20.10 60.30 (20.10) 40.20 side) Above for bath sides of laundry door and basement 1st floor entry door (basement side). 8/29/2012 5:41 PM Page: 10 Claim Rep Draft HETRICK. STEPHEN 38 -1685 -366 CONTINUED - Laundry DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Totals: Laundry 167.97 24.44 143.53 Height: ht: 8' T �r r--aaT T Basement g 371.33 SF V4'alls 202.57 SF Ceiling 573.90 SF Walls & Ceiling 202.57 SF Floor 46.42 LF Ceil. Perimeter 46.42 LF Floor Perimeter re Sub room: OFFSET (1) Height: 8' �—'' t 22627 SF Walls 98.66 SF Ceiling 1 -------------- -------- --- ---- - - - - - -- 2 1 '' " � 324.93 SF Walls & Ceiling 98.66 SF Floor 33.28 LF Ceil. Perimeter 27.28 LF Floor Perimeter Missing Wall - Goes to Floor 6' X 6' 8" Opens into Exterior Missing Wall 21'7" X 8' Opens into BASEMENT 2 Subroom: HVAC (2) Height: 8' 133.61 SF Walls 15.40 SF Ceiling 149.01 SF Walls & Ceiling 15.40 SF Floor 16.70 LF Ceil. Perimeter 16.70 LF Floor Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV No related damage - water leak - also affected doorway to bedroom Totals: Basement 0.00 0.00 0.00 Area Totals: Basement 1,208.82 SF Walls 421.92 SF Ceiling 1,630.74 SF Walls and Ceiling 421.92 SF Floor 464.81 Total Area 150.10 LF Floor Perimeter 421.92 Floor Area 9920 Exterior Perimeter 156.10 LF Ceil. Perimeter 8.52.81 Exterior Wall Area of Walls 1,208.82 Interior Wall Area 8/29/2012 5:41 PM Page: 11 Claim Rep Draft HETRICK. STEPHEN 38 -1685 -366 Total: Basement 376.42 62.84 313.58 Line Item Subtotals: 38 -1685 -366 4,323.50 725.04 3,598.46 Adjustments for Base Service Charges Adjustment Carpenter - Finish, Trim/Cabinet 125.30 Drywall Installer /Finisher 217.08 Wood Flooring Installer 125.40 Painter 99.58 Total Adjustments for Base Service Charges: 567.36 LINE ITEM TOTALS: 38 -168S -366 4,890.86 725.04 4,165.82 Grand Total Areas: 3,360.63 SF Walls 1,077.56 SF Ceiling 4,438.19 SF Walls and Ceiling 1.077.56 SF Floor 416.91 LF Floor Perimeter 435.91 LF Cell- Perimeter 1,077.56 Floor Area 1,191.49 Total Area 3,360.63 Interior Wall Area 2,128.89 Exterior Wall Area 240.99 Exterior Perimeter of Walls 8/29/2012 5:41 PM Page: 12 Trade Summary Includes all applicable Tax, General Contractor O &P, and Base Service Charges DESCRIPTION LINE ITEM REPL. COST ACV NON -REC. MAX ADDL. QNTY TOTAL DEPREC. AMT AVAIL. CAB CABINETRY R &R Cabinet drawer front - Standard 0.98 SF $22.60 $22.60 $0.00 50.00 grade Detach & Reset Cabinet knob or pull - 12.00 EA $27.63 $27.63 $0.00 $0.00 Standard grade Carpenter - Finish, Trim / Cabinet - per 2.00 HR $165.76 $165.76 50.00 $0.00 hour TOTAL CABINETRY $215.99 $215.99 $0.00 $0.00 CLN CLEANING Clean floor 518.26 SF $191.16 $191.16 50.00 $0.00 General clean - up 4.00 HR $151.01 $151.01 $0.00 $0.00 TOTAL CLEANING $342.17 $342.17 $0.00 $0.00 CON CONTENT MANIPtiLATION Content Manipulation charge - per hour 1.00 HR $33.19 $3319 $0.00 WOO TOTAL CONTENT MANIPULATION $33.19 $33.19 $0.00 $0.00 DMO GENERAL DEMOLITION Haul debris - per pickup truck load - 1.00 EA $146.49 $146.49 $0.00 $0.00 including dump fees TOTAL GENERAL DEMOLITION $146.49 $146.49 $0.00 $0.00 DOR DOORS R &R Interior door unit 1.00 EA $208.48 $198.92 50.00 $9.56 Detach & Reset Interior door unit 1.00 EA $73.05 $73.05 $0.00 50.00 R &R Interior door unit - Standard grade 1.00 EA $198.59 $189.47 SO.00 59.12 R &R Interior door - lauan/mahogany - 1.00 EA $116.57 $111.24 $0.00 $5.33 slab only R &R Storm door assembly - Standard 1.00 EA $240.31 $185.31 $0.00 $55.00 grade R &R Exterior door slab - insulated metal 1.00 EA $470.73 $341.93 SOHO $128.80 or wood - High grade TOTAL DOORS $1,307.73 $1,099.92 $0.00 $207.81 DRY DRYWALL Drywall Installer / Finisher - per hour 2.61 HR $335.85 $335.85 SO.00 SO.00 Drywall patch / small repair, ready for 2.00 EA $191.88 $191.88 SO.00 $0.00 paint TOTAL DRYR'ALL $527.73 $527.73 $0.00 $0.00 FCW FLOOR COVERING - WOOD Note: Slight variances may be found within report sections due to rounding 8/2912012 5:41 PM Page: 13 Trade Summary Includes all applicable Tax, General Contractor O &P, and Base Service Charges DESCRIPTION LINE ITEM REPL. COST ACV NON -REC. MAX ADDL. QNTY TOTAL DEPREC. AMT AVAIL. FCW FLOOR COVERING -WOOD Add for dustless floor sanding 604.04 SF $724.85 $724.85 $0.00 $0.00 Screen and coat wood floor 604.04 SF $1,041.47 $595.97 $0.00 $445.50 TOTAL FLOOR COVERING - WOOD $1,766.32 $1,320.82 $0.00 $445.50 FNC FINISH CARPENTRY / TRIMWORK R &R Door opening (jamb & casing) - up 1.00 EA $125.87 $125.87 50.00 $0.00 to 32 "wide - paint grade Finish Carpenter - per hour 1.00 HR $8188 $82.88 SO.00 $0.00 TOTAL FINISH CARPENTRY / TRIMWORK $208.75 $208.75 $0.00 $0.00 FNH FINISH HARDWARE Detach & Reset Door knob - interior - 3.00 EA $75.42 $75.42 50.00 $0.00 Standard grade Detach & Reset Door lockset - exterior - 1.00 EA $25.14 $25.14 $0.00 $0.00 Standard grade TOTAL FINISH HARDWARE $100.56 $100.56 $0.00 $0.00 MSD MIRRORS & SHOWER DOORS Detach & Reset Mirror - 1/4" plate glass 10.00 SF $67.68 $67.68 $0.00 $0.00 TOTAL MIRRORS & SHOVFTR DOORS $67.68 $67.68 $0.00 $0.00 PNT PAINTING Paint door slab only - 2 coats (per side) 6.00 EA $166.16 $141.60 $0.00 $24.56 Paint doorhvindow trim & jamb - 2 coats 1.00 EA $27.18 $19.15 $0.00 $8.03 (per side) Seal & paint cabinetry - lower - faces only 8.00 LF $149.94 $149.94 $0.00 $0.00 Floor protection - self- adhesive plastic 227.29 SF $131.42 $131.42 $0.00 SO.00 film Paint {V} - one coat 885.33 SF $486.57 $342.80 SO.00 $143.77 Seal/prime then paint {V} (2 coats) 8.00 SF $6.91 $6.91 SO.00 SO.00 Prime & paint door slab only - exterior 100 EA $85.06 $59.91 SO -Oa S25.15 (per side) TOTAL PAINTING $1,053.24 $851.73 $0.00 $201.51 SPE SPECIALTY ITEMS R&R Mailbox post - wood 1.00 EA $82.08 $61.55 $0.00 $20.53 R &R Rural mailbox 1.00 EA $56.33 $42.25 SO.00 $14.08 TOTAL SPECIALTY ITEMS $138.41 $103.80 SO.00 $34.61 WDR, WINDOW REGLAZING & REPAIR Note: Slight variances may be found within report sections due to rounding 8/29/2012 5:41 PM Page: 14 Trade Summary Includes all applicable Tax, General Contractor O &P, and Base Service Charges DESCRIPTION LINE ITEM REPL. COST ACV NON -REC. MAX ADDL. QNTY TOTAL DEPREC. AMT AVAIL. WDR WINDOW REGLAZING & REPAIR Reglaze window, 1 - 9 sf 1.00 EA $62.82 $62.82 $0.00 $0.00 TOTAL WINDOW REGLAZING & REPAIR $62.82 $62.82 $0.00 $0.00 TOTALS $5,971.08 $5,081.65 $0.00 $889.43 Note: Slight variances may be found within report sections due to rounding 8/29/2012 5:41 PM Page: 15 Claim Rep Draft HETRICK. STEPHEN 38 -1685 -366 Recap by Room Estimate: 38 -168S -366 Area: Main Level 410.09 8.38% Living Room 945.50 19.33% Bedroom 1 563.13 11.51% Hall 73.82 1.51% Bedroom 2 416.98 8.53% Dining Room 189.57 3.88% Bathroom 167.32 3.42% Kitchen 1,068.85 21.85% Exterior 111.82 2.29% Area Subtotal: Main Level 3,947.08 80.70% Area: Basement Bedroom 208.45 4.26% Laundry 167.97 3.43% Area Subtotal: Basement 376.42 7.70% Subtotal of Areas 4,323.50 88.40% Base Service Charges 567.36 11.60% Total 4,890.86 100.00% 8/29/2012 5:41 PM Page: 16 Claim Rep Draft HETRICK_ STEPHEN 38 -168S -366 Recap by Category with Depreciation O &P Items RCV Deprec. ACV CABINETRY 162.82 162.82 CLEANING 269.01 269.01 CONTENT MANIPULATION 27.66 27.66 GENERAL DEMOLITION 122.07 122.07 DOORS 961.37 16637 795.00 DRYWALL 22238 22238 FLOOR COVERING - WOOD 1,334.93 365.45 969.48 FINISH CARPENTRY / TRIN1WORK 154.93 154.93 FINISH HARDWARE 83.80 83.80 MIRRORS & SHO`VER DOORS 56.40 56.40 PAINTING 765.95 165.26 600.69 SPECIALTY ITEMS 111.82 27.96 83.86 WINDOW REGLAZIN & REPAIR 50.36 50.36 O &P Items Subtotal 4,323.50 725.04 3,598.46 Base Service Charges 567.36 567.36 Material Sales Tax @ 6.000% 68.89 16.15 52.74 General Contractor Overhead @ 10.0% 495.98 74.12 421.86 General Contractor Profit @. 10.0% 495.98 74.12 421.86 Cleaning S ales Tax @ 6.000% 1937 1937 Total 5,971.08 889.43 5,081.65 8/2920/2 5:41 PM Page: 17 Claim Rep Draft HETRICK. STEPHEN 38 - 1685 - 366 Time & Material Breakdown O &P Items Quantity Unit Cost Total Cost CABINETRY Material - Cabinet drawer front - Standard grade 0.98 S F 12.000 11.76 Material: 11.76 Contractor Labor - Carpenter - Finish, Trim/Cabinet 2.38 HR 62.6.50 148.86* Demolition Laborer 0.06 HR 37.320 2. 20* Labor: 151.06 C ABINETRY Subtotal: 162.82 CLEANING Supplies - General purpose cleaning chemical 0.00 GL 13-056 0.04* Supplies: 0.04 Contractor Labor - Floor Cleaning Technician 4.13 HR 36.400 150.30 Cleaning Technician 4.00 HR 29.670 118.68 Labor: 268.9 CLEANING Subtotal: 269.01 CONTENT MANIPULATION Contractor Labor - General Laborer 1.00 HR 2 7.660 27.66 Labor: 27.66 CONTENT MA,N�IIPULATION Sub total: 27.66 GENERAL DEMOLITION Contractor Labor - Demolition Laborer 1.8 HR 37.320 67.45 Labor: 67.45 Equipment - Landfrll charge - per ton 0.50 TN 65.000 32.50 1/2 or 3/4 ton pickup 0.05 WK 420.505 19.03 Equipment: 51.53 Miscellaneous: 3.09 GENERAL DEMOLITION Subtotal: 122.07 DOORS Material - Casing - 2 1/4" 75.19 LF 0.771 57.97 Wood shims 0.32 BN 4.340 1.37* 6d finish nails (based on 5 lb box) 0.45 LB 1153 0.97 Interior door - mahogany - slab only 1.00 EA 35.608 35.61 Interior door - Colonist - pre -hung unit 1.00 EA 68.600 68.60 Interior door - hardboard - flush - pre -hung unit 1.00 EA 62.649 62.65 Storm door assembly - Standard grade 1.00 EA 97.000 97.00 Exterior door slab - wood or metal - High grade 1.00 EA 259.400 259.40 8/29/2012 5:41 PM Page_ 18 Claim Rep Draft HETRICK_ STEPHEN 38 -1685 -366 O &P Items Quantity Unit Cost Total Cost Material: 583.58 Contractor Labor - Carpenter - Finish, Trim/Cabinet 5.13 HR 62.650 321.22 Demolition Laborer 1.48 HR 37.320 5537* Labor: 376.59 Miscellaneous: 1.20 DOORS Subtotal: 96137 DRYR'ALL Material - Gypsum board, 1/2" 9.41 SF 0328 3.09 Metal corner bead 4.21 LF 0.240 1.01 Drywall joint compound - 50 lb box 0.02 BX 11079 027* Drywall nails (based on 25 to 50 lb box) 0.02 LB 1.613 0.03 Drywall screws - grabber - (based on 25 to 50 lb box) 0.04 LB 1.890 0.08 Perfotape - 500' roll 0.03 RL 4.190 0.14* Drywall texture compound - 50 lb box 0.04 BX 14.007 0.62 Material: 5.24 Contractor Labor - Drywall Installer/Finisher 4.00 HR 54.270 217.14* Labor: 217.14 DRYWALL Subtotal: 222.38 FLOOR COVERING - WOOD Material - Polyurethane finish 2.48 GL 49.461 122.84 Sanding screen - floor sander, 120 grit 2.67 EA 7.025 18.74* Sanding screen - floor sander, 60 grit 167 EA 10.611 2830 Sanding screen - floor sander, 80 grit 2.67 EA 8.778 2141 Material: 193.30 Contractor Labor - Wood Flooring Installer 7.23 HR 62.700 453.03 Labor: 453.03 Equipment - Hardwood floor sander - screen 2.11 DA 40.000 84.57* Dustless sanding equipment 0.60 DA 1,000.000 604.04* Equipment: 688.60 FLOOR COVERING - WOOD Subtotal: 1,334.93 FINISH CARPENTRY / TRIXIWORK Material - Casing - 2 1/4" 33.96 LF 0.771 26.18 Wood shims 0.13 BN 4340 0.57* 6d finish nails (based on 5 lb box) 0.15 LB 2.153 0.32 Wood doorjamb stock - finger jointed pine, 4 9/16" 17.84 LF 1.830 32.65 4d finish nails (based on 5 lb box) 0.05 LB 2.136 0.10* Material: 59.83 Contractor Labor - Carpenter - Finish, Trim/Cabinet 1.44 HR 62.650 90.40 Demolition Laborer 0.13 HR 37.320 4.70* 8/29/2012 5:41 PM Page: 19 Claim Rep Draft HETRICK. STEPHEN 38 -168S -366 O &P Items Quantity Unit Cost Total Cost Labor: 95.10 FINISH CARPENTRY / TR IMWORK Subtotal: 154.93 FINISH HARDWARE Contractor Labor - Hardware Installer 1.34 HR 62.58 83.76* Labor: 83.76 Miscellaneous: 0.04 FINISH HARDWARE S ubtotal: 83.80 MIRRORS & SHOWER DOORS Contractor Labor - Harduare Installer 0.90 HR 62.580 56.40* Labor: 56.40 'MIRRORS & SHOWER DOORS Subtotal: 56.40 PAINTING Material - Latex paint 3.85 GL 32.394 124.74* Painter's putty 0.09 GL 17.454 1.65 160 - 180 grit sandpaper - per sheet 6.13 SH 0.550 337 PVA - latex drywall primer /sealer 0.02 GL 9.000 022* Oil base paint 0.40 GL 38.947 15.75* Oil base sealer /primer 0.55 GL 29.813 16.30* Paint thinner (mineral spirits) 0.10 GL 10.255 1.04* Caulking - acrylic 0.17 TB 1.910 0.33 Exterior latex 035 GL 33.690 11.95 Floor protection - self - adhesive plastic - 2 mil (400 sf) 0.58 RL 47.151 27.27* Material: 202.62 Contractor Labor - Painter 10.86 HR 49.790 540.75 Labor: 540.75 Miscellaneous: 22.58 PAINTING Subtotal: 765.95 SPECIALTY ITEMS Material - Rural mailbox 1.00 EA 23.700 2170 Mailbox post 1.00 EA 34.970 34.97 Material: 58.67 Contractor Labor - Demolition Laborer 0.34 HR 37.320 1161 Carpenter - Mechanic 0.60 HR 67.910 40.54 Labor: 53.15 SPECIALTY ITEMS Subtotal: 111.82 WINDOW REGLAZING & REPAIR Material - Window unit - reglaze - Small 1.00 EA 31.500 31.50 Window putty 0.08 GL 21.830 1.71 8/29/2012 5:41 PM Page: 20 Claim Rep Draft HETRICK. STEPHEN 38 -168S -366 O &P Items Quantity Unit Cost Total Cost lblaterial: 33.21 Contractor Labor - Carpenter - Mechanic 025 HR 67.910 17.15 Labor: 17.1 AVINDOW REGLAZING & REPAIR Subtotal: 5036 Material 1,148.21 Supplies 0.04 Labor 2,408.21 Equipment 740.13 Miscellaneous 26.9 O &P Items Subtotal 4,323.50 Base Service Charges 567.36 Material Sales Tax @ 6.000% 68.89 General Contractor Overhead 10.0% 49598 General Contractor Profit @ 10.0% 495.98 Cleaning Sales Tax @ 6.000 19.37 Total 5,971.08 8!29/2012 5:41 PM Page: 21 Labor Report State Farm P.O. Bog 106110 Atlanta, GA 30348 -6110 Phone: 1- 800406 -8543 egt: Fag: 1- 888 - 620 -2652 8/29/2012 5:41 PM Estimate: 38 -1685 -366 Claim Number: 381685366 Insured: HETRICK, STEPHEN Policy Number: 98- 130- W531 -4 Property: 804 Coolidge St Type of Loss: OTHER New Ctunberind, PA 17070 -1427 Deductible: 51,000,00 Home: 804 COOLIDGE ST Price List: PAHA9F_AUG12 NEW CUMBERLAND, PA 17070 -1427 Restoration/Service /Remodel Home: (716) 255 -5727 Date of Loss: 8/1/2012 Date Received: 8/1/2012 Date Inspected: 8/3/2012 Retail Labor Market Conditions Total Description Hours Quantity Units Per Unit Per Unit Amount Remove Cabinet drawer front - Standard grade 0.06 0.98 SF 2.24 0.00 2.20 Cabinet drawer front - Standard grade 0.04 0.98 SF 2.73 0.00 2.68 Detach & Reset Cabinet knob or pull - Standard grade 0.33 12.00 EA 1.74 0.00 20.88 Carpenter - Finish, Trim / Cabinet - per hour 2.00 2.00 HR 62.65 0.00 125.30 Clean floor 4.13 518.26 SF 0.29 0.00 150.29 General clean - up 4.00 4.00 HR 29.67 0.00 118.68 Content Manipulation charge - per hour 1.00 1.00 HR 27.66 0.00 27.66 Haul debris - per pickup truck load - including dump fees 1.81 1.00 EA 67.45 3.09 70.54 Remove Interior door unit 037 1.00 EA 13.99 0.00 13.99 Interior door unit 0.64 1.00 EA 39.89 1.20 41.09 Detach & Reset Interior door unit 0.87 1.00 EA 54.40 0.00 54.40 Remove Interior door unit - Standard grade 0.37 1.00 EA 13.99 0.00 13.99 Labor Report HETRICK, STEPHEN 8/29/2012 5:41 PM Retail Labor Market Conditions Total Description Hours Quantity Units Per Unit Per Unit Amount Interior door unit - Standard grade 0.64 1.00 EA 39.89 0.00 39.89 Remove Interior door - lauan/mahogany - slab only 0.17 1.00 EA 6.22 0.00 6.22 Interior door - lauan /mabogany - slab only 0.72 1.00 EA 44.89 0.00 44.89 Remove Storm door assembly - Standard grade 035 1.00 EA 13.17 0.00 13.17 Storm door assembly - Standard grade 1.07 1.00 EA 67.34 0.00 67.34 Remove Exterior door slab - insulated metal or wood - High grade 0.21 1.00 EA 8.00 0.00 8.00 Exterior door slab - insulated metal or wood - High grade 1.19 1.00 EA 74.81 0.00 74.81 Dry wall Installer / Finisher - per hour 2.61 2.61 HR 54.27 0.00 141.64 Drywall patch / small repair, ready for paint 1.39 2.00 EA 37.75 0.00 75.50 Add for dustless floor sanding 0.00 604.04 SF 0.00 0.00 0.00 Screen and coat wood floor 7.15 604.04 SF 0.75 0.00 453.03 Remove Door opening (jamb & casing) - up to 32 "wide - paint grade 0.13 1.00 EA 4.70 0.00 4.70 Door opening (jamb & casing) - up to 32 "wide - paint grade 0.44 1.00 EA 27.75 0.00 27.75 Finish Carpenter - per hour 1.00 1.00 HR 62.65 0.00 62.65 Detach & Reset Door luiob - interior - Standard grade 1.00 3.00 EA 20.94 0.01 62.85 Detach & Reset Door lockset - exterior - Standard grade 0.33 1.00 EA 20.94 0.01 20.95 Detach & Reset Mirror - 1/4" plate glass 0.90 10.00 SF 5.64 0.00 56.40 Paint door slab only - 2 coats (per side) 1.70 6.00 EA 14.07 0.00 84.42 Page: 2 Labor Report HETRICK. STEPHEN 8/29/2012 5:41 PM Retail Labor Market Conditions Total Description Hours Quantity Units Per Unit Per Unit Amount Paint door /window trim & jamb - 2 coats (per side) 033 1.00 EA 16.24 0.00 16.24 Seal & paint cabinetry - lower - faces only 1.74 8.00 LF 10.81 0.00 86.48 Floor protection - self - adhesive plastic film 1.26 227.29 SF 0.28 0.02 68.19 Paint {V} - one coat 5.01 885.33 SF 0.28 0.02 265.60 Seal/prime then paint {V) (2 coats) 0.08 8.00 SF 0.46 0.04 4.00 Prime & paint door slab only - exterior (per side) 0.77 2.00 EA 19.20 0.00 38.40 Remove Mailbox post - wood 0.19 1.00 EA 7.00 0.00 7.00 Mailbox post - wood 0.36 1.00 EA 24.33 0.00 24.33 Remove Rural mailbox 0.15 1.00 EA 5.61 0.00 5.61 Rural mailbox 0.24 1.00 EA 16.21 0.00 16.21 Reglaze window, I - 9 sf 0.25 1.00 EA 17.15 0.00 17.15 Totals 2,435.12 Adjustments for Base Service Charges Adjustment Carpenter - Finish, Trim/Cabinet 125.30 Drywall Installer/Finisher 217.08 Wood Flooring Installer 125.40 Painter 99.58 Total Adjustments for Base Service Charges 56736 Page: 3 Materials Report State Farm P.O. Box 106110 Atlanta, GA 30348 -6110 Phone: 1- 800406 -8543 ext: Fax: 1- 888 - 620 -2652 8/29/2012 5:41 PM Estimate: 38 -1685 -366 Claim Number: 381685366 Insured: HETRICK, STEPHEN Policy Number: 98- 130- W531 -4 Property: 804 Coolidge St Type of Loss: OTHER New Cumberhid, PA 17070 -1427 Deductible: $1,000-00 Home: 804 COOLIDGE ST Price List: PAHA9F_AUG12 NEW CUMBERLAND, PA 17070 -1427 Restoration/Servicer'Remodel Home: (716) 255 -5727 Date of Loss: 8/1/2012 Date Received: 8/1/2012 Date Inspected: 8/3/2012 Material Description Quantity Unit Cost" Total Cabinet drawer front - Standard grade 0.98 SF 12.00 11.760 Interior door - Colonist - pre -hung unit 1.00 EA 68.60 68.600 Interior door - hardboard - flush - pre -hung unit 1.00 EA 62.65 62.660 Wood doorjamb stock - finger jointed p'me. 4 9/16" 17.84 LF 1.83 32.660 Interior door - mahogany - slab only 1.00 EA 35.61 35.610 Storm door assembly - Standard grade 1.00 EA 97.00 97.000 Exterior door slab - wood or metal - High grade 1.00 EA 259.40 259.400 Gypsum board, 1/2" 9.41 SF 033 3.090 Metal comer bead 421 LF 0.24 1.010 Drywall joint compound - 50 lb box 0.02 BX 12.08 0.270 Drywall nails (based on 25 to 50 lb box) 0.02 LB 1.61 0.030 Drywall screws - grabber - (based on 25 to 50 lb box) 0.04 LB 1.89 0.080 Perfotape - 500' roll 0.03 RL 4.19 0.140 Drywall texture compound - 50 lb box 0.04 BX 14.01 0.620 Polyurethane finish 2.48 GL 49.46 122.840 Sanding screen - floor sander, 120 grit 2.67 EA 7.03 18.740 Sanding screen - floor sander, 60 grit 2.67 EA 10.61 28.300 Sanding screen - floor sander, 80 grit 2.67 EA 8.78 23.410 Casing - 2 1/4" 109.15 LF 0.77 84.160 Wood shims 0.45 BN 4.34 1.940 4d finish nails (based on 5 lb box) 0.05 LB 2.14 0.100 6d finish nails (based on 5 lb box) 0.60 LB 2.1.5 1-290 Caulking - acrylic 0.17 TB 1.91 0.330 Latex paint 3.85 GL 32.39 124.740 Floor protection - self - adhesive plastic - 2 mil (400 sf) 0.58 RL 47.15 27270 Oil base paint 0.40 GL 38.95 15.760 Oil base sealer /primer 0.55 GL 29.81 16.300 Page: 4 Nlaterials Report HETRICK, STEPHEN 8129/2012 5:41 PM Painter's putty 0.09 GL 17.45 1.660 160 - 180 grit sandpaper - per sheet 6.13 SH 0..5.5 3370 PVA - latex drywall primer /sealer 0.02 GL 9.00 0.210 Paint thinner (mineral spirits) 0.10 GL 10.26 1.030 Exterior latex 0.35 GL 33.69 11.950 Mailbox post 1.00 EA 34.97 34.970 Rural mailbox 1.00 EA 23.70 23.700 Window unit - reglaze - Small 1.00 EA 31.50 31.500 Window putty 0.08 GL 21.83 1.710 Retail Materials Subtotal 1 Material Sales Tax 6.000°0 @ 1,148.20 68.89 Total For Retail Materials 1,217.10 ** Rounded Cost Page: 5 Summary Report State Farm P.O. Box 106110 Atlanta, GA 30348 -6110 Phone: 1- 800406 -8543 ext: Fax: 1- 888 - 620 -2652 8/29/2012 5:41 PM Estimate: 38 -1685 -366 Claim Number: 381685366 Insured: HETRICK, STEPHEN Policy Number. 98- BO- W531 -4 Property: 804 Coolidge St Type of Loss: OTHER New Cu nberind, PA 17070 -1427 Deductible: 51,000.00 Home: 804 COOLIDGE ST Price List: PAHA9F_AUG12 NEW CUMBERLAND, PA 17070 -1427 Restoration/ServicetRemodel Home: (716) 255 -5727 Date of Loss: 8/1/2012 Date Received: 8/1/2012 Date Inspected: 8/3/2012 Summary for Contractors Payment Total Labor Amount 2,435.12 Total Adjustment for Base Service Charges 567.36 Supplies Allowance 0.04 Equipment Allowance 740.13 Cleaning Sales Tax 6.000% @ 26897 16.14 Cleaning Sales Tax, Tax on General Contractor O &P 123 General Contractor Overhead 10.000% @ 4,959.75 495.98 General Contractor Profit I0A00% @ 4,959.75 495.98 Total Contractor Costs 4,753.98 Deductible (1,000.00) Net Contractor Payment 3,753.98 Page: 6 Sketch: SKETCH I, Level: Basement e'i BMvom t'3 La. E� I RVAC i OH et Heiaomt J � InwGy u I I � ...._. __. __ ............153' ____. ..... .. ... i __ Sketch: SKETCHI, Level: Main Level ____ rr _. ... ......... ___ _._.. ...... \a T33• \ \ I r i r \ I I Price List Variation Usage Report Page: 1 8/29/2012 5 :41 PM State Farm Received Date: 8/1/2012 Completed Date: 8/29/2012 Operator: GR6U Estimator: SMITH Smith, Lori Checkpoint price list: PAHA91 AUG12 Harrisburg,PA Estimate price list: PAHA917 _AUG 12 Harrisburg,PA Restoration/ Ser-,ice/Remodel Claim Number: 381685366 Price List Item Total 4,890.86 Estimate Line Item Total 4,890.86 Line Item De- viation Total 0.00 * Totals may be different due to rounding. State Farm HETRICK. STEPHEN 38 -168S -366 Main Level Main Level DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Haul debris - per pickup truck load - 1.00 EA 122.07 122.07 122.07 including dump fees General clean - up 4.00 HR 29.68 D 118.72 118.72 Content Manipulation charge - per I.00 HR 27.66 D 27.66 27.66 hour Very few contents remain in the home Added labor below as outlined: Drywalier 4 hr needed 1.39 hr provided Drywall Installer / Finisher - per hour 2.61 HR 54.27 D 141.64 141.64 Total: Main Level 410.09 0.00 410.09 z s f- ' Living Room Height: 8' Gil iF , o^ H 500.00 SF Walls 218.25 SF Ceiling T LiviMR- I 718.25 SF Walls & Ceiling 218.25 SF Floor 1 64.17 LF Ceil. Perimeter 62.17 LF Floor Perimeter it r Missing Wall - Goes to Floor 2' X 6' 8 Opens into HALL Subroom: CLOSET (1) Height: 8' T 9733 SF Walls 9 -04 SF Ceiling 106.38 SF Walls & Ceiling 9.04 SF Floor 12.17 LF Ceil. Perimeter 12.17 LF Floor Perimeter 2 11" { DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Floor protection - self - adhesive plastic 227.29 SF 0.42 95.46 95.46 film Drywall patch / small repair, ready for 1.00 EA 40.37 40.37 40.37 paint Date: 8/29/2012 4:26 PM Page: 5 State Farm HETRICK. STEPHEN 38 -168S -366 CONTINUED - Living Room DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Seal /prime then paint the surface area 4.00 SF 0.63 2.52 2.52 (2 coats) Paint the walls - one coat 597.33 SF 0.40 238.93 (79.64) 159.29 Screen and coat wood floor 227.29 SF 121 275.02 (137.51) 137.51 Add for dustless floor sanding 22729 SF 1.00 227.29 227.29 Clean floor 227.29 SF 0.29 D 65.91 65.91 Totals: Living Room 945.50 217.15 728.35 6' s° -{ 3' T 2' Bedroom 1 Height: 8' 6' 6 -I ,„ 402.67 SF Walls 135.67 SF Ceiling 7" N eaAromn i ! T t 53833 SF Walls & Ceiling 135.67 SF Floor T r 52.00 LF Ceil. Perimeter 50.00 LF Floor Perimeter 11':5• t 1 lblissing Wall - Goes to Floor 2' X 6' 8" Opens into HALL Snbroom: ROOM3 (1) Height: 8' T 132.00 SF Walls 14.64 SF Ceiling P1 146.64 SF Walls & Ceiling 14.64 SF Floor 16.50 LF Ceil. Perimeter 16.50 LF Floor Perimeter Bedroom DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV R &R Interior door unit - Standard 1.00 EA 146.30 146.30 (7.32) 138.98 grade Detach & Reset Door knob - interior - 1.00 EA 20.95 D 20.95 20.95 Standard grade Paint door slab only - 2 coats (per side) 1.00 EA 20.10 20.10 20.10 Date: 8/29/2012 4:26 PM Page: 6 State Farm HETRICK. STEPHEN 38 -1685 -366 CONTINUED - Bedroom 1 DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Screen and coat wood floor 150.31 SF 1.21 181.88 (90.94) 90.94 Add for dustless floor sanding 15031 SF 1.00 150.31 150.31 Clean floor 150.31 SF 0.29 D 43.59 43.59 Totals: Bedroom 1 563.13 98.26 464.87 2' J Hall Height: 8' Walls =� . . -- Battuoom 12333 SF as 2149 SF Ceiling i C'4 _ b 144.82 SF V4'alls &Ceiling 21.49 SF Floor 20.83 LF Ceil. Perimeter 14.33 LF Floor Perimeter tom! (� Bedroom 2 .Iissing Wall - Goes to Floor 2' X 6' 8" Opens into LIVING ROOM Missing Wall - Goes to Floor 2' 6" X 6' 8" Opens into DINING ROOM Missing Wall - Goes to Floor 2' X 6' 8" Opens into BEDROOM - 1 DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Paint door slab only - 2 coats (per side) 1.00 EA 20.10 20.10 20.10 Screen and coat wood floor 21.49 SF 1.21 26.00 (13.00) 13.00 Add for dustless floor sanding 21.49 SF 1.00 21.49 21.49 Clean floor 21.49 SF 029 D 6.23 6.23 Totals: Hall 73.82 13.00 60.82 Date: 8/29/2012 4:26 PM Page: 7 State Farm HETRICK STEPHEN 38 -1685 -366 athro Bedroom 2 Height: 8' I rien 101 1i ° 34933 SF Walls 119.17 SF Ceiling T Bedroom 2 t 468.51 SF Walls & Ceiling 119.17 SF Floor 43.67 LF Ceil. Perimeter 43.67 LF Floor Perimeter F4'6" A f4'1" d DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Detach & Reset Mirror - 1i4" plate 10.00 SF 5.64 D 56.40 56.40 glass Finish Carpenter - per hour 1.00 HR 62.65 D 62.65 62.65 Above two items to repair broken frame to wall mounted mirror Screen and coat wood floor 119.17 SF 1.21 144.20 (72.10) 7110 Add for dustless floor sanding 119.17 SF 1.00 119.17 119.17 Clean floor 119.17 SF 0.29 D 34.56 34.56 Totals: Bedroom 2 416.98 72.10 344.88 Dining Room Height: 8' r` L 29533 SF Walls 85.78 SF Ceiling Ty 381.12 SF Walls & Ceiling 85.78 SF Floor 39.00 LF Cell. Perimeter 36.50 LF Floor Perimeter 1'9 12'1 Missing Wall - Goes to Floor 2' 6" X 6' 8" Opens into HALL DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Screen and coat wood floor 85.78 SF 1.21 103.79 (51.90) 51.89 Add for dustless floor sanding 85.78 SF 1.00 85.78 85.78 Totals: Dining Room 189.57 51.90 137.67 Date: 8/29(2012 4:26 PM Page: 8 State Farm HETRICK. STEPHEN 38 -168S -366 Bathroom Height: 8' T _;__J II , r+ 251.82 SF Walls 51.59 SF Ceilin $ zo 303.41 SF Walls & Ceiling 51.59 SF Floor 31.48 LF Ceil. Perimeter 31.48 LF Floor Perimeter a 2 DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Detach & Reset Interior door unit 1.00 EA 55.18 55.18 55.18 R &R Door opening (jamb & casing) - 1.00 EA 92.28 9228 92.28 up to 32" vv - paint grade Paint door /window trim & jamb - 2 1.00 EA 19.86 19.86 (6.62) 1124 coats (per side) Totals: Bathroom 167.32 6.62 160.70 Kitchen 0.00 SF Walls 0.00 SF Ceiling 0.00 SF Walls & Ceiling 0.00 SF Floor 0.00 SF Short Wall 0.00 LF Floor Perimeter 0.00 SF Long Wall 0.00 LF Ceil. Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Rear entry area: R &R Storm door assembly - Standard 1.00 EA 177.51 177.51 (44.38) 133.13 grade R &R Exterior door slab - insulated 1.00 EA 342.21 34221 (102.66) 239.55 metal or wood - High grade Detach & Reset Door lockset - 1.00 EA 20.95 D 20.95 20.95 exterior - Standard grade Prime & paint door slab only - 100 EA 30.75 61.50 (20.50) 41.00 exterior (per side) R &R Interior door unit 1.00 EA 153.45 153.45 (7.67) 145.78 Detach & Reset Door knob - interior - 1.00 EA 20.95 D 20.95 20.95 Standard grade Paint door slab only - 2 coats (per side) 1.00 EA 20.10 20.10 20.10 Cabinet drawer repair: Date: 8/29./2012 4:26 PM Page: 9 State Farm HETRICK. STEPHEN 38 -168S -366 CONTINUED - Kitchen DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV R &R Cabinet drawer front - Standard 0.98 SF 16.97 16.64 16.64 grade Carpenter - Finish, Trim / Cabinet - 2.00 HR 62.65 D 125.30 125.30 per hour Actual repair above should be to detach & reset the drawer face, to a new drawer, I do not have an entry for a dt -awer only (no face). Please advise and forward documentation if the repair exceeds the above two entries. Detach & Reset Cabinet knob or pull - 1100 EA 1.74 20.88 20.88 Standard grade Seal & paint cabinetry - lower - faces 8.00 LF 13.67 109.36 109.36 only Above to paint the left lower cabinets where the drawer is being repaired Totals: Kitchen 1,068.85 175.21 893.64 Exterior 0.00 SF Walls 0.00 SF Ceiling 0.00 SF Walls & Ceiling 0.00 SF Floor 0.00 SF Short Wall 0.00 LF Floor Perimeter 0.00 SF Long Wall 0.00 LF Ceil. Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV R &R Rural mailbox 1.00 EA 45.52 D 45.52 (11.38) 34.14 R &R Mailbox post - wood 1.00 EA 66.30 D 66.30 (16.58) 49.72 Includes: Mailbox post and installation labor. Quality: 4 "x 4 "solid cedar post and mounting arm and a drive in steel anchor. Totals: Exterior 111.82 27.96 83.86 Area Totals: Main Level 2,151.82 SF Walls 655.64 SF Ceiling 2.807.45 SF Walls and Ceiling 655.64 SF Floor 726.68 Total Area 266.81 LF Floor Perimeter 655.64 Floor Area 141.79 Exterior Perimeter 279.81 LF Ceil. Perimeter 1,276.08 Exterior Wall Area of Walls 2,151.82 Interior Wall Area Total: Main Level 3,947.08 662.20 3,284.88 Date: 8/29/2012 4:26 PM Page: 10 State Farm HETRICK. STEPHEN 38 -168S -366 Basement �- 1 U T � Bedroom Height: 8' T 9 11 288-00 SF Walls 80.16 SF Ceiling 368.16 SF Walls & Ceiling 80.16 SF Floor 2' 6" 2'11" 36.00 LF Ceil. Perimeter 36.00 LF Floor Perimeter J Z g „ ac DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Reglaze window, I - 9 sf 1.00 EA 50.36 D 50.36 50.36 Drywall patch / small repair, ready for 1.00 EA 40.37 40.37 40.37 paint Seal/prime then paint the surface area 4.00 SF 0.63 2.52 2.52 (2 coats) Paint the walls - one coat 288.00 SF 0.40 115.20 (38.40) 76.80 Totals: Bedroom 208.45 38.40 170.05 6' 4 " -1-f1' 1 " -q Base, Laundry Height: 8' 189.61 SF Walls 25.13 SF Ceiling _- 214.74 SF Walls & Ceiling 25.13 SF Floor 23.70 LF Cell. Perimeter 23.70 LF Floor Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Detach & Reset Door knob - interior - 1.00 EA 20.95 D 20.95 20.95 Standard grade R &R Interior door - lauan/mahogany - 1.00 EA 86.72 86.72 (4.34) 82.38 slab only Paint door slab only - 2 coats (per side) 3.00 EA 20.10 60.30 (20.10) 40.20 Above for both sides of laundry door and basement 1st floor entry door (basement side). Totals: Laundry 167.97 24.44 143.53 Date: 8/29/2012 4:26 PM Page: 11 State Farm HEUUCK_ STEPHEN 38 -1685 -366 - - -- -- - - - - 2 __ 1 _ ' _ 77 _ T Basement Height: 8' er a^ a �� 371.33 SF Walls 202.57 SF Ceiling ireia's 57190 SF Walls & Ceiling 202.57 SF Floor 46.42 LF Cell. Perimeter 46.42 LF Floor Perimeter 7 Subroom: OFFSET (1) Height: 8' ff r3* 226.27 SF Walls 98.66 SF Ceiling 1 21'7 32493 SF Walls & Ceiling 98.66 SF Floor 3328 LF Cell. Perimeter 27.28 LF Floor Perimeter Missing Wall - Goes to Floor 6' X 6 Opens into Exterior Missing Wall 21'7" X 8' Opens into BASEMENT *2'11" Subroom: HVAC (2) Height: 8' T 133.61 SF Walls 15.40 SF Ceiling 149.01 SF Walls & Ceiling 15.40 SF Floor 16.70 LF Ceil. Perimeter 16.70 LF Floor Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV No related damage - water leak - also affected doorway to bedroom Totals: Basement 0.00 0.00 0.00 Area Totals: Basement 1,208.82 SF Walls 421.92 SF Ceiling 1,630.74 SF Walls and Ceiling 421.92 SF Floor 464.81 Total Area 1.50.10 LF Floor Perimeter 421.92 Floor Area 99.20 Exterior Perimeter 156.10 LF Ceil. Perimeter 852.81 Exterior Wall Area of Walls 1,208.82 Interior Wall Area Total: Basement 376.42 62.84 313.58 Line Item Subtotals: 38 -1685 -366 4,323.50 725.04 3,598.46 Date. 8/29/2012 4 :26 PM Page: 12 State Farm HETRICK. STEPHEN 38 -1685 -366 Adjustments for Base Service Charges Adjustment Carpenter - Finish, Trim/Cabinet 125.30 Drywall Installer/Finisher 217.08 Wood Flooring Installer 125.40 Painter 99.58 Total Adjustments for Base Senice Charges: 567.36 LINE ITEM TOTALS: 38 -1685 -366 4,890.86 725.44 4,165.82 Grand Total Areas: 3360.63 SF Walls 1,077.56 SF Ceiling 4,438.19 SF Walls and Ceiling 1.077.56 SF Floor 416.91 LF Floor Perimeter 435.91 LF Ceil. Perimeter 1,077.56 Floor Area 1,191.49 Total Area 3,360.63 Interior Wall Area 2,128.89 Exterior Wall Area 240.99 Exterior Perimeter of Walls Date: 8/29/2012 4:26 PM Page: 13 Basement b IV ruum ,.� \ i '` L `4- V \i i� Offcet f31 • 29' � Best m ti {.illN.iLk.K .�• in 25'4" 8ss , Date: 8/29/2012 4:26 PM Page: 14 Main Level 1x• 11^ -- I , 2 . 7 . ii . �.• 2 ' 2 .. .............. ................. _ .................... ... y j € Li GlPSei��t 2 11" —I .i —� — � LIxArA4k24am \ ��� 7 11'1 "i J 3 I! Damage path (furniture drag e) on wood floor 1!' 7" hairs Lvael Date: 8/29;2012 4:26 PM Paee: 15 Ownership Audit Estimate: 38-168S-366 User Ownership Period Total Items Estimate Total (GR6U) 8(29/2012 to 8129!2012 51 $4,323.50 Session Statistics User Date Time Total Items Estimate Total (GR6U) 8/29/2012 15:09 :36 to 17.41:30 51 $4,323.50 8%29/2012 5:41 PM Page: 2 Estimate Audit Trail Estimate: 38 -1685 -366 Estimator Date /Time Update Beginning Price Ending Price % Change Notes (GR6U) 8/29/2012 15:10:27 $0.00 $0.00 NIA Type of loss set to OTHER (GR6U) 8/29/2012 15:10:38 $0.00 $0.00 N/A Deductible changed from 0 to 1000 (GR6U) 8/29/2012 15:10:44 $0.00 $0.00 N/A Tax jurisdiction set to 6% (GR6U) 8/29/2012 15:10:52 $0.00 50.00 NIA Estimate save (changes made) (GR6U) 8/29/2012 15 :19 :13 $0.00 $O.00 N/A Estimate save (changes made) (GR6U) 8/29/2012 15 :19 :27 $0.00 $0.00 NIA Estimate save (changes made) (GR6U) 8/29/2012 15 :19:56 $0.00 $O.00 N/A Estimate save (no changes made) (GR6U) 8/29/2012 15:26:56 $0.00 $0.00 N/A Estimate save (no changes made) (GR6U) 8129/2012 15:31:40 $0.00 $1,334.93 NIA Estimate total change(s) (GR6U) 8x'29/2012 15:31 :48 $1,334.93 $1,334.93 0.0 Estimate save (changes made) (GR6U) 8/29/2012 15 :33:00 $1,334.93 $1,682.66 +26.0 Estimate total change(s) (GR6U) 8/2912012 15:33:11 $1,682.66 $1,7262.5 +2.6 Paste from clipboard (item(s)) (GR6U) 8/29/2012 15:33:12 $1,7262.5 $1,732.48 +0.4 Paste from clipboard (item(s)) (GR6U) 8/29/2012 15:33:14 $1,732.48 $1,767.04 +2.0 Paste from clipboard (item(s)) (GR6U) 8/29/2012 15:33:19 $1,767.04 $1,791.92 +1.4 Paste from clipboard (item(s)) (GR6U) 8/29/2012 15:43:22 $1,791.92 $2,762.7.5 +542 Estimate total change(s) (GR6U) 8/29/2012 15.46:20 $2,762.75 $2,762.75 0.0 Estimate save (changes made) (GR6U) 8/29/2012 15:47:29 $2,762.75 $2,762.75 0.0 Estimate save (no changes made) (GR6U) 8/29/2012 15:48:44 $2,762-75 $2,874.89 +4.1 Estimate total change(s) (GR6U) 8/29/2012 15:48:47 $2,874.89 $2,874.89 0.0 Estimate save (changes made) (GR6U) 8/29/2012 15:57:24 $2,874.89 $3,321.08 +15.5 Estimate total change(s) (GR6U) 8/29/2012 15:57:32 $3,321.08 $3,321.08 0.0 Estimate save (changes made) (GR61) 8/29/2012 16:05:07 $3,321.08 $3,519.86 +6.0 Estimate total change(s) (GR6U) 8/29/2012 16:05:22 $3,519.86 $3,519.86 0.0 Estimate save (changes made) (GR6U) 8/29/2012 16:06:47 $3,519.86 $3,63891 +3.4 Estimate total change(s) (GR6U) 8x'29/2012 16:07:54 $3,638.91 $3,638.91 0.0 Estimate save (changes made) (GR6U) 8/2912012 16:12:41 $3,638.91 $3,638.91 0.0 Estimate save (changes made) (GR6U) 8/29/2012 16:13:00 $3,638.91 $3,588.55 -1.4 Estimate total change(s) 8/29/2012 5:41 PM Page: 3 Estimate Audit Trail Estimate: 38 -1685 -366 Estimator Date/Time Update Beginning Price Ending Price % Change Notes (GR6U) 8/29/2012 16:13:07 $3,588.55 $3,63891 +1.4 Paste from clipboard (item(s)) (GR6U) 8/29/2012 16:13:28 $3,638.91 $3,797.00 +4.3 Estimate total change(s) (GR6U) 8/29/2012 16:13 :31 $3,797.00 $3,797.00 0.0 Estimate save (changes made) (GR6U) 8/29/2012 16:14:08 $3,797-00 $3,629.03 -4.4 Estimate total change(s) (GR6U) 8/29/2012 16:14:18 $3,629.03 $3,797.00 +4.6 Paste from clipboard (item(s)) (GR6U) 8129/2012 16:14:52 $3,797.00 $3,797.00 0.0 Estimate total change(s) (GR6U) 8/29/2012 16:15:01 $3 $3,797.00 0.0 Estimate save (changes made) (GR6U) 8/29/2012 16 :15:17 $3,797.00 $3,919.07 +3.2 Estimate total change(s) (GR6U) 8/29/2012 16:15:22 $3,919.07 $3,919.07 0.0 Estimate save (changes made) (GR6U) 8/29/2012 16:15:52 $3,919.07 $3,919.07 0.0 Paste from clipboard (item(s)) (GR6U) 8/29/2012 16:16:14 $3,919.07 $3,919.07 0.0 Estimate save (changes made) (GR6U) 8/29/2012 16:16:48 $3,919.07 $3,919.07 0.0 Estimate save (changes made) (GR6U) 8/29/2012 16 :18:43 $3,919.07 $3,919.07 0.0 Estimate total change(s) (GR6U) 8/29/2012 16:18 :43 $3,919.07 $3,919.07 0.0 Estimate save (changes made) (GR6U) 8/29/2012 16. -18:50 $3,919-07 $3,919.07 0.0 General Contractor Overhead changed from 0 to 10 (GR6U) 8/29/2012 16 :18:50 $3,919.07 $3,919.07 0.0 General Contractor Profit changed from 0 to 10 (GR6U) 8/29/2012 16:19:32 $3,919.07 $3,940.02 +0.5 Estimate total change(s) (GR6U) 8129/2012 16 :19:42 $3,940.02 $3,940.02 0.0 Estimate save (changes made) (GR6U) 8/29/2012 1621:58 $3,940.02 $4,193.62 +6.4 Estimate total change(s) (GR6U) 8/29/2012 16:22 :06 $4 $4,193.62 0.0 Estimate save (changes made) (GR6U) 8/29/2012 16:22:16 $4 $4,221.28 +0.7 Estimate total change(s) (GR6U) 8/29/2012 16:22:31 $4,22128 $4,221.28 0.0 Estimate save (changes made) (GR6U) 8/29/2012 16 :23 :49 $4,22128 $4,362.92 +34 Estimate total change(s) (GR6U) 8/29/2012 16:23 :52 $4,362.92 $4,362.92 0.0 Estimate save (changes made) (GR6U) 8/29/2012 16:24:10 $4,362.92 $4,362.92 0.0 Estimate save (changes made) (GR6U) 8/29/2012 16:25:47 $4,362.92 $4,323_50 -0.9 Estimate total change(s) (GR6U) 8 16:25 :50 $4,32350 $4,323.50 0.0 Estimate save (changes made) (GR6U) 8/29/2012 16:26:14 $4,323.50 $4,323.50 0.0 Estimate save (no changes made) 8/29/2012 5 :41 PM Page: 4 Estimate Audit Trail Estimate: 38 -1685 -366 Estimator Date /Time Update Beginning Price Ending Price % Change Notes (GR6U) 8/29/2012 17:41:15 $4,32150 $4,323.50 0.0 Estimate save (changes made) (GR6U) 8/29/2012 17:41:30 84,32350 $4,323.50 0.0 Estimate set to complete 8/29/2012 5:41 PM Page: 5 HETRICK_ STEPHEN 38 -168S -366 AMStateFarw State Farm P.O. Box 106110 Atlanta, GA 30348 -6110 Phone: 1- 800406 -8543 ext: Fax: 1- 888 - 620 -2652 Structural Damage Claim Policy When you have a covered structural damage claim to your real property, you should know: • We want you to receive quality repair work to restore the damages to your property. • We will provide you with a detailed estimate of the scope of the damage and costs of repairs. Should the contractor you select have questions concerning our estimate, they should contact your claim representative directly. • Depending upon the complexity of your repair, our estimate may or may not include an allowance for general contractor's overhead and profit. If you have questions regarding general contractor's overhead and profit and whether general contractor services are appropriate for your loss, please contact your claim representative before proceeding with repairs. • There may be building codes, ordinances, laws, or regulations that affect the repairs of your property. These items may or may not be covered by your policy. Please contact your claim representative if you have any questions regarding coverage which may be available under your policy. • If you select a contractor whose estimate is the same as or lower than our estimate, based on the same scope of damages, we will pay based upon their estimate. If your contractor's estimate is higher than ours, you should contact your claim representative prior to beginning repairs. • State Faring cannot authorize any contractor to proceed with work on your property. Repairs should proceed only with your authorization. • State Farm does not guarantee the quality of the workmanship of any contractor or guarantee that the work will be accomplished within any specific time frame. • It is understood that the contractor is hired by you, our insured, and that they work for you - not State Farm. If you have any questions or need additional information regarding your claim, please contact your claim representative immediately. Date: 8129/2012 4 :26 PM 132214.1 06 -18 -2009 Page: 1 VERIFICATION I, Benjamin W. Lawrence, Esquire, attorney for the Plaintiff(s) do hereby swear and affirm that the averments in the attached Complaint are true and correct to the best of my knowledge, information and /or belief. These averments are made subject to the penalties of 18 Pa.C.S.A. §4904 relating to unsworn falsification to authorities. jamin W. Lawrence Date I l j SHERIFF'S OFFICE OF CUMBERLAND COUNTY Ronny R Anderson Sheriff Jody S Smith �Lttan�r � rri r,. Chief Deputy } CIO C Richard W Stewart Solicitor OMCEOF T�E S.,�,'nli' Z C) State Farm Fire&Casualty vs. Case Number Lori Ponder 2013-3415 SHERIFF'S RETURN OF SERVICE 06/13/2013 Sheriff Ronny R Anderson, being duly sworn according to law, states he made diligent search and inquiry for the within named Defendant to wit: Lori Ponder, but was unable to locate the Defendant in the Sheriffs bailiwick. The Sheriff therefore deputizes the Sheriff of Blair, Pennsylvania to serve the within Complaint& Notice according to law. 06/19/2013 10:55 AM-The requested Complaint&Notice served by the Sheriff of Blair County upon Brian Greene, who accepted for Lori Ponder, at 905 2nd Avenue,Altoona, PA 16602. Mitch Cooper, Sheriff, Return of Service attached to and made part of the within record. SHERIFF COST: $37.00 SO ANSWERS, June 27, 2013 RbNW R ANDERSON, SHERIFF (c)County-Suite Sheriff,Teleosoft,Inc. DATE RECEIVED DATE PROCESSED SHERIFF'S DEPARTMENT BLAIR COUNTY, PENNSYLVANIA COURTHOUSE, HOLLIDAYSBURG, PA. 16648 SHERIFF SERVICE INSTRUCTIONS: Print legibly,insuring readability of all copies. PROCESS RECEIPT, and AFFIDAVIT OF RETURN Do not detach any copies. BCSD ENV. # 1.PLAINTIFF/S 2.COURT NUMBER STATE FARM FIRE AND CASUALTY 12-3415160371 T-2013 3.DEFENDANTS/S 4.TYPE OF WRIT OR COMPLAINT LORI PONDER COMPLAINT SERVE 5.NAME OF INDIVIDUAL,COMPANY,CORPORATION,ETC.TO SERVICE OR DESCRIPTION OF PROPERTY TO BE LEVIED,ATTACHED OR SOLD. LORI PONDER 6.ADDRESS(Street or RFD.Apartment No:,City,Boro,Twp.,State and ZIP Code) AT 905 SECOND AVENUE ALTOONA, PA 16602 77.NDICATE UNUSUAL SERVICE: [Z]PERSONAL[Z]PERSON IN CHARGE[—]DEPUTIZE❑CERT.MAIL[—]REGISTERED MAIL EIPOSTED ❑OTHER �l NOW I,SHERIFF OF BLAIR,COUNTY,PA.,do hereby deputize the Sheriff of County to execute this Writ and make return thereof according to law.This deputation being made at the request and risk-of the plaintiff. SHERIFF OF BLAIR COUNTY 8.SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE. NOTE ONLY APPLICABLE ON WRIT OF EXECUTION N B WAIVER OF WATCHMAN--Any deputy sheriff levying upon or attaching any property under within writ may leave same without a watchman in custody of whomever is found in possession,after notifying person of levy or attachment,without liability on the part of such deputy or the sheriff of any plaintiff herein for any loss,destruction or removal of any such property before sheriffs'sale thereof. 9.SIGNATURE of ATTORNEY or other ORIGINATOR requesting service on behalf of: 10.TELEPHONE NUMBER 11. DATE �DEFEN'IDEPUTIZED BY CUMBERLAND CO DANT SPACE BELOW FOR USE OF SHERIFF ONLY— DO NOT WRITE BELOW THIS LINE I acknowledge receipt of the writ SIGNATURE o ut ged B UDDEputy or Clerk and Title 13 Date Received 14.Expiration/Hearing Date 12. or complaint ad indicated above. _I 06/17/2013 07/11/2013 I hereby CERTIFY and RETURN that I —have personally served. —have served person in charge. _have legal evidence of service as shown in 15. "Remarks"(on reverse). — have posted the above described property with the writ or complaint described on the individual,company,corporation,etc.,at the address shown above or on the individual,company,corporation,etc.,at the address inserted below by handing/or Posting a TRUE and ATTESTED COPY thereof. 16, 1 hereby certify and return a NOT FOUND because I am unable to locate the individual com an corporation,etc.,named above. (See remarks below) Name and title of individual served 18.A person of suitable age and discretion then Read Order s rigi 17. 1B V's 7residing in the defendant's usual place of abode. Address of where served(complete only if different than shown above)(Street or RFD,Apartment No.,City,Boro,Twp., 0. D ffervice 121.Time 19. State and ZIP Code) A r-vlli�- re o I 22. ATTEMPTS es k ep Int. Date Dep.Int. Miles Dep.Int Date Miles Dep.Int. Date I Miles Dep.Int. I e-1 � lem,I [Date I -I I Advance Co 24. 0 tv%v 25. 26. 27.Total Costs 28.—COST DUE Ol REFUND 23, 150.00 REC# KPT SjE>70-X) !)M 5iP) (3L-4 REMARKS: ij AFFIRMED and subscrib d to before me this t)l L-4 T-- SO ANSWER 5UDSCr'D a'o before me'n's ANU �, .z b3 day of By(Sheriff(U-pp,She"ff)(PI Pint or Type) Date, ease r oirt Date 2 q FH01Nk)%VNW%,B1 County _M -my commission expires Aup!t 16,2016 SHE FF OF BLAIR COUNTY MY COMMISSION EXPIR I ACKNOWLEDGE RECEIPT OF THE SHERIFFS RETURN SIGNATURE OF Received AUTHORIZED ISSUING AUTHORITY AND TITLE. e �t v C� G f+^ CD C IN THE COURT OF COMMON PLEAS r Y� CUMBERLAND COUNTY, PENNSYLVANIA F) CIVIL DIVISION" STATE FARM FIRE & CASUALTY Co Plaintiff No: 13-3415 CIVIL VS . PRAECIPE FOR DEFAULT JUDGMENT LORI SMITH PONDER AKA LORI PONDER Defendant FILED ON BEHALF OF Plaintiff COUNSEL OF RECORD OF THIS PARTY: Benjamin W. Lawrence, 209032 WELTMAN, WEINBERG & REIS CO. , L.P.A. 325 CHESTNUT STREET SUITE 501 PHILADELPHIA, PA 19106-2614 215-599-1500 FAX: 215-599-1505 20074243 C Y Jer DKM Judgment Amount $8066 . 65 OL644 IN THE COURT OF COMMON PLEAS e T" w CUMBERLAND COUNTY, PENNSYLVANIA ` CIVIL DIVISION ter- _-- `7Z- STATE FARM FIRE & CASUALTY co Plaintiff x .. cy � VS . Civil Action No. 13-3415 CIVIL, LORI SMITH PONDER AKA LORI PONDER PRAECIPE FOR DEFAULT JUDGMENT TO THE PROTHONTARY: Kindly enter Judgment against the Defendant LORI SMITH PONDER AKA LORI PONDER, above named, in the default of an Answer, in the amount of $8066 . 65 computed as follows : Amount claimed in Complaint $8066 . 65 Less payments / adjustments made $0 . 00 Attorney' s fees $0 . 00 TOTAL $8066 . 65 I hereby certify that appropriate Notices of Default, as attached have been mailed in accordance with PA R.C.P. 237 . 1 on the dates indicated on the Notices. WELTMAN, WEINBERG & REIS CO. , L.P.A. By: Benjamin W. Lawrence, 209032 20074243 C Y Jer DKM Plaintiff ' s address is : c/o WELTMAN, WEINBERG & REIS CO. , L.P.A. , 325 CHESTNUT STREET SUITE 501 PHILADELPHIA, PA 19106-2614 And that the last known address of the Defendant is LORI SMITH PONDER AKA LORI PONDER 905 2ND AVE ALTOONA, PA 16602 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION STATE FARM FIRE & CASUALTY Cd Plaintiff vs. Civil Action No. 13-3415 CIVIL LORI SMITH PONDER AKA LORI PONDER NOTICE OF JUDGMENT OR ORDER TO: ( ) Plaintiff (xx) Defendant ( ) Garnishee You are hereby notified that the foljow�ng Order of Judgment was entered against you on �'/a /3 (xx) Assumpsit Judgment in the amount of $8066 . 65 plus costs. ( ) Trespass Judgment in the amount of $ plus costs. ( ) If not satisfied within sixty (60) days, your motor vehicle operator' s license and/or registration will be suspended by the Department of Transportation, Bureau of Traffic Safety, Harrisburg, PA. (xx) Entry of Judgment of ( ) Court Order ( ) Non-Pros ( ) Confession (xx) Default ( ) Verdict ( ) Arbitration Awa Prothonotary By: a PROTHONOTARY OR PUTY LORI SMITH PONDER AKA LORI PONDER 905 2ND AVE ALTOONA, PA 16602 Plaintiff ' s address is : c/o WELTMAN, WEINBERG & REIS CO. , L. P.A. , 325 CHESTNUT STREET SUITE 501 PHILADELPHIA, PA 19106-2614 215-599-1500 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION STATE FARM FIRE&CASUALTY tCo Plaintiff Case No. 13-3415 CIVIL vs. LORI SMITH PONDER AKA LORI PONDER Defendant IMPORTANT NOTICE TO: LORI SMITH PONDER 905 2ND AVE ALTOONA, PA 16602',UL 2 Z 2013 Date of Notice: YOU ARE IN DEFAULT BECAUSE YOU HAVE FAILED TO ENTER A WRITTEN APPEARANCE PERSONALLY OR BY ATTORNEY AND FILE IN WRITING WITH THE COURT YOUR DEFENSES OR OBJECTIONS TO THE CLAIMS SET FORTH AGAINST YOU. UNLESS YOU ACT WITHIN TEN DAYS FROM THE DATE OF THIS NOTICE, A JUDGMENT MAY BE ENTERED AGAINST YOU WITHOUT A HEARING AND YOU MAY LOSE YOUR PROPERTY OR OTHER IMPORTANT RIGHTS. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE, IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. CUMBERLAND COUNTY BAR ASSOCIATION 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 (717)249-3166 WELTMAN,WEINBERG &REIS CO., L.P.A. By: Michael P6ugherty P.A.I.D.#76046 WELTMAN, WEINBERG& REIS CO., L.P.A. 325 Chestnut Street,Suite 501 Philadelphia, PA 19106 (215) 599-1500 (215)599-1505 20074243 Y PHI IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION STATE FARM FIRE & CASUALTY C6 Plaintiff vs . Civil Action No. 13-3415 CIVIL NON-MILITARY AFFIDAVIT LORI SMITH PONDER The undersigned is the duly authorized agent and/or attorney for the Plaintiff in the within matter and states as follows: Affiant states that the within Affidavit is made pursuant to and in accordance with the Servicemembers ' Civil Relief Act (SCRA) , 50 U.S.C. App. 521 . Affiant further states that based upon investigation it is the affiant ' s belief that the Defendant, LORI SMITH PONDER AKA LORI PONDER, is not in military service. Affiant further states that this belief is supported by the attached certificate from the Defense Manpower Data Center (DMDC) , which states that the DMDC does not possess any information indicating that the below individual is in the military service: LORI SMITH PONDER AKA LORI PONDER 905 2ND AVE ALTOONA, PA 16602 Affiant further states that the averments contained herein are true and correct to the best of Affiant ' s knowledge, information and belief and that these averments are made subject to the penalties of 18 Pa C.S.A. Section 4904 relating to unsworn falsification to authorities . AFFIANT t Department of Defense Manpower Data Center Results as of:Aug-0662013 06:40:09 _ SCRA 3.0 Status R pott Pursuant to Servicemennben Civil Relief. tat Last Name: PONDER First Name: LORI Middle Name: Active Duty Status As Of: Aug-06-2013 On Active Duty On Active Duty Status Date Active Duty Start Date Active Duty End Date Status Service Component NA NA No NA This response reflects the individuals'active duty status based on the Active Duty Status Date Left Active Duty Within 367 Days of Active Duty Status Date Active Duty Start Date Active Duty End Date Status Service Component NA NA -No NA This response reflects where the individual left active duty status within 367 days preceding the Active Duty Status Date The Member or His/Her Unit Was Notified of a Future Call-Up to Active Duty on Active Duty Status Date Order Notification Start Date Order Notification End Date Status Service Component NA NA No NA This response reflects whether the individual or his/her unit has receivetl earty notification to report for active duty Upon searching the data banks of the Department of Defense Manpower Data Center,based on the information that you provided,the above is the status of the individual on the active duty status date as to all branches of the Uniformed Services(Army,Navy,Marine Corps,Air Force,NOAA,Public Health,and Coast Guard). This status includes information on a Servicemember or his/her unit receiving notification of future orders to report for Active Duty. HOWEVER,WITHOUT ASOCIAL SECURITY NUMBER,THE DEPARTMENT OF DEFENSE MANPOWER DATA CENTER CANNOT AUTHORITATIVELY ASSERT THAT THIS IS THE SAME INDIVIDUAL THAT YOUR QUERY REFERS TO.NAME AND DATE OF BIRTH ALONE DO NOT UNIQUELY IDENTIFY AN INDIVIDUAL. AVL� + . Mary M.Snavely-Dixon,Director Department of Defense:Manpower Data Center 4800 Mark Center Drive,Suite 04E25 Arlington,VA 22350 The Defense Manpower Data Center(DMDC)is an organization of the Department of Defense(DoD)that maintains the Defense Enrollment and Eligibility Reporting System(DEERS)database which is the official source of data on eligibility for military medical care and other eligibility systems. The DoD strongly supports the enforcement of the Servicemembers Civil Relief Act(50 USC App.§501 at seq,as amended)(SC RA)(formerly known as the Soldiers'and Sailors'Civil Relief Act of 1940). DMDC has issued hundreds of thousands of"does not possess any information indicating that the individual is currently on active duty"responses,and has experienced only a small error rate. In the event the individual referenced above,or any family member,friend,or representative asserts in any manner that the individual was on active duty for the active duty status date,or is otherwise entitled to the protections of the SCRA,you are strongly encouraged to obtain further verification of the person's status by contacting that person's Service via the "defenselink.mil"URL:hftp://www.defenselink.mil/faq/pis/PC09SLDR.htmi. If you have evidence the person was on active duty for the active duty status date and you fail to obtain this additional Service verification,punitive provisions of the SCRA maybe invoked against you. See 50 USC App.§521(c). This response reflects the following information: (1)The individual's Active Duty status on the Active Duty Status Date(2)Whether the individual left Active Duty status within 367 days preceding the Active Duty Status Date(3)Whether the individual or his/her unit received early notification to report for active duty on the Active Duty Status Date. More information on "Active Duty Status" Active duty status as reported in this certificate is defined in accordance with 10 USC§101(d)(1). Prior to 2010 only some of the active duty periods less than 30 consecutive days in length were available. In the case of a member of the National Guard,this includes service under a call to active service authorized by the President or the Secretary of Defense under 32 USC§502(f)for purposes of responding to a national emergency declared by the President and supported by Federal funds. All Active Guard Reserve(AGR)members must be assigned against an authorized mobilization position in the unit they support. This includes Navy Training and Administration of the Reserves(TARs),Marine Corps Active Reserve(ARs)and Coast Guard Reserve Program Administrator(RPAs). Active Duty status also applies to a Uniformed Service member who is an active duty commissioned officer of the U.S. Public Health Service or the National Oceanic and Atmospheric Administration(NOAH Commissioned Corps). Coverage Under the SCRA is Broader in Some Cases Coverage under the SCRA is broader in some cases and includes some categories of persons on active duty for purposes of the SCRA who would not be reported as on Active Duty under this certificate. SCRA protections are for Title 10 and Title 14 active duty records for all the Uniformed Services periods. Title 32 periods of Active Duty are not covered by SCRA,as defined in accordance with 10 USC§101(d)(1). Many times orders are amended to extend the period of active duty,which would extend SCRA protections.Persons seeking to rely on this website certification should check to make sure the orders on which SCRA protections are based have not been amended to extend the inclusive dates of service. Furthermore, some protections of the SCRA may extend to persons who have received orders to report for active duty or to be inducted,but who have not actually begun active duty or actually reported for induction. The Last Date on Active Duty entry is important because a number of protections of the SCRA extend beyond the last dates of active duty. Those who could rely on this certificate are urged to seek qualified legal counsel to ensure that all rights guaranteed to Service members under the SCRA are protected WARNING: This certificate was provided based on a last name,SSN/date of birth,and active duty status date provided by the requester. Providing erroneous information will cause an erroneous certificate to be provided. Certificate ID: E439R140K097XA0 WELTMAN,WEINBERG & REIS CO.,L.P.A. BY: Benjamin W. Lawrence, Esquire Attorney for Plaintiff(s) I.D. No. 209032 325 Chestnut Street, Suite 501 Philadelphia, PA 19106 Phone: 215.599.1500 Fax: 215.599.1505 File# 20074243 STATE FARM MUTUAL AUTO INS CO CUMBERLAND County Court of Common Pleas `'W rn tC-) I vs. LORI SMITH PONDER NO. 13 3415 CIVIL .� PRAECIPE FOR CERTIFICATION OF MOTOR VEHICLE JUDGMENT TO THE PROTHONOTARY: Kindly issue a Certification of Motor Vehicle Judgment against the Defendant(s), LORI SMITH PONDER , above named in the amount of$8,066.65 . WELTMAN, WEINBERG & REIS CO., L.P.A. B Y Benjamin W. Lawrence, Esquire Attorney for Plaintiff Pl) ATTY � �99►�q