17A-118 (4) STORE COPY
to recover its reasonable attorneys'fees and expenses as provided by N.C. Gen. Stat. Section 6-21.2 or other controlling law. The parties agree that this arbitration agreement is made in connection with a
transaction involving interstate commerce and shall be governed by the Federal Arbitration Act, 9 U.S.C. Sections 1-16(as may be amended) (FAA), but if for any reason the Federal Arbitration Act does not
apply,then this arbitration agreement shall be goverened by the laws of the State of North Carolina.
16.GOVERNING LAW AND SEVERABILITY.This Contract shall be interpreted under and governed by the law of North Carolina,without regard to the choice of law rules of any state, except that the ARBIT-
RATION AGREEMENT, WAIVER OF JURY TRIAL AND WAIVER OF CLASS ACTION ADJUDICATION is governed by the FAA. If any provision of the Contract is contrary to any law to which it is subject,
such unlawful provision shall be ineffective without invalidating the other provisions,which shall remain in full force and effect.
17. CREDIT CARD/FINANCED TRANSACTIONS. If Customer uses a credit card or obtains financing to pay some or all of the Price, then Customer acknowledges that the terms of his or her cardholder
agreement or financing documents may change the total amount of money Customer must pay to the credit card provider or lender, including any interest charges and fees.Customer acknowledges that his or
her cardholder agreement or financing documents may have other terms and conditions to which Customer will be subject.Customer also acknowledges that Lowe's is not a party to any such cardholder or fin-
ancing agreement.
18.WAIVER OF LIENS.Because responsibility for paying the Installer on Customer's behalf belongs to Lowe's, Lowe's will require the Installer,on behalf of itself and any of the Installer's subcontractors,ma-
terialmen or suppliers,as a condition precedent to payment by Lowe's on Customer's behalf,to fully and unconditionally relinquish,waive and release any and all mechanic's liens,materialman's liens and oth-
er liens in the Premises which the Installer or its subcontractors,materialmen or suppliers might have or acquire in the future,by operation of law or otherwise,as a result of this Contract.
19. UNAVOIDABLE DELAY OR FAILURE IN PERFORMANCE EXCUSED.Any delay or failure by Lowe's or the Installer in performing this Contract because of strike,fire,flood,epidemic,acts of terrorism,
acts of God, inability to obtain Goods in a timely or commercially feasible manner, or any other causes beyond the reasonable control of Lowe's or the Installer shall be excused and shall not be breaches of
this Contract.
20. ENTIRE AGREEMENT/CHANGES IN WRITING.Customer and Lowe's agree that this Contract accurately states the entire agreement between Customer and Lowe's concerning the Goods and Installa-
tion Services and replaces and supersedes all prior agreements and understandings relating thereto, both oral and written, and all oral agreements and understandings entered into at the same time as this
Contract.Any additions or changes to this Contract,or any waiver of rights under this Contract,must be in writing signed by Customer and Lowe's.
21.CAPTIONS.Titles or captions of sections contained in this Contract have been inserted only as a matter of convenience and in no way define, limit,extend,describe or otherwise affect the scope or mean-
ing of this Contract or the intent of any provisions hereof.
22.ADDITIONAL INFORMATION.All contractors and subcontractors must be registered by the Administrator of the Board of Building Regulations and Standards.Inquiries about a contractor or
subcontractor relating to a registration should be directed to the Administrator of the Board at One Ashburton Place,Room 1301,Boston,MA 02108,(617)727-8598.
23. QUESTIONS OR CONCERNS.Customer should speak to the Lowe's salesperson whose name appears on this Contract and the manager of the Lowe's store at the address and/or phone number on the
front page of this Contract, regarding routine matters such as scheduling,any requested changes to Customer's order,or any concerns Customer may have about this Contract, the Goods or the Installation
Services.
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Premises will not interfere with performance of the Installation Services.Customer agrees to provide power to,as applicable,climate control in,the work areas.Customer agrees not to allow unattended minors
at the Premises while the Installer is present. Customer agrees to control and keep pets away from work areas.Customer agrees to keep posted permits on display at all times. Customer agrees that if Cus-
tomer or anyone Customer controls interferes with or delays performace of the Installation Services, Customer may be subject to transportation/storeage charges or other resulting charges. Customer agrees
not to assign or transfer this Contract. Customer agrees that any claim against Lowe's or the Installer under this Contract should be made to Lowe's within thirty(30)calendar days of the date Customer first
becomes aware of a problem. (Lowe's will attempt resolution of any claim(s)within sixty(60)calendar days of receiving Customer's notice.)CUSTOMER ASSUMES THE RISK AND THE FULL LIABILITY OF
PHYSICALLY ASSISTING WITH DELIVERY OF THE GOODS OR WITH PERFOMANCE OF THE INSTALLATION SERVICES.
12. MANUFACTURER WARRANTY FOR GOODS.Customer is entitled to any warranty provided by a manufacturer of the Goods sold under this Contract.The Installer will provide Customer with any manu-
facturer consumer warranty information accompanying the Goods,and Customer may also obtain such information by contacting Lowe's. LOWE'S DOES NOT WARRANT THE GOODS AND EXPRESSLY
DISCLAIMS ALL WARRANTIES,EXPRESSED OR IMPLIED,TO THE FULLEST EXTENT PERMITTED BY LAW.
13. LOWE'S WARRANTY FOR INSTALLATION SERVICES/LIMITATIONS OF LIABILITY. Lowe's does warrant that the Installtion Services will be performed by the installer in a good and workmanlike
manner. Lowe's warranty for Installation services shall extend for a period of one year from the earlier of(1)the date the Certificate of Completion is signed by Customer or(2)the date that Lowe's determines
that the Installation Services have been completed, or for such greater period as may be required by applicable law governing consumer warranties for workmanship (the "Warranty Period"). LOWE'S WAR-
RANTY THAT THE INSTALLATION SERVICES WILL BE PERFORMED BY THE INSTALLER IN A GOOD AND WORKMANLIKE MANNER DOES NOT COVER, AND LOWE'S WILL NOT BE RESPONS-
IBLE FOR,ANY DEFECT IN SUCH INSTALLATION SERVICES DUE TO(1)ANY DEFECT,WEAKNESS OR DANGEROUS CONDITION,INCLUDING BUT NOT LIMITED TO,MOLD, ROT,ASBESTOS OR
INFESTATION IN THE PREMISES'STRUCTURE, SUBSTRUCTURE,SUPERSTRUCTURE OR POINTS OF ATTACHMENT, OR OTHER PRE-EXISTING PHYSICAL OR ENVIRONMENTAL HAZARD, OR
(2) ABUSE,MISUSE, NEGLECT,OR IMPROPER CLEANING. LOWE'S WARRANTY FOR INSTALLATION SERVICES SHALL BE IN LIEU OF ANY OTHER WARRANTY,EXPRESSED OR IMPLIED,TO
THE FULLEST EXTENT PERMITTED BY LAW.
Customer acknowledges and agrees that Customer shall be limited to seeking recourse or remedy exclusively from Lowe's or the Installer(as applicable)and that no affiliate of Lowe's shall have any liability
under this Contract. Customer must give Lowe's written notice within the Warranty Period of any warranty claim relating to Installation Services. Customer agrees that its sole and exclusive remedy against
Lowe's for a warranty claim is reinstallation in a good an workmanlike manner,including the repair or replacement of any Goods if and to the extent resonably necessary to correct the defective Installation Ser-
vices.CUSTOMER SHALL HAVE NO OTHER REMEDY FOR A WARRANTY CLAIM, INCLUDING WITHOUT LIMITATION REMEDY FOR LOSS OR DAMAGE CAUSED BY NORMAL WEAR AND TEAR,
LOSS OR DAMAGE WHICH HAS NOT BEEN REASONABLY MITIGATED, OR LOSS OR DAMAGE CAUSED BY ACTS OF GOD. IN NO EVENT SHALL LOWE'S BE LIABLE FOR INDIRECT, PUNITIVE,
CONSEQUENTIAL OR INCIDENTAL DAMAGES (SUCH AS,WITHOUT LIMITATION, LOST PROFITS, LOST SALES,AND INJURIES TO PERSONS OR PROPERTY), EVEN WHERE LOWE'S HAS BEEN
ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. WHERE, DUE TO OPERATION OF LAW, SUCH DAMAGES CANNOT BE EXCLUDED, THEY ARE EXPRESSLY LIMITED IN AMOUNT TO THE
PURCHASE PRICE. In connection with any warranty claim,Customer agrees,at no cost to Lowe's or the Installer,to prepare the Premises and the reinstallation area in the manner described in Section 11 of
these Terms and Conditions.
14. DISPUTE RESOLUTION FOR CLAIMS COVERED BY M.G.L. c.142A. Most questions or complaints are resolved informally. If Customer has a question or complaint, Customer agrees to contact the
Lowe's salesperson whose name appears on this Contract and the manager of the Lowe's store at the address and/or phone number on the front page of this Contract.If Customer has a complaint which can-
not be resolved informally,The Home Improvement Contractor Law(M.G.L.c.142A)may provide Customer with the right to request arbitration through a private arbitration program approved by the Director of
the Office of Consumer Affairs and Business Regulation,as an alternative to court action.The same right is not afforded to Lowe's unless the"Notice Regarding Arbitration Agreement for Claims Covered by
M.G.L. c.142A"on the front page of this Contract is signed and dated by Lowe's and the owner. If allowed by statute or applicable law, the arbitrator may awared statutory damages and/or reasonable attor-
neys'fees and expenses. If Customer fails to pay Lowe's in accordance with this Contract, Lowe's shall be entitled to recover its reasonable attorneys'fees as provided by N.C. Gen. Stat. Section 6-21.2 or
other controlling law.To the fullest extent permitted by law, Lowe's and Customer agree that no class action lawsuit or class action artibration of any type may be pursued by or on behalf of the Customer or
ordered by a Court or arbitrator(s)under this Contract and,in addition,that there shall be no joinder of parties,except for joinder of parties to the transaction covered by this Contract.
15.ARBITRATION AGREEMENT,WAIVER OF JURY TRIAL AND WAIVER OF CLASS ACTION ADJUDICATION FOR CLAIMS NOT COVERED BY M.G.L.c.142A:All claims by Customer or Lowe's con-
cerning this Contract which cannot be resolved informally,and which are not covered by M.G.L.c142A or subject to the jurisdiction of a small claims court,shall be resolved by binding arbitration conducted by
a single arbitrator under the current applicable rules, procedures and protocols of JAMS, Inc. (JAMS) (www.jamsadr.com) (as amended) or the American Arbitration Association (AAA) (www.adr.org) (as
amended).The parties agree that if JAMS or AAA are unable or unwilling to arbitrate the matter,the parties will agree upon a single arbitrator with a nationally recognized arbitration firm to arbitrate the matter.
Claims to be resolved by binding arbitration include,but are not limited to(1)all claims directly or indirectly related to the signing of this arbitration agreement,the validity or scope of this arbitration agreement,
or any attempt to set aside this arbitration agreement, (2)all federal or state law claims relating directly or indirectly to this Contract(including this arbitration agreement),the information Customer gave Lowe's
before entering into this Contract and/or any past agreement or agreements between Customer and Lowe's, (3)all counterclaims,cross-claims and third-party claims,(4)all common law claims of any kind in-
cluding claims based upon alleged product defect,contract,tort,fraud,or other intentional torts, (5)all claims based upon a violation of any state or federal constitution,statute or regulation,(6)all claims as-
serted by Lowe's against Customer,including claims for money damages to collect any sum Lowe's claims Customer owes Lowe's,(7)all claims asserted by Customer individually against Lowe's and/or any of
Lowe's employees,agents,directors,officers,shareholders,managers,members, parent company or affiliated entities(herein collectively referred to as"related third parties")or the Installer, including claims
for money damages and/or equitable or injunctive relief, (8) all claims asserted on Customer's behalf by another person, (9) all claims asserted by or on behalf of a Customer as a private attorney general
against Lowe's, related third parties and/or the Installer, (10)all claims arising from or relating directly or indirectly to the disclosure by Lowe's,related third parties or the Installer of any non-public personal in-
formation about Customer,and/or(11)all other claims arising under or related to this Contract whether or not set forth above. If the dispute falls within the jurisdiction of a small claims court the claimant may,
at its option,choose to arbitrate or file a small claims action.Any appeal of a judgment from a small claims court shall be resolved by arbitration as provided herein.
Binding arbitration means that Customer waives:(1)any right to a jury trial; (2)any right to bring a lawsuit in a court(other than a small claims court as described above); and(3)any right to
seek relief in any other forum or from any other agency.Any claim not decided by a small claims court will be decided by an arbitrator selected as set forth immediately above. Lowe's and Cus-
tomer agree that binding arbitration provides a simple,cost efficient method to resolve disputes quickly. Lowe's and Customer agree that no class action lawsuit or class action arbitration of
any type may be pursued by or on behalf of the Customer or ordered by a Court or arbitrator(s)under this Contract and,in addition,that there shall be no joinder of parties,except for joinder of
parties to the transaction covered by this Contract.By agreeing to binding arbitration Customer and Lowe's waive any right to bring or participate in a class action lawsuit or class action arbitra-
tion regarding any claim.
How Arbitration Works:
Lowe's may demand arbitration by sending written notice to Customer at the address listed in this Contract.Customer may demand arbitration by sending written notice to Lowe's at the following address:Mail
code NB6LG, P.O. Box 1000, Mooresville, NC 28115.The arbitration shall be held in the city or county where the Premises are located or in such other convenient location as the Customer and Lowe's may
mutually agree. Lowe's shall pay the filing,administrative, hearing and arbitrator's fees associated with the arbitration. Customer shall not be required to reimburse Lowe's for these expenses even if Lowe's
wins the arbitration. Unless the arbitrator's award or controlling law specifically provides otherwise, Lowe's and Customer will each be responsible for its own attorneys'fees and other expenses,such as wit-
ness and expert witness fees.At the timely request of Customer or Lowe's,the arbitrator will provide a written explanation of the award so long as such requirement is consisent with the then current rules,pro-
cedures and protocols of the arbitration entity selected by the parties as set forth above.The arbitrator's award may be filed with and enforced by any court having jurisdiction. If allowed by statute or applicable
law,the arbitrator may award statutory damages and/or resonable attorneys'fees and expenses. If Customer fails to pay Lowe's in accordance with this Contract,Customer agrees that Lowe's shall be entitled
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TERMS AND CONDITIONS
1."LOWE'S"DEFINED.Within this Contract(as defined on the front page of this Contract),the term"Lowe's"shall refer to Lowe's Home Centers,LLC,a North Carolina limited liabity company.
2.GENERAL DESCRIPTION. By executing this Contract,Customer and Lowe's agree that 1) Lowe's shall provide Customer the goods and/or materials (the"Goods"),2) Lowe's shall procure on Customer's
behalf,the services to install the Goods(the"Installation Services") in or on the premises identified on the face of this Contract(the"Premises")and 3)Customer shall pay Lowe's the lump-sum Contract Total
stated on the face of this Contract(the"Price")and according to the provisions of the"Contract Documents".The Installation Services shall be perfomed in the specific rooms or areas of the Premises identified
on the face of this Contract("Project Area").The"Contract Documents"shall consist of(1)the face of this Contract, (2)these Terms and Conditions, (3)the applicable portion(s)of Lowe's receipt and(4)any
attached sketches, materials lists,floor plans,and/or specification sheets and other addenda or attachments hereto.The Contract Documents do not include any correspondence,advertisements,estimates or
other documents that are not attached.
3. INSTALLATION SERVICES.Customer authorizes Lowe's on Customer's behalf to(a)arrange for the Installation Services to be performed by an independent contractor(the"Installer")(licensed when leg-
ally required), (b) issue a work order to the Installer to perform the Installation Services, (c)have the Installer's work inspected,should Lowe's in its discretion choose to do so(it being agreed that Lowe's has
no obligation to do so),and (d) pay the Installer after completion of the work and after receipt of a certificate,signed and dated by Customer,that the work has been satisfactorily completed(the"Certificate of
Completion").Customer understands that Lowe's will rely upon the Certificate of Completion in paying the Installer for the Installation Services.Customer agrees that the Installation Services do not include ar-
chitectural/engineering services or structural changes to the Premises or any other services beyond the ordinary and routine installation of the Goods as specifically provided in this Contract. Customer is re-
sponsible,at Customer's cost,for providing any necessary architectural/engineering services or structural changes to the Premises or any other services not specifically identified in this Contract.
4. GOODS. Lowe's will arrange for delivery of the Goods to the Premises.Customer agrees that title to goods does not pass to Customer until installed in Customer's home,building,or on Customer's prop-
erty. Customer agrees Contract is being offered for the total Price(per below).Customer further agrees any surplus materials upon completion of the Installation Services are not the property of customer and,
if instructed by Lowe's,such surplus materials shall be returned to Lowe's by the Installer. Upon request from Customer at the time of job completion,Lowe's,in its discretion,will allow all or part of the unused,
receipted surplus materials to be retained by the Customer.
5. PRICE.The Price covers the Goods, Installation Services,and applicable taxes.The Price assumes sound existing substructures,superstructure and points of attachments.The Price shall be increased by
the cost and reasonable profit to Lowe's of having to provide additional Goods and/or Installation Services as a result of defective substructures, superstructures,or points of attachments or the existence of
any other Undisclosed Condition(per below).In the event of an Undisclosed Condition or the foregoing,Customer will execute a change order or a new replacement contract upon Lowe's request.
6. DISCOUNTS and PROMOTIONS. From time to time, Lowe's provides various promotions,offers and discounts that may apply to Goods and/or Installation Services. See specific promotion,offer and dis-
count for terms and conditions that may apply.All discounts are taken at the time of Customer's purchase.Applicable discounts or discounted Prices will appear on the Lowe's receipt and/or on the Contract.
7. PAYMENT. If the Price is$1,000.00 or less, payment of the Price by Customer to Lowe's is due in full uopon execution of this Contract. If the Price is over$1,000.00, Customer may choose to pay in full
upon execution of this Contract,but Lowe's may not require Customer to do so. If the Price is over$1,000.00 and Customer does not pay in full at the time of sale,Customer agrees to pay Lowe's according to
the payment schedule set forth in this Contract. Customer agrees to pay a deposit upon execution of this Contract equal to one-third of the Price.Customer agrees to make a payment for the balance of the
Price less the final payment at least one day after the date this Contract is executed and prior to the commencement of the Installation Services.Customer agrees to make the final payment upon completion of
the Installation Services and Customer's satisfaction. Payment for a new replacement contract is payable according to these Terms and Conditions. Payment for any change order is due at the time of that
change order. Lowe's will send to Customer by U.S.Mail a receipt evidencing Customer's purchase after Payment is processed.
8. LICENSES,PERMITS,SAFETY RULES,BUILDING CODES,ZONING ORDINANCES,AND OTHER LAWS.The Installer shall be solely responsible to Customer for obtaining any and all licenses, regis-
trations and certifications which are legally required to perform the Installation Services.The Installer shall also be solely responsible to Customer for the Installation Services being performed in compliance
with all applicable safety rules and all existing buidling codes,zoning ordinances and other laws. Lowe's shall be responsible to Customer for obtaining building permits which are legally required to perform the
Installation Services where Lowe's is legally required to obtain such permits.Where Installer is required to obtain such permits then Installer will be responsible to Customer for obtaining such permits.Custom-
ers who secure their own building permits will be precluded from claiming against certain state guaranty funds relating to home improvements. Neither the Installer nor Lowe's shall be responsible for any pre-
existing violations of safety rules, building codes,zoning ordinanaces or other laws and shall not be required to address or correct same. If prior to the completion of work a change occurs to any applicable
safety rule,building code,zoning ordinance or other law which requires additonal Goods and/or Installation Services to perform this Contract,Customer agrees to pay Lowe's the cost and reasonable profit for
such additional Goods and Installation Services and to execute a resulting change order or new replacement contract as requested by Lowe's. No additional work will be performed under this Contract due to
any change to any applicable safety rule,building code,zoning ordinance or other law that occurs after the completion of work.
9.CUSTOMER'S WARRANTY AGAINST VIOLATIONS OF EASEMENTS,COVENANTS,AND THIRD PARTY RIGHTS.Customer warrants that performance of Installation Services will not violate any exist-
ing real property easements,covenants,homeowner's association rules or rights of third parties holding an interest in the real property being improved.
10. UNDISCLOSED CONDITIONS IN PREMISES.If any defect,weakness or dangerous condition including,but in no way limited to,mold,mildew,rot,asbestos or infestation("Undisclosed Condition") is dis-
covered or identified in the Premises'structure,substructure,superstructure or points of attachment at any time prior to commencement or completion of the Installation Services,Customer must remedy the
Undisclosed Condition at Customer's sole cost and expense and to Lowe's sole satisfaction. If Customer refuses to permit inspection of the Premises as set forth below, Lowe's may terminate or rescind this
Contract without remedy or recourse by,or further obligation to,Customer,except as expressly provided below.If Customer and Lowe's disagree as to whether an Undisclosed Condition exists,Lowe's may in
its sole discretion obtain the services of an inspector to inspect the Premises at Lowe's sole cost and expense,and if Lowe's chooses to do so,such inspector's report shall be final and conclusive as to wheth-
er an Undisclosed Condition exists. In the event of any Undisclosed Condition that Customer does not remedy to Lowe's sole satisfaction,or any failure by Customer to perform any other obligation of Custom-
er under this Contract,then at Lowe's option (i)Lowe's may rescind this Contract and return the Price to Customer without further cost or obligation by either Customer or Lowe's if Lowe's notifies Customer of
its election to rescind this Contract prior to the earlier of delivery of the Goods and the Installer beginning performance of the Installation Services,or(ii) Lowe's may terminate this Contract without remedy or
recourse by,or further obligation to Customer,except as expressly provided below if Lowe's notifies Customer of its election to terminate this Contract after the earlier of delivery of the Goods and the installer
beginning performance of the Installation Services. In the event that Lowe's terminates the Contract as provided in this Section,then Customer may return the Goods(other than Goods that have been"custom-
made") in their original,unopened condition,to Lowe's for a refund or credit.Any such return must be made within 30 days after Lowe's terminates this Contract.Customer will be charged a 15%restocking fee
on any such returns. Goods not in their original, unopened condition, and custom-made goods, may not be returned. "Custom-made" goods include goods that have been uniquely altered, color-matched,
shaped,sized,cut or otherwise designed or fitted to accomodate the requirements of a particular space or environment. Examples of custom-made goods include,but are not limited to,cabinets,countertops,
floor and wall coverings,and window treatments. If Lowe's terminates this Contract as provided herein, Lowe's shall have no obligation to refund any portion of the Price(except as expressly provided herein)
and shall have no obligation to restore the Premises to their original condition. Notwithstanding the foregoing, and alternative to rescinding or terminating this Contract as described above,upon discovery or
identification of any Undisclosed Condition in the Premises, Lowe's may in limited circumstances and markets,and in Lowe's sole discretion,authorize the commencement or continuation of Installation Ser-
vices upon Lowe's receipt of Customer's written agreement(to be furnished to Customer by Lowe's)to release and hold harmless Lowe's and installer from any and all liability arising out of or related to the Un-
disclosed Condition and Customer's remedy of Undisclosed Condition.
11.CUSTOMER'S RESPONSIBILITIES: Customer agrees to pay Lowe's according to these Terms and Conditions. Customer agrees to facilitate the location of utility lines.Customer is responsible for identi-
fying property lines.Customer agrees to ensure that work areas are free of vermin and pre-existing physical or environmental hazards,and building/zoning code violations.Customer agrees to provide the In-
staller with access to work areas during working hours and to provide access to sanitary facilities or to pay the rental costs for such facilities. Customer agrees to ensure that any security system at the
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WITNESS OUR HAND(S) AND SEAL(S) BELOW THIS DAY OF
Lowe's Home Centers, LLC
By: (Seal)
Print Name: r�' �- ��T�/✓1 ?�� /
(Seal)
Address Owner
City State/Province Zip/Postal Code Print Name
Co-Owner or Witness (Seal)
Print Name
Customer acknowledges receipt of a true copy which was completely filled in prior to Customer's execution hereof. You the customer may cancel this transaction
at any time prior to midnight on the third business day after the date of this transaction. See the attached Notice of Right to Cancel for an explanation of
this right.
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er.
IF THE CONTRACT TOTAL IS $1,000.00 OR LESS Customer must pay in full
COMPLETE THIS SECTION ONLY WHEN THE CONTRACT TOTAL EXCEEDS$1,000.00:
Customer to Pay in Full; OR
[_] Customer to use the following payment schedule:
(1) Deposit of $ to be paid upon signing contract. Any deposit collected at the time this Contract is signed will not exceed one-third (1/3)
of the contract price; and
(2) Payment of $ to be collected upon or after the commencement of work. I/We authorize Lowe's to do one of the following (check ap-
propriate box below):
[_] Charge my/our credit card for the amount of the payment indicated above upon or after the commencement of work; or
[_] Deposit my/our check for the amount of the payment indicated above anytime upon or after the commencement of work; and
(3) Final payment of$100.00, to be paid upon completion of the installation to both parties' satisfaction.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES AND UNTIL YOU HAVE READ THE TERMS AND CONDITIONS CON-
TAINED IN THIS CONTRACT AND WHICH FOLLOW THE SIGNATURE PAGE(s). BY SIGNING BELOW, YOU ARE ACKNOWLEDGING THAT YOU
HAVE READ, UNDERSTAND AND AGREE TO THE TERMS AND CONDITIONS SET FORTH IN THIS CONTRACT. YOU ARE ENTITLED TO A COPY
OF THIS CONTRACT AT THE TIME OF SIGNATURE.
NOTICE REGARDING ARBITRATION AGREEMENT FOR CLAIMS COVERED BY M.G.L. c 142A
LOWE'S AND OWNER HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT LOWE'S HAS A DISPUTE CONCERNING THIS CON-
TRACT, THAT LOWE'S MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRET-
ARY OF THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE OWNER SHALL BE REQUIRED TO SUB-
MIT TO SLICH ARBITRATION _ Rp ED IN M.G.L. c.142A.
By: Date: /d
Lowe's Home Centers. LLC
Date:_
Own
By: Date:
Co-owner or Witness
THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE RESOLUTION
INITIATED BY LOWE'S PURSUANT TO M.G.L. c.142A. THE OWNER MAY BE PERMITTED TO INITIATE ALTERNATIVE DISPUTE RESOLUTION
EVEN WHERE THE SECTION ABOVE IS NOT SEPERATELY SIGNED BY THE PARTIES
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Child Care Providers and Schools. By signing this Contract, Customer acknowledges having received a copy of this pamphlet before work began informing
Customer of the potential risk of the lead hazard exposure from renovation activity to be performed in Customer's dwelling unit.
PHOTO RELEASE: Customer grants to Lowe's and Lowe's employees and independent contractors the right to take photograghs of the Premises where In-
stallation Services will be performed and all work performed at the Premises related to this Contract, and irrevocably grants to Lowe's all right, title, interest in
and to the photographs for use in all markets and media, worldwide, in perpetuity. Customer authorizes Lowe's to copyright, use and publish the photographs in
print and/or electronically, and agrees that Lowe's may use such photographs for any lawful purpose, irlcludir�, but not limited to, marketing, advertising, publi-
city, illustration, training and Web content. By initialing here, Customer agrees to the foregoing. ��/�� [Customer to initial to the left].
NOTICE TO CUSTOMER-PRICE CALCULATIONS: In order to properly perform the installation of certain Goods, the Contract Price may include more Goods
than actually will be installed based on the measured square footage of the Project Area. As a result, the parties agree that the lump-sum Price stated in this
Contract is calculated upon both the value of the estimated Goods required to fulfill the Contract (including waste), which may exceed the actual square footage
of the Project Area, and the labor which may be estimated based on the amount of Goods required to fulfill the contract (including waste). By signing this Con-
tract below, Customer acknowledges receipt of this notice and agrees and understands that the Price includes these costs which may not be refunded once the
Installation Services are performed..
TOTAL CHARGES OF ALL MERCHANDISE AND SERVICES where applicable
SUB-TOTAL $2932.4
*TAX $ 0.0
DELIVERY $ 0.0
ORDER TOTAL $2932.4
BALANCE DUE
Work is to commence upon reasonable availablity of Contractor which is anticipated to be 1�_ JCp"_-20" [fill in date].
Estimated completion date is �� [fill in date].
NOTICE TO CUSTOMER
All items listed in this contract and specification sheet(s) are to be installed under conditions agreed upon at time of purchase and at the price appearing
on this contract form. This assumes sound existing substructures, superstructure and points of attachments. Extra labor or material incident to installation
necessitated by defective substructures, superstructure, points of attachment, or the moving of fixtures or appliances to be billed at extra cost to custom-
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585253 : 14604032 : STK : LARSON TWFV 36 FRAME WHT : LARSON TWFV 36 FRAME WHT : LARSON MANUFACTURING COMPANY-QTY 1
585309 : 14604031 : STK : LARSON TWFV 32 FRAME WHT : LARSON TWFV 32 FRAME WHT : LARSON MANUFACTURING COMPANY - QTY 1
Materials Price $ 1648.9
INSTALLATION DESCRIPTION
Stock or SOS : SOS Door Type : Exterior
Select Location : Back Door Select New Door : Single Pre-hung
Hardwood (Mahogany or Oak) Door : No Side Lights or Transoms : No
Hidden Damage Description : None Number of additional holes bored for accessories : None
Install Specialized Mortise Hardware : No Install Storm Door : Install new storm, screen or security door
Select Storm Door : Storm Door Stock or SOS : SOS
Door Type : Exterior Select Location : Front Door
Select New Door : Single Pre-hung Hardwood (Mahogany or Oak) Door : No
Side Lights or Transoms : No Hidden Damage Description : None
Number of additional holes bored for accessories : None Install Specialized Mortise Hardware : No
Install Storm Door : Install new storm, screen or security door Select Storm Door : Storm Door
Total Linear Feet of Custom Trim to be Installed : 0 Deliver Door : Yes
Customer Understands Scope of the Project : Yes Permit Required : Yes
Who Will Obtain Permit : Lowe's Permit Fee : No
Additional Miles Traveled over 20 : 0 Bring Up To Code Description : None
Local Disposal Fee : Yes Describe Other Work Needed : Build up sub floors ans metal capping (supply)
Other Work Charge :Yes Comments : customer is looking at stock doors please add for ext kits if neces-
sary
Lead Safe Practices : No
Labor Charges $ 1318.5
Detail Deduction -$ 35.0
Additional Specifications:
Notation: Lowe's will not make structural modifications, paint or stain or remove/reinstall security system equipment. Customer is responsible to advise if prop-
erty is governed by Historic District Regulations.
Additional Specifications:Federal law requires Lowe's to provide you with the pamphlet Renovate Right: Important Lead Hazard Information for Families,
Store 1916 Project No. 450399928 for LINDA BERNIER Page 2 of 8
STORE COPY
INSTALLATION SERVICES CUSTOMER CONTRACT- MWORK - INT/EXT/PATIO DOOR
LOWE'S OF HADLEY, MA, STORE#1916 STORE PHONE: (413)588-0270
iliall f 282 RUSSELL STREET SALESPERSON: BRUCE HUNTER
HADLEY, MA 01035-0000 SALESPERSON ID: 1508948
Document Print Date : 08/16/2015
This is only a Quote for the merchandise and services printed below. This becomes an agreement upon payment and issuance of a Lowe's receipt, upon which the entire agree-
ment, including the specifically completed pages of this document, the Terms and Conditions included with this document, the applicable portion(s) of Lowe's receipt, and any
other addenda or attachments hereto, shall be referred to herein as this"Contract."
PLEASE READ THIS ENTIRE DOCUMENT, INCLUDING THE "TERMS AND CONDITIONS," BEFORE SIGNING.
Lowe's Registration or Contractor License Number/Lowe's Contractor Name
Lowe's Home Centers, LLC's MA HIC NO.: 148688 Lowe's Home Centers, LLC's FEIN: 56-0748358
Customer Name Home Phone
S LINDA BERNIER 413-584-9399
O Customer Address Other Phone
38 CLAIRE AVE
L City State/Province Zip/Postal Code
D FLORENCE MA 01062
Installation Address
T 38 CLAIRE AVE
O Installation City Installation State/Province Installation Zip/Postal Code
FLORENCE MA 01062
MERCHANDISE AND INSTALLATION SUMMARY
MERCHANDISE SUMMARY
39683 : PRODUCTCODE : SOS : SOS RB COMMODITY FBRGLS-DORFAB TC : ENTRY/EXTERIOR SINGLE UNIT, HALF LITE MINI BLIND ***15% OFF
RETAIL ON ALL SPECIAL ORDER ENTRY DOORS FROM 08/05/15 THROUGH 08/18/15*** : DOOR FABRICATION SERVICES INC -QTY 1
223281 : PRODUCTCODE : SOS : SOS RB DECORATIVE FBRGLS DORFAB : ENTRY/EXTERIOR SINGLE UNIT, VINTAGE CRAFTSMAN CRAFTSMAN
***15%OFF RETAIL ON ALL SPECIAL ORDER ENTRY DOORS FROM 08/05/15 THROUGH 08/18/15*** : DOOR FABRICATION SERVICES INC -QTY 1
14334 : STK : PNE CASE 351 2-1/2 X11/16 X7' : PNE CASE 351 2-1/2 X11/16 XT -QTY 6
238345 : 2827-8 : STK : 3/4X5.5X8 RF EMBOSD PVC TRM BOARD : 3/4X5.5X8 RF EMBOSD PVC TRM BOARD : ROYAL MOULDINGS LIMITED -QTY 1
238348 : 2828-8 : STK : 3/4X7.25X8 RF EMBOSD PVC TRM BRD : 3/4X7.25X8 RF EMBOSD PVC TRM BRD : ROYAL MOULDINGS LIMITED -QTY 1
585248 : 20297857 : STK : LARSON QUICKFIT HDL KIT AGBRZ : LARSON QUICKFIT HDL KIT AGBRZ : LARSON MANUFACTURING COMPANY - QTY 2
Store 1916 Project No. 450399928 for LINDA BERNIER Page 1 of 8
The Commonwealth of Massachusetts
Print Form
Department of'Industrial Accidents
Office of Investigations
T ; I Congress Street, Suite 100
Boston, MA 02114-2017
www.mass.govldia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/individual):
Address: Te5K_T�
0 i Ca {
City/State/Zip: Phone#: � ` C 1
Are ou an employer? Check the appropriate box: Type of project(required):
I. 1 am a employer with k 4. ❑ i am a general contractor and I
employees t full and/or part-time!. "
have hired the sub-contractors t' E] New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have R. ❑ Demolition
working for me in any capacity. employees and have workers'
[No workers' comp. insurance comp.insurance.$ 9 ❑ Building addition
required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3.❑ 1 am a homeowner doing all work officers have exercised their 1 l.❑ Plumbing repairs or additions
right of exemption r MGL 1 ❑ Rtxwf repairs
myself. (No workers' comp. g P per ?
insurance required.] t c. 152,§1(4),and we have no
employees. [No workers' 13Other
comp. insurance required.!
*Any applicant that checks box#I must also fill out the sectirnt below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers"comp.policy number.
I ant an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: O.-��7sUxt�)
Policy#or Sell'-ins. Lie.#: �i C 6 0 (Q��P�-�i Axpiration Date: ^ ?J1
Job Site Address:�s- t!�LA-X7eL<. City/State/Zip:e 1��-0eL,<_-0JQ_P_
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certi de a pains d enalties o erjur that the information provided abo a is tru and correct.
Si nature: J / / Date:
Phone#: �( / Q
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/Licensc#
Issuing Authority(circle one):
1. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6. Other
Contact Person: Phone#:
City of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as
a condition of the building permit all debris resulting from the construction
activity governed by this Building Permit shall be disposed of in a properly
licensed solid waste disposal facility, as defined by MGL c 111 , S 150A.
Address of the work: cS� cl A--oL -- M�-- -
The debris will be transported by: P -
The debris will be received by:
Building permit number:
Name of Permit Applicants
Date Si ature of Permit Applicant
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: 1�`F 1,� V +� `�
License Num qer
Address Expiration Dat
Signature Telephone
9. Registered Home Improvement Contractor: t Not Applicable ❑
Company Name Regist tion umber
r
ddress r 3 Expira ion D to
Telephone
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152,§25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the buil ing permit.
Signed Affidavit Attached Yes....... No...... ❑
11. - Home Owner Exemption
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families
and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts
as supervisor.CMR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner: Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there
is, or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm
structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner.
Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official, that he/she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s)
you hire to perform work for you under this permit.
The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of
Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable
New House ❑ Addition ❑ Replacemen W'ndows Alteration(s) ❑ Roofing ❑
Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks Siding[0] Other[Q]
Brief Description of Proposed \ � `` ;� �►�'S �`
Work-.11""'
ork 1."-.v �L " ��.Til�� `, L�C� —1
Alteration of existing bedroom Yes No Adding new bedroom Yes _ No C2
Attached Narrative Renovating unfinished basement Yes '-.-/ No��70
Plans Attached Roll -Sheet Cti/11�C�-
6a. If New house and or addition to existing housing, complete the following:
a. Use of building : One Family Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No .
I. Septic Tank City Sewer Private well City water Supply
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I b_ �✓y as Owner of the subject
property
hereby authorize
to act on my behalf, in all matters relative to work authorized by this building permit applicaiklb
Signature of Owner Date
�V , as OwnerlAuthorized
gent byAfeclare that the s atements and information on the foregoing a ication are true and accurate,to best of my knowledge
and b ef.
Signed under the pains and penalties of perjury.
Pri ame
igna . O er/Agent Date
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be tilled in by
Building Department
Lot Size
1�rontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg. Square Footage %
Open Space Footage %
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
(volume&Location)
A. Hasa Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DON'T KNOW Q YES Q
IF YES date issued:
IF YES Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW Q YES O
IF YES enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW 0 YES 0
IF YES has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained Q Date Issued:
C. Do any signs exist on the property? YES 0 NO Q
IFYES� describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO 0
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES Q NO Q
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Q ' Department use only
City of Northampton Status of Permit:
I0 3 , 2015 / Building Department Curb Cut/Driveway Permit
� 212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability
Electric, Plun-�bing&Gas Inspections
Northarno,ton, MA 01060 Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans
Other Specify
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address: This section to be completed by office
�� Map Lot Unit
Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Na��mee(�(PP�rint) Current Mailing Address:
<JCrCe ���� Telephone p�
Signature !
2.2 Authorized Agent:
Name Current Mailing Address:
z L-1 r--"� <is- a � T
a Telephone
SECTION 3- ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
com leted by ermit applicant
1. Building —1 (a) Building Permit Fee
2. Electrical _1 (b) Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total = 0 +2 + 3 +4 +5) Check Number ® 3
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
38 CLAIRE AVE BP-2016-0309
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17A- 118 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Cate ory' REPLACEMENT DOOR BUILDING PERMIT
Permit# BP-2016-0309
Project# JS-2016-000496
Est. Cost: $2933.00
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: LOWE'S 049918
Lot Size(sa. ft.): 13372.92 Owner: BERNIER STEPHEN J&LINDA J TRUSTEES
Zoning: RI(101)/URA(101)/ Applicant: LOWE'S
AT: 38 CLAIRE AVE
Applicant Address: Phone: Insurance:
282 RUSSELL ST (413) 588-0270 WC
HADLEYMA01035 ISSUED ON.911012015 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL 2 REPLACEMENT DOORS
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 9/10/2015 0:00:00 $40.00
212 Main Street,Phone(413)587-1240, Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner