1528 WETMORE AVE 2022-05-17 - Laserfiche WebLink

� 'i�19.►/YJ�` -- -� Customer Equipment Respoosibility Form __�_.._._ CustomerName: _� '��'1( '�,< t��l �'� ` � `��'�E'j�� Dateof Loss: --�%j` L�- � � � � � ,� LossAddress: 1L.1�1._L:..i�`"��. �::I �:F.J -.---- —�_---- — City: —L�I.=�E�-�-�� __ State: �:`�� _ Zip: r�i)�C'�_ tnsurance/Clicnl• ,�;��`�� F�yL`.4.!i1f�1�.L_ Claim Numher(if avoiloble): � � I� �(r7�"1 �C� ._��,,yy�,y_ Conventional Dehumldifiers � _.___ lGR Dehumldi(iers � ' � ____Desiccant Dehumidifiers � -"�. Air Moven � -_..� S�mcially Orying Equipment(Iist�:.Y, . _'_ � -_-_—_ � /__.. PowerDistributlonCenters __OJorControlDevices�lis[�. . ___ _ ....._._.____� � '--- AdditlanalEquiomentOn-5ite�list�: -_---'.--'—.._'—._____—,_„'_"_._'_-.:.'—�`—�"-----.— I Custorncr h�s Leen informed of thc JoNo�vii�y requirements regarding equipmen[pinced on the Jo6 site. ` i ' 1. Tha equipmenr should be left operating at all times, �o noi move equipman[uniess you cmitacl the SERVPROtO I . Francf•�ise identified beloaJ re�arding fiandling prucedures.Tuming eryuipment ofF will Increase time requircd to diyshvd.�reandcuntentsanclniaycausedamap,e. � ' , � � 2. A water-damaged dwellin�shnuld mainlain a[empenture setting that promotes ideal drying r.ondilions.Leaving I tvindows or doors npen during dehumidi0cation or setting air cundltioning too low may increase drying time and I damage strucfure and/or contents. � � 3. Should customer have.any pro5lems wilh the equipment,shut It off Immediately and call our of(ice at � I � . � lL<':(:1.�1=�_�,f�_,_as soon as possible. . - . � . 'I ' 4. Customer Is responsible fnr damage[o,and/or loss of,this equlpmect while il is in wstomer's wre and custody, I including but noC Ilmiled to loss taused by[heft,vandalism or disappearence. i 5. It is the customer's responsibiliry to allow perxonnel access to rnstomer's location to r.hed<on and plck up the � equipmenL � ' f. The abnve equipment may he picked up hehveen thc h�ours of,. '�y a,m.and_ �'j__p.m. Monclay through , Prlday exduding holidays. . . I 7. The equipment will be connected tn the electriwl sys[em in cuslomei s dwelling/stiuclure.Custorner warranls � the integrity and safety of lhe elecUicai system in the dwelling/slructure.Il shall be ihe customer's respons�bllity I to hwe the electri�al system inspedeJ and xrvi�ed by a qisilified electrician if necessary. I ' N. 'Ihe cuslomr.r agrees to hold fhe SENVPRO° Franchisr.below,its Franchisor and their rrspectiee of(iceis, directors,employces,a�;enU and a((iliates harmless and fndemnify it frnm any ancl all r.laims,lnduding costs, expenses and attomc�/s fees,resultin�from the improper use of lhc equlpmcnt by the customer and/or any defects in the electrical system or plumhing systein in customer's dwellinP/slrudure. Cuslomer,��,��l��Kr',=�;�ce(�::l��C�,�t. ;and Provider�SCHVPRO of.��SyL�L�/L�2''�,eC(�j\h ��-..,� � � ) i !'�-----'- . ad<nowledp,e rec�ipt of the a6o��e documenfed equipment in Rood vrorl<ing order. � � �, i y � >. % Cuslomer's SiFnaturc��(2/J�il�� C,G�2�i?�rf�C/L�_ .�� Date:' ��.,?�.� ��, �_ _- • C.• -^ ��(, �d �� c� . - Prnvidcr's5ignature: �U:r .�� U-- ---•1.-- -.- , Date:._l�/�� 3 , i � % �..------ ------------__�._.��_�,_�_�. . . . .� � - � ' I .._ .�_.__._.�_� ��._._._._�_._.__�. �._--- i �SEPVP0.0'MTFIIf.f7UALPROPERfY,lnc. ALLRIGHTSIlESERVEf1 fE�051707],0 Z8509 11/l0 f.cL SLl'lTRO"lincd�irc ii LulrprnJrml�•OnurAmid Opr,�.r2 . I � �