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Backup Documents 06/12/2012 Item #16D1016D10 &- Id A0. b. /0 EXECUTIVE SUMMARY Recommendation to approve a homeowner insurance check endorsement policy for all borrowers assisted with purchase assistance and/or rehabilitation housing program funds and authorizes Board Chairman or Vice Chairman, in his absence to endorse two homeowner insurance claim checks. OBJECTIVE: To allow homeowners in good standing with the State Housing Initiatives Partnership (SHIP) program to deposit their homeowner insurance claim check into the bank so they can use the funds to repair their damaged homes. CONSIDERATION: On July 25, 2008, the subject homeowners purchased a home located at 2505 41st Ave NE, Naples, FL 34120. Collier County approved down payment assistance through the SHIP program and the borrowers signed a second mortgage for SHIP down payment assistance on July 25, 2008. On January 20, 2012, the homeowners filed a homeowner's insurance claim due to water seepage damage to their home. The total claim for damages was $9,935.68. The insurance company paid the claim minus the homeowner's $1,000 deductible, in two separate checks. Check #1 in the amount of $7,964.41 and check #2 in the amount of $971.37. The insurance company made the checks payable to the homeowner, Bank of America and Collier County since all parties have an interest in the property. According to the SHIP loan documents and SHIP local housing administrative plan (LHAP) the homeowner is not required to pay back any funds to Collier County unless the homeowners sell, refinance or lose their homestead exemption on the property. None of these triggering events have occurred and the homeowner's second mortgage loan with Collier County is in good standing. Therefore, Collier County has no claim to the homeowner's insurance claim money that was provided to make repairs to the home. The homeowner has expressed frustration in having to wait for her checks to be endorsed because her house is in urgent need of repairs. Accordingly, Housing staff has developed a proposed Homeowners Insurance Check Endorsement Policy for similar circumstances in the future. If this item is approved, the Board Chairman or Vice Chairman, in his absence may endorse a check only if certain enumerated documentation is provided and the homeowner is in compliance with the SHIP and/or Single Family Home Rehabilitation program. The proposed Homeowners Insurance Check Endorsement Policy is attached as back -up for Board consideration. FISCAL IMPACT: There is no fiscal impact associated with this Executive Summary. GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact associated with this Executive Summary. LEGAL CONSIDERATIONS: This item is legally sufficient and requires a majority vote for Board action. - JBW RECOMMENDATION: That the Board of County Commissioners approves a homeowner insurance check endorsement policy for all borrowers assisted with purchase assistance and /or rehabilitation housing program funds and authorizes the Board Chairman or Vice Chairman, in his absence to endorse two homeowner insurance claim checks. PREPARED BY: Lisa Carr/Housing Outreach Coordinator, Housing Human and Veteran Services COLLIER COUNTY Board of County Commissioners Item Number: 16.13.10. 16010 + Item Summary: Recommendation to approve a homeowner insurance check endorsement policy for all borrowers assisted with purchase assistance and /or rehabilitation housing program funds and authorizes Board Chairman or Vice Chairman, in his absence to endorse two homeowner insurance claim checks. Meeting Date: 6/12/2012 Prepared By Name: AlonsoHailey Title: Operations Analyst, Public Service Division 6/4/2012 2:47:35 PM Submitted by Title: SHIP Program Coordinator Name: CarrLisa 6/4/2012 2:47:37 PM Approved By Name: AlonsoHailey Title: Operations Analyst, Public Service Division Date: 6/4/2012 2:56:25 PM Name: AlonsoHailey Title: Operations Analyst, Public Service Division Date: 6/4/2012 2:57:40 PM Name: GrantKimberley Title: Interim Director, HHVS Date: 6/4/2012 3:38:01 PM Name: WhiteJennifer Title: Assistant County Attorney,County Attorney Date: 6/4/2012 4:04:42 PM 16010., Name: CarnellSteve Title: Director - Purchasing/General Services,Purchasing Date: 6/4/2012 4:07:16 PM Name: PryorCheryl Title: Management/ Budget Analyst, Senior,Office of Management & Budget Date: 6/4/2012 4:47:02 PM Name: KlatzkowJeff Title: County Attorney Date: 6/5/2012 12:13:21 PM Name: IsacksonMark Title: Director -Corp Financial and Mgmt Svs,CMO Date: 6/5/2012 4:06:55 PM Patricia a .Morgan ((DOI 19 4 From: NeetVirginia < Virg iniaNeet @colIiergov.net> Sent: Friday, April 26, 2013 3:15 PM To: Patricia L. Morgan Cc: White, Jennifer Subject: Item 16 -D -10 - 6/12/12 BCC Meeting Attachments: Item 16 -D -10 (6_12_12) - Insurance Claim Check - NOT ROUTED.pdf Trish Jennifer White asked that I email the attached to you for the Clerk's records. This is in regards to an insurance claim check endorsed by the Chairman today. Please call if you have any questions. Jennifer: I will hold the documents and check for you for pick up. Dinny Virginia A. Neet, Legal Assistant Office of the Collier County Attorney Telephone (239) 252 -8066 - Fax (239) 252 -6600 Under Florida Law, e mail addresses are public records. If you do not want ymir e mail address released in re ponse to a public records request, do not send electronic mail to this entity. Imstead, contact this office by telephone or in writing, I: Forms/ County Forma% BCC Forms/ Original Documents Routing Sbo S 06jidii 9:03.04, Revised 1.26.05, Revised 2.2,05; Revise joiltial the Yes column or mark "N! �c in the Not Arpplicabla Win, vehichevtr is yes N/A (Not appropriate. •fiat licabie App) 1. Does the document requim the chairmaWs'on 2. Does the document need to be sent to anothar agopt jr vide the Contact Information " bad.. 3. Original document has been ss ed for. o$at "(' s�octmten>>be signed by the Chairman, with the: ' ofmost LOtterS,`mpat by the Office of the County Attmoo All handwritten strike - through and re have `ieatt ' " bq t AeY's 4. N/A Office and all other 2arties SEqLtkjCC Cliskirmim,sodA.Clorkto the Board 5. The Chairman's signature "line date hai been entered as 0* date bf BCC approvat Of the V %A docuzent or the Anal' otlated c trs►d date w)iic 6. "Sign here" tabs are placed on the a hate pages indic�iag tfgen's sigrialurvand initials are required. 7. In most cases (some contracts are anaxc t3onk je i�rigiunt..+ ipaut►ta routinngAslip should be provided to the County Attorney Office At 601time f iron} is'input into Sm. Some documents are time sensitive and rbquire Wwi4og to, :T time frame or the BCC's actions are n iBa: . i 8. The document was approved. by tb6'7 dsw and h dtsliug n the meeting have been ineorporated'*the at�stitheV dbcumel�`*s Codpty 10 IsOfftebasre0ewedtbe,dNi'aaes�ifainlicable. 191 9. Initials of attorney verifying that therWoched document is me vi FIM" aprroved by the.. ^ BCC, all changes directed by the BGt& have been made, euad thiea ready for the J Chairman's g �. 1 I: Forms/ County Forma% BCC Forms/ Original Documents Routing Sbo S 06jidii 9:03.04, Revised 1.26.05, Revised 2.2,05; Revise IFINq Collier County APR 112013 Housing, Human and Veteran Services (FW§JNG & HUMAN SERVICES Homeowner Insurance Check Endorsement PolicjjScAL SECTION Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage /lien, then the loan will not have to be repaid. On occasion, the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and receive money to make the repairs. If the insurance claim check is made payable to the homeowner and Collier County, then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to HHVS at the address below for check endorsement consideration: Copy of Homeowner's current insurance policy - Declaration Page. Copy of insurance company's claim report with worksheet including description of repairs and costs. ,4 Copy of photos of claim damaged v�. Copy of Insurance check(s) payable to homeowner, first lien holdrr and Collier County p� ✓S. Contact phone number and email address for the homeowner. Housing, Human and Veteran Services, 3339 Tamiami Trail E, Room 211, Attn: Housing Manager, Naples, FL 34112 If approved, the HHVS staff will contact you to schedule an appointment to endorse the insurance claim check. OFFICE USE ONLY 1 File Name: Ir File # U y �� %eview HHVS staff Date 13 Approved HHVS Director Date 0 Denied 0 Review OA &Z County Attorney Date a G & P INSURANCE INC. 4930 GOLDEN GATE PKWY STE A NAPLES FL 34116 -5992 JP MORGAN CHASE, N.A. ISAOA PO BOX 47020 DORAVILLE GA 30362 04- 11 -13A10 16010 UHV 2064987 01 UPC�'�l INSURANCE UNITED PROPERTY & CASUALTY INS P.O. Box 51149 Sarasota, FL 34232 -0330 16D10 HOMEOWNERS POLICY NUMBER POLICY PERIOD UHV 2064987 04 01 From To 03/09/2013 03/09/2014 12:01 A.M. SWrAva Time at the aes«roed acesan Date Issued: 01/09/2013 INSURED AGENT JORGE VALDES JR G & P INSURANCE INC. 4297 21 STAVE SW 4930 GOLDEN GATE PKWY STE A NAPLES FL 34116 NAPLES FL 34116 -5992 Telephone: 239 -353 -3500 Property Address: 4297 21 ST AVE SW NAPLES FL 34116 PREMIUM NOTICE This is a Bill Transaction History Transaction Date 01/08/2013 01/08/2013 03/09/2013 Minimum Amount Due Now: To pay in Pull: Transaction Type Renewal Premium Surcharge -- Due Dates and Amounts -- $ 1,228.00 $1,228.00 Amount $1,201.00 $27.00 Current Balance $1,228.00 A payment is due on this homeowners policy number UHV 2064987 04 01 The premium must be received by 03/09/2013 to keep the homeowners policy in effect. P R E M I U M N O T I CE - M O R T G A G E E Policy Number: UHV 2064987 04 MINIMUM AMOUNT DUE NOW: Insured: JORGE VALDES JR 4297 21ST AVE SW NAPLES FL 34116 $1,228.00 Loan Number 1877024155 PLEASE SEND PAYMENT TO: UPC Insurance P.O. Box 31512 Tampa, FL 33631 -3512 PLEASE CONTACT YOUR AGENT IF YOU HAVE ANY QUESTIONS OR TO CONFIRM RECEIPT OF YOUR PAYMENT UPC 1191004 MORTGAGEE COPY UPC0001UHV20649870403091303091300001228009 UPC�I INSURANCE UNITED PROPERTY & CASUALTY INS CO P.O. Box 51149 Sarasota, FL 34232 -0330 RENEWAL DECLARATION HOMEOWNERS DECLARATION POLICY NUMBER POLICY PERIOD r TO UHV 2064987 04 01 03/09/2013 03/09/2014 12:01 a. m. d tM rssidence premises• Effective: 03/09/2013 Date Issued: 01/08/2013 JORGE VALDES JR 4297 21 ST AVE SW NAPLES FL 34116 G & P INSURANCE INC. 4930 GOLDEN GATE PKWY STE A NAPLES FL 34116 -5992 The residence promises covered by this Policy is located at the address listed below. 4297 21ST AVE SW NAPLES FL 34115 ON OR BEFORE THE POLICY RENEWAL EFFECTIVE DATE, IF PAYMENT IS NOT RECEIVED THIS POLICY WILL NOT BE IN FORCE. and limit of liability is shown. Flood coverage is not provided and is not a Coverage is provided where premium part of this policy. PREMIUMS SECTION 1 COVERAGE LIMIT LIABILITY $1,135.00 A. DWELLING $200 5,000.00 $4 INCLUDED ,100.00 B. OTHER STRUCTURES $1$4,500.00 C. PERSONAL PROPERTY INCLUDED INCLUDED D. LOSS OF USE $41, 000.00 SECTION II COVERAGE $300,000.00 E. PERSONAL LIABILITY $30.00 INCLUDHD F. MEDICAL PAYMENTS $5,000.00 OPTIONAL COVERAGES $733.00 Premium charge for Hurricane Exposure: h b coverages are subject to a 2% / $4,100 Hurricane Deductible per T e a ove hurricane loss. The above coverages are subject to a 10% ! $20,500 Sinkhole Deductible per sinkhole loss. The above coverages are subject to a $1,000 All Other Peril Deductible. $1,226.00 TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES: $85.00 The amount of premium Increase due to approved rate increase is $42.00 The amount of premium increase due to coverage increase is COVERAGES HAVE BEEN INCREASED TO HELP KEEP PACE WITH RISING REPLACEMENT COSTS. PLEASE CONTACT YOUR AGENT IF THERE ARE ANY QUESTIONS PERTAINING TO YOUR POLICY. HO 0003 HO 0350 HO 0446 MORTGAGEE 1877024155 JP MORGAN CHASE, N.A. ISAOA PO BOX 47020 DORAVILLE GA 30362 HO 0334 (05/03) COUNTERSIGNED DATE 01/08/2 13 HO 0355 (05/05) HO 0490 (04191 HO 2370 (06/97 BY _ O V - SECOND MORTGAGEE & HUMAN COUNTY 3050 N HORSESHOE DR # 110 NAPLES FL 34104 UPC 119 1212 MORTGAGEE COPY Page 1 of 4 UPC INSURANCE UNITED PROPERTY & CASUALTY INS CO P.O. Box 51149 Sarasota, FL 34232 -0330 RENEWAL DECLARATION JORGE VALDES JR 4297 21 ST AVE SW NAPLES FL 34116 TIBER rVLr -_ From . I UHV 2064987 04 01 1 03/09/2013 12:01 a.m. at sN raiMnu pn Effective: 03/09/2013 Date Issued:01 /08/2013 G & P INSURANCE INC. 4930 GOLDEN GATE PKWY STE A NAPLES FL 34116 -5992 Telephone: 239-298-9573 Telephone: 239-353 -3500 The residence premises covered by this Policy Is located at the above insured address unless otherwise stated below: ____ _..._ 11.1 NAPLES FL 34116 To :— 03/09/2014 Premium: SECTION I, SECTION II AND OPTIONAL PREMIUMS $1,165.00 .00 EMERGENCY MANAGEMENT TRUST FUND SURCHARGE $ $a$2.00 MANAGING GENERAL AGENCY (MGA) POLICY FEE $16.00 FLORIDA HURRICANE CATASTROPHE FUND ASSESSMENT FL INS GUAR ASSOC ASSESS 2012 $8.00 2006 CITIZENS HIGH RISK ACCOUNT EMERGENCY ASSESSMENT $12.00 TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES $15733.00 NOTE: The portion of your premium for Hurricane Coverage is: $432,00 The portion of your premium for All Other Coverages is: An adjustment of 0 % is included to reflect the Building Code grade for your area. Adjustments range from 1% surcharge to 46.1 % credit. Your policy includes endorsement HO 04 46 Inflation Guard - which automatically Increases the amount of Dwelling Coverage by the annual percentage amount shown on the declaration page (but not less than 4 0/6). Therefore your Hurricane deductible may be higher than indicated on the policy when a hurricane loss occurs due to application of this endorsement. FLOOD CARRIER N/A FORM TYPE HO-3 CONSTRUCT TYPE M AOP TERRITORY 551 MUNICIPAL CODE 999999 PROT DEVICE/FIRE N WIND/HAIL EXCLUSION N FLOOD CREDIT N YEAR BUILT 1968 CONSTRUCT SUPERIOR N PROTECTION CLASS 04 COUNTY CODE 021 PROT DEV /SPRINKLER N REPLACEMENT COST Y SINKHOLE COVERAGE I WATER PREVENTION CR N TOWNIROW HOUSE NUMBER OF FAMILIES N/A USE CODE PROT DEVICE/BURGLAR P N PROT DEV /SHUTTER OCCUPANCY CODE OWNER WIND TERRITORY 551A UPC 11912 12 MORTGAGEE COPY Page 2 of 4 UPC HOMEOWNERS DECLARATION 16D10 I NSURANCE UNITED PROPERTY & CASUALTY INS CO P.O. Box 51149 Sarasota, FL 34232 -0330 POLICY NUMBER POLICY PERIOD From` To UHV 2064987 04 01 03/09/2013 03/09/2014 1507 . m .t are resident prnmhm. RENEWAL DECLARATION Effective: 03/09/2013 Date Issued: 01/08/2013 INSURED 'AGE4T'1003040. JORGE VALDES JR 4297 21 ST AVE SW NAPLES FL 34116 Telephone: 239 - 298 -9573 G & P INSURANCE INC. 4930 GOLDEN GATE PKWY STE A NAPLES FL 34116 -5992 Telephone: 239 - 353 -3500 The residence premises covered by this policy is located at the above Insured address unless otherwise stated below: 4297 21ST AVE SW NAPLES FL 34116 LAW AND ORDINANCE COVERAGE COVERAGE THAT YOU MAY WISH TO ALSO NEED TO CONSIDER THE P INSURANCE FROM THE NATIONAL PROGRAM. WITHOUT THIS COVERAI UNCOVERED LOSSES. PLEASE DISCU.c WITH YOUR INSURANCE AGENT. IS AN PURCHAE JRCHASE FLOOD -XE, YOU S THESE IMPORTANT oE. YOU MAY OF FLOOD INSURANCE MAY HAVE COVERAGES Coinsurance Contract: The rate charged in this policy is based upon the use of the coinsurance clause attached to this policy, with the consent of the insured. A rate adjustment of 78% of wind premium is included to reflect the windstorm mitigation. features of your dwelling. Adjustments range from 0% to 89% credit subject to verification that your home meets the windstorm mitigation characteristics of the 2001 Florida Building Code. THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES, WHICH MAY RESULT IN HIGH OUT OF POCKET EXPENSES TO YOU. ************* Additional Information ** ****** ***** This replaces all previously issued policy declarations, if any. This policy applies to accidents, occurrences, or losses which happen during the policy period shown above. In case of loss under Section I, only that part of loss over the stated deductible applies. The declarations page together with all policy provisions and any other applicable endorsements completes your policy. UPC 119 12 12 MORTGAGEE COPY Page 3 of 4 UPC INSURANCE UNITED PROPERTY & CASUALTY INS CO P.O. Box 51149 Sarasota, FL 34232 -0330 ` HPINSTALL (09/12) ` UPC PDCOVB(05/12) UPC 112 (08/99) UPC 164 (06/06) -UPC 192 (10/12) `OIRB11655 (02110) UPC 105 (09/06) UPC 119 (08107) UPC 174 (09/06) UPC 195 (01/09) 16D10 " POLICY NUMBER POLICY PERIOD From :- To UHV 2064987 04 01 03/09/2013 03109/2014 12:01 a.m. at ft resWence preniWw FORMS SCHEDULE (continued from page 1) ` OIRB11670 (01/06) -UPC 107 (08/99) UPC 151 (06/06) -UPC 176 (10/12) `OIRB11802 (01/12) UPC 108 (08/99) -UPC 155 (01/06) UPC 184 (08110) ` UIM 424 (06101) UPC 110 (08199) `UPC 160 (10105) " UPC 191 (10/12) UPC 119 12 12 MORTGAGEE COPY Page 4 of 4 February 15; 2013 Jorge Valdes 4297 21a Ave SW Naples, FL 34116 Re: insured: Claim Number: Policy Number Date of Loss: Cause of Loss: Loss Location: 1-6010 IrVz$VKAN(.:t Jorge Valdes 2013-0182 UW- 2064987 117113 Pipe Leak 4297 21 st Ave SW, Naples, FL 34116 ESTIMATE AND SETTLEMENT OF DAMAGES Por favor l6alo cuidadosamente. La informacl6n on esta carts afecta sus derechos cubiertos por In p6liza de seguro quo as menclona abajo. S1 usted no puede leer esta carta o no entiende algunn porcl6n de In misma, es muy importante quo usted solicite consejo de aiguna persona quo to pueda Interpretar y explicarle el contenido de este documento. Dear Jorge Valdes: Endosed is our estimate in the amount of $25,347.64. The payment represents settlement of damages under the foliowing'Coverage(s): ravment of your claim is being mailed to you separately. P.O. Box 10111 • ST. PETERSBURG, FL 33731 -1011 Replacement Cost $ 25,347.64 Other $ 25,347.64 Recoverable Depreciation ( -) 1 $ - on - Recoverable Depreciation ( -) $ - Prior Payment(s) ( -) $ - Deducdble ( -) 1 $ 1,000.00 1 $ 1,000.00 Net Payment 1 $ 24,347.64 $ $ - $ - 1 $ 24.347.64 ravment of your claim is being mailed to you separately. P.O. Box 10111 • ST. PETERSBURG, FL 33731 -1011 16D10 IMS Claim Services, Inc Multi -Line Insurance Adjusters 222159th Street West - Bradenton, FL 34209 Phone (941) 746-3328 Fax (941) 746 -1858 Home: (239) 298 -9573 Insured: JORGE VALDES JR property. 4297 21ST AVE SW NAPLES, FL 34116 Claim Rep.: Mike Tschida Estimator: Mike Tschida Reference: Company: UNnW PROPERTY & CASUALTY Business: 360 CENTRAL AVE SUrM 900 ST. PETERSBURG, FL 33701 Claim Number: 201300000182 Policy Number; UHV2064987 Date Contacted: 1/11/2013 3:59 PM Date of Loss: 1/7/2013 12:00 PM Date. lnspeated: 1/15/2013 10:30 AM Date Est. Completed: 1/17/2013 10:33 AM Price List: FLNA7X_JAN13 Restoration/Scmce/Remodel Fctimate: IMS- VALDES Business: (651) 210 -6546 E -mail: muschida @hotmail.com Business: (651) 210 -6546 E -mail: mttschida@hotmail.com Business: (877) 467 -4677 Type of Loss: Water Damage Date Received: 1111/2013 3:00 PM Date Entered: 1/15 /2013 4:35 PM -Mis adjuster, the author of this estimate, has no authority to: (1) approve or deny claims; or, (2) bind your insurer as to coverage for your claim or the amount of your loss, if any. A copy of this estimate does not constitute a settlement off our insurer. co any representation is sub' to the review, modification and approval Y entation on cite part of your insurer. The estimate > visions. Any additional repairs including, but not limited to, the application of policy limitations, exclusions and deductible provisions. ' required to to, or replacement of, items not included in this estimate are also subject a your acemc s prior approval. You are on reports, etc- , as Proof of repairhePlacxrttent in � event of any future loss and keep all records, canceled checks, inspection policy. This estimate is not an andtorization of repair The hiring of a pursuant to your post -loss duties under your contractor is strictly the decision of the policy holder." IMS Claim Services. Inc Multi -Line Insurance Adjusters 222159th Street West - Bradenton, FL 34209 Phone (941) 746 -3328 Fax (941) 746 -1858 IMS- VALDES INTERIOR INTERIOR I w DESCRIPTION QUANTITY UNIT COST RCV D13WC. ACV 1, Dumpster load - Approx. 30 yards, 1.00EA 492.11 492.11 (0.00) 492.11 5 -7 tons of debris 2. Final cleaning - construction - 1,034.28 SF 0.19 196.51 (0.00) 196.51 Residential Total: PMRIOR 688.62 0.00 688.62 i ---•rs ro --� der Bedroom Height: 8' .... _ , 406.42 SF Walls 154.45 SF Ceiling 560.87 SF Walls & Ceiling 154.45 SF Floor r 1 17.16 SY Flooring 50.80 LF Floor Perimeter 50.80 LF Ceil. Perim DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 3. Contents - move out then reset - 1.00 EA 105.68 105.68 (0.00) 105.68 Extra large room 4. Window blind - horizontal or 2.00 EA 30.52 61.04 (0.00) 61.04 vertical - Detach & reset 5. Mask wall - plastic, paper, tape (per 50.80 LF 0.78 39.62 (0.00) 39.62 LIP) 6. R&R Baseboard - 4.1/4" 50.80 LF 4.26 216.41 (0.00) 216.41 7. Casing - Detach & reset 58.00 LF 1.80 104.40 (0.00) 104.40 8. Paint baseboard - two coats 50.80 LF 0.97 49.28 (0.00) 49.28 9. Paint casing - one coat 58.00 LF 0.64 37.12 (0.00) 37.12 10. Paint the walls - one coat 406.42 SF 0.45 182.89 (0.00) 182.89 11. R&R Tile floor covering 154.45 SF 8.62 1,331.36 (0.00) 1,331.36 12. Remove Additional labor to 154.45 SF 1.65 254.84 (0.00) 254.844 remove file from concrete slab 13. Interior door - Detach & reset 1.00 EA 74.09 74.09 (0.00) 74.09 Totals: Master Bedroom 2,456.73 0.00 2,456.73 IMS- VALDES 1/17/2013 Page:2 1MS Claim Services, Inc Multi-Line Insurance Adjusters 222159th Street West - Bradenton, FL 34209 Phone (941) 746 -3328 Fax (941) 746 -1858 Missing Wall Master Bath 163.46 SF Walls 211.29 SF Walls & Ceiling 5.31 SY Flooring 20.43 LF Ceil. Perimeter 7' 3 3/16" % 8' Height: 8' 47.83 SF Ceiling 47.83 SF Floor 20.43 LF Floor Perimeter Opens into MASTER-SHOWE DESCRIPTION QUANITPY UNIT COST RCV DEPREC. ACV 14. Contents - move out then reset - 1.00 EA 26.45 26.45 (0.00) 26.45 Small room 15. Detach & Reset Exhaust fan 1.00 EA 121.54 121.54 (0.00) 121.54 16. Detach & Reset Light fixture 1.00 EA 37.12 37.12 (0.00) 37.12 17. Mirror - plate glass - Detach & 12.00 SF 5.49 65.88 (0.00) 65.88 reset 18. R &R Baseboard - 41/4" 8.00 LF 4.26 34.08 (0.00) 34.08 19. Casing - Detach & reset 16.30 LF 1.80 29.34 (0.00) 29• 20. Paint baseboard - two coats 8.001.17 0.97 7.76 (0.00) 7.76 21. Paint casing - one coat 0.00LF 0.64 0.00 (0.00) 0.00 22. Drywall - Labor Minimum 1.00 EA 257.97 257.97 (0100) 257.97 23. Seal the surface area w/PVA 16.00 SF 0.38 6.08 (0.00) 6.08 primer - one coat 24. Paint the surface area - two coats 157.00 SF 0.64 100.48 (0.00) 100.48 25. Mask wall - plastic, paper, tape 20.43 LF 0.78 15.94 (0.00) 15.94 (per LF) 26. R&R Tile floor covering 40.33 SF 8.62 347.65 (0.00) 347.65 27. Remove Additional labor to 40.33 SF 1.65 66.54 (0.00) 66.54 remove file from concrete slab 28. Detach & Reset Toilet 1.00 EA 166.21 166.21 (0.00) 166.21 29. Apply anti- microbial agent 47.83 MN 0.20 9.57 (0.00) .57 30. Interior door - Detach & reset 1.00 EA 74.09 74.09 (0.00) 744.09 Totals: Master Bath 1,366.70 0.00 1,366.70 IMS- VALDES 1/172013 Page:3 IMS Claim Services, Inc Multi -Line Insurance Adjusters 222159th Street West - Bradenton, FL 34209 Phone (941) 746 -3328 Fax (941) 746 -1858 T b � Missing Wall 16010 Master Shower Height: 8' 114.13 SF Walls 25.43 SF Ceiling 139.55 SF Walls & Ceiling 25.43 SF Floor 2.83 SY Flooring 14.27 LF Floor Perimeter 14.27 LF Coil. Perimeter 7133116 "R8' Opens into MASTER..)3ATH DESCRIPTION QUANTITY UNIT COST Rte' DEIrREC. ACV 31. R &R Tile shower - 65 to 100 SF 1•00EA 52.84 52.84 (0.00) ACV 32. R&R Tile concrete shower curb - 4.00 LF 1,245.97 1,245.97 (0.00) 1,245.97 per LF 3353 SF 74.36 297.44 (0.00) 297.44 33. Detach & Reset Shower faucet 1.00 EA 0.78 22.88 (0.00) 22.88 34. Shower pan LOOEA LOO 53.22 53.22 (0.00) 53.22 35. Detach &Reset Exhaust fan 1.00 EA 12.74 12 .74 (0.00) 127.74 36. Detach & Reset Light fixture 1. 00 EA 1211.54 1211.54 (0.00) 121.54 37. Seal the walls and ceiling w/PVA 13955 SF 37.12 37.12 (0.00) 37.12 prima - one coat 0.38 53.03 (0.00) 53.03 38. Apply anti - microbial agent 25.43 MN 0.20 5.09 (0.00) 5.09 Totals: Master Shower 1,941.15 a an •- - - II Master Closet Height. 8' 234.67 SF Walls 3353 SF Ceiling zr a ,T, 268.19 SF Walls & Cciling 33.53 SF Floor t 3.73 SY Flooring 29.33 LF Floor Perimeter as ir -, 29.33 LF Ceil. Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEP'REC. ACV 39. Contents - move out then reset - 1.00 EA 52.84 52.84 (0.00) 52.84 Large room 40. R &R Tile floor covering 33.53 SF 8.62 289.03 (0.00) 289.03 41. Remove Additional labor to 3353 SF 1.65 55.32 (0.00) 55.32 remove tile from concrete slab 29.33 LF 0.78 22.88 (0.00) 22.88 42. Mask wall - plastic, paper, tape (per LF) 43. R&R Baseboard - 41/4" 8.00 LF 426 34.08 (0.00) 34.08 44. Paint baseboard - two coats 8.00 LF 0.97 7.76 (0.00) 7.76 IMS- VALDES 1/172013 Page:4 16D10 IMS Claim Services, Inc Multi -Line Insurance Adjusters 222159th Street West - Bradenton, FL. 34209 phone (941) 746 -3328 Fax (941) 746 -1858 CONTINUED - Master Closet DESCRIPTION QUANTITY UNIT COST RCV DEPREC- ACV 100.48 (0.00) 100.48 45. Paint the surface area - two coats 157.00 SF 0.64 24.13 24.13 (0'00) 2,4.13 46. Bifold door - (2 slabs only) - 1' Single - Detach & reset 586.52 586.52 0.00 Totals: Master Closet 233.75 SF Walls 270.25 SF Walls & Ceiling 4.06 Sy Flooring 29.22 LF Ceil. Perimeter 3650 SF Ceiling 36.50 SFFloor 29.22 LF Floor Perimeter 8. 1 Opens into LPMG -ROOM Missing Wall 24 3" X 8- ACV DESCRIPTION QUANTITY -- UNIT COST RCV DEPREC. (0.00) 22.79 476 Mask wall - plastic. Paper, tape 29.22 LF 0.78 (Per 1 31.94 31.94 (0.00) 31.94 124.48 48. Door chime - Detach & reset 426. 124.48 (0.00) 49. R&R Baseboard - 41/4" 29.22 LF 1.80 122.40 (0.00) 122:40 50. Casing - Detach &reset 68.00LF 0.97 x •34 (0'00) 28.34 51. Paint baseboard - two coats 29.22 LF 0' 43.52 (0.00) 43.52 52. Paint casing -one coat 68.001 F 0.45 105.19 (U.00) 105.19 53. Paint the walls - one coat 233.75 SF 8.62 314.64 (0.00) 314.64 54. R&R Tile floor covering 36.50 SF 1.65 60.23 (0.00) 60.23 55. Remove Additional labor to 36.50 SF remove tile from concrete slab 0.00 853.53 853.53 Totals: IiallwaY 1/17/2013 Page:5 IMS -V ALDES 16D1 IMS Claim Services, Inc Multi -Line Insurance Adjusters 222159th Street West - Bradenton, FL 34209 Phone (941) 746 -3328 Fax (941) 746 -1858 Linen Closet Height: 8' TT-I '. 98.67 SF Walls 9.06 SF Ceiling aye, * 107.73 SF Walls & Ceiling 9.06 SF Floor 1 i i 1.01 SY Flooring 12.33 IF Floor Perimeter w-T r � 1 12.33 LF Ced. Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 56. Contents - move out then reset - 1.00 EA 26.45 26.45 (0.00) 26.45 Small room 1.0011A 26.45 26.45 (0.00) 26.45 57. R&R Tile floor covering 9.06 SF 8.62 78.10 (0.00) 78.10 58. Remove Additional labor to 9.06 SF 1.65 14.95 (0.00) 14.95 remove file from concrete slab 30.27 SF 1.65 49.95 (0.00) 49.95 59. Mask wall - plastic, paper, tape 12.33 LF 0.78 9.62 (0.00) 9.62 (per LF) 15.601Y 0.78 12.17 (0.00) 12.17 60. R &R Baseboard - 41/4" 8.00LF 4.26 34.08 (0.00) 34.08 61. Paint baseboard - two coats 8.00 LF 0.97 7.76 (0.00) 7.76 62. Paint the surface area - two coats 157.00 SF 0.64 100.48 (0.00) 100.48 63. Interior door- Detach & reset 1.00 EA 74.09 74.09 (0.00) 74.09 Totals: Linen Closet 34553 0.00 34553 Bathroom Height: 8' T 6 - f 124.79 SF Walls 30.27 SF Ceiling 155.07 SF Walls & Ceiling 3027 SF Floor ! s 3.36 SY Flooring 15.60 LF Floor Perimeter 15.60 LF Cell. Perimeter r Mussing Wall T33116 "X8' Opens into ROOM2 DESCRIPTION QUANTITY UNrP COST RCV DEPREC. ACV 64. Contents - move out then inset - 1.0011A 26.45 26.45 (0.00) 26.45 Small room 65. R &R Tile floor covering 30.27 SF 8.62 260.92 (0.00) 260.92 66. Remove Additional labor to 30.27 SF 1.65 49.95 (0.00) 49.95 remove file from concrete slab 67. Mask wall - plastic, paper, tape 15.601Y 0.78 12.17 (0.00) 12.17 (per LF) 68. R&R Baseboard - 41/4" 15.60 LF 4.26 66.45 (0.00) 66.45 69. Casing - Detach & reset 16.30 LF 1.80 29.34 (0.00) 29.34 IMS- VALDES 1/172013 Page:6 16D1 1Ms Claim Services. Inc Multi -Line Insurance Adjusters 222159th Street West - Bradenton, FL 34209 Phone (941) 746 -3328 Fax (941) 746 -1858 CONTINUED - Bathroom Totals: Bathroom Height: 8' Boys Clot T ' 150.92 SF Walls 15.74 SF Ceiling H z s' I"'" r, 166.66 SF Walls & Ceiling 15.74 SF Floor i +'r 1.75 SY Flooring 18.86 LF Floor Perimeter 18.86 LF Ceil. Perimeter tl DESCRIP'T'ION QUANTITY UNIT COST RCV DEPREC. ACV DESCRIPTION 1.00 EA 26.45 15.13 (0.00) 15.13 70. Paint baseboard - two coats 15.60 LF 0.97 10.43 (0.00) 10.43 71. Paint casing - one coat 16.30 LF 0• 56.16 (0.00) 56.16 72. Paint the walls - one coat 124.79 SF 0.45 74.09 (0.00) 74.09 73. Interior door - Detach & reset 1.00 EA 74.09 14.71 (0.00) 14.71 77. Mask wall - Plastic, Paper. tape 18.86 LF 601.09 0.00 601.09 Totals: Bathroom Height: 8' Boys Clot T ' 150.92 SF Walls 15.74 SF Ceiling H z s' I"'" r, 166.66 SF Walls & Ceiling 15.74 SF Floor i +'r 1.75 SY Flooring 18.86 LF Floor Perimeter 18.86 LF Ceil. Perimeter tl DESCRIP'T'ION QUANTITY Q UNIT COST RCV DEPREC. ACV 74. Contents -move out then reset - 1.00 EA 26.45 26.45 (0.00) 26.45 Small room 15.74 SF 8.62 135.68 (0,00) 135.68 75. R &R Tile floor covering 1.65 25.97 (0.00) 25.97 76. Remove Additional labor to 15.74 SF remove rile from concrete slab 0.78 14.71 (0.00) 14.71 77. Mask wall - Plastic, Paper. tape 18.86 LF (per 78. R&R Baseboard - 41/4" 8.00 LF 4.26 34.08 (0.00) 34.08 7.76 79. Paint baseboard - two coats 8.00 LF 0.97 7.76 100.48 (0.00) (0.00) 100.48 80. Paint the surface area - two coats 157.00 SF 0.64 74.09 (0.00) 74.09 81. Interior door - Detach & reset 1.00 EA 74.09 24.13 (0.00) 24.13 82. Bifold door - (2 slabs only) - 1.00 EA 24.13 Single - Detach & reset 44335 0.00 443.35 Totals: Boys Closet 1/17/2013 Page:7 TMs- VALDES IMS Claim Services. Inc Multi -Line Insurance Adjusten 222159th Street West - Bradenton, FL 34209 Phone (941) 746 -3328 Fax (941) 746 -1858 .' UNIT COST RCV DEPREC. ACV DESCRIPTION 160100 Height: S' Boys Bedroom 370.67 SF Walls 501.17 SF Walls & Ceiling 14.50 SY Flowing 46.33 LF Ceil. Perimeter 13050 SF Ceiling 130.50 SF Floor 46.33 LF Floor Perimeter QUANTITY 52.84 (0.00) 52.84 83. Contents - move out then reset - 1.00 EA 52 84 Large room 8.62 1,124.92 (0.00) 1.124.92 84. R &R Tile floor covering 130.50 SF 215.33 85. Remove Additional labor to 130.50 SF 1.65 215.33 (0-00) remove tile from concrete slab 30.52 61.04 (0.00) 61.04 86. Window blind - horizontal or 2.00EA vertical - Detach & reset 0.78 36.14 (0.00) 36.14 87 Mask wall - plastic. paper, tape 46.33 LF (per LF) 46.33 LF 4.26 197.37 (0.00) 197.37 88. R&R Baseboard - 4 U4" 1.80 75.60 (0.00) 75.60 89. Casing - Detach & reset 42.00LF ' 0.97 44.94 (0.00) 44.94 90. Paint baseboard - two coats 46.33 0.64 26.88 00 (0.) 26.88 91. Paint casing - one coat 42.00 LF 0.45 166.80 (0.00) 166.80 92. Paint the walls - one coat 370.67 SF 74.09 74.09 (0.00) 74.09 93. Interior door - Detach & reset 1.00 EA 2,075.95 0.00 2,075.95 Totals: Boys Bedroom Missing Wall Missing Wall 1VFissing Wan. Goes to Floor Height: 8' Living Room Ceil' 333.25 SF Walls 568.78 SF Walls & Ceiling 26.17 Sy Flooring 49.85 LF Ceil: Perimter 10' 213/16" X 8' 2'3 "X8' 9'10 "X6'8" 235.54 SF rn8 235.54 SF Floor 40.02 LF Floor Perimeter Opens into DINING ROOM Opens into HALLWAY Opens into PATIO � lrf COST RCV DEPREC. ACV DESCRIPTION QUANTITY 1.00 EA 105.68 105.68 (0.00) 105.68 94. Contents - move out then reset - Extra large room 1/172013 Page:8 rMS- VALDES ibio�4 IMS Claim Services, Inc Multi-Line Insurance Adjusters 2221 59th Street West - Bradenton, FL 34209 Phone (941) 746 -3328 Fax (941) 746 -1858 CONTINUED - Livhtg Room DESCREMON QUANTITY UNIT COST RCV DEPREC. ACV 95. R &R Tile floor covering 235.54 SF 8.62 2,030.36 (0.00) 2,030.36 96. Remove Additional labor to 235.54 SF 1.65 388.64 (0.00) 388.64 remove the from concrete slab 140.56 SF 8.62 1,211.63 (0.00) 1,211.63 97. Mask wall - plastic, paper, tape 49.85 LF 0.78 38.88 (0.00) 38.88 (per LF) 98. R&R Baseboard - 41/4" 40.02 LF 4.26 170.49 (0.00) 170.49 99. Casing - Detach & reset 28.00 LF 1.80 50.40 (0.00) 50.40 100. Paint baseboard -two coats 40.02 LF 0.97 38.82 (0.00) 38.82 101. Paint casing - one coat 28.00 LF 0.64 17.92 (0.00) 17.92 102. Paint the walls - one coat 333.25 SF 0.45 149.96 (0.00) 149.96 Totals: Living Room 21991.15 0.00 2,991.15 Patio Height: 8' 322.44 SF Walls 140.56 SF Ceiling r o 463.00 SF Walls & Ceiling 14056 SF Floor s: -+- s --i-a r 1 15.62 SY Flooring 38.67 LF Floor Perimeter a-rs -r F-r ir-4 `� 'Perimeter Missing Wall - Goes to Floor 9' 10" X 6'8" Opens into LIVING ROOM DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 103. Contents - move out then reset - 1.00 BA 52.84 52.84 (0.00) 52.84 Large room 104. R&R Tile floor covering 140.56 SF 8.62 1,211.63 (0.00) 1,211.63 105. Remove Additional labor to 14056 SF 1.65 231.92 (0.00) 231.92 remove tile from concrete slab 106. Mask wall - plastic, paper; tape 48.50 LF 0.78 37.83 (0.00) 37.83 (per LF) 107. R&R Baseboard - 41/4" 8.00 LF 4.26 34.08 (0.00) 34.08 108. Paint baseboard - two coats 8.00 LF 0.97 7.76 (0.00) 7.76 109. Paint the surface area - two coats 157.00 SF 0.64 100.48 (0.00) 100.48 Totals: Patio 1,676.54 0.00 1,676.54 IMS-VALDES 1/17/2013 Page:9 16010 1 IMS Claim Services, Inc Multi -Line Insurance Adjusters 222159th Street West - Bradenton, FL 34209 Phone (941) 746 -3328 Fax (941) 746 -1858 Dining Room height: 8' 11653 SF Walls 4333 SF Ceiling b ; b 159.86 SF Walls & Ceiling 4333 SF Floor 4.81 SY Flooring 14.57 LF Floor Perimeter 14.57 LF Ceil. Perimeter Missing Wall 41291 X 8' Opens into KITCHEN Missing Wall 10'2 13/16" X 8' Opens into LIVING -ROOM DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 110. Contents - move out then reset - 1.00 EA 52.84 52.84 (0.00) 52.84 Large room 1,426.93 0.00 1,42693 Total: INTERIOR 18,10531 111. R&R Zile floor covering 4333 SF 8.62 373.51 (0.00) 373.51 112. Remove Additional labor to 43.33 SF 1.65 71.49 (0.00) 71.49 remove file from concrete slab 113. Mask wall - plastic, paper, tape 14.57 LF 0.78 11.36 (0.00) 11.36 (per LF) 114. R&R Baseboard - 4 1/4" 8.00LF 4.26 34.08 (0.00) 34.08 115. Paint baseboard - two coats 8.00 LF 0.97 7.76 (0.00) 7.76 116. Paint the surface area - two coats 157.00 SF 0.64 100.48 (0.00) 100.48 Totals: Dining Room 65152 0.00 65152 fl.-, Shower Height: 8' ; 103.46 SF Walls 20.59 SF Ceiling j 124.04 SF Walls & Ceiling 20.59 SF Floor ereacritl 2.29 SY Flooring 12.93 LF Floor Perimeter 12.93 LF Ceil. Perimeter Missing War[ T3 3/16" R 8' Opens into BATHROOM DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 117. R&R rile shower - 65 to 100 SF 1.00EA 1,245.97 1.245.97 (0.00) 1,245.97 118. Detach & Reset Shower faucet 1.0013A 53.22 53.22 (0.00) 53.22 119. Shower pan 1.00 EA 127.74 127.74 (0.00) 127.74 Totals: Shower 1,426.93 0.00 1,42693 Total: INTERIOR 18,10531 0.00 18,10531 IMS- VALDES 1/17/2013 Page: 10 IMS Claim Services, Inc Multi -Line Insurance Adjusters 2221 59th Street West - Bradenton, FL 34209 Phone (941) 746 -3328 Fax (941) 746 -1858 y T Exterior Wall EAST ELEVATION 644.00 SF Walls 908.00 SF Walls & Ceiling 29.33 SY Flooring 8050 .LF Ceil. Perimeter 16010 Height, 8' 264.00 SF Ceiling 264.00 SF Floor 80.50 LF Floor Perimeter DESCRIPTION QUANITPY UNff COST RCV DEPREC. ACV 120. Concrete CY - Minimum charge 1.00 EA 483.77 483.77 (0.00) 483.77 121. Stucco color coat (Redash) - 644.00 SF 2.33 1,500.52 (0.00) 1,500.52 Coarse texture 122. Pressure%hemical wash - 1.00 EA 128.23 128.23 (0.00) 128.23 Minimum charge 123. Seal & paint stucco 644.00 SF 0.90 579.60 (0.00) 579.60 Totals: Exterior Wan 2,692.12 0.00 2,692.12 Total: EAST ELEVATION 2,692.12 0.00 2,692.12 Line Item Totals: IM- VALDES 20,797A3 0.00 20,797.43 Grand Total Areas: 3,750.47 SF Walls 1,298.28 SF Floor 0.00 SF Long Wall 1,298.28 Floor Area 2,251.50 Exterior Wall Area 0.00 Surface Area 0.00 Total Ridge Length 1,298.28 SF Ceiling 144.25 SY Flooring 0.00 SP Short Wall 1,421.84 Total Area 250.17 Exterior Perimeter of Walls 0.00 Number of Squares 0.00 Total Hip Length 5,048.75 SF Walls and Ceiling 465.53 LF Floor Perimeter 485.20 LF Ceil. Perimeter 3,750.47 Interior Wail Area O.UO Total Perimeter Length IMS- VALDES 1/172013 Page: ll 16010 1MS Claim Services, Inc Multi -Line Insurance Adjusters 222159th Street West - Bradenton, FL 34209 Phone (941) 746 -3328 Fax (941) 746- 1858 Line Item Total Material Sales Tax Overhead Profit Replacement Cost Value Less Deductible Net Claim Summary for DweDing @ 6.000% x 5,426.89 @ 10.0% x 21.123.04 @ 10.0% x 21,123.04 Mike Tschida 20.797.43 325.61 21,123.04 2.112.30 2,112.30 $25,347.64 (1,000.00) $14,347.64 IMS- VALDES 1/17/2013 Page: 12 IMS Claim Services. Inc Multi -Line Insurance Adjusters 222159th Street West - Bradenton, FL 34209 Phone (941) 746 -3328 Fax (941) 746 -1 858 Recap by Room Estimate: IMS- VALDES Area: INTERIOR 688.62 3.31% Master Bedroom 2,456.73 11.81% Master Bath 1,366.70 6.57% Master Shower _ 1,941.15 9.33% Master Closet 586.52 2.82% Hallway 853.53 4.10% Linen Closet 345.53 1.66% Bathroom 601.09 2.89% Boys Closet 443.35 2.13% Boys Bedroom 2,07595 9.98% Living Room 2,991.15 14.38% Patio 1,676.54 8.069'0 Dining Room 65152 3.13% Shower 1,426.93 6.86% Area Subtotal: INTERIOR ' 18,10531 87.06% Area: EAST ELEVATION Exterior Wall 2,692.12 12.94% Area Subtotal: EAST ELEVATION 2,692.12 12.94% Subtotal of Areas 20,797.43 100.00% Total 20,797.43 100.00% IMS- VALDES 1/17/2013 Page: 13 IMS Claim Services, Inc Muld -Line Insurance Adjustors 222159th Street West - Bmdenton. FL 34209 Phone (941) 746 -3328 Fax (941) 746 -1858 Recap by Category O &P Items Total % CLEANING 324.74 1.2890 CONCRETE & ASPHALT 483.77 1.91% CONTENT MANIPULATION 52852 2.09% ..— GENERAL- DEMOLMON - __.— --- - - - '4,413 -.R 17.4w - DOORS 492.80 1.94% DRYWALL $1991 2.05% ELECTRICAL 275.02 1.08% FLOOR COVERING - CERAMIC TILE 5,453.72 215290 FINISH CARPENTRY I TFJ1MWORK 1,28997 5.09% LIGHT FIXTURES 74.24 0.29% MIRRORS & SHOWER DOORS 65.88 0.26% PLUMBING 528.13 108% PAINTING 2426133 892% STUCCO & EXTERIOR PLASTER 1,50052 5.92% TILE 2,448.02 9.66% WINDOW TREATMENT 122.08 0.48% WATER EXTRACTION & REM MIAT7ON 14.66 0.06% O &P Items Subtotal 20,797A3 92.05% Material Sales Tax C 6.000% 325.61 1.28% Overhead 0 10.0% 2,112.30 833% Profit (fly 10.0% 2,112.30 8.33% Total 25,347.64 100.00% TMS- VALDES 1/17/2013 Page: 14 �� 1 �,... ., .. e �, . ? / United Property & Casualty Insurance Co. POLICY NUMBER UHV 2064987 03 CLAIM NUMBER 201300000182 INSURED Jorge Valdes JR CLAIMANT... Jorge Valdes_ JR ADJUSTER Cherise Evering CLAIM DESCRIPTION Water -Pipes DATE OF LOSS 01/07/2013 MEMO Mail To: Jorge Valdes JR 4297 21 STAVE SW NAPLES FL 34116 RECEIVED MAR 08 2013 02/15/2013 `G o> ' 3036355 _ °,AN�QNFf; $24,347.64 •. ... 1113036355115 1 :0630000471: 898043 38 257 3u' 01 Re: Claim Number: 2013 -0182 This settlement deck represents the unrestricted tender of the amount we believe you are owed as a result of your loss. You are permitted to use this check at this time. If you believe you are owed more, please send us additional documentation in support of your claim. In the event that we cannot agree on the final settlement of your claim, your policy provides the right to invoke mediation which must be done prior to bringing any lawsuit against us. If your mortgage holder has been shown as a payee on your check, please understand we are obligated to do so according to the terms of your policy. Please contact your mortgage holder regarding their procedures for endorsing payments. Should have any additional questions regarding the settlement, or have any other information you would like for us to consider in regards to this claim, please contact the undersigned at the information shown below. Sincerely, Mason Tippitt 11 Claims Adjuster II United Insurance Management, LC , Servicing Claims on Behalf of United Property ill Casualty Insurance Company Ph: 800- 861 -4370 ext. 250 Fax: 800- 380 -5053 Email: mbppitt@upcic.com Enc: Estimate of Damages Notice of Mediation of Residential Property Insurance Claims F. S. 817.234(1)(b) Any person who knowingly and with intent to injure, defraud, or deceive any insurer tNes a statement of claim or an application containing any False, incomplete, or misleading information Is guilty of a felony of the third degree. Page 3of3 Mediation of Residential Property Insurance Claims UPC INSURANCE The Chief Financial Officer for the State of Florida has adopted a rule to facilitate the fair and timely handling of residential property insurance claims. The rule gives you the right to attend a mediation conference with your insurer in order to settle any claim you have with your Insurer. An independent mediator, who has no connection with your insurer, will be in charge of the mediation conference. You can start the mediation process after receipt of this notice by calling the Department of Financial Services at 1 (877) 693 -5236. The parties will have 21 days from the date of the notice to otherwise resolve the dispute before a mediation hearing can be scheduled. a. You [the insured] may also request mediation by faxing a request to the Department at (850) 488 -6372 or by writing to the Department of Financial Services, Mediation Section, Bureau of Education, Advocacy and Research, 200 East Gaines Street, Tallahassee, FL 32399 -0319. b. The parties [insured and Insurer] will have 21 days from the date of the notice to otherwise resolve the dispute before a. mediation hearing can be scheduled. c. if you desire additional information, please contact us at United Property and Casualty Insurance Company PO Box 1011 St. Petersburg, FL 33731 or call us at (800) 861- 4370. d. The Administrator will select the mediator. e. At any time a party may move to disqualify a mediator for good cause. Good cause consists of conflict of interest between a party and the mediator, that the mediator is unable to handle the conference competently, or other reasons which would reasonably be expected to impair the conference. Complaints concerning a mediator shall be written and submitted to the Department of Financial Services, Mediation Section, Bureau of Education, Advocacy and Research, 200 East Gaines Street, Tallahassee, Florida 32399 -4212. f. You [the insured] will need to notify the mediator 14 days before the mediation conference if you will bring representation to the conference, unless the insurer waives the right to the notice of representation. Upon receipt of such notice from the insured, the mediator shall provide to the insurer that the insured will be represented at the mediation conference. version 1 G & P INSURANCE INC. 4930 GOLDEN GATE PKWY STE A NAPLES FL 34116 -5992 0000000015 JORGE VALDES JR 4297 21ST AVE SW NAPLES FL 34116 UHV 2064987 01 g� 8 g UPC INSURANCE United Property and Casrealty Inswance Co. P.O. Box 51149 Sarasota, FL 34232 -0330 INSURED JORGE VALDES JR 4297 21 ST AVE SW NAPLES FL 34116 Property Address. 4297 21 ST AVE SW NAPLES FL 34116 Dear. JORGE VALDES JR 16D10 POLICY NUMBER POLICY PERIOD UHV 2064987 04 01 From To 03/09/2013 03109/2014 12-01 . n Swtwn Date Issued: 02!82013 Ttrn rt te m mn eddn1e`d s shown blow AGENT G & P INSURANCE INC. 4930 GOLDEN GATE PKWY STE A NAPLES FL 34116.5992 Telephone: 239 -353 -3500 REMINDER NOTICE Policy Number. UHV 2064987 04 01 Please remember your payment is due MARCH 9, 2013 Recently we sent you a renewal offer for your homeowners insurance policy. This is just a friendly reminder that I a payment is not received your policy will be cancelled as of 12:01 a.m. on the "payment is due" — .. _.._.ddo abovaJeaving -Pur-bome- uopwiws:tmL— .... If you have already sent us a payment, please disregard this notice as the documents may have crossed in the mail. If not, please detach and mail the payment coupon below along with your payment. If your insurance premium is paid through an escrow amount with your mortgage, please contact them and inquire about payment status. If your insurance premium is paid by automatic draft and the current pending scheduled draft is not stopped/cancelled, Please disregard this notice. Thank you for allowing us to serve you. We appreciate your businessl Policy Number. UHV 2064987 04 MINIMUM AMOUNT DUE NOW. $1.228.00 Insured: JORGE VALDES JR 4297 21 ST AVE SW NAPLES FL 34116 Loan Number. 1877024155 PLEASE SEND PAYMENT TO: UPC Insurance P.O. Box 31512 Tampa, FL 33631-3512 CHASE Cr JPMorgan Chase Bank, N.A. Insurance Claims Department 465 P.O. Box 47607 Atlanta GA 30362 (866) 742 -1461 March 12, 2013 JORGE VALDES _ �J /S 3— -73 4297 21ST AVE SW 7 O� 7 NAPLES FL 34116 Je�'�v'� fides �7 � d °� co�i Re: Home Mortgage Loan * * * ** *4155 Tracking Number 4751039 Check Returned for Endorsement Dear Jorge Valdes: This letter is to inform you that Chase has enclosed your insurance claim check for your endorsement. Please endorse the back of the check and return it to us for deposit. Once the check is received, we can release the first disbursement to repair your home. Procedures for loss claims from $10.000 to $20,000 • We have enclosed a mortgagor's affidavit, contractor's lien waiver and Internal Revenue Form W -9. Please complete these forms and send them to us. If you are completing the repairs yourself you do not need to complete the IRS W -9 form. • In addition, please provide us with a copy of the adjuster's report or the contractor's bid if your insurance company did not provide an adjuster's report. • We will deposit your claim check and release $10,000 to you and all payees on the original check When your repairs are 90 -100% complete please call us to arrange an inspection of the property repairs. Upon receipt of the inspection results confirming 90 -100% completion we will release the remainder of your claim funds payable to all payees on the check, mortgage account holders if different from the payees on the check and your contractor. If you do not wish to have your contractor appear as a payee on the check, please provide us with a daytime phone number for your contractor and paid receipts from the contractor. Loss Claims Exceeding $20,000 • We have enclosed a mortgagor's affidavit, contractor's lien waiver and Internal Revenue Form W -9. Please complete these forms and send them to us. If you are completing the repairs yourself you do not need to complete the IRS W -9 form. 1a,x: 4283149 OR: 4443 PG: 3208 ,,>,� -DU 10 UMISn T= IMSM O CM SSC0 M in at OPPICM wris of imin M", 11 OLI 119130 sit$ M CIPHIS IT 01 84/14/10" at 62:32PM MW 1. S10Ct, Chin nC In 39.50 TIS71 PL 33101 DK -.39 10.15 \ 884201M NO RTUGH V THiS SECOND MORTGAGE (^SeW" Inatnmsnt") is given on 2009, The Second Mortgagor is; Jorge Valdes Jr., a single person ("BOn veer''). This Security Instrument is given to Coili•r Conaty ('Lerx�P), which Is organised and existing under the laws of Ore United States of America, and whom address is 3801 E. Tauaiami Trail bra lea, Florida 34117 . Borrower owes Lander the sun of Two Thousand Hight Hundred Ninety one and DO 100 Dollars ($2,891-00). This debt is evidenced by Borrower's NOW doled the erne data es this Soma" Instrument (^Second Mgtpsgeq, which provbav for MW ft Payments, with the full debt, If not paid earlier, due and payable on gal • of DroDertY, refinance, or loss Of homestead eacsartion . This Security Instnanent secures to Lender: (a) the repayment Of the debt evidenced by Ors Nola, with Interest, and elf renewats, extensions and modifications; (b) the payment of ell other suns, with interest advanced caber paragraph 7 b protect the security of to Security Instrument and (c) the performance of Borrower'l cover ants and agreements under this Security Instrument and the Note. For No purpose, Bonowver does hereby second mortgage, grant and convey to Loxler the following described property I I in Collier County, Florida. As more Particularly described as golden Gala Unit 2, Blk 31, Lot 14, Collier County, Florida and which has the oddness at ("Property Addfess"): 4797 71" Ave ow, Naples FL 34116 TOGETHER MTN elf the improvements now or hereafter erected on the property, and all essemems, rights, eppurtsnences, rents, roys"". mftW, al and gas rights and Profit. water rights and stock and at factures now or haresfisr a Pot 01 the property. At nepacenents and additions shot also be covered by the Security Instrunem. Ah of the foregdng is relerred to in this Security Instrument av the ^Property^. BORROWER COVENANTS that Bonowar is lawfully i w7m Of tie estate hereby conveyed and has the right to mortgage, grant and Convey the Property and that the PropaAy Is unencumbered, a ces of record. Borrower warrants and will defend generally the this to the Property against at claims and demands, a of record.' THIS SECURITY INSTRUMENT Combines u AotdwtiOn b corsObA a utrm rear rd non uniform Covenants will' limited variation by UNIFORM COVENANTS. Borrower covewrot and agree as fail : 1. Payment of PrMroipal and IrhOtres Late r lf promptly pay when due the principal of end interest on to debt evidenced by the Note. 7. Trop. The Mortgagor will pay a esem rents r water r to the accrual of thereon. —r any penalties or interest The Mortgagor thatI pay or cause to p e t (A 1) ON tyros and governmental charges of any kind whatsoever which may at any Ome be I or Property. (2) all utility and other charges, Including 'service ohrpes incurred or u upkeep and impronmad of the Property, and (3) erg sswunents or other governmental chn may W**Ay be paid sW period of years, the Mortgagor shall be Obligated under fie Mortgage to pay or cause only such krtatmris one be paid during the tam of the Mortgage, and shot promptly payment of any d the forward to MOrpepee payment, Interest due; fib. Unleav law provbes oterwise• received by Lender shall be applied. fast, to and, to principal due; and IaK to any s due under Ohs 4. Charges; Lone. Borrower shah pay at t fi nd impositions attributable to the Property which may attain prbdtr over this arhy. Borrower shell promptly furnish ro Lender at WOODS of amounts b y Instrument, and r Baraver shed under this pwagraph, and ed re payments. its Peymtnt of the Promptly discharge any Ilen which has priority over this Security Instrument unless Borrower. (a) agrees in writing to obllpatiOn waxed by the Dan In a manner acceptable to Luber, (b) cots In good faith the hen by. or defends t eni0row nent of the ten In, legal proceedings which In the Lender's opinion operate to prevent cue enforcement of the lien; or (c) secure, the holder of the hen an agreement satisfactory to Lender subordinating the hen to tits Secu ft Instrument If Lender determines that any part of the Property is subject to a lien which may attain priority Over the Security Instrument, Lander may give Borrower a notice identifying the Ion. Bonowar shat so" the lien r take one or more of tho actions set forth above within 10 days of the giving of notice. 6. Hazard r Property {nsurann e. Borrower snafu keep the improvements now existing r hereaftr erected on the Property insured against lost by fire. hazards included within the term "extatded wverage and amts otter hazards. khduding floods r flooding. for which Lender requires hns nfarlCe. This insurance shell be mashtafned in the rnOhlnU and for the periods that Lender requires. The insurance carrier Providing tie instxanw shale be chosen by Borrower subject ro Lrber'e approval which shah not be irueawnably withheld. If Borrower falls to maintain Cowrege desenbed above, Lender may, ol Caber's option, obWn ooprage ro protect Lender's rights in the Properly in accordance with paragraph T. At at Imes that the Note is outstanding the Mortpagr snail maintskh insurmco with reaped to the Premises against such ricks cub for such amourds av ere custorrariy insured sgabst end pay. p the same become dw ob payable, all prerNume In respect thereto. byfire including, but not limited er , eh rfelc insurance ril0lsghhp tle Interests of the McApegor and Mortgagee against kss r damage to the Probes by firs, agfhtrhin9, and other wtualdss customarily insured agaimt (bnoludkng boiler axplaion, t appropriate). with a uniform standard extended coverage endoreerrsn>t including debris removal coverage. Such insurance at at times to be in an amount not toes Nixon to full replacement oust of to Premises, exclusive of footings and foundations. AN the right to hold to Insurance Policies and renewats shah be acceptable to lender and shall include a standard mortgage douse Lender shah have policies and renewals. If Lender requksa, Borrower shell promptly give to Lander at receipts of paid premiums and renewal nodoes. In the event of loss. Borrower shat give prompt notice to the insurance tarsier and Lender. Lender may make proof of fees it not made Promptly by Borrower. darnaged, if Unless Lender and Borrower olhea6ss agree in writing, insuranoe proceeds shelf be applied to reatorston or repair of the Property the resloration�rpair Is economically feasible and Lender's security is not baserned. If to restoration r repair is not economically m whether r not then dw�wri would be Wavered, to Insurance proceeds shall be opptled to the ems secured by to Security a notice from Lander that the insurance carrrier excess paid to Borrower. If has offered to sett a cWm, than nLLand CONGO tte��ran�prepeeds. i,p�r may d� he proceeds to repair or castors the Property or to pay suns secured by this Security Instrument, whether or not then due. The 30-day period begin when the notice is mailed. Unless Lander and Borrower otherwise agree in writing, any application of proceeds b prinelpsl &W not extend or postpone the due dale of the monthly Payments referred to M paragraph 1 or change On amount of the payments. H under paragraph 21 the Property is acquired by Lender, Borrower's rigid to any insurance policies and Proceeds resulting from damage to the Property prior to the acquisition shot Pao to Lander to the extent of the sums secured by this Security Instrument hmrnsd1atey prior b the acquishion. R Occupancy, Preservation, Maintenance and Protection of the Property; Borrower's Loan wne Application, Lpeeholds Borrower' shelf occupy, establish, and up the Property as Borrower's principal residence within abdy days eta the execution of this Security Insbumad and shall continue to occupy the Property as Borrower's principal residence for at Wesel one yew alter to dab of ocxupanry, unleav Lender otherwwise sprees in writing, which consent shall not be unreasonably wkhheld, or unless extenuating drarnstanoes exist which are beyond Borrower's control. Borrower shall not destroy, damage or Impair the Property, allow the Property to deteriorate, or commit waste on the Property. Borrower shall be in default If any forfeiture actor or proceeding, whether civil or criminal, is begun that in Lender's good faith OR: 4493 PG: 320916010 b+dgaaM COW result result In rorreit" of the Property or oOerwise materially Impair the Man created by this security Instrument or Lenders security interest Borrower may curs such a default end reinstate, es provided in paragraph IS, by causng the ad or proceeding to be oNtmkaed with • ruling OhaL in Lenders good faith detennanation, precludes forfeiture of the Borrowers interest in the Property or other malarial knwm come Ibn created by nuts Security Instrument or Lenders:eu,rigr Interest Borrovrer:t,ar also be In derawt it Borrower during the loan WPkstWn Puss, gave materially false or inaccurate Information or statements to Lender (or faded to provide Leander with any msbriai information) In connectan with the ban evidenced by the Note, including, but not limited to, representallorq If Of Property es a Prnclpal maiden, if this Security Instrument is on a leasehold, Borrower shad campy with all tide provision of ma lees. Wires be tWs to the Property, the leasehold and the fee We shall root merge unless Lender agrees to the merger I writing. T. Pnobctk m of Leader's Rights in the Property. If Borrower Wis to perform to ooverwrts and agreements orontainsw it this Security lnsftn* t, or tiers b s legal proceeding that may significantly affect Lerdars rights in the Property (such es a proceeding In �nkn+PwY, probate, for condemnation or forfeiture or b enforce laws or regulations), then Lender may do and pay for whalswr b necessary b proles trio wee hi the Property and Lenders rights in the Property. I.sn $ actions may include paying any sums *eomW a an which tae priority Under r may take In We appearing In count, paying rewonable attorneys, fans and entering on the Property make repairs. Although Launder may take action under this paragraph 7, Lander does not have to do so. Any amounts disbursed by Lender under Oft Paragraph 7 shall became additional debt of Borrower secured by this Security rurument. Unless Borrower and Lender agree to 9t ar bmns of payment, these amounts shop bear khtsrest from the data of disbursement at the Nob rate and shall be payable, with interest, upon notice from lender to Borrower requasOng payment I. Mortgage Insurance. If Lender required morigsgs insurance a a condition of MWdng the ban secured by this Security Instrument Borrower shall pay the Premiums required to maintain the mortgage insurance in effect. If, for any reason, the mortgage insumnca coverage required by Lender lapses or assess to be In effect, Barm wr shad pay the Pura required to obtain omwage subsiantisfy p►evioualy ko the fe marillm II alternate Prevhoutly in affect, at a cost substantially equivalent to the cost to Borrower of to mortgage insurance aWleble, Borrower stop mortgage Irmw approved by Lender. 11 substantially, equivalent mortgage insurarhce coverage is not Borrower when the Insurance coverage Lender each mhor c s sum steel to or*4w@lfth of One yearly mortgage I surarrca premium being paid by coverage lapsed or ceased y o in longer b Lsrrbr wi accept use and retain tees In lieu ot mortgage insurance. Loss reserve payments may no lager be required, al trio PBYmahhts es a bas reserve the amount and for the Period that Lender mWilret) provided by an insurer a won of Lander, if mortgage insurance coverage (in Borrower shall pay the premiums required to maintain PP�d by Lender again becomes avalable and is obtained. mortgage Insurance In affect, or to provide a loss reserve, urd the mquksnamt for mortgage Insurance ends in accordance with any written agmemeM between Borrower and Lender or applicable low. f. Inspaetien• Lender or Its ayatot may make ressonablo entries upon and inspections of One Property. Lander shed give Borrower notice at the Oms of or prior b an Inspection sPWJ tng masonabb own for the inspection. 10. Condemnation. The Pmeaads of any award or claim for danages, drect or consequential, in connection with any condsmrodw or other taking of arty Part of the Property, or for conveyance in Hsu of condemnation, are hereby assigned and shall be pail to Lender. In the event Of* total taking of the Property. the proceeds Shad be applied to the sums secured by this Security Instrument. what her d not clan due, with any excm Paid to Borrower. In the event of a partial taking of the Property. in which the fair market value of the Property Immediately before the taking is equal to or greater than the amount of the sums secured by this Security InstmnraM immediately before On taking, unress Borrower and Lender otherwise agree in writing, the sums secured curity Instrument shad be reduced by the smount of the proceeds multipiled by the following hacdpn: (a) One total amount of th r stay before the taking, divided by (b) the fair market value of the Property immediately before the taking. Any bald a the event of a partial taking of the Property In which the far market value of to Property Immediately less tra of the awns secured knmadisoey for the taking, Unless Borrower and Lender otherwise agree in we applicable law des, use proceeds snap be applied to the sums seared by this Security Insb,anent whom or are than due. Unless r Borrower Otherwise agree h wring, any appikation of proceeds to principal shall not or m Pa referred to in paragraphs 1 or change the amount or such Payments. 11. Borrow Not Released, Farb* ran a tine for payment or modification of anartksdomr d the sums secured by this r interest of Borrower call rot operate b rebate the liability of the original Borrower or In not required to commence proceedings against any Suxessor In Interest or refuse to on of the sum aewred try this Security katnrneM by reason of any demand mods by s Any term se ut by Lender In exercising any right or remedy shall not be a or Preclude the e>asr,I any M 1Z Successors and Assigns and Several Iiabill I covenants and agreements of this Security Instrument shad bind and !anent the successors ns of lender and the Provisions of Paragraph 17. Sonowers ox venaMS shad ba joint a . Any Borrower who co-sipns this Security Instrument but does not execute the Note; (a) is rity I grant and convey that Borrowers interest In the Property under the Wm of and (c) +eraaa that Lander any Bauer war to pay the Burns secured by tlob Security IrawmeM; nY may r or make any accommodations wino regard to the tams Of this security Instrument or the Note without that Borrowers law Is U. Loan Charges. If the loan seared by this Security instrument b subject to a law whim sets mananum tan charges, and that finally ktanpmw to that the Interest or other ban changes copeclad or to be collected In connection with to loan exceed to pemnhW limits, Men: (a) any such loan charge shad be reduced by to amount necessary to reduce the charge to the psmnhad dmag and (b) any sums already collected from Borrower which exceeded permitted limits will be refunded to Borrower. Lander may choose to make this refund by reducing the principal owed under the Note or by making a direct payment to Borrower. If a refund reduces principal, the reduction will be treated as a partial prepayment without any prepaymnsM charge under the Note. 14 Notices. Any notice b Borrower provided for in this Security Instrument shall be given by delivering it or by mailing it by prat class mail unless applicable law required use of rater method. The noda &hall be dheded to the Property Address or any other address Borrower designates by notice to Lender. Any notice to Lander *hall be given to Borrower or lender when given as provided in this paragraph. 10. Governing Law; Severability. This Security Instrument shall be governed by fed" law and the taw of the jurisdiction in which ths Property b bated. In the event that any provision or clause of this Searrity Instrument or the Nob conideb with apppcable law. such Col. Shelf not affect other provisions of this Beauty Instrur eni or to Nob whim an be given effect without the aoMtictkg provision. To Ott and the Provisions of this Security Instrument and the Not* we declared to be severable. 1a. Borrroaers Copy. Borrower shat be given one conk ned copy of the Nord and of this Security instrument 1T. Transfer of the Property or a Senraffolel interest In Borrower. If all or any part of the Property or any interest in it is said or transferred (or If a bww§ciml interest in Borrow ar Is sold or trensfamsd and Borrower is not a natural person) without Lenders prior written not be - robed bey i«dir .if 4 " - is prohibited by federal low a M 9r � of this SSmm�nty Instrument, lnstnarant tfowawr, wa option snail If Larder eall"clead tat opaan. Larder shall give Borrower notice of aealeralion. The notice shad provide a Period of not less than 30 days from the deb Oe WON Is delivered or madod within whim Borrower must pay all cams 96MW by We Security Instrument if Sorower fads to Pay than sums prior to the expiration of this period, Lender may Woke any remedies permitted by this Security Instrument without further rota or demand on Borrower. 1S. Borrower's Right to Ralnsbb. t Borrower meats certain tcnAtlOns, Borrower Shop have the right to have enfooement of this Security instrument discontinued at any time prior to the sander of: (a) 5 days (or such other period as applicable law may specify for reinstatement) before sale of the Property pureuat to any power of sale comaflad In this Security Instn,msM or (b) entry of a Judgment enforcing this Security Instrument. Those conditions are that Borrower. (e) pays Lender all suma whim then would be due under Mis Security instrument and the Note as it no acceleration had occurred; (b) was and default of any other covenants or agreements: (c) pays all expeness Incurred in enforcing this Security Instrument, including, but not limited to, reasonable attwWa less; and (d) takes such action as Lender may reasonably require to am" that the lien of this security Instrument lenders rights n the Prop.ny and Borrowers obdgaran to pay the area secured by tlaB seamy Instrument shall continue urahanpsd. upon reinstatement by Burrower, this Security Instrument and to obligations secured hereby shall remain fully effective as O no scasismibn had occurred. However, this right to minstata shall root apply in the ones of acceleration under paragraph 17. W. Sate of Nob; Change of Loan Servieer. The Nob or a partial Interest in the Note (together with Otis Security Instrument) may be sold we or more times without prior notice to Borrower. A sale may result In a change In the entity (known es the'Lcan Servicer) anal oo1acb monthly payments due under the Note and this Sswrfty Instrument, There also may be one or more changes of the Luau Ssrvicer unrelated to a sale of the Note. If there is a change of the Loan Servfoer, Borrower will be given written notice of the change in accordance with 1 G010 OR; 4443 PG; 3210 paragraph 11 and applicable law. The notice will state the name and address of the new Loan Semicer and the address to which payments should be made. The notice will also contain any other Inkmistiah roWksd by applicable law. 20. Haardow Still - cov. Borrower shalt not woes or permit the presence, use. disposal, storage. or release of any Haarck us Substances on or In the Property. Bomower shall not do, nor allow anyone Win to do, atlyClNrg affecting the Property that is in violation of any Environmental Low. The preceding two sentences :hall not apply to the presence, use, or storage on the Property of small quantities of Hazardous substances that are generally recognized to be appropriate to normal residential uses and to moinlonarms of the Property. Borrower shall promptly give Lander written notice for any investigation, claim, demand, lawsult or other action by any govenaneMat or regulatory agency or private party involving the Property and any Hazardous Substance or Environmental Law of which Borrower has actual knowledge. If Borrower hams, or is notified by any govemmsntai or regulatory authority, that any removal or other remedlotlon of arty Hazadas Substance affecting the Property Is necessary, Borrower shell promptly take all necessary remedial actions in accordance with Environmental Law. As used in this paragraph 20, "Hazardous Substances' are those substances defined as toxic or hazardous wbstsnas by Environmental Law and On following substances: soherds, materials containing asbestos or formaldehyde, le or toxic petroleum preclude, toxic pesticides and herblcldes, volatile radioactive materials. As used In this paragraph 20, "Envkonnoo Latta' meal federal laws and laws of the jurisdiction where the Properly is located that relate to health, safety or environmentol protection. 21. Acceleration; Rerthaalu. Lander shall give notice to Borrower prior to acceleration following Bonowees beach of any covenant or agreement In this Sscurfiy Instrwort (but not prior to acceleration under paragraph 17 unless applicable law provides otherwise). The notice shall specify: (a) the default (b) the action ro luired to we the defouiL (c) a date, not less than 30 days from the data the notice is given to Borrower, by w l ddh the default must be awed; and (d) that failure to cure the default on or before the dab specified In the notice may result in noceler stion of the sums seared by this Securty Instrument, foreclosure by Mi ial proaedsp and sale of the Property. The notice shall further inform Borrower of the not to reinstate altar acceleration and the right to assert In the foreclosure proceeding the nonexabnca of a default or any other deface of Borrower to acceleration and foreclosure. If the default Is not erred on or before the dab specified in to notice, Leader, at its option, may require immediate payment in fun of all sums seared by this Socut y Instrument without further demand and may foreclose this Security Irntrurnsnt by judicial proceeding. Lender shag be entitled to collect an expenses incurred in pursuing the remedies provided in this paragraph 21, including, but not tin itsd to, reasonable anomaly's fees and costa of the tilt evidence. 22. Release. Upon payment of an sums secured by this Sow* Inxft n K Lender shop release this Seaxity instrument, WOW charge, to Borrower. Borrower shall pay any reoordabon ants. 23. an appeeate m at * Fees. As used in this Security Instrument and the Note. "attorneys' fsee" shall include any attorneys' fees awarded by 24. Riders to this Securfly InWwrwnL If one or more ridere am axaabd by Borrower and recorded together with this Security Inslrumsnl, the covenants and agreamerits of each such rider shalt be boorporeted into and shell anehd and supplement the covenants and agreement of this Security Instrument as ti the rider(:) were a part of this Security linstruawt (Chedx Applic" Box) H Ad)ustable Rate Rider OroduMed Payment Rider BWoon Rider Otlner(s) (specify ❑ 1.4 � am�/'� Second Home Rider ❑ BiweaWy Pa Unit Development Rider SIGNING BELOW. Borrower accepts and ago by Borrower and recorded with IL Signed sealed Jand delivered In the presence wm,esssl:lCMkE,FA/ CUEVRI STATE OF FLORI COUNTY OF COLD Instrument and in any rider(s) executed signature: Co. norm "4297 21i6 Ave SW Naples, Tlorida 34116 I hereby om* that on this day, before me, an otfiarr duly authorized In the stab aforesaid and in the county aforesaid to take aiuow ledgemsMs, personally appeared Jorge Valdes Jr. to me krrown to be the person(s) described In and who exsabd the foregoing instrurrhent and acknowledged before me that (He/ shat they) executed the same for the purpose therein expressed. WITNESS my hand and official seal In the County end State M tnle -clays CI"'. 20 r% Ck My Commission Ehgires: "� I3�� (✓ � ~ NotsaPutalcs W (Seat) �_dh.� /T Notary's I�r��'' CargY e/hnBE� . Votary g��a.St.... s io tied 600 "Rio File#!: 09 -092 POe /Case No: 090025014 EXHIBIT "A" 16D10 ' * ** OR: 4443 PG: 3211 * ** Lot 14, Block 31, Golden Gate Unk 2, according to the plat thereof recorded in Plat Book 5, Pages 65 throtgh 77, incknive, pubic records of Collier County, Florida. r Leo Description Page 1 of 1 M cr N Ln Cl) C0 Cl) O Cl) M O N LO N Co 16.010f 1"1'1 N Ln ry CO rr rm J O c CO 0 O O O rm LD O n 71 'f1 Y1 o N '-,) co N N O -° N O— a O d N M N C) 75 C14 00 O . LY Z d O d F= L� IL > W m U W ~ U W LLI Z < o tY O U of-) U Q� I V C i y 1 O <Y c)) C °Wo U N i N N 0- �t O ` W � M U i- LL _ 1) Q w 0)r d 0 m U) Z CL � � O a zoWLL w ULCU00 ow�Hg ° °?QO2 2 M cr N Ln Cl) C0 Cl) O Cl) M O N LO N Co 16.010f 1"1'1 N Ln ry CO rr rm J O c CO 0 O O O rm LD O n 71 'f1 Y1 r� M Co M M s--I �J 16010 IN SE ERE, ,X, •`DO •+WRITE, STAMFO SIGN BELOWii UNE. RESERVED FOR FiRfANCBAi IpFMJTION I.RSE. SIGNATURE GUARANTEED Bank medca, N.A. BY Auftftod nature % , 7' ✓ ��x Glrtit'1iS, 16D10 To: County Attorney's Office Board of County Commia4a= CC: Jennifer Belpedio, Assistant County Attorney From: Priscilla Doria, Grant Coordinator, Housing, Human & Veteran Services Date: 5/28/2013 Re: Homeowner Insurance claim check endorsement- Jorge Valdes Jr. The Homeowner Insurance Check Endorsement Policy approved by the Board on June 12, 2012 (16.D.10) authorizes the Board Chairman or Vice Chairman to endorse homeowner insurance claim checks for recipients assisted with Purchase Assistance and/or rehabilitation program funds as Collier County is named as Second Mortgagee on their insurance policies. Pursuant to the Board approved policy, Chairwoman, Georgia A. Hiller endorsed an original insurance claim check (# 3036355) in the amount of $24,347.64 on 4/26/2013 for homeowner Jorge Valdes Jr. This check was then returned to the lender for deposit of which $10,000 will be paid when repairs are 90 -100% complete. The attached check ( #0009669153) in the amount of $10,000 is the first disbursement of the claim funds requiring endorsement by Board Chairwoman Hiller or Vice Chairman. The release of the remaining funds will follow once homeowner meets all other lender requirements. This is a time - sensitive item and must be endorsed as soon as possible as homeowner is waiting to pay for work performed on home. Attachments: First disbursement check ( 40009669153) $10,000 Letter from first mortgage lender (CHASE) Copy of original check (front and back) with endorsements 1112;01 MINAMI-11, l_ .............y Ysd`^�i' w wfi�� ✓fir? oYukaY n 5th✓ F "j�SS ei J !, i... /,` .., �= %'4 Ei 7t '��T , .?!i'. , ✓/:7 F i. CHASE O JPMorgan Chase Bank, N.A. Insurance Claims Department 465 P.O. Box 47607 Atlanta GA 30362 (866) 742 -1461 May 10, 2013 JORGE VALDES 4297 21 ST AVE SW NAPLES FL 34116 Re: Home Mortgage Loan * * * ** *4155 Tracking Number 4751039 Initial Disbursement of Homeowner's Insurance Claim Funds Dear Jorge Valdes: 16010 I am writing to inform you that Chase has released the enclosed check which is the initial disbursement of your insurance claim funds. When your repairs are 50% complete, please contact our office at (866) 742 -1461 to schedule an inspection of the repairs. After we receive a copy of the inspection report, with inspection results greater than or equal to 50% we will release half of the remaining funds to you. When we receive the final inspection results greater than or equal to 90% we will release the remaining funds to you. To expedite the release of your remaining claim funds please provide us with the following items and note the following requirements: • Please contact our office 10 days prior to your repairs reaching 50% completion. • The mortgagor and/or contractor must be present at the time of inspection. Please provide the inspector with a copy of your adjuster's report to enable the inspector to identify the scope of the damage and to assist them in making an accurate inspection. • An executed and notarized Declaration of Intent (enclosed) • A copy of the detailed adjuster's report or contractor's estimate. Please do not send the original adjuster's report. • A Contractor's Lien Waiver and Internal Revenue Service W -9 form completed by the contractor repairing your property. Please note that Internal Revenue Service (IRS) regulations require mortgage companies to report payment of insurance proceeds to contractors; therefore, we must receive the completed W -9 form from your contractor before we can make future disbursements of claim funds. Page 2 Jorge Valdes May 10, 2013 16DJO • Subsequent draws will be payable to you and your contractor. If you do not wish to have your contractor added as a payee on the check, please send us the daytime phone number for your contractor and receipts indicating that your contractor has been paid in full. The contractor's lien waiver is not a confirmation of payment. • If you are self - contracting please provide copies of paid receipts for materials and labor used to repair the damages. • Name, address and telephone numbers of your contractor, if applicable. Chase's goal is to provide the highest level of quality service. If you have further questions, please contact our Insurance Claims Department at (866) 742 -1461. We appreciate your business and value our relationship with you. Sincerely, J.Corley Insurance Claims Department Enclosures OP -Ll 16010 Patricia L. Morgan From: DoriaPriscilla <PriscillaDoria @colliergov.net> Sent: Friday, May 31, 2013 3:20 PM To: Neet, Virginia; Patricia L. Morgan Cc: BelpedioJennifer Subject: RE: Item 16 -D -10 - 6/12/12 BCC Meeting Thank you Dinny, I am on my way to pick up the check. Which floor do I go to? Priscilla Doria, Grant Coordinator Housing, Human & Veteran Services Department 3339 East Tamiami Trail, Suite 211, Naples, FL 34112 Phone: (239) 252 -5312 E -fax: (239) 252 -6518 Under f londa Law, e -mail addresses are public records. if you do not want your e -mail address released in response to a public, records request, do not send electronic mail to this entity. Instead. contact this office.; by telephone or in writing. From: NeetVirginia Sent: Friday, May 31, 2013 3:12 PM To: Trish L. Morgan Cc: BelpedioJennifer; DoriaPriscilla Subject: Item 16 -D -10 - 6/12/12 BCC Meeting Trish: Jennifer Belpedio asked that I email the attached to you for the Clerk's records. This is in regards to an insurance claim check endorsed by the Vice Chairman today. Please call if you have any questions. Jennifer and Priscilla: I will hold the documents and check for one of you pick up. Dinny Virginia A. Neet, Legal Assistant Office of the Collier County Attorney Telephone (239) 252 -8066 - Fax (239) 252 -6600 Under f lorida t..aw, e -inail addresses are public records. If you do riot want your e -mail address released in response to a public records request, do not send electronic mail to this entity. instead, contact this office by telephone or in writing. DAYEE NAME MAX CLAIM CONSULTANTS, ADDRESS COLLIER COUNTY HOUSING AND JORGE VALDES SHORT NAME/ INIT NAME/ LOAN NUMBER PROPERTY ADDRESS 1877024155 J7 VALDESS Disbursement Check Voucher DESCRIPTION FIRST BATCH: HOC CHECK NUMBER: 0009669153 CHECK DATE: 05/09/2013 PAYEE CODE: D4588 PAGE 1 OF 1 TRAN CODE DATE 304 AMOUNT DUE 10,000.00 ieck Totals: 1 Item $10,000.00 3b7.9? 7f Patricia L. Morgan 16DIO From: Neet, Virginia Sent: Monday, September 30, 2013 2:11 PM To: Patricia L. Morgan Cc: BelpedioJennifer; Doria, Priscilla Subject: Item 116 -D -10 - 6/12/12 RCC Muting- Insurance Claim Checks - not routed Attachments: Item 16 -D -10 Insurance Claim Check - Valdez - NOT ROUTED.pdf Trish Jennifer Belpedio asked that I email the attached to you for the Clerk's records. This is in regards to insurance claim checks endorsed by the Chairman on Friday. Please call if you have any questions. Priscilla: The checks are ready for pick up at our front desk. Dinny Virginia A. Neet, FRP Office of the Collier County Attorney Telephone (239) 252 -8066 - Fax (239) 252 -6600 Under Florida Law, e-mail addresses are public records. If you do not want your e -mail address released in response to a public records request: do not send� e.ectron c mail to this entity. instead, contact this office by telephone or in writing. ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 10 U TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Wee at the time the item is placed on the agenda. All completed routing slips and original documents most be received in the County Attorney /Mice no later than Monday preceding the Board meeting. * *NEW ** ROUTING SLIP Complete routing lines k t through N2 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the eICCCDti011 Of the Chairman's Signature- draw a line thmu¢h rtu�rinu liru� i't 1 rhm..ol. # ...,,....I.r A...r.- W;4 - A c .... -..r ....r.- n,... -... ♦ «....u., f%=-- Route to Addressees (List in routing order) Office Initials Date 1. Priscilla Doria Housing, Human & Veteran Services Department 2— licable 2. Jennifer B. White, ACA Office located in HHVS Agenda Item Number 144 -.10 County Attorney Office Does the document need to be sent to another agency for additional signatures? If yes, F. F. BCC Office Board of County Number of Original 2 Attached Commissioners Documents Attached NQjA: Clerk's attestation is not required. Please do III route :this item to Clerk's Board Minutes and Records. CAO please scan document after execution. by Chairwoman and e-mail them to Clerk's Minute and Records for its records. PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact inIb mation is needed in the event one of the addressees above may need to contact staff for additional or -i-ina information Name of Primary Staff Priscilla Doria, HVS Phone Number 252 -5312 Contact / Department appropriate. Initial licable Agenda Date Item was 06/12/2012 y Agenda Item Number 144 -.10 Approved by the BCC Does the document need to be sent to another agency for additional signatures? If yes, Type of Document Final Insurance Claim Check Number of Original 2 Attached Endorsement- Jorge Valdez Jr. Documents Attached PO number or account signed by the Chairman, with the exception of most letters, must be reviewed and signed N /�- number if document is by the Office of the County Attorney. to be recorded All handwritten strike - through and revisions have been initialed by the County Attorney's N/A INSTRUCTIONS & CHECKLIST 1: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Rev d 2 ; Revised 11/30/12 Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is Yes N/A (Not appropriate. Initial licable I. Does the document require the chairman's original signature? 2. Does the document need to be sent to another agency for additional signatures? If yes, Provide the Contact Information (Name; Agency; Address; Phone on an attached sheet. tJ /Q 3. Original document has been signed/initialed for legal sufficiency. (All documents to be signed by the Chairman, with the exception of most letters, must be reviewed and signed N /�- by the Office of the County Attorney. 4. All handwritten strike - through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the document or the final negotiated contract date whichever is applicable. N �� 6. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's signature and initials are reciuired. 7. In most cases (some contracts are an exception), the original document and this routing slip should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents I a, are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be e.of our deadlines! 8. The document was approved by the BCC os: And all changes made during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes, if applicable. 7 Aloe 9. Initials of attorney verifying that the attached document is the version approved by the I BCC, all changes directed by the BCC have been made, and the document is ready for the Y�i Chairman's signature. 1: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Rev d 2 ; Revised 11/30/12 PAYEE NAME MAX CLAIM CONSULTANTS, COLLIER COUNTY HOUSING & ADDRESS AND JORGE VALDES Disbursement Check Voucher BATCH: IOE CHECK NUMBER: 0010448515 CHECK DATE: 09/09/2013 PAYEE CODE: D4588 PAGE 1 OF 1 SHORT NAME/ INIT NAME/ TRAN AMOUNT LOAN NUMBER PROPERTY ADDRESS DESCRIPTION CODE DATE DUE 1877024155 JL VALDES FINAL 304 9,594.32 RFWE'C�`C�MC D S P 2 5 2013 Coll' C unty HH S rants By �- Check Totals: 1 Item $9,594.32 160lu 3923922 �s Ii X r x � U n i 3 0 J S o C: z `& ZZ 4 A G i 7 ui c PAYEE NAME MAX CLAIM CONSULTANTS, COLLIER COUNTY HOUSING & ADDRESS AND JORGE VALDES Disbursement Check Voucher BATCH: HOC CHECK NUMBER: 0010405263 CHECK DATE: 0813012013 PAYEE CODE: D4588 PAGE 1 OF 1 SHORT NAME/ INIT NAME/ TRAN AMOUNT —11— nccrDiDTinki Cnr)F DATE DUE JL VALDES ADD DRAW 304 4,753.32 RD EC OV D SEP 252013 Collier o my HH Grants By Check Totals: 1 Item $4,753.32 UAL 3943017 0 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 16010 THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. * *NEW ** ROUTING SLIP Complete routing lines #1 through 42 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the exception of the Chairman's signature, draw a line through routine lines # l through #2. complete the checklist_ and forward to the Countv Attornev Office_ Route to Addressees (List in routing order) Office Initials Date 1. Priscilla Doria Housing, Human & Veteran (Initial) Agenda Date Item was Services Department Agenda Item Number / 2. Jennifer A. Belpedio, ACA Office located in HHVS i 3 County Attorney Office Insurance Claim Check lM Number of Original I 2. BCC Office Board of County Documents Attached PO number or account Commissioners ) /� NOTE: Clerk's attestation is not required. Please do not route this item to Clerk's Board Minutes and Records. CAO please scan document after execution by Chairwoma�i ` and e-mail them to Clerk's Minute and Records for its records. C �p� 81243 PRIMARY CONTACT INFORMATION /IQD� @ U Im Normally the primary contact is the person who created /prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above, may need to contact staff for additional or missing information. Name of Primary Staff Priscilla Doria, HHVS Phone Number 252 -5312 Contact / Department appropriate. (Initial) Applicable) Agenda Date Item was 06/12/2012 V Agenda Item Number 16 -D -10 Approved by the BCC Does the document need to be sent to another agency for additional signatures? If yes, Type of Document Insurance Claim Check lM Number of Original I Attached Original document has been signed/initialed for legal sufficiency. (All documents to be Documents Attached PO number or account signed by the Chairman, with the exception of most letters, must be reviewed and signed ) /� number if document is by the Office of the County Attorney. N to be recorded All handwritten strike - through and revisions have been initialed by the County Attorney's N/A INSTRUCTIONS & CHECKLIST I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12 Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is Yes N/A (Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature? 2. Does the document need to be sent to another agency for additional signatures? If yes, provide the Contact Information (Name; Agency; Address; Phone) on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be signed by the Chairman, with the exception of most letters, must be reviewed and signed ) /� by the Office of the County Attorney. N 4. All handwritten strike - through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the /A document or the final negotiated contract date whichever is applicable. 6. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's signature and initials are required. f� 7. In most cases (some contracts are an exception), the original document and this routing slip should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 06/12/2012 and all changes made during _ the meeting have been incorporated in the attached document. The County Attorne 's Office has reviewed the changes, if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC, all changes directed by the BCC have been made, and the document is ready for the Chairman's signature. _1P I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12 . §. \ \ }0k \.y \ \ 16010 Memorandum To: Dinny Neet, CAO Legal Assistant County Attorney's Office CC: Jennifer Belpedio, Assistant County Attorney From: Priscilla Doria, Grant Coordinator, HHVS Date: 8/19/2013 Re: Homeowner Insurance claim check endorsement - Osvaldo & Odalys Labrada The Homeowner Insurance Check Endorsement Policy approved by the Board on June 12, 2012 (16.13. 10) authorizes the Board Chairman or Vice Chairman to endorse homeowner insurance claim checks for recipients assisted with Purchase Assistance and/or rehabilitation program funds as Collier County is named as Second Mortgagee on their insurance policies. The attached check (605113) in the amount of $2,886.76 requires the endorsement by Board Chairwoman Hiller or Vice Chairman Henning. This is a time - sensitive item and must be endorsed as soon as possible as homeowner is waiting to pay for work performed on home. 1 16D10 EXECUTIVE SUMMARY Recommendation to approve a homeowner insurance check endorsement policy for all borrowers assisted with purchase assistance and /or rehabilitation housing program funds and authorizes County Manager or designee to endorse two homeowner insurance claim checks. OBJECTIVE: To allow homeowners in good standing with the State Housing Initiatives Partnership (SHIP) program to deposit their homeowner insurance claim check into the bank so they can use the funds to repair their damaged homes. CONSIDERATION: On July 25, 2008, the subject homeowners purchased a home located at 2505 41st Ave NE, Naples, FL 34120. Collier County approved down payment assistance through the SHIP program and the borrowers signed a second mortgage for SHIP down payment assistance on July 25, 2008. On January 20, 2012, the homeowners filed a homeowner's insurance claim due to water seepage damage to their home. The total claim for damages was $9,935.68. The insurance company paid the claim minus the homeowner's $1,000 deductible, in two separate checks. Check #1 in the amount of $7,964.41 and check #2 in the amount of $971.37. The insurance company made the checks payable to the homeowner, Bank of America and Collier County since all parties have an interest in the property. According to the SHIP loan documents and SHIP local housing administrative plan (LHAP) the homeowner is not required to pay back any funds to Collier County unless the homeowners sell, refinance or lose their homestead exemption on the property. None of these triggering events have occurred and the homeowner's second mortgage loan with Collier County is in good standing. Therefore, Collier County has no claim to the homeowner's insurance claim money that was provided to make repairs to the home. The homeowner has expressed frustration in having to wait for her checks to be endorsed because her house is in urgent need of roof repairs. Accordingly, Housing staff has developed a proposed Homeowners Insurance Check Endorsement Policy for similar circumstances in the future. If this item is approved, the County Manager or designee may endorse a check only if certain enumerated documentation is provided and the homeowner is in compliance with the SHIP and /or Single Family Home Rehabilitation program. The proposed Homeowners Insurance Check Endorsement Policy is attached as back -up for Board consideration. FISCAL IMPACT: There is no fiscal impact associated with this Executive Summary. GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact associated with this Executive Summary. LEGAL CONSIDERATIONS: This item is legally sufficient and requires a majority vote for Board action. - JB W RECOMMENDATION: That the Board of County Commissioners approves a homeowner insurance check endorsement policy for all borrowers assisted with purchase assistance and /or rehabilitation housing program funds and authorizes the County Manager or designee to endorse two homeowner insurance claim checks. PREPARED BY: Lisa Carr/Housing Outreach Coordinator, Housing Human and Veteran Services 16D10 Collier County Housing, Human and Veteran Services (HHVS) Homeowner Insurance Check Endorsement Policy Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage /lien, then the loan will not have to be repaid. On occasion, the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and receive money to make the repairs. If the insurance claim check is made payable to the homeowner and Collier County, then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to HHVS at the address below for check endorsement consideration: 1. Copy of Homeowner's current insurance policy - Declaration Page. 2. Copy of insurance company's claim report with worksheet including description of repairs and costs. 3. Copy of photos of claim damage. 4. Copy of Insurance check(s) payable to homeowner, first lien holder and Collier County. 5. Contact phone number and email address for the homeowner. Housing, Human and Veteran Services, 3339 Tamiami Trail E, Room 211, Attn: Housing Manager, Naples, FL 34112 If approved, the HHVS staff will contact you to schedule an appointment to endorse the insurance claim check. %%�� OFFICE USE ONLY File Name: (/ Lt 0/",,1(,1__ File # sw C_ WReview � HHVS Staff Date ` A S Q/ 3113 ) approved HHVS Director Date 0 Denied 0 Review Cbt&County A torney Date BASIC ATTACHED Homeowners 16DIO 5240 Pa for Lane Gulfstr,oam t Sarasota, FL 34240 Amended Declaration ProP.rI,V MCss.aRy 44 , Customer Service: (866) 485 -3004 DIRECT BILL EFFECTIVE 1114113 AMENDED MITIGATION CREDITS ' - .pOLICYNUMBER .. POUCY PERIOD :.. FROM TO.. _ -. ;: :. - -:. Agency, .... ...: ... GPH0008411 4124112 4 24 13 12:01 AM STANDARD TIME 70300300 NAMED INSURED AND ADDRESS Coverage -C- (Personal Property) _ AGENT OSVALDO LABRADA 001 ------------------------------- INS & RISK MGMT SVCS INC ODALYS LABRADA � ALL OTHER PERILS FORM 8950 FONTANA DEL SOL WAY #200 2082 41ST TER SW NUMBER OF NAPLES FL 34109 -4421 NAPLES FL 34116 TYPE SUPERIOR BUILT FAMILIES OCCUPANCY PHONE # 239 - 649 -1444 BASIC ATTACHED SCHEDULED POLICY POLICY TOTAL 21 COVERAGES ENDORSEMENTS PROPERTY FEES / ASSESSMENT POLICY ADDITIONAL PREMIUM PREMIUM PRE14IUM TAXES -- PREMIUM PREMIUM $1,689.00 $30.00 $27.00 $40.00 $1,786.00 Coverage -C- (Personal Property) --------------------------- - - - - -- LOCATION 001 ------------------------------- $13,400 Incl � ALL OTHER PERILS FORM CONSTRUCTION DATE NUMBER OF DEDUCTIBLE TYPE TYPE SUPERIOR BUILT FAMILIES OCCUPANCY $1000 HO -3 MA N 01 -1967 1 Owner HURRICANE DEDIICTIBLE 2% = $2,680 SINKHOLE DEDIICTIBLE = $13,400 LAW AND ORDINANCE PROTECTION CLASS TERRITORY COUNTY CODE USE 25-t 04 551 21 Primary MORTGAGEE (S) THAT APPLY: 1 2 ------------ - - - - -- COVERAGE LIMITS AND PREMIUMS - SECTION I --------------- -- Coverage -A- (Dwelling) $134,000 $2,544.00 Coverage -B- (Other Structures) $2,680 Incl Coverage -C- (Personal Property) $67,000 Incl Coverage -D- (Loss of Use) $13,400 Incl Hurricane Premium -- - - - - -- $1,855 Incl Non-Hurricane Premium - --- $689 Incl ------------ - - - - -- COVERAGE LIMITS AND PREMIUMS - SECTION II --------------- -- Coverage -E- (Personal Liability) $100,000 Incl Coverage -F- (Medical Payments) $1,000 Incl --------- --------- - - - - -- POLICY CHARGES AND CREDITS ----------------------.- 2$ Hurricane Deductible $2,680 Incl Mitigation Device Credit $855.00 - Policy Fee $25.00 Emergency Management Preparedness and Assistance Trust Fund Surcharge $2.00 Citizens Property Insurance Corporation 2011 Emergency Assessment (1.00$) $17.00 Florida Hurricane Catastrophe Fund Emergency Assessment (1.30$) $23.00 ---------------- - - - - -- LOCATION(S) OF PROPERTY INSURED --------------- --- - - - -- 2082 41ST TER SW NAPLES FL 34116 Insured Copy GSDECI 01 12 •0201GPH00084113200• PAGE 1 OF 3 Guifstram Property and Casualty x.,,; Insurance Company DIRE'C"I'``'ILL 5240 Paylor Lane Sarasota, FL 34240 Customer Service: (866) 485 -3004 Homeowners 16010 Amended Declaration EFFECTIVE 1114113 PHONE # 239- 649 -1444 -- ---- ------- -------- ----- - - - - -- MORTGAGEE(S) -------------------------------- MORTGAGEE 001 MORTGAGEE 002 EVERHOME MORTGAGE A DIVISION HOME INC. OF EVERBANK F.S.A. ISAOA 4351 GULF SHORE BLVD. N., #19N PO BOX 620138 NAPLES FL 34103 DORAVILLE GA 30362 LOAN # 9000780241 LOAN # 2 ------------------ - - - - -- POLICY FORMS AND ENDORSEMENTS ----------------------- NUMBER DATE LIMIT PREMIUM GP DO 01 -07 Deductible Options Notice GP HOJI 01 -11 Homeowners Ins Policy GP OL 01-07 Law & Ordinance Cov Info GP 101 01 -07 Animal Liability Exc GP 107 01 -07 Home Day Care Exclusion GP 108 01 -07 Trampoline Liability Exc GPH OC 10 -11 Outline of Coverage GPH 100 05 -11 Special Provisions - FL GPH 160 02-11 Catastrophic Ground Cover GS 1288 04 -10 Privacy Notice IL P 001 01 -04 OFAC Advisory Notice 0IR -B1 -1670 01 -06 Checklist of Coverages GP 109 12 -11 Carports, Pool Cages & SE GPH 2394 05 -11 Sinkhole Loss Coverage $5.00 Deductible: 10$ of Coverage A GS WL 08 -10 Mitigation Device Credit HO 00 03 10 -00 HO -3 Special Form HO 03 34 05 -03 Limited Fungi,Wet /Dry Rot HO 03 52 01 -06 Calendar Yr Hurricane Ded HO 04 95 10 -00 Water Back Up & Sump Dis $25.00 H03 -IDX 10 -00 Policy Index 0IR -Bl -1655 -------------------------------------------------------------------------------- 02 -10 Hurricane Loss Mitigation ** *Coverage is provided where premium and limit of liability are shown. Flood coverage is not provided by this policy. Insured Copy GSDECI 01 12 PAGE. 2 OF 3 OSVALDO LABRADA INS & RISK MGMT SVCS INC ODALYS LABRADA 8950 FONTANA DEL SOL WAY #200 2082 41ST TER SW NAPLES FL 34109-4421 NAPLES FL 34116 PHONE # 239-649-1444 LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD ° INSURANCE FROM THE NATIONAL FLOOD INSURANCE PROGRAM. WITHOUT THIS COVERAGE, YOU MAY HAVE - UNCOVERED LOSSES. PLEASE DISCUSS THESE COVERAGES WITH YOUR INSURANCE AGENT. THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES, WHICH MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU. Loss or damage caused by the peril of windstorm or hurricane is not covered unless notice of the claim, supplemental claim or reopened claim is provided to us in accordance with the policy conditions, within three (3) years from the date the hurricane made landfall or the windstorm caused the damage. A rate adjustment of 0.0$ surcharge is included to reflect building code grade in your area. Adjustments range from 49-'surcharge to 46g credit. A rate adjustment of 57.0$ credit is included to reflect the Windstorm Mitigation Device Credit. This credit applies only to the wind portion of your premium. Adjustments range from 0$ to 89$ credit Property coverage limit may increase at renewal by an inflation factor measured by a building cost index provided by Xactware. THIS REPLACES ALL PREVIOUSLY ISSUED POLICY DECLARATIONS, IF ANY. THIS POLICY APPLIES ONLY TO ACCIDENTS, OCCURRENCES, OR LOSSES WHICH HAPPEN DURING THE POLICY PERIOD SHOWN ABOVE. GIs+ AGENCY AT NAPLES FL DATE 1127113 AUTHORIZED COUNTERSIGNATURE Insured Copy GSDECI 01 12 *0202GPH000841133M* PAGE 3 OF 3 Claim Summary File # 16010 MP -13 -0784 Adjuster MP & Associates Insurance Adjusters, Inc. Jorge Delgado 13501 SW 136th Street May 22, 2013 Phone Suite 206 Fax Miami, FL 33186 Phone (305) 971 -2676 Fax (305) 971 -5274 Insured Name Labrada, Osvaldo & Odalys Loss Address 2082 41 Ter SW, Naples, FL 34116 Phone Number (239) 404 -5902 Policy # GPH0008411 Other Phone Ins Claim # GV 13000600 Date of Loss 5/14/2013 Ins Company Gulfstream Property & Casualty Coverage - Building Repl. Cost Depr. ACV Estimate Totals Contractor's Overhead & Profit (20 %) Total With Overhead & Profit Collier Total With Tax Less Deductible Applied Coverage - Building Claim $4,285.41 $402.21 $3,883.20 $857.08 $80.44 $776.64 $5,142.49 $482.65 $4,659.84 $71.89 $0.00 $71.89 $5,214.38 $482.65 $4,731.73 - $2,500.00 - $2,500.00 $2,714.38 $482.65 $2,231.73 Coverage - UPP Repl. Cost Depr. ACV Estimate Totals $174.36 $7.54 $166.82 Collier $1.02 $0.00 $1.02 Total With Tax $175.38 $7.54 $167.84 Less Deductible Applied $0.00 $776.64 $0.00 Coverage - UPP Claim $175.38 $7.54 $167.84 Summary: File # MP -13 -0784 Estimate Totals Less Amount Not Subject To Overhead & Profit Amount Subject To Overhead & Profit Contractor's Overhead & Profit (20 %) Sub -Total Amount Not Subject To Overhead & Profit Total With Overhead & Profit Collier Claim Summary (MS/13 0170) File # MP -13 -0784 Repl. Cost Depr. ACV $4,459.77 $409.75 $4,050.02 - $174.36 -$7.54 - $166.82 $4,285.41 $402.21 $3,883.20 $857.08 $80.44 $776.64 $5,142.49 $482.65 $4,659.84 $174.36 $7.54 $166.82 $5,316.85 $490.19 $4,826.66 $72.91 $0.00 $72.91 - 1 - May 22, 2013 Total With Tax Less Deductible Applied ($2,500.00 Maximum) Net Claim 16010 $5,389.76 $490.19 $4,899.57 - $2,500.00 - $2,500.00 $2,889.76 $490.19 $2,399.57 A copy of this document does not constitute a settlement of this claim. The above figures are subject to insurance company approval. Accepted by. Claim Summary (MSB 0170) - 2 - May 22, 2013 File # MP -13 -0784 Estimate File # Coverage BLDG 16D10 MP -13 -0784 Adjuster MP & Associates Insurance Adjusters, Inc. Jorge Delgado 13501 SW 136th Street May 22, 2013 Suite 206 Coverage - Building Miami, FL 33186 Phone (305) 971 -2676 Fax (305) 971 -5274 Insured Labrada, Osvaldo & Odalys Loss Address 2082 41 Ter SW, Naples, FL 34116 Phone Number (239) 404 -5902 Policy # GPH0008411 Ins Claim # GV13000600 Date of Loss 5/14/2013 Ins Company Gulfstream Property & Casualty Kitchen (10' 9" x 12' 6" x 8') 134 sf Floor 289 sf Wall 134 sf Ceiling 33 If Floor 461f Ceiling 1,075 cf Volume Missing Wall(s) 2'6" x 61811 8' 7" x 7' 2' x 3' Clean Cabinet, Wall 24 LF @ $3.66 Repl. Cost Depr. ACV OP RD Move & Reset Contents per Hour 2 HR @ $24.39 $48.78 $0.00 $48.78 Mask & Protect Floor, per SF 134 SF @ $0.08 $10.72 $0.00 $10.72 Mask Walls - per SF 289 SF @ $0.18 $52.02 $0.00 $52.02 Rem & Reinstall Dishwasher I EA @ $163.20 $163.20 $0.00 $163.20 Clean Dishwasher 1 EA @ $12.20 $12.20 $0.00 $12.20 Rem & Reinstall Refrigerator 1 EA @ $42.28 $42.28 $0.00 $42.28 Clean Refrigerator 1 EA @ $12.20 $12.20 $0.00 $12.20 Rem & Reinstall Range 1 EA @ $53.27 $53.27 $0.00 $53.27 Clean Range 1 EA @ $13.42 $13.42 $0.00 $13.42 Rem & Replace Microwave Oven 1 EA @ $353.79 $353.79 $70.76 $283.03 I Burnt front plate and metal cover Clean Cabinet, Wall 24 LF @ $3.66 $87.84 $0.00 $87.84 Clean Cabinet, Base 20 LF @ $3.80 $76.00 $0.00 $76.00 Scrape & Prepare Texture Walls 64 SF @ $0.38 $24.32 $0.00 $24.32 Replace Texture Walls 64 SF @ $0.94 $60.16 $12.03 $48.13 Seal Walls 64 SF @ $0.47 $30.08 $6.02 $24.06 Paint Walls 64 SF @ $0.63 $40.32 $8.06 $32.26 Rem & Reinstall Recessed Light 5 EA @ $39.74 $198.70 $0.00 $198.70 Clean Recessed Light 5 EA @ $6.10 $30.50 $0.00 $30.50 Rem & Reinstall Register 1 EA @ $11.31 $11.31 $0.00 $11.31 Clean Register 1 EA @ $2.38 $2.38 $0.00 $2.38 Scrape & Prepare Texture Ceiling 134 SF @ $0.38 $50.92 $0.00 $50.92 Replace Texture Ceiling 134 SF @ $0.94 $125.96 $25.19 $100.77 Seal Ceiling 134 SF @ $0.47 $62.98 $12.60 $50.38 Paint Ceiling 134 SF @ $0.63 $84.42 $16.88 $67.54 Clean Cove Molding 4" 46 LF @ $0.18 $8.28 $0.00 $8.28 Clean Ceramic Floor Tile 134 SF @ $0.27 $36.18 $0.00 $36.18 $1,692.23 $151.54 $1,540.69 Estimate (MSB 0410) (000.000.001) - 1 - May 22, 2013 File # MP -13 -0784 16D10 Dining Room (10'9" x 11'6" x 8') 124 sf Floor 256 sf Wall 124 sf Ceiling 361f Floor 44 if Ceiling 989 cf Volume Missing Wall(s) 8' 7" x 7' Window(s) 8' x 5' Move & Reset Contents, per Hour Mask & Protect Floor, per SF Mask Walls - per SF Rem & Reinstall Blinds, Vertical . Clean Blinds, Vertical Scrape & Prepare Texture Walls Replace Texture Walls Rem & Reinstall Chandelier Clean Chandelier Seal Walls Paint Walls Clean Recessed Light Rem & Reinstall Register Clean Register Scrape & Prepare Texture Ceiling Replace Texture Ceiling Seal Ceiling Paint Ceiling Clean Cove Molding 4" Clean Ceramic Floor Tile $1,250.71 $155.04 $1,095.67 Living Room/ Entry (15'5" x 22'6" x 8') 347 sf Floor 412 sf Wall 347 sf Ceiling 52 if Floor 63 if Ceiling 2,775 cf Volume Door(s) 8' x 6' 8" Missing Wall(s) 2'6" x 8' Window(s) 3' x 5' Move & Reset Contents, per Hour Mask & Protect Floor, per SF Mask Walls - per SF Rem & Reinstall Blinds, Vertical Clean Blinds, Vertical Rem & Reinstall Ceiling Fan Clean Ceiling Fan Clean Texture Walls Paint Walls Rem & Reinstall Register Clean Register Clean Texture Ceiling Paint Ceiling Clean Cove Molding 4" Clean Ceramic Floor Tile 3' x 6' 8" 10' 9" x 8' Repl. Cost Depr. ACV OP RD 1 HR @ $24.39 $24.39 $0.00 $24.39 124 SF @ $0.08 $9.92 $0.00 $9.92 256 SF @ $0.18 $46.08 $0.00 $46.08 1 EA @ $28.45 $28.45 $0.00 $28.45 1 SF @ $0.53 $0.53 $0.00 $0.53 256 SF @ $0.38 $97.28 $0.00 $97.28 256 SF @ $0.94 $240.64 $48.13 $192.51 1 EA @ $99.56 $99.56 $0.00 $99.56 1 EA @ $36.59 $36.59 $0.00 $36.59 256 SF @ $0.47 $120.32 $24.06 $96.26 256 SF @ $0.63 $161.28 $32.26 $129.02 5 EA @ $6.10 $30.50 $0.00 $30.50 1 EA @ $11.31 $11.31 $0.00 $11.31 1 EA @ $2.38 $2.38 $0.00 $2.38 124 SF @ $0.38 $47.12 $0.00 $47.12 124 SF @ $0.94 $116.56 $23.31 $93.25 124 SF @ $0.47 $58.28 $11.66 $46.62 124 SF @ $0.63 $78.12 $15.62 $62.50 44 LF @ $0.18 $7.92 $0.00 $7.92 124 SF @ $0.27 $33.48 $0.00 $33.48 $1,250.71 $155.04 $1,095.67 Living Room/ Entry (15'5" x 22'6" x 8') 347 sf Floor 412 sf Wall 347 sf Ceiling 52 if Floor 63 if Ceiling 2,775 cf Volume Door(s) 8' x 6' 8" Missing Wall(s) 2'6" x 8' Window(s) 3' x 5' Move & Reset Contents, per Hour Mask & Protect Floor, per SF Mask Walls - per SF Rem & Reinstall Blinds, Vertical Clean Blinds, Vertical Rem & Reinstall Ceiling Fan Clean Ceiling Fan Clean Texture Walls Paint Walls Rem & Reinstall Register Clean Register Clean Texture Ceiling Paint Ceiling Clean Cove Molding 4" Clean Ceramic Floor Tile 3' x 6' 8" 10' 9" x 8' $1,096.19 $95.63 $1,000.56 Estimate (MSB 0410) (000.000.001) - 2 - May 22, 2013 File # MP -13 -0784 Repl. Cost Depr. ACV OP RD 1 HR @ $24.39 $24.39 $0.00 $24.39 347 SF @ $0.08 $27.76 $0.00 $27.76 412 SF @ $0.18 $74.16 $0.00 $74.16 1 EA @ $28.45 $28.45 $0.00 $28.45 1 SF @ $0.53 $0.53 $0.00 $0.53 1 EA @ $126.86 $126.86 $0.00 $126.86 1 EA @ $18.29 $18.29 $0.00 $18.29 412 SF @ $0.23 $94.76 $0.00 $94.76 412 SF @ $0.63 $259.56 $51.91 $207.65 1 EA @ $11.31 $11.31 $0.00 $11.31 1 EA @ $2.38 $2.38 $0.00 $2.38 347 SF @ $0.30 $104.10 $0.00 $104.10 347 SF @ $0.63 $218.61 $43.72 $174.89 63 LF @ $0.18 $11.34 $0.00 $11.34 347 SF @ $0.27 $93.69 $0.00 $93.69 $1,096.19 $95.63 $1,000.56 Estimate (MSB 0410) (000.000.001) - 2 - May 22, 2013 File # MP -13 -0784 General Remove Debris Single Axle Pickup Truck Remove Debris, oer HR 16D10 Repl. Cost Depr. ACV OP RD 1 EA @ $197.50 $197.50 $0.00 $197.50 2 HR (a) $24.39 $48.78 $0.00 $48.78 Progressive & Final Cleaning, includes hauling debris to dumpster or pickup truck. Estimate Totals Contractor's Overhead & Profit (20 %) Total With Overhead & Profit Collier Total With Tax $246.28 $0.00 $246.28 Repl. Cost Depr. ACV $4,285.41 $402.21 $3,883.20 $857.08 $80.44 $776.64 $5,142.49 $482.65 $4,659.84 $71.89 $0.00 $71.89 $5,214.38 $482.65 $4,731.73 A copy of this document does not constitute a settlement of this claim. The above figures are subject to insurance company approval. Accepted by Estimate (MSB 0410) (000.000.001) - 3 - May 22, 2013 File # MP -13 -0784 Estimate File # Coverage UPP 16D10 MP -13 -0784 Adjuster MP & Associates Insurance Adjusters, Inc. Jorge Delgado 13501 SW 136th Street May 22, 2013 Suite 206 Coverage - UPP Miami, FL 33186 Phone (305) 971 -2676 Fax (305) 971 -5274 Insured Labrada, Osvaldo & Odalys Loss Address 2082 41 Ter SW, Naples, FL 34116 Phone Number (239) 404 -5902 Policy # GPH0008411 Ins Claim # GV13000600 Date of Loss 5/14/2013 Ins Company Gulfstream Property & Casualty Contents Ref Description Repl. Cost Depr. ACV OP RD 1 Replace Beach Towel 20% 1 LF @ $24.72 $24.72 $4.94 $19.78 N 2 Replace Kitchen Towel 20% 1 EA @ $12.99 $12.99 $2.60 $10.39 N 3 Repair Range 1 EA @ $136.65 $136.65 $0.00 $136.65 N Repair allowance for range, top glass and minor pait to a side panel Estimate Totals Collier Total With Tax $174.36 $7.54 $166.82 Repl. Cost Depr. ACV $174.36 $7.54 $166.82 $1.02 $0.00 $1.02 $175.38 $7.54 $167.84 A copy of this document does not constitute a settlement of this claim. The above figures are subject to insurance company approval. Accepted by Estimate (MSB 0410) (001.000.001) -1 - May 22, 2013 File # MP -13 -0784 16010 Perimeter Sheet File# P-13-07 Coverage BLDG G Policy # PH000841 1 Insured Labrada, Osvaldo & Odalys Ins Claim # GV13000600 Perimeter Diagram Perimeter Sheet (MSB 0460) - 1 - May 22, 2013 File # MP -13 -0784 Profile & Labor /Material (MS/B 063 1) 1 _ May 22, 2013 File # MP -13 -0784 ISubtotal $77,919 $11,645 $138,768 $228,332 Property Description 16010 Profile & Labor /Material 1967 Construction Type Standard File # MP -13 -0784 Insured Name Osvaldo & Odalys Labrada Policy Number GPH0008411 Total Living Area May 22, 2013 Mailing Address Naples Effective Date 04/24/2013 • Slab FL • Crawl Space % Basement % Basement Finished Current Coverage $135,000 % Hillside Foundation Property Address 2082 41 Ter SW Cost as of 2/2010 Shape Naples FL 34116 Flat Area/Easy Access Roads Cost Estimate Category Labor Equipment Material Total Sitework Coverage A Foundations Reconstruction Cost w/o Debris Removal $ 228,332 Slab on Grade 3,544 107 4,734 8,385 Debris Removal $ 10,897 Framing 14,228 11,054 25,282 Reconstruction Cost Debris Removal $ 239,229 Roofing 6,045 25 4,702 10,772 Exterior Walls 18,031 831 16,379 35,241 Partitions 6,390 285 3,091 9,766 Wall Finishes 4,409 2,677 7,086 Floor Finishes 4,731 5,665 10,396 Ceiling Finishes 2,206 1 1,511 3,718 Equipment 1,941 35,983 37,924 Conveying Systems Plumbing Systems 8,724 42,691 51,415 HVAC Systems 2,050 2,174 4,224 Current Coverage % ofCoverage A RC 56.4% Electrical Systems 3,816 4,543 8,359 Current Coverage % of Coverage A ACV 56.4% Attached Structures 1,804 3,564 5,368 Detached Structures General Conditions 10,396 10,396 Profile & Labor /Material (MS/B 063 1) 1 _ May 22, 2013 File # MP -13 -0784 ISubtotal $77,919 $11,645 $138,768 $228,332 Property Description Main Home Wing I Wing 2 Year Built 1967 Construction Type Standard Predominat Style I Story Number of Stories 1.0 Total Living Area 1,399 • Cathedral Ceilings • Lower Level Unfinished • Slab 100 • Crawl Space % Basement % Basement Finished % Pier Foundation % Hillside Foundation Slope Shape Site Access Flat Area/Easy Access Roads Profile & Labor /Material (MS/B 063 1) 1 _ May 22, 2013 File # MP -13 -0784 Profile & Labor/Material Exterior Walls 100% Brick Veneer Roofing 90% Tile, Concrete 10% Built- Up/Tar and Gravel Attached Structures 1 Attached Garage - l Car Partitions 10% Drywall 90% Drywall, Textured Wall Coverings 98% Paint 2% Ceramic Tile Ceilings 10% Drywall 90% Acoustical Floor Coverings 95% Ceramic Tile 5% Concrete, Stamped/Textured Interior I Kitchen - Designer 1 Full Bath - Custom 1 Full Bath - Designer HVAC 100% Central Air Conditioning -Average Cost 16D10 File # MP -13 -0784 Profile & Labor/Material (MSB 063 1) - 2 - May 22, 2013 File # MP -13 -0784 Photo Sheet Insured Labrada, Osvaldo & Odalys 16D10 File # MP -13 -0784 Policy # GPH0008411 Ins Claim # GV13000600 Kitchen Fire damage microwave, no damage to upper cabinets Kitchen Soot damage to control panels, glass top sustain damage from heat Photo Sheet (MS /B 0270) - 7 - May 22, 2013 .V ll I z a x oM ozQ —m zsv O O J U� W m -_- CD o r � o'n° N > A,, LLZ �'Og Z W U til g ? W U Lu U°wU °a III j Y�Fi N .dd� III II , II� - N{1'.:I I N'. k{II' II y"LIINIP�P'in �! IXI N�1 'INN II, I�'W'NINry,,,01111� IP',y'I�NNaIIhhWI ,�xli IymNN,, I'wPry,'41111'14mN�,,, IM P II P /'1 1100 ryrl�dhlPl Jl IM1I BFI Opqq ry�',: µ'I 5L'Ii411N11 n:i�'4!x °jI j la IIIIM1 (p�i�IIkIW i� !I "w G,:I U�'.� S✓,If'm'I` Iw ;,�iiul��Rlr' c � �h' "`�.��^I�''Ll n m f xNi �y 11r -20 J � OIft�Y l N14 lll��w 'Atll� cu fA . y �: M I m }. 010 � "aw ul, .I; W �u� lC� JNNL NANNI f0 �� mh'� 1 tlWm ;II}y% O Q C II V � IVII N 0 0 '��yl�h�INIIIltii d' elu ae N Al 1wd U N,� it rfl ��I II YItl M4[� Q Lu ,��vpy� �y O) �.5kk O On F 4'N✓a' r1 , W Q m �IQXl @ ¢� li U w M •.. 017 Q d' TC Z = O W F-- - . p a2U i 0 5' O t^a I ,IN p W 0 Q) ,��.41 w —� p LLJ C7 Ipp �o WWp x' -j u Q v I 'A5"M'I'�N N �(3 ra r7N N W co Q O III tip Z QIN P,�Iy%q,4M1 rl Cl) 0 > N Z i �PIII Yti,h l hlluhr I d w oc .,p •+ bl- I �'� aryl 14 O d I •;.a�.IF - U IdM;.A111�NN1 L ; y A � 'I� PO 'I.'YaNWI• i AUG 12 2013 Collier u HVS Grants By 16010 0 A 1601n ENDORSE HERE / x S �i -1,6e� / 'Z'jV" BORDERS ON THE FACE AND BACK CONTAIN MICRO - PRINTING AND MAY BE SEEN UNDER MAGNIFICATION • LOO FOR - ORIGINAL DOCUMENT DO NOT WRITE. STAMP OR SIGN BELOW - RESERVED FOR FINANCIAL INSTITUTION USE Everhome Mortgage, a division of EverBank Without Recourse BY- '.,J .. .. G u f1� ,)a m proty & ca1sumaty VWfArance Company May 15, 2013 Osvaldo Labrada and Odalys Labrada 2082 41st Ter Sw Naples FL 34116- Insured: Osvaldo Labrada and Odalys Labrada Claim #: GV13000600 Date of Loss: 5/14/2013 Dear Osvaldo Labrada: Claims Processing Center 215 N. Westmonte Drive Altamonte Springs, FL 32714 1601 7 — "6M M -- tcU This acknowledgement letter shall confirm our receipt of notice of your recent claim to the Gulfstream Insurance Company, received on 5/14/2013 regarding the above - referenced loss. We will review your claim and respond to you in writing or by telephone within 24 hours of this notice. Please accept this notification that it will be necessary to inspect your home to investigate and adjust the loss. If you should have any questions on your claim in the interim or while the claim is pending, please direct your inquiries to your assigned claims examiner, Julia Bermudez, at (866) 485 -3004, extension 6119. Although we do not anticipate problems in the handling of your claim, you should be advised that Florida Statutes provide you the right to participate in mediation to resolve any dispute between the parties that may arise related to this claim, subject to certain limited exceptions. That cost of mediation will be borne by the insurance company, and is a non - binding process in which any settlement agreement reached in mediation may be rescinded by the insured within 3 days following mediation; unless, the insured negotiates any settlement check issued as a result of a settlement agreement in mediation. If you wish to invoke mediation during the claim, please notify the undersigned in writing. Thank you for your attention to the foregoing. Please do not hesitate to contact the undersigned if you have any questions. Sincerely, Julia Bermudez Sr Claims Examiner Tel: (866) 485 -3004 Ext: 6119 Fax: (866) 800 -9840 Email: julia.bermudez @seibels.com /' goo- 6cl::, 9 - / 1 09 — SY9 — Viz ( Any person who knowingly and with intent to injure, defraud or deceive any insurance company files a statement of claim containing any false, incomplete, or misleading information is guilty of a felony of the third degree. INSTR 4538185 OR 4662 PG 1059 RECORDED 3/17/2011 3:38 PN PAGES 2 DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT, COLLIER COUNTY FLORIDA REC $18.50 , J Without title review or opinion: This Instrument Prepared By: And After Recording Return To: G. Carson McEachem, Esq. Roetzel & Andress, LPA 850 Park Shore Drive Naples, Florida 34103 ASSIGNMENT OF MORTGAGE AND OTHER LOAN DOCUMENTS KNOW ALL MEN BY THESE PRESENTS: THAT HOUSING OPPORTUNITIES MADE FOR EVERYONE, INC., a Florida not - for - profit corporation, whose address is 4351 Gulf Shore Boulevard North, Residence 19N, Le Rivage, Naples, Florida 34103, as party of the first part, in consideration of the sum of $10.00 and other good and valuable considerations, the receipt and sufficiency of which is hereby acknowledged received from or on behalf of Collier Co of County Commissioners, c/o Housing, Human & Veteran Services, 3299 i[itr�li cite 303, Naples, Florida 34112, as party of the second part, at or d yl my of these presents, the receipt whereof is hereby acknowled hereby grant, b 11, assign, transfer and set over unto the said party of the s nd n Purchase M y ortgage dated April 24, 200, recorded May 1, 2009 as I s e be in O.R B 4448, Page 2662 made by OSVALDO LABRADA d S t G OPPORTUNITIES MADE FOR EVERYONE, INC. a o da of fo - o r > up n the following described piece or parcel of land, si je bei i r s i o to �o 't 1 Lot 10, Block olden Gate, Unit 2, rd ng plat thereof as recorded in Plat Book 5, Pa through 77, of the is �i' of Collier County, Florida. The address of the Real Prope i 4l" Terrace S y 40 , Florida 34116 In addition to this Mortgage, this Ass`igisN1 include the following loan documents, to wit: 1. PROMISSORY NOTE dated April 24, 2009 in the original principal amount of S35,000.00 from OSVALDO LABRADA and ODALYS LABRADA. 2. EVERYONE, E INC., recorded May 1 009 0asSInstrument Number 4290014, 4, ci 4290014, Official ial Records Book 4448, Page 2675. TO HAVE AND TO HOLD the same unto the said party of the second part, its legal representatives, successors and assigns forever. This assignment is made on an "AS IS" basis and without recourse, with all faults, and Assignee expressly acknowledges that Assignor MAKES NO REPRESENTATIONS OR WARRANTIES, EXPRESS OR IMPLIED, OR ARISING BY OPERATION LAW OF ANY KIND OR NATURE. n� 16D10 * ** OR 4662 PG 1060 * ** �t S WHEREOF, they have hereunto set their hands and seals, this day of 2010. Signed, sealed and delivered in the presence of Priv Na>ne: 2 a- A� Print Name: A1H�GT19 A. FAX STATE OF FLORIDA ) :ss COUNTY OF COLLIER ) I HEREBY CERTIFY aforesaid and in the County Engel, as President of HOU known to be the person er acknowledged before me t HOUSING OPPORTUNITIES MADE FOR EVERYONE, INC. BY Melvin Engel, President =Officer duly authorized in the State .,ckno ts, ponally E R EVERYONE, INC., to me executed a re¢oina instrumeat, and he WITNESS my h0 �ea f ( 2 �f Iry [SEAL] 6 636235.113551=8 1601.0 161310 Teresa L. Cannon From: Neet, Virginia Sent: Friday, October 02, 2015 8:49 AM To: Teresa L. Cannon Cc: Belpedio, Jennifer Subject: YY-1456 BCC Meeting 11/13/12 and prior meetings Agenda Items - post board review of items: Attachments: Item 16-D-10 (6_12_12)Insurance Claim Check- NOT.pdf • Teresa: The attached involves an insurance claim check pursuant to Item 16-D-10(6/12/2012). There have been several of these since 2012. This does not require Clerk's attestation so it is not routed. I am emailing you a copy for the Clerk's records. Dinny Virginia A. Neet, FRP Office of the Collier County Attorney Telephone (239)252-8066 - Fax (239) 252-6600 Under Florida Law,e-mail addresses are public records.If you do not want your e-mail address released in response to a public records request,do not send electronic mail to this entity.Instead,contact this office by telephone or in writing. 1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 161) 1 0 TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. **NEW**ROUTING SLIP Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the exception of the Chairman's signature,draw a line through routinglines#1 through#2,complete the checklist,and forward to the Attorney Office. Route to Addressee(s)(List in routing order) Office Initials Date 1. Lisa N. Carr Community and Human ZWG 9/23/15 Services 2. County Attorney Office County Attorney Office (›al6 33120//5 3. BCC Office Board of County Commissioners V f / lo\t\1_ 4. Minutes and Records Clerk of Court's Office PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above,may need to contact staff for additional or missing information. Name of Primary Staff Lisa Carr Phone Number 239-252-2339 Contact/ Department Agenda Date Item was June 12,2012 Agenda Item Number 16.D.10 Approved by the BCC Type of Document Check in the amount of$3,773.74 Number of Original 1 Attached Documents Attached PO number or account number document is .�• �... to be recorded INSTRUCTIONS&CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is • Yes N/A(Not appropriate. - (Initial) Applicable) 1. Does the document require the chairman's original si a ?'ORIGINAL LNC 2. Does the document need to be sent to another agency for ..'tional signatures f yes, LNC provide the Contact Information(Name;Agency;Address;Phone on:, :": hed sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be LNC signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's LNC Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the LNC document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's LNC signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip LNC should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tal ahassee within a certain time frame or the BCC's actions are•nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 6/12/12 and all changes made during the LNC meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC,all changes directed by the BCC have been made,and the document is ready for Chairman's signature. I:Forms/County Forms/BCC Fortes/Original Documents Routing Slip W WS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12 `; 4 x61 .0 an,(H P:w 14:01 .: Nf ANIZWAITI OfEGIALWATERIVIAR I(-.HOLMZCIMISHT. •.VIEW . LJPC BANK OF AMERICA r' 1 Tampa,FL 33630 INSURANCE 2015FLO21147 4012417 September 16,2015 United Property&Casualty Insurance Co. CLAIMS Vold Mow s Months P.O.Box 1011 63-4 St Petersburg,FL 33731-1011 630 FL PAY THREE THOUSAND SEVEN HUNDRED SEVENTY-THREE AND 74/100 DOLLARS **$3,773.74•* TO THE ORDER OF PIERRE A BORGELA and FIFTH THIRD BANCORP ISAOA and HOUSING .+. HUMAN&VETERAN SERVIC J 1I 4437 54TH AVE NE BY Ir NAPLES FL 34120 AUTHORIZED SIGNATURE BY AUTHORIZED SIGNATURE O O II (min O mm—� m min TD � Eck) zox�� Dfl, zz zIn Cy 71-2 b m • 161310 EXECUTIVE SUMMARY Recommendation to approve a homeowner insurance check endorsement policy for all borrowers assisted with purchase assistance and/or rehabilitation housing program funds and authorizes Board Chairman or Vice Chairman, in his absence to endorse two homeowner insurance claim checks. OBJECTIVE: To allow homeowners in good standing with the State Housing Initiatives Partnership (SHIP) program to deposit their homeowner insurance claim check into the bank so they can use the funds to repair their damaged homes. CONSIDERATION: On July 25,2008,the subject homeowners purchased a home located at 2505 41st Ave NE, Naples, FL 34120. Collier County approved down payment assistance through the SHIP program and the borrowers signed a second mortgage for SHIP down payment assistance on July 25, 2008. On January 20, 2012,the homeowners filed a homeowner's insurance claim due to water seepage damage to their home. The total claim for damages was$9,935.68. The insurance company paid the claim minus the homeowner's $1,000 deductible, in two separate checks. Check #1 in the amount of$7,964.41 and check#2 in the amount of$971.37.The insurance company made the checks payable to the homeowner, Bank of America and Collier County since all parties have an interest in the property. According to the SHIP loan documents and SHIP local housing administrative plan(LHAP)the homeowner is not required to pay back any funds to Collier County unless the homeowners sell, refinance or lose their homestead exemption on the property. None of these triggering events have occurred and the homeowner's second mortgage loan with Collier County is in good standing. Therefore, Collier County has no claim to the homeowner's insurance claim money that was provided to make repairs to the home. The homeowner has expressed frustration in having to wait for her checks to be endorsed because her house is in urgent need of repairs. Accordingly, Housing staff has developed a proposed Homeowners Insurance Check Endorsement Policy for similar circumstances in the future. If this item is approved,the Board Chairman or Vice Chairman, in his absence may endorse a check only if certain enumerated documentation is provided and the homeowner is in compliance with the SHIP and/or Single Family Home Rehabilitation program. The proposed Homeowners Insurance Check Endorsement Policy is attached as back-up for Board consideration. FISCAL IMPACT: There is no fiscal impact associated with this Executive Summary. GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact associated with this Executive Summary. LEGAL CONSIDERATIONS: This item is legally sufficient and requires a majority vote for Board action. -JBW RECOMMENDATION: That the Board of County Commissioners approves a homeowner insurance check endorsement policy for all borrowers assisted with purchase assistance and/or rehabilitation housing program funds and authorizes the Board Chairman or Vice Chairman, in his absence to endorse two homeowner insurance claim checks. PREPARED BY: Lisa Carr/Housing Outreach Coordinator,Housing Human and Veteran Services 1613 10 Collier County Housing, Human and Veteran Services (HHVS) Homeowner Insurance Check Endorsement Policy Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage/lien,then the loan will not have to be repaid. On occasion,the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and receive money to make the repairs. If the insurance claim check is made payable to the homeowner and Collier County,then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to HHVS at the address below for check endorsement consideration: 1. Copy of Homeowner's current insurance policy-Declaration Page. 2. Copy of insurance company's claim report with worksheet including description of / repairs and costs. 3. Copy of photos of claim damage. / 4. Copy of Insurance check(s)payable to homeowner,first lien holder and Collier County. ✓ 5. Contadhone n ber and email address for the homeowner.. 6 e4"64 -' Sec HO De4. 0A�e. "- Housing,Human and Veteran Services, 3339 Tamiami Trail E,Room 211,Attn:Housing Manager,Naples,FL 34112 If approved,the HHVS staff will contact you to schedule an appointment to endorse the insurance claim check. OFFICE USE ONLY ,,l (� • File Name: Pierre. ,4- J3°roe!a File# )SP 061 -19L/ -19L/ L IS oc- de/4/r- //�//J' ii'tteview *WO Staff Date (Z9 K .05 Approved AM'S Director Date ❑Denied CAS 10 h \1 S $Review Cou orney Date UPC HOMEOWNERS DECLARAT N6 1) 10 B INSURANCE . s � UNITED PROPERTY&CASUALTY INSURANCE CO ... F P.O. Box 51149 UHV 2801254 02 01 08/29/2014 08/29/2015 Sarasota,FL 34232-0330 12:01 a.m.at the residence premises. ' 't�� f< ! !a rt `c r.7:.` ��.. _:�.`r c'P.s �� AMENDED DECLARATION Effective: 08/29/2014 Date Issued:08/27/2014 CORRECT MORTGAGEE .,e.r:.:: ;"X,>.�. t..h r_.,:, +rs$:,`+, wksu',rn._ire as.+.;5� .';a•{it -t, .......<....r.,. M...e�._ .,. err y 4. r'.s 2 t;:-x y'.!?' +;p'3 M .+'r.,t�., PIERRE A BORGELA BRIGHTWAY INSURANCE INC 4437 54TH AVE NE PO BOX 5700 NAPLES FL 34120 JACKSONVILLE FL 32247 Telephone:239-867-1275 Telephone:888-254-5014 The residence premises covered by this policy is located at the address listed below. 4437 54TH AVE NE NAPLES FL 34120 IF PAYMENT IS NOT RECEIVED ON OR BEFORE THE POLICY RENEWAL EFFECTIVE DATE, THIS POLICY WILL NOT BE IN FORCE. Coverage is provided where premium and limit of liability Is shown. Flood coverage Is not provided and is not a part of this policy. SECTION I COVERAGE LIMIT OF LIABILITY PREMIUMS A. DWELLING $216,000.00 $874.00 B. OTHER STRUCTURES $4,320.00 INCLUDED C. PERSONAL PROPERTY $108,000.00 INCLUDED D. LOSS OF USE $43,200.00 INCLUDED SECTION II COVERAGE E. PERSONAL LIABILITY $300,000.00 $18.00 i F. MEDICAL PAYMENTS $1,000.00 INCLUDED OPTIONAL COVERAGES Premium charge for Hurricane Exposure: $561.00 The above coverages are subject to a 2% / $4,320 Hurricane Deductible. The above coverages are subject to a 10% / $21,600 Sinkhole Deductible per sinkhole loss. The above coverages are subject to a $2,500 All Other Peril Deductible. TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES: $940.00 PLEASE CONTACT YOUR AGENT IF THERE ARE ANY QUESTIONS PERTAINING TO YOUR POLICY. r c .it.:•._ r.' 5h ,�•t,r:=a..s;�, 4�saf �_ x .tr,t��?�. i __ HO 0003 (04/91) HO 0334 (05/03) COUNTERSIGNED DATE 08/27/2014 HO 0350 (06/97) HO 0355 (05/05) HO 0446 (04/91) HO 0490 (04/91) HO 0496 (04/91) HO 2370 (06/97) BY ` Continued on Forms Schedule ADDITIONAL INTERESTS MORTGAGEE SECOND MORTGAGEE FTB0010-0414814699 FIFTH THIRD BANCORP ISAOA HOUSING HUMAN&VETERAN SERVIC ATIMA 3339 E TAMIAMI TRL BLDG H 211 PO BOX 598 NAPLES FL 34112 AMELIA OH 45102 UPC 101 12 12 AGENT COPY Page 1 of 4 16010 U PC HOMED ERS DECLARATION INSURANCE PO.UCY.NL POLICY PERIOD UNITED PROPERTY&CASUALTY INS CO From To P.O.Box 51149 UHV 2801254 02 01 08/29/2014 08/29/2015 Sarasota,FL 34232-0330 12:01 cm.et the residence pmml.0 AMENDED DECLARATION Effective: 08/29/2014 Date Issued:08/27/2014 CORRECT MORTGAGEE INSURED: AGENT:3006378 PIERRE A BORGELA BRIGHTWAY INSURANCE INC 4437 54TH AVE NE PO BOX 5700 NAPLES FL 34120 JACKSONVILLE FL 32247 Telephone:239-867-1275 Telephone:888-254-5014 The residence premises covered by this policy is located at the above Insured address unless otherwise stated below: 4437 54TH AVE NE NAPLES FL 34120 Premium: SECTION I, SECTION II AND OPTIONAL PREMIUMS $892.00 EMERGENCY MANAGEMENT TRUST FUND SURCHARGE $2.00 MANAGING GENERAL AGENCY (MGA) POLICY FEE $25.00 FLORIDA HURRICANE CATASTROPHE FUND ASSESSMENT $12.00 2006 CITIZENS HIGH RISK ACCOUNT EMERGENCY ASSESSMENT $9.00 TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES $940.00 NOTE: The portion of your premium for Hurricane Coverage is: $561.00 The portion of your premium for All Other Coverages is: $331.00 An adjustment of -5.8%Is included to reflect the Building Code grade for your area.Adjustments range from 1% surcharge to 46.1%credit. CHANGE IN POLICY PREMIUM $0.00 Your policy includes endorsement HO 04 46 Inflation Guard-which automatically increases the amount of Dwelling Coverage by the annual percentage amount shown on the declaration page (but not less than 4%). Therefore your Hurricane deductible may be higher than indicated on the policy when a hurricane loss occurs due to application of the endorsement. FLOOD CARRIER N/A FORM TYPE HO-3 YEAR BUILT 2005 TOWN/ROW HOUSE N/A CONSTRUCT TYPE M CONSTRUCT SUPERIOR N NUMBER OF FAMILIES 00001 AOP TERRITORY 551 PROTECTION CLASS 04 USE CODE P MUNICIPAL CODE 999999 COUNTY CODE 021 PROT DEVICE/BURGLAR N PROT DEVICE/FIRE N PROT DEV/SPRINKLER N PROT DEV/SHUTTER N WIND/HAIL EXCLUSION N REPLACEMENT COST Y OCCUPANCY CODE OWNER FLOOD CREDIT N SINKHOLE COVERAGE I WIND TERRITORY 551A WATER PREVENTION CR N INFLATION GUARD 4% UPC 101 12 12 AGENT COPY Page 2 of 4 t 161310 0 UPC HOMEOWNERS DECLARATION INSURANCE POLICY NUMBER POLICY PERIOD UNITED PROPERTY&CASUALTY INS CO From To P.O. Box 51149 UHV 2801254 02 01 08/29/2014 08/29/2015 Sarasota, FL 34232-0330 12:01 s m.et the residence premises. AMENDED DECLARATION Effective: 08/29/2014 Date Issued:08/27/2014 CORRECT MORTGAGEE INSURED: AGENT:3006378 PIERRE A BORGELA BRIGHTWAY INSURANCE INC 4437 54TH AVE NE PO BOX 5700 NAPLES FL 34120 JACKSONVILLE FL 32247 Telephone:239-867-1275 Telephone:888-254-5014 The residence premises covered by this policy Is located at the above insured address unless otherwise stated below: 4437 54TH AVE NE NAPLES FL 34120 LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE FROM THE NATIONAL FLOOD INSURANCE PROGRAM. WITHOUT THIS COVERAGE, YOU MAY HAVE UNCOVERED LOSSES. PLEASE DISCUSS THESE COVERAGES WITH YOUR INSURANCE AGENT. Coinsurance Contract: The rate charged in this policy is based upon the use of the coinsurance clause attached to this policy, with the consent of the insured. A rate adjustment of 78% of wind premium is Included to reflect the windstorm mitigation features of your dwelling.Adjustments range from 0%to 89%credit subject to verification that your home meets the windstorm mitigation characteristics of the 2001 Florida Building Code. THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES, WHICH MAY RESULT IN HIGH OUT OF POCKET EXPENSES TO YOU. ************* Additional Information ************* This replaces all previously issued policy declarations, If any. This policy applies to accidents, occurrences, or losses which happen during the policy period shown above. In case of loss under Section I, only that part of loss over the stated deductible applies.The declarations page together with all policy provisions and any other applicable endorsements completes your policy. UPC 101 12 12 AGENT COPY Page 3 of 4 UPC 16Di0 INSURANCE POLICY NUMBER POLICY PERIOD UNITED PROPERTY&CASUALTY INS CO From To P.O.dox 51149 UHV 2801254 02 01 08/29/2014 08/29/2015 Sarasota,FL 34232-0330 12:01 a.m.at the residence premises. 1 FORMS SCHEDULE (continued from page 1) HPINSTALL(09/12) OIRB11655(02/10) OIRB11670(01/06) OIRB11802(01/12) UIM 424 (06/01) UPC 105 (09/06) UPC 107 (08/99) UPC 108 (08/99) UPC 110 (08/99) UPC 112 (08/99) UPC 151 (06/06) UPC 155 (01/06) UPC 160 (10/05) UPC 164 (06/06) UPC 174 (09/06) UPC 176 (10/12) UPC 184 (08/10) UPC 191 (04/13) UPC 192 (10/12) UPC 195 (01/09) UPC 601 (02/14) UPC 602 (02/14) UPC 101 12 12 AGENT COPY Page 4 of 4 i•r UPC INSURANCE September 10, 2015 16 fl 1 n Pierre Borgela 4437 54th Ave NE Naples, FL 34120 Re: Insured: Pierre Borgela Claim Number: 2015FL021147 Policy Number: UHV 280125402 Date of Loss: 07/22/2015 Cause of Loss: Water-Other Loss Location: 4437 54th Ave NE, Naples, FL 34120 ESTIMATE AND SETTLEMENT OF DAMAGES Por favor Iealo cuidadosamente. La Informacidn en este carte afecta sus derechos cubiertos por la poliza de seguro que se menciona abajo. SI usted no puede leer esta carte o no entlende alguna porcidn de la misma,es muy importante que usted solicite consejo de alguna persona que lo pueda interpreter y explicarle el contenido de este documento. Dear Mr. Borgela: Enclosed is our estimate in the amount of$2,477.31. The payment represents settlement of damages under the following Coverage(s): Building Mold Other Contents ALE FRV Total Structures Replacement Cost $2,477.31 $3,796.43 $6,273.74 Recoverable $0.00 Depreciation (-) $0.00 Non-Recoverable Depreciation (-) Prior Payment(s) (-) $ Deductible(-) $2,500.00 $2,500.00 Net Payment _ $-22.69 $3,796.43 $ $ $ $3,773.74 Iyment of your claim Is being mailed separately, PO Box 1011•ST.PETERSBURG,FL 93701-1011 TEL 888-CLM-DEPT•FAX(727)8954623 Erna:CLAIMS @UPCIOtw>u.cE.cox UNITED INSURANCE HcTnam CORP.•UNITED INSURANCE MANAGEMENT,LC WIND PROPERTY&CASUALTY INSURANCE COIWANV•SKYWAY CLAIMS SERVICES,LLC www.UPCPItuGNCE.CCM le:Claim Number: 2015FL021147 This settlement check represents the unrestricted tender of the amount we believe you are owed 13 drf ylurloss. • 'ou are permitted to use this check at this time. If you believe you are owed more,please send us a iti al locumentation in support of your claim. In the event that we cannot agree on the final settlement of your claim,your policy provides the right to invoke appraisal which must be done prior to bringing any lawsuit against us. 'our policy provides a$10,000 limit for mold/fungi.Your deductible was applied to that amount that was in excess of the lolicy limit before your limit was applied to the loss of your N/A.These amounts are reflected above accordingly. your mortgage holder has been shown as a payee on your check, please understand we are obligated to do so accordinf 3 the terms of your policy. Please contact your mortgage holder regarding their procedures for endorsing payments. ►ttached is the notice of Mediation of Residential Property Insurance Claims for your reference. Thould have any additional questions regarding the settlement, or have any other information you would like for us to ;onsider in regards to this claim, please contact the undersigned at the information shown below. sincerely, leffrey Orr kilted Insurance Management, LC, Servicing Claims on Behalf of JPC Insurance 'h: 888-256-3378 x254 'ax: 800-380-5053 Email: claims@upcinsurance.com Eno: Estimate of Damages Jotice of Mediation of Residential Property Insurance Claims S. 817.234(1)(b)Any person who knowingly and with intent to injure,defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree. Aediation of Residential Property Insurance Claims 6 1 Li he Chief Financial Officer for the State of Florida has adopted a rule to facilitate the fair and timely handling of esidential property insurance claims.The rule gives you the right to attend a mediation conference with your isurer in order to settle any claim you have with your insurer. An independent mediator,who has no connection with your insurer,will be in charge of the mediation conference.You can start the mediation process after receipt if this notice by calling the Department of Financial Services at 1 (877) 693-5236.The parties will have 21 days vm the date of the notice to otherwise resolve the dispute before a mediation hearing can be scheduled. a. You [the insured]may also request mediation by faxing a request to the Department at(850)488-6372 or by writing to the Department of Financial Services, Mediation Section, Bureau of Education,Advocacy and Research,200 East Gaines Street,Tallahassee, FL 32399-0319. b. The parties[Insured and Insurer]will have 21 days from the date of the notice to otherwise resolve the dispute before a mediation hearing can be scheduled. c. If you desire additional information, please contact us at United Property and Casualty Insurance Company PO Box 1011 St. Petersburg, FL 33731 or call us at(800)861-4370. d. The Administrator will select the mediator. e. At any time a party may move to disqualify a mediator for good cause.Good cause consists of conflict of interest between a party and the mediator,that the mediator is unable to handle the conference competently or other reasons which would reasonably be expected to impair the conference.Complaints concerning a mediator shall be written and submitted to the Department of Financial Services, Mediation Section, BureaL of Education, Advocacy and Research, 200 East Gaines Street,Tallahassee, Florida 32399-4212. f. You [the insured]will need to notify the mediator 14 days before the mediation conference if you will bring representation to the conference, unless the insurer waives the right to the notice of representation. Upon receipt of such notice from the insured,the mediator shall provide to the insurer that the insured will be represented at the mediation conference. • , 16D10 . ., .. . ,,,.,. . , .; 'TH, I" 1• a atA j..,,11214):SAC i#OUFID AND AN Ar'FIFICIAL ATERQAARK-HOLD TO LIGHT • IEW BANKOFAMERICA 14►) ,, ' ! .. "1 .. Tampa J.3-'6'O ' 20 SFL021 7 111417 I, Sept n)•0.-1§,401b a f: N S A fV, tE;' ,C L`Al M,S w� z r ,:, 4 Unit pro &Cad al Insurance Co. °' ," P.O.Box 1011 St.Pte[,by F1,33731-1011 630+FL ra ' 1"'+';"111 AY ,,'r I aTHR.,E THOUSAND SEVEN HUND ED SEVENTY TNREE�AND 74/100 09LLAI�,S*:"0" S*S.. ,**".' k A II TO THE ORDER OF „" PIERRE A B ORG�ELA aStd FIFTH THIRD B1INCORP ISAOA and HOUSING ,r I 3 HUMAN VETERAiV ERYlG r ,4 �+M43754TH AV E , r ,,, ' NAPLES FL 34120 „' , AUTHORIZED SIGNATURE BY Y .., AUTHORIZED SIGNATURE 11'401 241 ?II' 1:06 300004 71: 89801, 3 38 257311' United Property& Casualty Insurance Co. POUCY NUMBER UHV280125402 CLAIM NUMBER 2015FL021147 INSURED PIERRE A BORGELA CLAIMANT PIERRE A BORGELA ADJUSTER Jeffrey Orr CLAIM DESCRIPTION Water-Other- DATE OF LOSS July 22,2015 MEMO Homeowners Mail To: PIERRE A BORGELA and FIFTH THIRD BANCORP ISAOA and HOUSING HUMAN&VETERAN SERVIC 4437 54TH AVE NE NAPLES FL 34120 jyt` ' i? , September 16,2015 illanellill 4012417 MEM= 3,773.74 .. • .1j. *PC "" ` Kee UPj: !gc;L53373l ifi, ' P INSURANCE Promise' 1-888-CLM-DEPT CLAIM NO.:2015FLO21147 Relnspection',u� INSURED Policy No.: UHV280125402 PIERRE A BORGELA Date of Loss: 07/22/2015 12:01 PM 4437 54TH AVE NE NAPLES FL 34120 Type of Loss: Water-Other Home phone: Deductible: $2,500.00 Business phone: Mobile phone: 1 (239)245-3555 Year Built: Cat No Bus. Fax: Adjuster: ontact: PIERRE A BORGELA 1 ter: Jeffrey Orr (239)245-3555 Phone: (800) 861-4370 x254 Loss address: 4437 54TH AVE NE Email: jorr@upcinsurance.com NAPLES FL 34120 "This adjuster,the author of this estimate,has no authority to:(1)approve or deny daims;or,(2)bind UPC as to coverage for your daim or the amount of your loss,if any.A copy of this estimate does not constitute a settlement of this daim or any representation on the part of UPC.The estimate is subject to the review,modification and approval of UPC,including,but not limited to,the application of policy limitations,exclusions and deductible provisions.My additional repairs to,or replacement of,items not induded in this estimate are also subject to UPCs prior approval.You are required to keep all records,cancelled checks,inspection reports,etc.,as proof of repair/replacement in the event of any future loss and pursuant to your post-loss duties under your insurance policy.This estimate is not an authorization of repair.The hiring of a contractor is strictly the derision of the UPC policyholder." Claim 2015FL021147 Page 1 of 19 09/22/2015 16D1 0 Description "' Quantity Unit Prue Per Total Cost i � ,Trl Clairrl#201`5 L02.'1.4'7,P1E1 RE A OORG :=.'iornple*q t', FLOOD►HOLD General Items 1 Equipment Set-up,Take Down,&Monitor During Business Hours 5 $44.99 HR $224.95 la Exduded from Sales Tax calculation. IN Excluded from O&P calculation. 2 Decontaminate Equipment 1 $17.83 EA $17.83 tay Excluded from Sales Tax calculation. la Excluded from O&P calculation. 3 Dehumidifier,per Day Low Grain Refrigerant,Under 110 Pint 5 $73.53 DY $367.65 C3 Excluded from Sales Tax calculation. Q Exduded from O&P calculation. Q 1 unit for 5 days 4 Negative Air Machine,per Day Small 5 $74.43 DY $372.15 O Excluded from Sales Tax calculation. El Exduded from O&P calculation. 1 unit for 5 days 5 HEPA Filters Canister/Bad:pad(Vacuum-Replace 1 $56.66 EA $56.66 Q Excluded from Sales Tax calculation. la Excluded from O&P calculation. 6 HEPA Filters Negative Air Exhaust Fan-Replace i $157.64 EA $157.64 Cij Excl uded from Sales Tax calculation. Q Excluded from O&P calculation. 7 Cleanup&Debris Removal 3 $31.38 HR $94.14 O Excluded from Sales Tax calculation. El Excluded from O&P calculation. 8 POST TEST(SUB) 1 $500.00 EA $500.00 Excluded from Sales Tax calculation. C] Excluded from O&P calculation. 9 PPE Respirator 2 $37.45 EA $74.90 Q Excluded from O&P calculation. 10 PPE Respirator Filters 6 $13.33 PR $79.98 O Excluded from O&P calculation. 11 PPE Daily,Per Person 6 $16.20 DY $97.20 Q Excluded from O&P calculation. General Items-Subtotal $2,0413.10 ICI Linen ,1 Length: 1'5" Width: 2'10" Height: B`Flat ti: Walls: 68.00 SF Walls-subs: 68.00 SF Walls-subs-cas-bsbd: 65.52 SF + pen ngs: 0.00 SF Missing Walls: 0 Doors: 0.00 SF Windows: 0.00 SF 4 0.00 00 SF Floor: 4.01 SF Ceiling: 4.01 SF Perim(F): 8.50 IF Perim(C): 8.50 IF to 12 Contents,Move&Protect 0.50 $31.38 HR $15.69 Illf Excluded from Sales Tax calculation. Claim 2015FL021147 Page 2 of 19 09/22/2015 16010 l� Pt Quantity Unit Friar r Per ' Total Cost a MOW RyE , i Maim a 2 i1 � : '2y 1p ,RE BC)RGEux y 1 Exduded from O&P calculation. 13 Apply Anti-Microbial Agent During Business Hours 76.02 $0.20 SF $15.20 O Exduded from Sales Tax calculation. Exduded from O&P calculation. 14 Hepa Vac,Detailed(SF) 76.02 $0.81 SF $61.57 Exduded from Sales Tax calculation. • Exduded from O&P calculation. Linen-Subtotal Q Bathroom offset } Length: 23 a Width: 210� h Height: 8 Rat Walls: 81.34 SF Walls-subs: 52.23 SF Walls-subs-cas-bsbd: 47.97 SF Doom: 11.11 SF Windows: 0.00 SF Openings: 18.00 SF Missing Walls: 0.00 SF rn Floor. 6.38 SF Ceiling: 6.38 SF Perim(F): 5.95 LF Perim(C): 7.91 LF 15 Tear Out&Bag Trim/Base During Business Hours 3.00 $0.33 LF $0.99 U Excluded from Sales Tax calculation. Q Exduded from O&P calculation. 16 Tear Out&Bag Wet Drywall(SF)Category 3 Water 6.00 $0.75 SF $4.50 111 Excluded from Sales Tax calculation. Q Excluded from O&P calculation. U estimated amount 17 Apply Anti-Microbial Agent During Business Hours 64.99 $0.20 SF $13.00 • Excluded from Sales Tax calculation. ▪ Excluded from O&P calculation. 18 Hepa Vac,Detailed(SF) 64.99 $0.81 SF $52.64 • Excluded from Sales Tax calculation. • Excluded from O&P calculation. Bathroom Offset-Subtotal $71.13 Q Tub/Shbvwer Length: 5' Width: 2'10" Height 8'Hat Walls: 125.34 SF Walls-subs: 85.34 SF Walls-subs-cas-bsbd: 82.22 SF Doors: 0.00 SF Windows: 0.00 SF Openings: 40.00 SF Missing Walls: 0.00 SF ,4 Floor. 14.17 SF Ceiling: 14.17 SF Perim(F): 10.66 IF Perim(C): 10.66 LF 19 Plumbing Fixtures,Remove&Bag Tub&Shower Unit 1 $91.02 EA $91.02 Q Excluded from Sales Tax calculation. Q Excluded from O&P calculation. Not responsible for breakage 20 Plumbing Fixtures,Remove&Bag Shower Faucet 1 $34.26 EA $34.26 Q Excluded from Sales Tax calculation. Q Exduded from O&P calculation. Claim 2015FL021147 Page 3 of 19 09/22/2015 613 10 . • Dena ipNon Quantity Unit Price Per Total Cost M Ry lt,ink;) gaihi 1 ;O f J) 147, PIERRE A BOkGEIA 1 171 lUb/Shower(co n•t)x •>:z 21 Tear Out&Bag Wet Drywall(SF)Category 3 Water 44.00 $0.75 SF $33.00 la Excluded from Sales Tax calculation. la Excluded from O&P calculation. C] estimated amount 22 Apply Anti-Microbial Agent During Business Hours 113.68 $0.20 SF $22.74 lit Excluded from Sales Tax calculation. • Excluded from O&P calculation. 23 Hepa Vac,Detailed(SF) 113.68 $0.81 SF $92.08 C] Excluded from Sales Tax calculation. Q Excluded from O&P calculation. Tub/Shower-Subtotal $273.10 Q Bathroom Length: 9'4" Width: 31.0" Height: 8'Flat ■ Walls: 210.68 SF Walls-subs: 136.01 SF Walls-subs-cas-bsbd. 126.55 SF Doors: 16.67 SF Windows: 0.00 SF Openings: 58.00 SF Missing Walls: 0.00 SF floor: 35.78 SF Ceiling: 35.78 SF Perim(F): 15.99 LF Perim(C): 19.07!F 24 Tear Out&Bag Trim/Base During Business Hours 7.00 $0.33 LF $2.31 C] Excluded from Sales Tax calculation. • Excluded from O&P calculation. 25 Tear Out&Bag Wet Drywall(SF)Category 3 Water 28.00 $0.75 SF $21.00 Ni Excluded from Sales Tax calculation. Q Exduded from O&P calculation. C] estimated amount 26 Containment/Airlodc Chamber During Business Hours-Replace 30.00 $1.96 SF $58.80 El Excluded from Sales Tax calculation. LI Excluded from O&P calculation. 27 Containment Chamber Zipper-Replace 1 $24.57 EA $24.57 • Exduded from Sales Tax calculation. Q Excluded from O&P calculation. 28 Apply Anti-Microbial Agent During Business Hours 207.57 $0.20 SF $41.51 Q Excluded from Sales Tax calculation. la Excluded from O&P calculation. 29 Hepa Vac,Detailed(SF) 207.57 $0.81 SF $168.13 Q Excluded from Sales Tax calculation. • Exduded from O&P calculation. Bathroom-Subtotal $316:32 Claim 2015FL021147 Page 4 of 19 09/22/2015 . • 16E110 Desolation Quantity Unit Price Per Total Cost 4fa1Cri2O1Sa66t4 ,PIERRE A ORGELA r MOLD y eth,Inc!) r ' Bedroom Length: 9' Width: 9'6" Height: 8'Flat Walls: 296.00 SF Walls-subs: .25,3.78 SF Walls-subs-cas-bsbd: 237.16 SF boors: 42.22 SF Windows: 0.00 SF Openings: 0.00 SF Missing Walls: 0.00 SF Floor: 85.50 SF Ceiling: 85.50 SF Perim(F): 29.79 LF Perim(C): 37.00 if 30 Contents,Move&Protect 3 $31.38 HR $94.14 • Excluded from Sales Tax calculation. Q Excluded from O&P calculation. 31 Tear Out&Bag Trim/Base During Business Hours 18.00 $0.33 LF $5.94 CI Excluded from Sales Tax calculation. Q Excluded from O&P calculation. 32 Containment/Alriodc Chamber During Business Hours-Replace 30.00 $1.96 SF $58.80 Q Exduded from Sales Tax calculation. Ej Excluded from O&P calculation. 33 Containment Chamber Zipper-Replace 1 $24.57 EA $24.57 Exduded from Sales Tax calculation. Excluded from O&P calculation. 34 Tear Out&Bag Wet Drywall(SF)Category 3 Water 54.00 $0.75 SF $40.50 Q Excluded from Sales Tax calculation. Q Excluded from O&P calculation. Q 54 Square feet/Estimated amount.36 square feet from wall that Interfaces with the bathroom and 18 square feet from exterior wall. 35 Tear Out&Bag Wet Carpet Category 3 Water 85.50 $039 SF $33.35 • Excluded from Sales Tax calculation. Q Excluded from O&P calculation. 36 Tear Out&Bag Wet Carpet Pad Category 3 Water 85.50 $0.28 SF $23.95 El Excluded from Sales Tax calculation. W Excluded from O&P calculation. 37 Tear Out&Bag Tack Strips During Business Hours 20.00 $0.50 LF $10.00 lj Excluded from Sales Tax calculation. Li Excluded from O&P calculation. 38 Apply Anti-Microbial Agent During Business Hours 424.78 $0.20 SF $84.95 • Excluded from Sales Tax calculation. C3 Excluded from O&P calculation. 39 Hepa Vac,Detailed(SF) 424.78 $0.81 SF $344.07 C] Excluded from Sales Tax calculation. Q Excluded from 0&P calculation. Bedroom-Subtotal $720:27 Claim 2015FL021147 Page 5 of 19 09/22/2015 • 16o10 • Description Quantity -Unit Price Per Total Cost ; X14 T�IQi-Q j y h,Iric) _ a O FLO21141, PIERRE A :1111F edmplete l w :, iP Bedroom Closet Flew Length: 2'6" Width: 9'6" Height: 8'Flat Walls: 192.00 SF Wails-subs: 163.11 SF Wails-subs-cas-bsbd: 152,22 SF Doors: 28.89 SF Windows: 0.00 SF Openings: 0,00 SF Missing Walls: 0.00 SF Floor. 23.75 SF Ceiling: 23.75 SF Perim(F): 19.08 LF Perim(C): 24.00 LF 40 Contents,Move&Protect 1 $31.38 HR $31.38 • Excluded from Sales Tax calculation. ▪ Excluded from O&P calculation. 41 Apply Anti-Microbial Agent During Business Hours 210.61 $0.20 SF $42.12 • Exduded from Sales Tax calculation. Exduded from O&P calculation. 42 Hepa Vac,Detailed(SF) 210.61 $0.81 SF $170.59 • Exduded from Sales Tax calculation. Excluded from O&P calculation. Bedroom Closet-Subtotal $24+109 1 +� t - tot ,. . _ ; > .47 Claim 2015FL021147 Page 6 of 19 09/22/2015 1 6 1 0 ` , OLD(Ryt t, �c.) ', z ,ail„#Zb11$K0211 l7,PIERRE A 30RGELA', , QaRa.4AN:Flaprpia n , k Quantity Walls 3,084.02 SF Walls and Ceilings 4,731,97 SF Floors 1,647.95 SF Floor Perimeter' 340.99 LF 'SF Ceilings 1,647.9,5 Ceiling Perimeter 385.50,1,E EL RPLAN: Main Level R .. . . Quantity• Walls 754.68 SF Walls and Ceilings 945.69,SF Floors 591,01 SF Floor Perimeter 82.20 LF Ceilings 191.01,SF Coiling Perimeter 94.32 LF �LQQRPLAW{ MOO::. .. Quatrtity Walls 93.35 SF Walls and Ceilings 1,142.95 SF floors 109.59 5F Floor Perimeter :8997 IF Ceilings 369.59 SF Ceiling Perimeter LF Sfl7a1 Recap by Area Total Cost Percentage footprint $0.00 0.00% Garage $0.00 0.00% Bedroom $0.00 0.00% Bathroom $0.00 0.00% Hallway $0.00 0.00% O $0.00 0.00% tub $0.00 0.00% Bedroom $0.00 0.00% Hallway $0.00 0.00% Bathroom $0.00 _ 0.00% General Items $0.00 0.00% Linen $92.46 2.46% Bathroom Offset $71.13 1.89% Tub/Shower $273.10 7.26% Bathroom $316.32 8.41% Bedroom $720.27 19.15% Bedroom Closet $244.09 6.49% General Items $2,043.10 54.33% Total,all areas $3,75047, 100.00% Recap by Category Total Cost Percentage Claim 2015FL021147 Page 7 of 19 09/22/2015 • . 16D10 • , '„, (..{Q'l R h,3nc) 4, „ Ck- m#4Q15FLO2114.7,PIERRE A BORGELA i..Compleed ib', 7 CLN Cleaning CLN Ceiling,Floors and Walls $889.08 23.64% CPS-Contents-Packing,Handling,Storage $141.21 3.76% LAB-Labor Only $94.14 2.50% MIS-Miscellaneous $500.00 13.30% MIT-Mitigation-MIT-Equipment&Accessories $1,363.62 36.26% MIT-Mitigation-MIT-Mold Remediation $47160 12.54% MIT-Mitigation-MIT-Water Mitigation $175.54 4.67% PLM-Plumbing-PLM-Faucets $34.26 0.91% PLM-Plumbing-PLM-Showers $91.02 2.42% Total,all categories .;., $3,76047 100.00% I Claim 2015FL021147 Page 8 of 19 09/22/2015 16010 • O (R ch, 00) it -: _ „p!, !Maim#20I5F21147,"PIERRE A BSRGELA. Ctxnpleired " ur I lQt► Total.. .. . x c Apply Anti-Microbial Agent During Business Hours 1,097.65 SF n/a $43.90 Containment Chamber Zipper(Replace) 2 EA n/a $26.64 Contalnment/Airlodc Chamber During Business Hours(Replace) 60.00 SF n/a $50.40 Decontaminate Equipment 1 EA n/a $0.17 HEPA Filters Canister/Backpack Vacuum(Replace) 1 EA n/a $48.82 HEPA Filters Negative Air Exhaust Fan(Replace) 1 EA n/a $149.80 Hepa Vac,Detailed(SF) 1,097.65 SF n/a $175.62 Plumbing Fixtures,Remove&Bag Shower Faucet 1 EA n/a $7.83 Plumbing Fixtures,Remove&Bag Tub&Shower Unit 1 EA n/a $28.26 POST TEST(SUB) 1 EA n/a $500.00 PPE Daily,Per Person 6 DY n/a $97.20 PPE Respirator 2 EA n/a $74.90 PPE Respirator Filters 6 PR n/a $79.98 Tear Out&Bag Tack Strips During Business Hours 20.00 LF n/a $0.60 Tear Out&Bag Trim/Base During Business Hours 28.00 LF n/a $0.84 Tear Out&Bag Wet Carpet Category 3 Water 85.50 SF n/a $5.99 Tear Out&Bag Wet Carpet Pad Category 3 Water 85.50 SF n/a $5.99 Tear Out&Bag Wet Drywall(SF)Category 3 Water 132.00 SF n/a $10.56 $1. 7:50 iOiiit) "'' a Rate. Tatai■ 1 CLEANING LABORER "1.41 hrs $23.54 L $33.34 1 LABORER -2.00 hrs $31.38 $62.76 1 LABORER "'8.34 hrs $31.38 $261.78 1 WATER REMEDIATION TECHNICIAN 27.93 hrs $44.99 $1,256.51 X9.68 hrs $1,644.39 J : 0Y .:FEN'S` ., Qua,ititl► Total Dehumidifier,per Day Low Graln Refrigerant,Under 110 Pint 5 DY $367.65 Hepa Vac,Detailed(SF) 1,097.65 SF $98,78 Negative Air Machine,per Day Small 5 DY $372.15 $838.58 Claim 2015FL021147 Page 9 of 19 09/22/2015 • 0 1 MoLb(Rytet t,Inc. „ C10ir11 4015FL021 7, I� 4 P A BORGELA Total Materials: $1,307.50 Total Labor: $1,614.39 Total Equipment: $838.58 Total Market Conditions: $0.00 Subtotal: $3,760.47 Add 10.00%overhead(some items excluded): $17.98 Add 10.00%profit(some items excluded): $17.98 Estimate Subtotal: $3,796.43 Estimate Total: $3,796.43 Finalization Claim 2015FL021147 Page 10 of 19 09/22/2015 __ 16010 . . Deaaiptlon Quantity Unit Price Per RC Depredation ACV C am #2401021147,pf t=.A BORGELA i ) t ESU Structure LUnited Pope#j t. kiti,i,w , , °.:',rN, ,- -.","" `:.',:°";°.1, °"."./'C t 1 w.. 3> Q Bedroom Length: 9'10" Width: 9'9" Height: 8'Hat Walls: 313.34 SF Walls-subs: 235.33 SF Walls-subs-cas-bsbd: 211.19 SF Doors: 70.01 SF Windows: 8.00 SF Openings: 0.00 SF Missing Walls: 0.00 SF Floor: 95.88 SF Ceiling: 95.88 SF Perim(F): 27.33 IF Perim(C): 39.16'LF /- 1 1 Drywall,Up to 2'From Floor,Taped-Replace 7.28 $3.44 LF $25.04 $0.81 V $24.23 U Indudes 6%waste on quantity. 2 Base Molding Colonial,4 1/2"-Replace 7.28 $3.15 LF $22.93 $1.57 V $21.36 Q Includes 6%waste on quantity. 3 Blinds(SF)Vertical-Rem/Reset 8.00 $2.12 SF $16.96 $0.00 $16.96 4 Prep&Mask For Painting(SF) 235.33 $0.20 SF $47.06 $0.00 $47.06 5 Contents,Move&Protect 1 $31.38 HR $31.38 $0.00 $31.38 6 Walls 1 Coat,Roller-Paint 313.34 $035 SF $109.67 $10.45✓ $99.22 7 Carpet,Wall to Wall,Good-Replace 105.47 $1.82 SF $191.95 $124.45 V $67.50 la Includes 10%waste on quantity. 8 Carpet Pad,Good-Replace 100.67 $0.54 SF $54.36 $31.2111 $23.15 Q Includes 5%waste on quantity. 9 Texture,Walls Knockdown-Replace 56.08 $0.48 SF $26.92 $0.45 V $26.47 10 Base Molding Colonial,4 1/2"-Paint 27.33 $0.99 11 $27.06 $1.37 V $25.69 11 Reset Switch/Outlet Plate 2 $2.66 EA $5.32 $0.00 $5.32 12 Floor,Cover&Protect 95.88 $0.16 SF $15.34 $0.00 $15.34 13 Floor,Cover&Protect 95.88 $0.16 SF $15.34 $0.00 $15.34 Bedroom-Subtotal $419.02 Q Bathroom Length: 6'8" Width: 9'3" Heights 8'Rat Walls: 212.01 SF Walls-subs: 178.67 SF Walls-subs-cas-bsbd: 165.10 SF Doors: 33.34 SF Windows: 0.00 SF Openings: 0.00 SF Missing Walls: 42.67 SF Floor. 42.78 SF Ceiling: 42.78 SF Perim(F): 20.63 LF Perim(C): 26.50 LF iri 14 Drywall,Up to 2'From Floor,Taped-Replace 21.87 $3.44 LF $75.23 $2.42 V $72.81 CI Includes 6%waste on quantity. 15 Base Molding Colonial,4 1/2"-Replace 10.07 $3.15 LF $31.72 $2.17 V $29.55 la Includes 6%waste on quantity. 16 Prep&Mask For Painting(SF) 178.67 $0.20 SF $35.74 $0.00 $35.74 17 Contents,Move&Protect 1 $31.38 HR $31.38 $0.00 $31.38 18 Walls 1 Coat,Roller-Paint 212.01 $0.35 SF $74.20 $7.07 V $67.13 19 Texture,Walls Knockdown-Replace 76.44 $0.48 SF $36.69 $0.61 V $36.08 20 Base Molding Colonial,4 1/2"-Paint 20.63 $0.99 LF $20.43 $1.03 V $19.40 21 Floor protection 42.78 $0.16 SF $6.85 $0.00 $6.85 22 Reset Switch/Outlet Plate 2 $2.66 EA $5.32 $0.00 $5.32 Claim 2015FL021147 Page 11 of 19 09/22/2015 1 6 D 1 0 . • .. .................. Desaiption Quantity Unit Price Per RC Depredation ACV < * .(bniied Properly Sir,S, 4&ty) a1 0 #„,201,FL0,1147,PIERRE A B(RGELA Q Bathrooin(con't) 23 Accessory,Bathroom Good-Rem/Reset 1 $17.44 EA $17.44 $0.00 $17.44 24 Ceramic Paper Holder-Rem/Reset 1 $2532 EA $25.32 $0.00 $25.32 25 Cleaning Technician,Per Hour During Business 1 $23.54 HR $23.54 $0.00 $23.54 Hours 26 Reset Toilet Only 1 $103.21 EA $103.21 $0.00 $103.21 Bathroom-Subtotal iiiiin Q Hallway - Length: 2'10" Width: 10'5" Height 8'Flat il Walls: 189.33 SF Walls-subs: 122.67 SF Walls-subs-cas-bsbd: 103.82 SF n, Doors: 66.68 SF Windows: 0.00 SF Openings: 0.00 SF Missing Walls: 22.67 SF Floor: 29.51 SF Ceiling: 29.51 SF Perim(F): 11.89 LF Perim(C): 23.67 LF I 27 Drywall,Up to 2'From Floor,Taped-Replace 7.78 $3.44 LF $26.77 $0.86 V $25.91 Q Includes 6%waste on quantity. 28 Base Molding Colonial,4 1/2"-Replace 7.78 $3.15 LF $24.51 $1.67 V $22.84 cj Includes 6%waste on quantity. 29 Texture,Walls Knockdown-Replace 59.74 $0.48 SF $28.67 $0.48 V $28.19 30 Prep&Mask For Painting(SF) 122.67 $0.20 SF $24.54 $0.00 $24.54 31 Contents,Move&Protect 1 $31.38 HR $31.38 $0.00 $31.38 32 Base Molding Colonial,41/2"-Paint 11.89 $0.99 LF $11.77 $0.59 V $11.18 33 Walls 1 Coat,Roller-Paint 189.33 $0.35 SF $66.27 $6.31 V $59.96 34 Floor protection 29.51 $0.16 SF $4.72 $0.00 $4.72 35 Reset Switch/Outlet Plate 2 $2.66 EA $5.32 $0.00 $5.32 Hallway Subtotal S214.04 1 Closet Length: 9'10" Width: 2'6" Height: 8'Flat Walls: 197.34 SF Walls-subs: 144.00 SF Walls-subs-cas-bsbd: 130.97 SF Doors: 53.34 SF Windows: 0.00 SF Openings: 0.00 SF Missing Walls: 0.00 SF d Floor: 24.58 SF Ceiling: 24.58 SF Perim(F): 15.79 LF Perim(C): 24.66 LF 36 Contents,Move&Protect 1 $31.38 HR $31.38 $0.00 $31.38 37 Carpet,Wall to Wall,Good-Replace 27.04 $1.82 SF $49.22 $31.91 V $17.31 0 Indudes 10%waste on quantity. 38 Carpet Pad,Good-Replace 25.81 $0.54 SF $13.94 $8.00 V $5.94 C Indudes 5%waste on quantity. 39 Door,Closet,Bi-Fold,Hush 4'-Rem/Reset 4 $37.78 EA $151.12 $0.00 $151.12 40 Carpet!).Pad,Good-Tear Out 24.58 $0.16 SF $3.93 $0.00 $3.93 Closet-Subtotal Claim 2015FL021147 Page 12 of 19 09/22/2015 16010 Description Quantity Unit Price Per RC De • predation ACV � a aity) t !aim#2d15FL02i147,PIERREA BORGELA s" ttie{lilt Y 4 Canplet , r ? k.y 17 thb Length; 3' Width: 5'4" Height+ 8'Rat Walls: 90.67 SF Walls-Subs: 90.67 SF Walls-subs-cas-bsbd: 87.37 SF boors: 0.00 SF Windows: 0,00 SF Openings: 0.00 SF Missing Walls: 42.67 SF Floor: 16.00 SF Ceiling: 16.00 SF Perim(F): 11.33 LF Perim(C) 11.33 LF 41 Bath Tub,Good Steel Enamel-Rem/Reset 1 $179.18 EA $179.18 $0.00 $179.18 42 Bath Tub Wall Kit,Acrylic Good-Replace i $283.34 EA $283.34 $95.97 $187.37 43 Cap Drain Line 1 $33.81 EA $33.81 $0.00 $33.81 44 Faucet&Showerhead Double Valve,Good- 1 $103.18 EA $103.18 $0.00 $103.18 Rem/Reset tub Subtotal 4503.54 Flobrplan-Sub"itoitai !,,E :�' $1;020.05 Claim 2015FL021147 Page 13 of 19 09/22/2015 , 16010 �" S Stl`7�C#tlte{llnite�Ptop�rt�r& su 1 Y lGalm 015FL0zij47, .,. --- A;B:,- .,- ; ;,r r h r :r i»• Conapli FI OO RP N I9oorpIan a: �i QG n#Ity• U ails 5,08402 5F •WeICs and Ceilings 4,731,97 SF Floors 1,647.95 SF Floor Perimeter ], 340.99 LF Ceilings i;M7.95 SF Ceiling Perimeter `'385.50 LF F40t`RPL 11:1 1ni Level y. � ntity walls 754,68 SF •Walls and Ceilings 9$5.69 SF Floors 191.0 SF Floor Perimeter 82: 0 LF Ceilings 391 131 SF Ceiling Perimeter :0442 LF i FLooket4 hs Mb b .x " len ity Walls 9"l3.36 SF Walls and Ceilings f;142 9$SF Floors 1f�.59 SF•Floor,Perimeter x.97 LF Ceilings <; :169.59.SF, Ceiling Perimeter 197.14 l F Recap by Area Total Cost Percentage footprint $0.00 0.00% Garage $0.00 0.00% Bedroom $589.33 27.42% Bathroom $487.07 22.66% Hallway $223.95 10.42% aoset $249.59 11.61% tub $599.51 27.89% Bedroom $0.00 0.00% Hallway $0.00 0.00% Bathroom $0.00 0.00% General Items $0.00 0.00% Linen $0.00 0.00% Bathroom Offset $0.00 0.00% Tub/Shower $0.00 0.00% Bathroom $0.00 0.00% Bedroom $0.00 0.00% Bedroom aoset $0.00 0.00% General Items $0.00 0.00% Total,all areas $ . 49.45 100.00% Recap by Category Total Cost Percentage Claim 2015FL021147 Page 14 of 19 09/22/2015 • . 16010 • al<x 5tryctur+ t�nited Pro '` f Pe ,,,,,7, _ - ,- 0 5Fj�12i 4 , I RRE A GELA CPS-Contents-Packing,Handling,Storage $125.52 5.84% DOR-Doors-DOR-Bi-fold Doors $151.12 7.03% DRY-Drywall-DRY-Ceiling&Walls $21932 10.20% ELE-Electrical-ELE-Switches&Outlets $15.96 0.74% FCO-Floor Covering-FCO-Carpet $313.40 14.58% FNC-Finish Carpentry/Trimwork-FNC-Trims&Moldings $79.16 3.68% FNH-Finish Hardware $25.32 1.18% MIT-Mitigation-MIT-Labor/Minimum Charge $23.54 1.10% PLM-Plumbing-PLM-Bathtubs $462.52 21.52% PLM-Plumbing-PLM-Faucets $103.18 4.80% PLM-Plumbing-PLM-Rough Plumbing $33.81 1.57% PLM-Plumbing-PLM-Toilets&Bidets $103.21 4.80% PNT-Painting-PNT-Other $107.34 4.9996 PNT-Painting-PNT-Trims&Moldings $59.26 2.76% PNT-Painting-PNT-Walls $250.14 11.64% TBA-Toilet&Bath Accessories $17.44 0.81% TMP-Temporary Repairs $42.25 1.97% WDW-Windows-WDW-Treatments $16.96 0.79% Total,all categories #2,149.45 100.0096 Claim 2015FL021147 Page 15 of 19 09/22/2015 161210 zoti*' I t#0 Un drops t... ? ) -00 #;01:50LO L 7, PIERRE A".B()RG A.., , :,,,. ,...... .A ,.. > 0,00111se Qity Totall Base Molding Colonial,4 1/2"(Paint) 59.85 LF n/a $3.59 Base Molding Colonial,4 1/2"(Replace) 25.13 LF n/a $54.03 Bath Tub Wall Kit,Acrylic Good(Replace) 1 EA n/a $191.93 Bath Tub,Good Steel Enamel(Rem/Reset) 1 EA n/a $1.72 Cap Drain Line 1 EA n/a $1.96 Carpet Pad,Good(Replace) 126.48 SF n/a $39.21 Carpet,Wall to Wall,Good(Replace) 132.51 SF n/a $156.36 Ceramic Paper Holder(Rem/Reset) 1 EA n/a $0.29 Drywall,Up to 2'From Floor,Taped(Replace) 36.93 LF n/a $30.65 Faucet&Showerhead Double Valve,Good(Rem/Reset) 1 EA n/a $0.03 Floor protection 72.29 SF n/a $4.34 Floor,Cover&Protect 191.76 SF n/a $11.50 Prep&Mask For Painting(SF) 536.67 SF n/a $21.47 Reset Toilet Only 1 EA n/a $7.06 Texture,Walls Knockdown(Replace) 192.26 SF n/a $3.84 Wails 1 Coat,Roller(Paint) 714.68 SF n/a $57.18 ' 585.16 .iOR... . .1 i! .. , Rate Total 1 CARPENTER -0.30 hrs $56.77 $16.96 1 CLEANING LABORER -1.00 hrs $23.54 $23.54 1 CRPT&1 LBR -0.40 hrs $44.07 $17.44 1 DRY&1 PLSTR -2.01 hrs $47.99 $96.39 1 ELECTRICIAN X0.24 hrs $66.09 $15.96'' 1 FINISH CARPENTER -0.40 hrs $62.44 $25.13 1 FINISH CARPENTER&1 LABORER -3.22 hrs $46.91 $151.12 1 LABORER -4.98 hrs $31.38 $155.86 1 PAINTER -8.25 hrs $49.49 $409.48 1 PLMR&1 LBR&1 PLUM APPR -3.73 hrs $47.62 $177.46 1 PLMR&1 PLUM APPR -1.64 hrs $55.74 $91.41 1 PLUMBER -3.63 hrs $63.70 $231.15 1 TILESETTER -0.51 hrs $48.67 $25.03 FLOORING INSTALLER -2.36 hrs $48.31 $113.90 N32.67 hrs: $1 5S0.1113 EQUIPMEtiT; v . . `Quantth/r. Total Texture,Walls Knockdown(Replace) 192.26 SF $13.46 Claim 2015FL021147 Page 16 of 19 09/22/2015 16010 Estsivi, 0( ed i >a �'�P��Y&�asualty�. tm 4,t).8F.Lb211,47,PIERRE A BQRGELA:� Total Materials: $585.16 Total Labor: Total Equipment: $1,$550.83 46 13. 13 Total Market Conditions: $0.00 Subtotal: $2,149.45 Sales Tax 6.000%(applies to materials only): $35.11 Subtotal: $2,184.56 Add 10.00%overhead: $214.95 Add 10.00%profit: $214.95 Replacement Cost Value: $2,614.46 Less Recoverable Depredation(includes taxes): $(349.16) Less Non-Recoverable Depredation(includes taxes): $0.00 Net ACV Estimate: $2,265.30 Deductible: $(2,500.00) Net Estimate: $(234.70) Total Net Recoverable Depredation: $349.16 Net Estimate if Depreciation is Recovered: $114.46 "This adjuster,the author of this estimate,has no authority to:(1)approve or deny claims;or,(2)bind UPC as to coverage for your daim or the amount of your loss,if any.A copy of this estimate does not constitute a settlement of this claim or any representation on the part of UPC.The estimate is subject to the review,modification and approval of UPC,induding,but not limited to,the application of policy limitations,exdusions and deductible provisions.Any additional repairs to,or replacement of,items not included in this estimate are also subject to UPCs prior approval.You are required to keep all records,cancelled chedcs,inspection reports,etc.,as proof of repair/replacement in the event of any future loss and pursuant to your post-loss duties under your insurance policy.This estimate is not an authorization of repair.The hiring of a contractor is strictly the dedsion of the UPC policyholder." Finalization Claim 2015FL021147 Page 17 of 19 09/22/2015 16010 .r o f=sbma � Claim ��i5��f�21147.,-P�fRf'2E,,�►B4i2�ELA i► ins �a i`lH .Purchase+Q�ir •Total $O.Ob Claim 2015FL021147 Page 18 of 19 09/22/2015 •• 1613 10 * No #ci to ' Ci l #20 I147; PIERRE'A''B©RGgloA �v far f :srP .. tYrr v '! e Claim Breakdown Total Materials: $0.00 Total Labor: $0.00 Total Equipment: $0.00 Total Market Conditions: $0.00 Subtotal: $0.00 Add overhead: $0.00 Add profit: $0.00 Claim Subtotal: $0.00 Deductible($2,500.00): $0.00 Claim Total: $0.00 Claim 2015FL021147 Page 19 of 19 09/22/2015 16010 Li PCt*v Keep UPC Insurance the PO Box 1011 INSURANCE: Promise" St.Petersburg, FL 33731 1-888-CLM-DEPT CLAIM NO.:2015FL021147 Po einsp :tion• INSURED Policy No.: UHV280125402 PIERRE A BORGELA Date of Loss: 07/22/2015 12:01 PM 4437 54TH AVE NE NAPLES FL 34120 Type of Loss: Water-Other Home phone: Deductible: $2,500.00 Business phone: Year Built Cat No.: Mobile phone: 1 (239)245-3555 Built: Bus. Fax: Adjuster: Jeffrey Orr Contact: PIERRE A BORGELA 1 Phone: (800)861-4370 x254 Coss address. (239)245-3555 4437 54TH AVE NE Email: jorr©upcinsurance.com NAPLES FL 34120 "This adjuster,the author of this estimate,has no authority to:(1)approve or deny claims;or,(2)bind UPC as to coverage for your claim or the amount of your loss,if any.A copy of this estimate does not constitute a settlement of this daim or any representation on the part of UPC The estimate is subject to the review,modification and approval of UPC,including,but not limited to,the application of policy limitations,exdusions and deductible provisions.Any additional repairs to,or replacement of,items not Included in this estimate are also subject to UPCs prior approval.You are required to keep all records,cancelled checks,inspection reports,etc.,as proof of repair/replacement in the event of any future loss and pursuant to your post-loss duties under your insurance policy.This estimate is not an authorization of repair.The hiring of a contractor is strictly the decision of the UPC policyholder." Claim 2015FL021147 Page 1 of 20 09/28/2015 1 .• , ! . , • 1601. 0 . 0 Photos: 1 1, 1. 1 4 block construction risk, front, sides & rear / #- 4., ', ,\\\ f ,,o s `, f 1` 9 s s a•. block construction risk, front, sides & rear Claim 2015FL021147 Page 2 of 20 09/28/2015 Photos: 16010 3 block construction risk, front, sides & rear 4 t r 3 4 site c r x, r- shed or small barn Claim 2015FL021147 Page 3 of 20 09/28/2015 • 16010 Photos: 5 sL ,� , block construction risk, front, sides & rear 6 •i4. } block construction risk, front, sides & rear Claim 2015FL021147 Page 4 of 20 09/28/2015 16010 Photos: 7 (*Ai 4,4 Vfk pp { rx $T. i � � I 1 I water damage here from leaking toilet 8 tub, Rytech mold says there is mold behind it Claim 2015FL021147 Page 5 of 20 09/28/2015 . 1613 10 Photos: 9 i -=? q 1 TMdh C , s 1 ,, I I above shower insert 10 vio ,r .., ,fib tac{- 4,i''' ' 4,„,„, ._ ,,,,„.„,„,, im, 4-4.-. .--4,,,, ft ,.., , Vie, h .. .:r 1 leak area Claim 2015FL021147 Page 6 of 20 09/28/2015 • ' 1 161J1P Photos: 11 ///,.17 bathroom ceiling above toilet 12 • a t ip 21 k T 4 D .4 y • de-hu or air scrubber in cavity of bathroom next to linen closet Claim 2015FL021147 Page 7 of 20 09/28/2015 • 16D10 Photos: 13 '7'44 vanity, but not subtracting sq ft out to ccount for painting above tub insert once work done 14 iE s qf�t t � £ QA� £troy M� � .. i��St £�h x. Amt g •^"'�� . g r- 'i maw ti +.,.€ ¢ ., ,.gip 4. •d:._ e no damage to vanity seen or claimed Claim 2015FL021147 Page 8 of 20 09/28/2015 16D10 Photos: 15 • k %T -fir 4 •tl ,y W 4 } • vanity at linen closet 16 • },•- • yT ng tt shower insert and red tape where was originally found to be wet Claim 2015FL021147 Page 9 of 20 09/28/2015 16010 0 Photos: 17 • 4+csF. ++i•>,sv s I 'X{ . moisture readings around shower 18 pa 1 +4_ moisture readings around shower Claim 2015FL021147 Page 10 of 20 09/28/2015 Photos: 1 6 D 10 19 moisture readings around shower 20 zt moisture readings around shower Claim 2015FL021147 Page 11 of 20 09/28/2015 Photos: 1 b , 1 0 21 s t —ft !•b main living area, left; right to hall - bath & BR 22 1 main living area, left; right to hall - bath & BR Claim 2015FL021147 Page 12 of 20 09/28/2015 • . • 16010 Photos: 23 A w: a shows hall hall, ceiling stops at room change 24 ...E tl . 4K may::..... this is the other door to the bathroom, insd says no damage in here Claim 2015FL021147 Page 13 of 20 09/28/2015 . • 1 6 13 1 0 Photos: 25 , < \&> ® & . » -,*„ 74st" \ ^ ?\ © \ �y . yy . \ this w.m < \ : is the other do0 to the bathroom, bsd says no damage in here 26 insd says he fixed the wax ring, th e maybe wasn't ong he has no recei p and it le aked fo r a while, when flushed Claim 215m2117 Page 14 of 20 09/28/2015 16010 Photos: 27 ' #" 'p'rFr n, a t,i S fo h J re ; q�.i. v pk�x L� t 4 ¢} t Y insd says he fixed the wax ring, there maybe wasn't one. he has no receipt and it leaked for a while, when flushed 28 ' . 4 /4k r��Y k 7Pq;4te.% red tape along baseboards where wet Claim 2015FL021147 Page 15 of 20 09/28/2015 16D1 , Photos: 29 bedroom - red tape along baseboards where wet 30 bedroom, carpeting continues into closet Claim 2015FL021147 Page 16 of 20 09/28/2015 , • 161) 10 Photos: 31 • • t�� r ra bedroom, carpeting continues into closet 32 kht "J_ bedroom, carpeting continues into closet Claim 2015FL021147 Page 17 of 20 09/28/2015 I ' ` Photos: .• 16010 33 ,o,„; c,L br -t x i 11E i moisture reading, bedroom 34 ie F. J � e u Valltranted ram YF H f � of o { 6$ fi Sa L: A/ S ,53 t • Leak Detection Invoice Claim 2015FL021147 Page 18 of 20 09/28/2015 16 13 I Li Photos: 35 Leak Detection Invoice 36 Leak Detection Invoice Claim 2015FL021147 Page 19 of 20 09/28/2015 16Db0 Photos: 37 Leak Detection Invoice Claim 2015FL021147 Page 20 of 20 09/28/2015 16.010 Cr) • • . . 4 • •Cr)CD -• •'•'••' ••DO • WRITE,ST •4.0e• SIGN BEIAW A UNE. RESERVED FOR ,.i.• Ly. Ar • .. :y' .."' TANTS - NATURE SIGNATURE GUARANTEED Bank N.A. BY Al L// °� A lhorized / , 4 • oy/L., "rlaA vJ ......_______-...._._._....._.....___....... _. 16010 . • , .„......, ,,..°1`11Nli:C11;cis."•-`4°1: 1 M • — 1, s:y' xa . ;•,—;V.'...-: a ,...' ....:;4i. ': .4' .1i: ., 1,.:.•,_ 4...ilr y i �F►y a} � • ct N u C CO to -`a 34 gy.{ q7, J a• 1'"---:,,,1,4.Allit- '''.4 tott.r.'Nt"'• Q ,�a �'.• tt. � » "� •3 u r ., ;Y a x , -V v00 m C .. Pi l � >•Z xr . a b , ,t4. . . ..,.. .-,,,,, c - .,... ...... ,..,- , ., , ..... t. O K O. 'F • y ' pS C V OCR K' .d "c".."-..,:c -RI a To u) it ( A4 j4- 1 *7: m 'N 0 c c Q , ax W �N t ^-.: al N ' ppp' �" Nom' �' a Q a p.0 s } g J -x°jF, • Q a- b zowu. 6 .1 a _ � �,. 015D111.16 H 4�,-.., • • • 10 Patricia L. Morgan From: Neet,Virginia Sent: Thursday, November 17, 2016 2:49 PM To: Patricia L. Morgan Cc: Belpedio,Jennifer Subject: YY-1456 BCC Meeting 11/13/12 and prior meetings Agenda Items - post board review of items: Attachments: Item 16-D-10 6_12_12 Insurance Claim Check- NOT R.pdf Trish: Jennifer Belpedio asked that I email the attached to you for the Clerk's records. This is in regards to an insurance claim check endorsed by the Chairman yesterday. Please call if you have any questions. Dinny Virginia A, Neet, FRP e ot the Col'ier County Attorney elf phone (239) 252 3x66 - Fax (23 9) 252-66n0 1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP ,. 60 10 TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the exception of the Chairman's signature,draw a line through routintlines#1 through#2,complete the checklist,and forward to the County Attorney Office. Route to Addressee(s)(List in routing order) Office Initials Date 1. Jennifer A. Belpedio,ACA County Attorney Office 111, �V 2. BCC Office Board of County V Commissioners // 3. Minutes and Records Clerk of Court's Office7. r,1 tisto1Qt1 e 'e ' �; �this. 4�!m e��'k? ° cr 'MIgtlll e$ wk��MInut� ir0 #t#410004* PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above,may need to contact staff for additional or missing information. Name of Primary Staff Priscilla Doria,CHS Phone Number 239-252-5312 Contact/ Department Agenda Date Item was June 12,2012 Agenda Item Number 16D10 Approved by the BCC Type of Document Insurance Claim Check Endorsement for Number of Original Attached Pierre A.Borgela Documents Attached PO number or account Aco number if document is to be recorded c/`% INSTRUCTIONS& CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature? 2. Does the document need to be sent to another agency for additional signatures? If yes, 1 N/A provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. N to 3. Original document has been signed/initialed for legal sufficiency. (All documents to be N/A signed by the Chairman,with the exception of most letters,must be reviewed and signed N(lc by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N(A N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's -O /° N/A signature and initials are required. r/J 7. In most cases(some contracts are an exception),the original document and this routing slip N/A should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of our deadlines! 8. The document was approved by the BCC on . R;1s and,all changes made during /'� the meeting have been incorporated in the attached document. The County i(.J Attorney's Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC,all changes directed by the BCC have been made,and the document is ready for the Chairman's signature. I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12 . i 4 1 6 0 1 0 THIS DOCUMENT HASA VOID PANTOGRAPH,MICRO PRINTING,A COIN REACTIVE ARTIFICIAL WATERMARK AND THERNIOCHROMATIC INK. if U PC,'"_ _N - -' - ,.„,,,,,„.... ..,. „„.„).,,.. ,,,„ ,. Nd „P-, . 6 , ,-.14. 4-4,inirlqa-i,-,3 ,,..,-.„..,.,1 Check-N , ,:._,:...E,,,- gCr) cic-Da* , INSURANCE' 2016FL029277 .. 69912 October 27,2016 UPC Insurance 11-24 P.O.Box'14568 , 1210 Saint Petersburg,FL 33733-4568 • • PAY Seven Thousand Four Hundred Fifty Nine and 02/100 Dollars $*****7,459.02 —... PIERRE A BORGELA•and HOUSING HUMAN &VETERAN TO THE Authorized Sig,7a7....--nge ORDER OF SERVIC and FIFTHTHIRD BANCORP ISA0A and All Quality Inc Wells Fargo Bank,N.A. orize San Fanciso,CA Authdtt°, . , i 41. - .: ..:,,,:•, 0 g 1 -.5 `',1, ,;-.- , 331 n ,:•::> IN 7, riC.P. - ; I F-: , -.. .•7',> i Li 47 1 rc• 1 •-.; , , , ,,,.. •,... 1 ,. ,, ....... , - 1 ,•r; 73. 1 %-f, - l •‘_. i •-. I , : , A ' I . • . • • • • • • 4 , 160 i u C. GRAM-COORDINATOR • RECEIVED NOV 03 2016 COLLIER COUNTY CHS GRANTS BY: 1.„,• • , 1 1 THIS DOCUMENT HAS A VOID PANTOGRAPH MICROPRINTING A COIN REACTIVE ARTIFICIAL WATERMARK AND THER11.10CHROMATIC INK '-'t ,f.-77—v. 4. .A L.....v1,.:... .-..- .. ..-...../._. . INS -'• N AF ,, , , *4, .dor .111117411:12,14,. ., 69912 October 27,2016 1‘ UPC Insurance ''''' 1% /***0- — ' 11-24 ,,,,vi,-----t r/V f 104 4 vec,% 1210 `4 lai Pe Iiirigt ISV3-45q8 ''7- Ar i i -k - '4 ria * 14 vt ' - : 4 V - . 1 t -IPAN.PS-',,e- T olisehci Fr Ru ,• :• AO-.Nine .,' cli9241 0 ol:rs $*****7,459.02 Nk .....ft. T 0 14 , alvt*Aitiver7 rA.,..... Ali... 1°' t .,AITE A BORGa and HJ G H `1'. & ERAN Authorizect Signature ar I :reTR OR, -s o F s 7 V eVitt, IFT&I" MIR 3 ,,,.,ii. •,ORP p ' ="i i A ,s Inc A i - : t, ,,,,. !-.L4,edid rlaeifiallide rg, , • •,,„, -a, ',.. . h if i r i 4 , Authorized Sign ) atu I ''' San Fa s , A e If x, • I i ' jit , _1 160 10 Memorandum To: Kimberly Grant,CHS Director CC: Jennifer Belpedio,Assistant County Attorney From: Priscilla Doria,Grant Coordinator,Community and Human Services Date: 11/10/2016 Re: Homeowner Insurance claim check endorsement-Borgela,Pierre 4437 54th Avenue NE,Naples,Florida 34120 The Homeowner Insurance Check Endorsement Policy approved by the Board on June 12,2012(16.D.10)authorizes the Board Chairman or Vice Chairman to endorse homeowner insurance claim checks for recipients assisted with Purchase Assistance and/or rehabilitation program funds as Collier County is named as Second Mortgagee on their insurance policies. The attached check in the amount of$7,459.02 is the disbursement of the claim funds requiring endorsement by Board Chairman Fiala or Vice Chairman. The check names Fifth Third Bancorp ISAOA as the first mortgage lender and Housing Human&Veteran Service,now known as,Community and Human Services, as subordinate lien holders. In order for the check to be properly processed,proper signatures/endorsement for all parties listed on check must be obtained. This is a time-sensitive item and must be endorsed as soon as possible as homeowner is waiting to pay for work to be performed on home. Attachments: Homeowners insurance policy-Declaration Page Insurance claim check(#69912)$7,459.02 Insurance claim report&photos of damage Collier County Second Mortgage loan 1 _ _ _ _ 6 1 0 Collier County Community and Human Services Division (CHS) Homeowner Insurance Check Endorsement Policy Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage/lien,then the loan will not have to be repaid. On occasion,the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and receive money to make the repairs. If the insurance claim check is made payable to the homeowner and Collier County,then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to CHS at the address below for check endorsement consideration: 1. Copy of Homeowner's current insurance policy-Declaration Page. 2. Copy of insurance company's claim report with worksheet including description of repairs and costs. 3. Copy of photos of claim damage. 4. Copy of Insurance check(s)payable to homeowner,first lien holder and CollierieCounty. Homeowner Name: I . r / 1 at .. f 4 IA Homeowner Address: v q3 7 S / i/,t. A) tileildt j, f ,3g e) Primary Contact Number:h-&3 -ol L-1f`3S-s",r/ i — tis'- 0/ 4? Homeowner Email: ///6 //Q Reviewed CHS-Grant Coordma or Y'/ /,� �r;� Date (-;Kd(42:2 , (I/14/b )4 Approved CHS Director Date Denied 1 6 0 1 I„. 6c crew (o. I a. a-o A - e& 4ice. D. /0 EXECUTIVE SUMMARY Recommendation to approve a homeowner insurance check endorsement policy for all borrowers assisted with purchase assistance and/or rehabilitation housing program funds and authorizes Board Chairman or Vice Chairman, in his absence to endorse two homeowner insurance claim checks. OBJECTIVE: To allow homeowners in good standing with the State Housing Initiatives Partnership (SHIP) program to deposit their homeowner insurance claim check into the bank so they can use the funds to repair their damaged homes. CONSIDERATION: On July 25,2008,the subject homeowners purchased a home located at 2505 41st Ave NE, Naples, FL 34120. Collier County approved down payment assistance through the SHIP program and the borrowers signed a second mortgage for SHIP down payment assistance on July 25, 2008. On January 20,2012,the homeowners filed a homeowner's insurance claim due to water seepage damage to their home. The total claim for damages was$9,935.68. The insurance company paid the claim minus the homeowner's $1,000 deductible, in two separate checks. Check #1 in the amount of$7,964.41 and check#2 in the amount of$971.37.The insurance company made the checks payable to the homeowner, Bank of America and Collier County since all parties have an interest in the property. According to the SHIP loan documents and SHIP local housing administrative plan(LHAP)the homeowner is not required to pay back any funds to Collier County unless the homeowners sell, refinance or lose their homestead exemption on the property. None of these triggering events have occurred and the homeowner's second mortgage loan with Collier County is in good standing. Therefore, Collier County has no claim to the homeowner's insurance claim money that was provided to make repairs to the home. The homeowner has expressed frustration in having to wait for her checks to be endorsed because her house is in urgent need of repairs. Accordingly, Housing staff has developed a proposed Homeowners Insurance Check Endorsement Policy for similar circumstances in the future. If this item is approved,the Board Chairman or Vice Chairman, in his absence may endorse a check only if certain enumerated documentation is provided and the homeowner is in compliance with the SHIP and/or Single Family Home Rehabilitation program. The proposed Homeowners Insurance Check Endorsement Policy is attached as back-up for Board consideration. FISCAL IMPACT: There is no fiscal impact associated with this Executive Summary. GROWTH MANAGEMENT IMPACT:There is no Growth Management Impact associated with this Executive Summary. LEGAL CONSIDERATIONS: This item is legally sufficient and requires a majority vote for Board action. -JBW RECOMMENDATION: That the Board of County Commissioners approves a homeowner insurance check endorsement policy for all borrowers assisted with purchase assistance and/or rehabilitation housing program funds and authorizes the Board Chairman or Vice Chairman, in his absence to endorse two homeowner insurance claim checks. PREPARED BY: Lisa Carr/Housing Outreach Coordinator,Housing Human and Veteran Services 0 INSTR 4746554 OR 4841 PG 1595 RECORDED 10/2/2012 1:23 PM PAGES 4 1 6 0 DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT, COLLIER COUNTY FLORIDA 1 DOC@.35 $106.05 INT@.002 S60.60 REC $35.50 OBLD $30,300.00 OBLI $30,300.00 7-/- tihNt 4- d -241s XS-C. NEIGHBORHOOD STABILIZATION PROGRAM Property Address: 4437 54TH AVENUE NE,NAPLES,FL 34120 Folio Number 39027360008 W it4 74G—dlr.- Oog RECORD AND RETURN TO: p� COWER COUNTY HOUSING,HUMAN&VETERAN SERVICES 3339 TAMIAMI TRAIL EAST,SUITE 212 -4.. NAPLES,FL 34112 • .p `:..(&O'lit ;C'' .3 PURCHASE MONEY SECOND MORTGAGE THIS PURCHASE MONEY SECOND MORTGAGE("Security Instrument")is given on2day ofSGe/al1�C?.--- 2012. The Purchase Money Second Mortgagor is PIERRE A.BORGELA and YOLANDE BORGELA,husband and wife,("Borrowers"). This Security Q' Instrument is given to COLLIER COUNTY,a Political Subdivision of the State of Florida("Lender"),whose address is 3335 Tamiaml Trail REast,Suite 101,Naples,Florida 34112.5356. Borrower owes Lender the sum of THIRTY THOUSAND,THREE-HUNDRED AND N01100 DOLLARS ($30,300.00) in US currency. This debt is evidenced by Borrower's Note dated the same date as this Security Instrument ("Purchase Money Second Mortgage"),which provides for monthly payments,with the full debt,if not paid earlier,due and payable upon sale of i. property,refinance,or loss of homestead exemption. This Security Instrument secures to Lender.(a)the repayment of the debt evidenced by the Note, with interest, and all renewals, extensions and modifications; (b) the payment of all other sums, with Interest advanced under paragraph 7 to protect the security of the Security Instrument and(c)the performance of Borrower's covenants and agreements under this =jZ Security Instrument and the Note. For this purpose, Borrower does hereby mortgage,grant and convey to Lender the following described property located in Collier County,Florida. s As more particularly described as The West 75 feet of As .,,�:- •.* .. '•. :3 of Golden Gate Estates Unit No.45,according to the plat thereof as recorded In Plat Book 7,Pa• 2,, e Public Reco • ' w• er County,Florida and which has the address of: ("Property Address"): 4437 64th Avenue NE,Nap • da 34120. TOGETHER WITH all the improveme,ti n•• o , .-afte - - • • he pro.- y,a.d all easements,rights,appurtenances,rents, --.9- royalties,mineral,oil and gas rights and profits wat righ s an• t• d all fi res now.r he after a part of the property. All replacements and additions shall also be covered by the Sec rity ....: t - - '-��-•to this Security Instrument as the"Property". 4 BORROWER COVENANTS that ,Be . -r - d , fit_ -,,r ,•nv= ed and has the right to mortgage,grant and convey the Property and that the Property is en..., • red x• fo r^'•ran,, f re-rd. Borrower warrants and will defend generally the title to the Property against all claims and -- ,..,+ • I. J,•ran• THIS SECURITY INSTRUMENT co , urn orm covenants or . tiona se = _"...n-uniform covenants with limited variation by jurisdiction to constitute a uniform security inst ,e...1 .covering real property. • UNIFORM COVENANTS. Borrower a rr er covenant and ag •• _�,'.'II 1. Payment of Principal and Interest; '. nt and Late Charg s '-• hall promptly pay when due the principal of and interest on the debt evidenced by the Note. 2. Taxes. The Mortgagor will pay all taxes, ='*_-_ .ts,sewer re. -L rates prior to the accrual of any penalties or interest thereon. The Mortgagor shall pay or cause to be paid,as +• ? e ,1 • come due,(a)all taxes and governmental charges of any kind whatsoever which may at any time be lawfully assessed or iev:• •-inst or with respect to the Property,(b)all utility and other charges, including"service charges",incurred or imposed for the operation,maintenance,use,occupancy,upkeep and improvement of the Property,and (c)all assessments or other governmental charges that may lawfully be paid in installments over a period of years,the Mortgagor shall be , obligated under the Mortgage to pay or cause to be paid only such installments as are required to be paid during the term of the Mortgage. 3. Application of Payments. Unless applicable law provides otherwise,all payments received by Lender shall be applied;first,to interest due;and,to principal due;and last,to any late charges due under the Note. 4. Charges;Liens: Borrower shall pay all taxes,assessments,charges,fines and impositions attributable to the Property which may attain priority over this Security Instrument,and leasehold payments or ground rents,If any. Borrower shall promptly discharge any lien which has priority over this Security Instrument unless Borrower.(a)agrees in writing to the payment of the obligation secured by the lien in a manner acceptable to Lender,(b)contests in good faith the lien by,or defends against enforcement of the lien in,legal proceedings which in the Lenders opinion operate to prevent the enforcement of the lien;or(c)secures from the holder of the lien an agreement satisfactory to Lender subordinating the lien to this Security Instrument. If Lender determines that any part of the Property is subject to a lien which may attain priority over the Security Instrument,Lender may give Borrower a notice identifying the lien. Borrower shall satisfy the lien or take one or more of the actions set forth above within 10 days of the giving of notice. 5. Hazard or Property Insurance. Borrower shall keep the improvements now existing or hereafter erected on the Property insured against loss by fire,hazards included within the term"extended coverage"and any other hazards,including floods or flooding,for which Lender requires insurance. This insurance shall be maintained in the amounts and for the periods that Lender requires. The insurance carrier providing the insurance shall be chosen by Borrower subject to Lender's approval which shalt not be unreasonably withheld. If Borrower fails to maintain coverage described above,Lender may,at Lender's option,obtain coverage to protect Lender's rights in the Property in accordance with paragraph 7. At all times that the Note is outstanding,the Mortgagor shall maintain insurance with respect to the Premises against such risks and for such amounts as are customarily insured against and pay,as the same become due and payable,all premiums in respect thereto, including,but not limited to,all-risk insurance protecting the interests of the Mortgagor and Mortgagee against loss or damage to the Premises by fire,lightning,and other casualties customarily insured against,with a uniform standard extended coverage endorsement,including debris removal coverage. Such insurance at all times to be in an amount not fess than the full replacement cost of the Premises,exclusive of footings and foundations. R 1 'Nib OR 4841PG 1596 y1 6 0 1 0 All insurance policies and renewals shall be acceptable to Lender. Lender shall have the right to hold the policies and renewals. If Lender requires,Borrower shall promptly give to Lender all receipts of paid premiums and renewal notices. in the event of loss,Borrower shall give prompt notice to the Insurance carrier and Lender. Lender may make proof of loss If not made promptly by Borrower. Unless Lender and Borrower otherwise agree in writing,insurance proceeds shall be applied to restoration or repair of the Property damaged, if the restoration or repair is economically feasible and Lender's security Is not lessened. If the restoration or repair is not economically feasible or Lender's security would be lessened,the insurance proceeds shall be applied to the sums secured by the Security Instrument,whether or not then due,with any excess paid to Borrower. If Borrower abandons the Property,or does not answer within 30 days a notice from Lender that the Insurance carrier has offered to settle a claim,then Lender may collect the insurance proceeds. Lender may use the proceeds to repair or restore the Property or to pay sums secured by this Security Instrument,whether or not then due. The 30-day period will begin when the notice is mailed. Unless Lender and Borrower otherwise agree in writing,any application of proceeds to principal shall not extend or postpone the due date of the monthly payments referred to in paragraph 1 or change the amount of the payments. If under paragraph 21 the Property is acquired by Lender,Borrower's right to any insurance policies and proceeds resulting from damage to the Property prior to the acquisition shall pass to Lender to the extent of the sums secured by this Security Instrument immediately prior to the acquisition. 6. Occupancy, Preservation, Maintenance and Protection of the Property; Borrower's Loan Application, Leaseholds. Borrower shall occupy,establish,and use the Property as Borrower's principal residence within sixty days after the execution of this Security Instrument and shall continue to occupy the Property as Borrower's principal residence for full term as described in the note,unless Lender otherwise agrees in writing;which consent shall not be unreasonably withheld,or unless extenuating circumstances exist which are beyond Borrower's control. Borrower shall not destroy, damage,or impair the Property, allow the Property to deteriorate,or commit waste on the Property. Borrower shall be in default if any forfeiture action or proceeding,whether civil or criminal, is begun that in Lender's good faith judgment could result in forfeiture of the Property or otherwise materially impair the lien created by this Security Instrument or Lender's security interest Borrower may cure such a default and reinstate,as provided in paragraph 18,by causing the action or proceeding to be dismissed with a ruling that, in Lender's good faith determination, preclude •,-iture of the Borrower's interest in the Property or other material impairment of the lien created by this Security Instrument or 3- . r. - st Borrower shall also be in default if Borrower,during the loan application process,gave materially false or ina.- .-�_ IT•-;h.,�., ,�_ to Lender(or failed to provide Lender with any material information)in connection with the loan evidenced • 1'r"i uding,bu + ,representations concerning Borrower's occupancy of the Property as a principal residence. If this Se i i-ment is on a leaseho• - =r shall comply with all the provision of the lease. If Borrower acquires fee title to the Property,the I:-se and the fee title shall not me•a un ss Lender agrees to the merger in writing. 7. Protection of Lender's Rights i the • , I ,• to pe rm t = covenants and agreements contained in this Security Instrument, or there is a legal pro - •in! t : -*gni, - fly a'e Lende - rig Ats in the Property(such as a proceeding in bankruptcy,probate,for condemnation or forfe'um.,r - r-- - • may do and pay for whatever Is necessary to protect the value of the Property and Lender' rig h • •.- a, 1.. • Y incl •e paying any sums secured by a lien which has priority over this Security Instrument,a arin, -•urt .- - • ( -t s' --s .nd entering on the Property to make repairs. Although Lender may take action under this •:. • 7 �= • o ;• - y amounts disbursed by Lender under this paragraph 7 shall become additional debt of:.ju'*„-r - red• s - '',I I = t. ,: Borrower and Lender agree to other terms of payment,these amounts shall bear interest A e date of disbursement I ote ISd shall be payable,with interest,upon notice from Lender to Borrower requesting payment. i•- 8. Mortgage Insurance. If Lender -• mortgage insurance -• cy of making the loan secured by this Security Instrument,Borrower shall pay the premiums requc , o -intain the mortgage ins effect. If,for any reason,the mortgage insurance coverage required by Lender lapses or ceases to • Q-, ., Borrower sha remiums required to obtain coverage substantially equivalent to the mortgage insurance previously in effe- c • •.yl • iii w ent to the cost to Borrower of the mortgage insurance previously in effect,from an alternate mortgage insurer a..., . • i •stantially equivalent mortgage insurance coverage is not available, Borrower shall pay to Lender each month a sum equ• . - - Ifth of the yearly mortgage insurance premium being paid by Borrower when the insurance coverage lapsed or ceased to be in effect. Lender will accept,use and retain these payments as a loss reserve in lieu of mortgage Insurance. Loss reserve payments may no longer be required,at the option of Lender,If mortgage insurance coverage(in the amount and for the period that Lender requires)provided by an insurer approved by Lender again becomes available and is obtained. Borrower shall pay the premiums required to maintain mortgage insurance in effect, or to provide a loss reserve, until the requirement for mortgage insurance ends in accordance with any written agreement between Borrower and Lender or applicable law. 9. Inspection. Lender or its agent may make reasonable entries upon and inspections of the Property. Lender shall give Borrower notice at the time of or prior to an inspection specifying reasonable cause for the inspection. 10. Condemnation. The proceeds of any award or claim for damages,direct or consequential,in connection with any condemnation or other taking of any part of the Property,or for conveyance in lieu of condemnation,are hereby assigned and shall be paid to Lender. In the event of a total taking of the Property,the proceeds shall be applied to the sums secured by this Security Instrument,whether or not then due, with any excess paid to Borrower. In the event of a partial taking of the Property,In which the fair market value of the Property immediately before the taking is equal to or greater than the amount of the sums secured by this Security Instrument immediately before the taking,unless Borrower and Lender otherwise agree in writing,the sums secured by this Security Instrument shall be reduced by the amount of the proceeds multiplied by the following fraction:(a)the total amount of the sums secured immediately before the taking,divided by(b)the fair market value of the Property immediately before the taking. Any balance shall be paid to Borrower. In the event of a partial taking of the Property in which the fair market value of the Property Immediately before the taking is less than the amount of the sums secured immediately for the taking, unless Borrower and Lender otherwise agree in writing or unless applicable law otherwise provides,the proceeds shall be applied to the sums secured by this Security Instrument whether or not the sums are then due. Unless Lender and Borrower otherwise agree In writing, any application of proceeds to principal shall not extend or postpone the due date of the monthly payments referred to in paragraphs 1 or change the amount of such payments. 11. Borrower Not Released, Forbearance by Lender Not a Waiver. Extension of the time for payment or modification of amortization of the sums secured by this Security Instrument granted by Lender to any successor in interest of Borrower shall not operate to release the liability of the original Borrower or Borrower's successors in interest. Lender shall not be required to commence proceedings against any successor In Interest or refuse to extend time for payment or otherwise modify amortization of the sums secured by this Security Instrument by reason of any demand made by the original Borrower or Borrower's successors in interest. Any forbearance by Lender in exercising any right or remedy shall not be a waiver of or preclude the exercise of any right or remedy. 2 ?i8 OR 4841 PG 1597 1 6 0 1 0 12. Successors and Assigns Bound;Joint and Several Liability;Co-Signers. The covenants and agreements of this Security Instrument shall bind and benefit the successors and assigns of Lender and Borrower,subject to the Provisions of Paragraph 17. Borrowers covenants and agreements shall be joint and several. Any Borrower who co-signs this Security Instrument but does not execute the Note;(a)is co-signing this Security Instrument only to mortgage,grant and convey that Borrowers Interest in the Property under the terms of this Security Instrument;(b)Is not personally obligated to pay the sums secured by this Security Instrument;and(c)agrees that Lender and any other Borrower may agree to extend,modify,forbear or make any accommodations with regard to the terms of this Security Instrument or the Note without that Borrower's consent. 13. Loan Charges. If the loan secured by this Security Instrument is subject to a law which sets maximum loan charges,and that law is finally interpreted so that the Interest or other loan charges collected or to be collected in connection with the loan exceed the permitted limits,then:(a)any such loan charge shall be reduced by the amount necessary to reduce the charge to the permitted limit;and(b)any sums already collected from Borrower which exceeded permitted limits will be refunded to Borrower. Lender may choose to make this refund by reducing the principal owed under the Note or by making a direct payment to Borrower. It a refund reduces principal,the reduction will be treated as a partial prepayment without any prepayment charge under the Note. 14. Notices. Any notice to Borrower provided for in this Security instrument shall be given by delivering it or by mailing it by first class mail unless applicable law required use of another method. The notice shall be directed to the Property Address or any other address Borrower designates by notice to Lender. Any notice to Lender shall be given to Borrower or Lender when given as provided in this paragraph. 15. Governing Law;Severability. This Security Instrument shall be governed by federal law and the law of the jurisdiction in which the Property is located. In the event that any provision or clause of this Security Instrument or the Note conflicts with applicable law,such conflict shall not affect other provisions of this Security Instrument or the Note which can be given effect without the conflicting provision. To this end the provisions of this Security Instrument and the Note are declared to be severable. 16. Borrower's Copy. Borrower shall be given one conformed copy of the Note and of this Security Instrument. 17. Transfer of the Property or a Beneficial Interest I Bna0 or. If all or any part of the Property or any interest in it is sold or transferred(or if a beneficial interest in Borrower is sold o •;,-r, r. .. -r is not a natural person)without Lender's prior written consent,Lender may,at its option,require Immediate p . i 1'RtirilM -•by this Security Instrument. However,this option shall not be exercised by Lender if exercise Is prohibited b > - of the da my Instrument. if Lender exercised this option,Lender shall give :• - notice of acceleration. `ems"' ce shall provide a period of not less than 30 days from the date the notice is delivered or mailed wi n Trel Borrower must pay all sum- ecu d by this Security Instrument. if Borrower fails to pay these sums prior to the expiration of this .-riod •er ma '• •. -n • medic •_ 'tied by this Security Instrument without further notice or demand on Borrower. . 18. Borrower's Right to Reinstate If B• - --- a' •I • =r= ibUiO6 0 1 1 1 *** OR 4841 PG 1598 *** .- foreclose foreclose this Security Instrument by judicial proceeding. Lender shall be entitled to collect all expenses incurred in pursuing the remedies provided in this paragraph 21,including,but not limited to,reasonable attorney's fees and costs of the title evidence. 22. Release. Upon payment of all sums secured by this Security Instrument,Lender shall release this Security Instrument,without charge,to Borrower. Borrower shall pay any recordation costs. 23. Attorneys'Fees. As used in this Security Instrument and the Note,"attorneys'fees"shall include any attorneys'fees awarded by an appellate court. 24. Special Covenants. I. Subsidy Retention. a. Fair Market Value:Fair Market Value is the market value of the Property as reasonably determined by appraisal. Lender and Homeowner shall mutually select an appraiser whose determination shalt be deemed Fair Market Value. If Lender and Homeowner cannot mutually agree on an appraiser,each shall select an appraiser who shall each submit an appraisal. If the two appraisals differ, then the average of the two appraisals shall be deemed the Fair Market Value. All costs of appraisal shall be borne by Homeowner. b. Term:The Subsidy Retention requirement shall commence upon transfer of title to the Property to Homeowner and shall end on the later of(i)the original maturity date of the Note;or(ii)fifteen(15)years. c. Purpose:The subsidy retention amount is the amount necessary to reduce the purchase price to an affordable level for the qualifying Homeowner having an income below one hundred twenty percent(120%)of the Area Median Income CAM). d. index: U.S. Department of Labor Bureau of Labor Statistics consumer Price Index—All Urban Consumers Miami-Fort Lauderdale,Florida Area,effective date of proposed transfer. e. Appreciation Limitation: Should Homeowner desire to transfer the Property prior to maturity date of the Note and Mortgage,appreciation shall be limited to the••-' - .. •-se price plus annual appreciation based upon the Index defined in section(I)(d)of this Mortgage. For 'mss eowner purchases the home for$175,000 and there is a 3%annual income inflation as Bete• .,,_ ;ii._ . 1. nd of five years the house will be worth$202,873.00 representingthe projected Home. �#' '� •• of$27,873. No �i• ng that the Property could be sold for a greater Fair Market Value than$202,873,$ d-; ''II be the maximum allow=•e• ase price the house can be sold for,and only to an income qualified Applicant, ,ppr• • • ' r County Housing: • Hu •an Services. f. Joint and Several Liability Ea • pe'k. • . •age a Ho eowner shall be jointly and severally liable for each and every obligation a sing ereunder. SIGNING BELOW,Borrower accepts and agr: s t• -term a d ct. t • S-- rity Instrument and In any rider(s)executed lJ by Borrower and recorded with it. n t'� Signed,sealed and delivered in the presence o _ Witness#1: 1---TS A- IQ• ', Signature: ) sAryl�f1 Borrower PI:+ - + BORGELA �� Signature: � 1- ,O 4i n Borrower ii LANDS GORGE! Witness#2: _. ._ 10. Signature: • I _i • it ` Address: 1141 Eisenhower Boulevard,Lehigh Acres,FL 33974 STATE OF FLORIDA COUNTY OF COLLIER I hereby certify that on this day, before me, an officer duly authorized in the state aforesaid and in the county aforesaid to take acknowledgements,personally appeared PIERRE A.BORGELA and YOLANDE BORGELA to me known to be the persons described In and who executed the foregoing instrument and acknowledged before me that they executed the same for the purpose therein expressed. WITNESS my hand and official seal in the County and State aforesaid this D day o ,2012. My Commission Expires: lir ota s Ninat - , op (Seal) •. . TAMMY J. OR /� Commission#DO 891857 f� = Expires May 21,2013 �'sh.,.cr &-,yy TM,Try ran Mnnn'=257E.3 ANEW 4 h 1'6111 - y - .1! $r c t F " a 40 t f s ' t � ' • . - 1. {S !d 2 -, , ,;. ,.lit;',;,, ';', 1 !� f i 7 .�`Sr x H e ,. . , ',,, G e, �, 1 ,- 9 A i u L 9 a'g s. cis '� o r i ii, .,-2-“,, - 4 r'�a i �r `fi s{r ti x#g� 4 ,,,,,, ...,,,,,,,, ,,,,,,...,.....„,2,i„,_,..„0,41v.:77._,,,,:n..„. ,,.. r 1 #1,:ptitt.,:c..,,,y2,,i.e47. ; ",,,..kr':'' 'CFiftti'rWOkekl,,..,i.'.:-.‘,.. ...,-„.:, Y y ..x '{'� . •` 1x a, g,,X 9 't lig' •` 16010 All Quality Inc. 0 rr /lL, -._ 5061 Mahogany Ridge Dr - 2.47_ Naples, FL 34119 (239)566-9271 All Quality_ Info@AQCleaning.com www.AQCleaning.com BILL TO SHIP TOINVOICE 1876 Pierre Borgelo Pierre Borgelo r.:• s 4437 54th Ave NE 4437 54th Ave NE !DATE i0/29I20fi6 TERMS Doe L1pafr 771 Naples, Florida 34120 Naples, Florida 34120 keceipf DUE DATE 11;30/2016 ACTIVITY QTY RATE AMOUNT service 8 110.00 880.00 Dehumidifer(per 24 hour period) -XLarge-No monitoring, 2 for 4 days. service 8 48.76 390.08 Equipment setup,take down,and monitoring(hourly charge). service 1 240.01 240.01 Add for Hepa filter(nor negative air machine/vacuum- large. service 1 50.01 50.01 Add foe Hepa filter(for canister/backpackk vacuums) service 10 105.00 1,050.00 Negative air fan/Air scubber-large(per 24 hour period)-No monitoring.2 for 5 days. Materials 12 4.00 48.00 Personal protective gloves-Heavy duty(per pair) Materials 15 17.75 266.25 Add for •-rsonal •rotective e.ui•ment-Hea Dut Materials 5 24.23 121.15 Respirator cartridge-Hepa&vapor&gas per pair. service 11 75.00 825.00 Clean ductwork and treat W/antimicrobial/fungcide. service 1 180.00 180.00 Clean air handler and treat w/antimicrobial-fungicide service 1,600 0.27 432.00 Apply plant-based anti-microbial agent. 1600 sqft. service 1,600 0.56 896.00 Hepa vacuuming-Detailed-(per SF).This includes walls,ceiling,floors,furniture,vanities,cabinets etc. ACTIVITY Q.TY RATE AMOUNT service 32 60.94 1,950.08 Hazardous Waste/Mold Cleaning Technician-per hour. This includes wiping down walls ,floors,ceiling,furniture,personal items,also includes washing clothing ,linens and what can not be washed will be sent out to clean. mice 4 32.61 130.44 Equipment decontamination charge-per piece of equipment. Due upon receipt. ITOTAL DUE $7,459.02 - • --A% 41Z' • e • It 16010 1 0 • r 7 :b 5p J - _ ar 411, • _- pw w r. x .:, .. rel Rr� <r 1. '✓^;'fix.`:K��# r� . %..' 16010 0 DoriaPriscilla From: • All Quality Cleaning[info©agcleaning.com] Sent: Tuesday, November 08,2016 4:14 PM To: DoriaPriscilla Subject: Pierre Borgela Pictures Attachments: IMG_7025.JPG; IMG_7026.JPG; IMG 7029.JPG; IMG_7030.JPG; IMG_7031.JPG; IMG_ 7032.JPG; IMG_7033.JPG Attached photos of clients home,we did a mold remediation which included heap vacuuming wiping down items ,floors,ceiling,walls etc.with an anti-microbial agent for mold.This also includes leaving equipment on site.Please let me know if these pictures are sufficient. aleie4 Linda Bower All Quality, Inc. 5061 Mahogany Ridge Dr Naples, FL 34119 Email: infon;aacleaning.com Phone: (239) 566-9271 Fax: (239)775-0861 loU 1U U PCHOMEOWNERS DECLARATION INSURANCE POLICY NUMBER POLICY PERIOD UNITED PROPERTY&CASUALTY INS CO From To P.O.Box 51149 UHV 2801254 04 01 08/29/2016 08/29/2017 Sarasota,FL 34232-0330 12:01 a.m.at the residence premises. RENEWAL DECLARATION Effective: 08/29/2016 Date Issued:07/11/2016 INSURED: AGENT:9960049 PIERRE A BORGELA BRIGHTWAY INSURANCE,INC. 4437 54TH AVE NE PO Box 5700 NAPLES FL 34120 Jacksonville FL 32247 Telephone:239-867-1275 Telephone:239-676-8199 The residence premises covered by this policy is located at the address listed below. 4437 54TH AVE NE NAPLES FL 34120 IF PAYMENT IS NOT RECEIVED ON OR BEFORE THE POLICY RENEWAL EFFECTIVE DATE, THIS POLICY WILL NOT BE IN FORCE. Coverage is provided where premium and limit of liability Is shown. Flood coverage is not provided and is not a part of this policy. SECTION I COVERAGE LIMIT OF LIABILITY PREMIUMS A. DWELLING $234,000.00 $1,023.00 B. OTHER STRUCTURES $4,680.00 INCLUDED C. PERSONAL PROPERTY $117,000.00 INCLUDED D. LOSS OF USE $46,800.00 INCLUDED SECTION II COVERAGE E. PERSONAL LIABILITY $300,000.00 $18.00 F. MEDICAL PAYMENTS $1,000.00 . INCLUDED OPTIONAL COVERAGES Premium charge for Hurricane Exposure: $686.00 The above coverages are subject to a 2% / $4,680 Hurricane Deductible. The above coverages are subject to a 10%/ $23,400 Sinkhole Deductible per sinkhole loss. The above coverages are subject to a $2,500 All Other Peril Deductible. TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES: $1,068.00 The amount of premium increase due to approved rate increase is $47.00 The amount of premium increase due to coverage increase is $37.00 COVERAGES HAVE BEEN INCREASED TO HELP KEEP PACE WITH RISING REPLACEMENT COSTS. PLEASE CONTACT YOUR AGENT IF THERE ARE ANY QUESTIONS PERTAINING TO YOUR POLICY. FORMS AND ENDORSEMENTS HO 0003 (05/11) HO 0334 (05/13) COUNTERSIGNED DATE 07/11/2016 HO 0350 (06/97) HO 0355 (05/13) HO 0446 (10/00) HO 0496 (04/91) ,�eW /, HO 2370 (05/13) HO 2386 (05/13) BY Continued on Forms Schedule ADDITIONAL INTERESTS MORTGAGEE SECOND MORTGAGEE FTB0010-0414814699 FIFTH THIRD BANCORP ISAOA HOUSING HUMAN&VETERAN SERVIC ATIMA 3339 E TAMIAMI TRL BLDG H 211 PO BOX 598 NAPLES FL 34112 AMELIA OH 45102 UPC 119 12 12 AGENT COPY Page 1 of 4 16010 ' UPCHOMEOWNERS DECLARATION INSURANCE POLICY NUMBER From PERIOD To UNITED PROPERTY&CASUALTY INS CO P.O.Box 51149 UHV 2801254 04 01 08/29/2016 08/29/2017 Sarasota,FL 34232-0330 12:01 a.m.at the residence premises. RENEWAL DECLARATION Effective: 08/29/2016 Date Issued:07/11/2016 INSURED: AGENT:9960049 PIERRE A BORGELA BRIGHTWAY INSURANCE,INC. 4437 54TH AVE NE PO Box 5700 NAPLES FL 34120 Jacksonville FL 32247 Telephone:239-867-1275 Telephone:239-676-8199 The residence premises covered by this policy is located at the above insured address unless otherwise stated below: 4437 54TH AVE NE NAPLES FL 34120 Premium: SECTION I, SECTION II AND OPTIONAL PREMIUMS $1,041.00 EMERGENCY MANAGEMENT TRUST FUND SURCHARGE $2.00 MANAGING GENERAL AGENCY (MGA) POLICY FEE $25.00 TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES $1,068.00 $686.00 NOTE: The portion of your premium for Hurricane Coverage is: The portion of your premium for All Other Coverages is: $355.00 An adjustment of -5.8%is included to reflect the Building Code grade for your area.Adjustments range from 1% surcharge to 46.1%credit. Your policy Includes endorsement HO 04 46 Inflation Guard-which automatically increases the amount of Dwelling Coverage by the annual percentage amount shown on the declaration page (but not less than 4%). Therefore your Hurricane deductible may be higher than indicated on the policy when a hurricane loss occurs due to application of the endorsement. FLOOD CARRIER N/A FORM TYPE HO-3 YEAR BUILT 2005 TOWN/ROW HOUSE N/A CONSTRUCT TYPE M CONSTRUCT SUPERIOR N NUMBER OF FAMILIES 00001 AOP TERRITORY 551 PROTECTION CLASS 03 USE CODE P MUNICIPAL CODE 999999 COUNTY CODE 021 PROT DEVICE/BURGLAR N PROT DEVICE/FIRE N PROT DEV/SPRINKLER N PROT DEV/SHUTTER N WIND/HAIL EXCLUSION N REPLACEMENT COST Y OCCUPANCY CODE OWNER FLOOD CREDIT N SINKHOLE COVERAGE I WIND TERRITORY 551A WATER PREVENTION CR N INFLATION GUARD 4% UPC 11912 12 AGENT COPY Page 2 of 4 16010 UPC HOMEOWNERS DECLARATION INSURANCE POLICY NUMBER POLICY PERIOD UNITED PROPERTY&CASUALTY INS CO From To P.O.Box 51149 UHV 2801254 04 01 08/29/2016 08/29/2017 Sarasota,FL 34232-0330 12:01 am.at the residence premises. RENEWAL DECLARATION Effective: 08/29/2016 Date Issued: 07/11/2016 INSURED: AGENT:9960049 PIERRE A BORGELA BRIGHTWAY INSURANCE,INC. 4437 54TH AVE NE PO Box 5700 NAPLES FL 34120 Jacksonville FL 32247 Telephone:239-867-1275 Telephone:239-676-8199 The residence premises covered by this policy is located at the above insured address unless otherwise stated below: . 4437 54TH AVE NE NAPLES FL 34120 LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE FROM THE NATIONAL FLOOD INSURANCE PROGRAM. WITHOUT THIS COVERAGE, YOU MAY HAVE UNCOVERED LOSSES. PLEASE DISCUSS THESE COVERAGES WITH YOUR INSURANCE AGENT. Coinsurance Contract: The rate charged in this policy is based upon the use of the coinsurance clause attached to this policy, with the consent of the insured. A rate adjustment of 81% of wind premium is included to reflect the windstorm mitigation features of your dwelling.Adjustments range from 0%to 89%credit subject to verification that your home meets the windstorm mitigation characteristics of the 2001 Florida Building Code. THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES, WHICH MAY RESULT IN HIGH OUT OF POCKET EXPENSES TO YOU. ************* Additional Information ************* This replaces all previously issued policy declarations, if any.This policy applies to accidents, occurrences, or losses which happen during the policy period shown above. In case of loss under Section I,only that part of loss over the stated deductible applies.The declarations page together with all policy provisions and any other applicable endorsements completes your policy. UPC 119 12 12 AGENT COPY Page 3 of 4 1601 UPC POUCY NUMBER POUCY PERIOD INSURANCE UNITED PROPERTY&CASUALTY INS CO From To P.O.Box 51149 UHV 2801254 04 01 08/29/2016 08/29/2017 Sarasota,FL 34232-0330 12:01 a.m.at the residence premises. FORMS SCHEDULE (continued from page 1) "HPINSTALL(11/14) *OIRB11855(02/10) *OIRB11670(01/06) *UIM 424 (06/01) UPC 105 (07/14) *UPC 107 (08/99) UPC 112 (08/99) *UPC 155 (01/06) *UPC 160 (10/05) UPC 164 (06/06) UPC 174 (09/06) UPC 176 (10/12) *UPC 191 (08/15) UPC 192 (07/14) UPC 601 (02/14) UPC 602 (02/14) UPC 603 (12/14) *UPCNCPT (01/16) UPC 119 12 12 AGENT COPY Page 4 of 4 160 10 •wif "PP- - b-All Quality. .�� 5061 Mahogany Ridge Dr Naples,FL 34119 239-566-9271 Work Authorization I authorize All Quality Inc,to do all work it deems necessary for b./444,r mitigation and/or repairs to my property at the address listed below.This work authorization. along with approved scopes of work, shall constitute the contractual obligations of the Owner and Contractor. I understand that the contractor has no connection with my insurance company or its adjuster, and that I have the authority to authorize contractor to make any repairs. I agree that any portion of work, such as deductibles, betterment depreciation or additional work requested by me not covered by insurance must be paid by me. I agree to pay the deductible in the amount of$ -to the contractor prior to the commencement of the work. I also authorize All Quality Inc.to supply and/or receive information regarding the claim to my insurance company U PC- and to make a full report of all work done by All Quality Inc. and I authorize my insurance company to review and approve Contractor's estimate promptly after receipt of same. Assignment: I hereby irrevocably and absolutely assign to All Quality Inc. all payments and proceed under the below referenced policy,for the work performed here under to contractor, and I authorize my insurance company to pay all proceeds due to contractor payable under my policy directly to All Quality Inc. and home owner. Payments shall be either mailed directly to the contractors office or hand delivered to contractors representative only. If my name is included on any said payment, I understand that this form constitutes a contract for services performed and acknowledge that temporary repairs do not carry any guarantee. 160 10 \,,,, e - * I.UIQua1*tv .... Disclaimer: Customer acknowledges that when All Quality Inc. attempts to restore items which were damaged by fire, wind,water, mold, vandalism or other traumatic occurrence, permanently discolored,faded and/or bleached areas might remain even though All Quality Inc. covenants to use every diligent effort and means available to remove all spots. Customer understands that there is no guarantee that in all circumstances items can be restored to their condition prior to the disaster. In the case of the items made of, or covered with fabric,there may be shrinkage,fugitive colors,fabric separation,changes in texture and other hidden conditions such as loose carpet or tackless strip, improperly laid carpet, broken scams, delamination or permanent deterioration that cannot reasonably be anticipated prior to restoration or cleaning attempts. In the event that these items cannot be restored to pre-disaster conditions, normal recourse is to file an additional damage claim under the appropriate insurance policy provisions.All Quality Inc.will not be held responsible for such conditions.Any corrections made because of the above-named conditions are the owner's responsibility together with any cost involved in correcting these conditions. Authorized Antimicrobial Agents: I understand that in the best judgment of All Quality Inc. materials may be treated with a commercial antimicrobial agent to inhibit the growth of micro-organisms during the process. I have received a notice of use of anti-microbial agents and/or anti-microbial product as part of the restoration process. I understand it is beyond the expertise of All Quality Inc.,to determine if someone is sensitive to its application and will not hold All Quality Inc,. harmless for its use. Stop Work-Hold Harmless: In the event All Quality Inc. is not allowed to perform its recommended procedures and/or drying equipment is removed prematurely, I agree to release and hold All Quality Inc. harmless, and indemnify All Quality Inc.against all claims or actions that may result from such approaches. rr . 16010 Ls. All Quality.., Waiver Of Right To Cancel I acknowledge that the goods and services provided hereunder are services and authorize All Quality Inc.to proceed with the work without delay. By requesting that All Quality Inc. undertake its work immediately, I understand that I am waiving my rights to cancel this transaction under the provisions of the Florida State Laws. Authorization: Insured: .pi e.r-r€ 0r5 e, t ib Date of Loss: 9' - / 0 - i 4 Address: 4-15 3 1 ve-. , C Policy Number: U E11( .ZSO I ZS'L/O Claim Number: Z O Ho 1 0 2.•, a2.1 -} Authorization Signat - ; Date Signed: /0 -/7.-/6 All Quality Inc Representativeaz1. `, 07N�^- ; Date Signed: /a -/ 7/6 • 16010 Kee a UPC Insurance U1tj( 2. fie POBox 1011 r.�+..r....�. St.Petersburg,FL 33731 INSURANCE Promise'- 1-888-CLM-DEPT r 1 a'1 +l'4 F_" 'x +i S. �.,'%iti If '. Cs:.,yNc,Y �$: CLAIM NO.:201 nFL0292 i% P.emspectwn� t f . ' Policy No.: UHV280125404 PIERRE A BORGELA Date of Loss: 09/10/2016 12:01 PM 47 AVE NE NAPLES FL 34120 Type of Loss: Water-Pipes Home phone: (392)445-3555 Deductible: $2,500.00 Business phone: Mobile phone: 1 (239)245-0108 Year Built: Cat No.: Bus.Fax: (392)445-3555 Adjuster: Robert Erwin Contact Phone: (904)425-4240 Loss address: 4437 54TH AVE NE Email: terwin@Iozanoadjusters.com NAPLES FL 34120 "This adjuster,the author of this estimate,has no authority to:(1)approve or deny claims;or,(2)bind UAC as to coverage for your daim or the amount of your lass,if any.A copy of this estimate does not constitute a settlement of this daim or any representation on the part of UPC.The estimate is subject to the review,modification and approval of UP( including,but not limited to,the application of policy limitations,a cdusions and dedudible provisions Any additional repairs to,or replacement of,items not included in this estimate are also subject to UPCs prior approval.You are required to keep all records,cancelled checks,inspection reports,etc.,as proof of repair/replacement in the event of any future loss and pursuant to your post-loss duties under your insurance policy.This estimate is not an authorization of repair.The hiring of a contractor is strictly the decision of the UPC policyholder." Claim 2016FL029277 Page 1 of 8 10/07/2016 . 1 6 0 1 0 , . ,_.0 N N. 0 O 1-10 O �o7.0 E V R \ 8 8 O 0 J J .b,ZS • E ', -11111111P t K. •—.Z,S--IL i6 !o'-, N N O G •-1 m N '. s C • m J c 1)54� : ' / Lo:, to ...123 al' &TAFT ... E r d CI o 01 m . C . .. _ 01;:� al C OD --� co .1 o 0 -- - 'o a "' ,L,..., .6.6----I. .1-- * • M ' S.1 .0T,6 - —.OT,OT— 4—2,8—• m .9,ZZ _o_ .6,E 4•• .9,9—► C pg rn 1171 N� 1 1 .b.LT N C 01N o I — "- 0 N LIN V I1O0 4 ..I.6TI. h • ' L� • o0 rl 0 w m asL IIV�^ 0 w ..L.L 1-4 CO N CA N CaN \ i CiLU CO O C1 Crl• E C9 • G E r-1 U M T C CO in Y c O"" a) m a ..0T.6 4 U9.8--: • •r ..S.L$ a 4--„S.S----• lli BS '' it `��•1 46 -\ >. i.. 3 rn= E rio0 m N OO i° LL 1-1 J i N I O R ii . 0 160101 Description Quantity Unit Price Per RC Depredation ACV ESTIMATE:Structure(UPC Insurance) Claim#2016FL029277,PIERRE A BORGELA ' Completed C] FLOORPLAN: Floorplan ;aJ General Items 1 Dumpster 5 Yard 1 $320.43 EA $320.43 $0.00 $320.43 General Items-Subtotal $320.43 Q Closet Length: 9'10" Width: 2'6" Height 8'Flat Walls: 197.34 SF Walls-subs: 157.34 SF Walls-subs-cas-bsbd: 146.25 SF E-----1 Doors: 40.00 SF Windows: 0.00 SF Openings: 0.00 SF Missing Walls: 0.00 SF N, Floor: 24.58 SF Ceiling: 24.58 SF Perini(F): 18.08 LF Perim(C): 24.66 LF 2 Contents,Move&Protect 1 $31.38 HR $31.38 $0.00 $31.38 3 Carpet,Wall to Wall,Good-Replace 27.04 $1.82 SF $49.22 $31.919 $17.31 a Includes 10%waste on quantity. 4 Carpet Pad,Good-Replace 25.81 $0.54 SF $13.94 $8.00 V $5.94 a Includes 5%waste on quantity. 5 Carpet&Pad,Good-Tear Out 24.58 $0.16 SF $3.93 $0.00 $3.93 Closet-Subtotal $58.56 ri Bedroom 2 I Length: 9'10" Width: 14'1" Height: 8'Flat Wails: 382.68 SF Walls-subs: 310.01 SF Walls-subs-cas-bsbd: 283.26 SF , " A 1 Doors: 56.67 SF Windows: 16.00 SF Openings: 0.00 SF Missing Walls: 0.00 SF Floor: 138.49 SF Ceiling: 138.49 SF Perim(F): 38.16 LF Perim(C): 47.82 LF 6 Drywall,Up to 2'From Floor,Taped-Replace 11.66 $3.44 LF $40.11 $1.291 $38.82 a Includes 6%waste on quantity. 7 Base Molding Colonial,41/2"-Replace 11.66 $3.15 iF $36.73 $2.51 V $34.22 O Includes 6%waste on quantity. 8 Prep&Mask For Painting(SF) 283.26 $0.20 SF $56.65 $0.00 $56.65 9 Contents,Move&Protect 1 $31.38 HR $31.38 $0.00 $31.38 10 Walls 1 Coat,Roller-Paint 283.26 $0.35 SF $99.14 $9.44V $89.70 11 Carpet,Wall to Wall,Good-Replace 152.34 $1.82 SF $277.26 $179.76 V $97.50 a Indudes 10%waste on quantity. 12 Carpet Pad,Good-Replace 145.41 $0.54 SF $78.52 $45.08 V $33.44 Q Includes 5%waste on quantity. 13 Texture,Walls Knockdown-Replace 88.00 $0.48 SF $42.24 $0.701 $41.54 14 Reset Switch/Outlet Plate 2 $2.66 EA $5.32 $0.00 $5.32 15 Carpet&Pad,Good-Tear Out 138A9 $0.16• SF $22.16 $0.00 $22.16 16 Prep&Mask For Painting(SF) 283.26 $0.20 SF $56.65 $0.00 $56.65 17 Base Molding Colonial,3 1/4"-Replace 14.92 $2.43 LF $36.26 $0.00 $36.26 CI Includes 6%waste on quantity. 18 Base Molding Colonial,3 1/4"-Paint 38.16 $1.00 LF $38.16 $0.00 $38.16 Claim 2016FL029277 Page 4 of 8 10/07/2016 i Description Quant y Una Price Per RC Depredation ACV ESTIMATE:Structure(UPC Insurance) Claim#2016F1029277,PIERRE A BORGELA ':r Completed Bedroom 2(con't) 19 Reset Switch/Outlet Plate 3 , $2.70 EA $8.10 $0.00 $8.10 20 Paint Textured Walls Brush-Paint 283.26 $0.77 SF $218.11 $0.00 $218.11 21 Door,Closet,Bi-Fold,Panel 6'-Rem/Reset 2 $42.97 EA $85.94 $0.00 $85.94 22 Blinds(SF)Vinyl,Mini-Rem/Reset 16.00 $1.96 SF $31.36 $0.00 $31.36 a or other window treatment Bedroom 2-Subtotal $925.31 Laundry Room Length: 10'3" Width: 4'11" Height: 8'Flat 1 Walls: 242.66 SF Walls-subs: 226.55 SF Walls-subs-ccs-bsbd: 215.76 SF Doors: 16.11 SF Windows: 0.00 SF Openings: 0.00 SF Missing Walls: 0.00 SF / G Floor: 50.40 SF Ceiling: 50.40 SF Perim(F): 27.63 LF Perim(C): 30.34 IF 23 Contents,Move&Protect 1 $31.52 HR $31.52 $0.00 $31.52 24 Paint Textured Walls Brush-Paint 215.76 $0.77 SF $166.13 $0.00 $166.13 25 Prep&Mask For Painting(SF) 215.76 $0.20 SF $43.15 $0.00 $43.15 26 Base Molding Colonial,3 1/4"-Replace 5.22 $2.43 LF $12.68 $0.00 $12.68 Q Includes 6%waste on quantity. 27 Base Molding Colonial,3 1/4"-Paint 27.63 $1.00 LF $27.63 $0.00 $27.63 28 Floor protection 50.40 $0.16 SF $8.06 $0.00 $8.06 29 Reset Switch/Outlet Plate 1 $2.70 EA $2.70 $0.00 $2.70 30 Drywall,Up to 2'From Floor,Taped-Replace 5.22 $3.53 IF $18.43 $0.00 $18.43 Q Includes 6%waste on quantity. .00 31 Texture,Walls Knockdown-Replace 37.90 $0.49 SF $18.57 $0 $18.57 32 Reset Appliance Dryer 1 $14.69 EA $14.69 $0.00 $14.69 33 Reset Appliance Washer 1 $14.69 EA $14.69 $0.00 $14.69 Laundry Room-Subtotal $356.25 V Dining Area Length: 12'4" Width: 9'10" Height: 8'Flat Walls: 279.34 SF Walls-serfs: 154.91 SF Walis•subs-cas-bsbd: 123.46 SF Doors: 16.67 SF Windows: 0.00 SF Openings: 107.75 SF Missing Wails: 75.33 SF i l.. Floor: 121.28 SF Ceiling: 121.28 SF Perim(F): 2237 LF Perim(C) 18.90 IF 34 Prep&Mask For Painting(SF) 123.46 $0.20 SF $24.69 $0.00 $24.69 35 Contents,Move&Protect 1 $31.38 HR $31.38 $0.00 $31.38 36 Walls 1 Coat,Roller-Paint 123.46 $0.35 SF $43.21 $4.12 V $39.09 37 Reset Switch/Outlet Plate 2 $2.66 EA $5.32 $0.00 $5.32 38 Floor,Cover&Protect 95.88 $0.16 SF $15.34 $0.00 $15.34 39 Countertop,Laminate(SF)Good-Rem/Reset 6.42 $9.06 SF $58.17 $0.00 $58.17 Dining Area-Subtotal $173.99 Claim 2016FL029277 Page 5 of 8 10/07/2016 .. 160 Ii Description Quantity Unit Price Per RC Depredation ACV ESTIMATE:Structure(UPC Insurance) Claim#2016FL029277,PIERRE A BORGELA ' Completed Hallway _ rte- s Length: 9'10" Width: 12'1" Height 8'Flat Walls: 275.34 SF Walls-subs: 209,22 SF Walls-subs-cas-bsbd: 187.52 SF . Doors: 66.12 SF Windows: 0.00 SF Openings: 0.00 SF Missing Walls: 75.33 SF - Floor. 49.55 SF Ceiling: 49.55 SF Perim(F): 22.75 LF Perim(C): 34.41 LF 40 Floor protection 49.55 $0.16 SF $7.93 $0.00 $7.93 Hallway-Subtotal $7.93 57 Kitchen i Length: 9' Width: 9'10" Height 8'Flat < Walls: 301.34 SF Walls-subs: 230.92 SF Walls-subs-cas-bsbd: 155:43 SF Doors: 0.00 SF Windows: 12.00 SF Openings: 58.42 SF Missing Wags:. 0.00 SF , a;s Floor: 88.50 SF Ceiling: 88.50 SF Perim(F): 34.58 LF Perim(C): 27.83 LF - - ill rfs.ttgit' >1i 41 Contents,Move&Protect 1 $31.52 HR $31.52 $0.00 $31.52 42 Paint Textured Walls Brush-Paint 155.43 $0.77 SF $119.68 $0.00 $119.68 43 Prep&Mask For Painting(SF) 155.43 $0.20 SF $31.08 $0.00 $31.08 44 Base Molding Colonial,3 1/4"-Replace 8.75 $2.43 IF $21.27 $0.00 $21.27 Q Incudes 6%waste on quantity. 45 Base Molding Colonial,3 1/4"-Paint 25.51 $1.00 LF $25.51 $0.00 $25.51 46 Floor protection 88.50 $0.16 SF $14.16 $0.00 $14.16 47 Reset Switch/Outlet Plate 3 $2.70 EA $8.10 $0.00 $8.10 48 Drywall,Up to 2'From Floor,Taped-Replace 19.96 $3.53 IF $70.46 $0.00 $70.46 ® Incudes 6%waste on quantity. 49 Texture,Walls Knockdown-Replace 44.45 $0.49 SF $21.78 $0.00 $21.78 50 Cabinet,Base(LF)Good-Replace 11.24 $166.82 LF $1,875.06 $0.00 $1,875.06 j.14 51 Cabinet,Wall(LF)24"H,Good-Tear Out 13.92 $8.04 LF $111.92 $0.00 $111.92 52 Cabinet,Wall(LF)24"H,Good-Replace 13.92 $108.75 LF $1,513.80 $0.00 $1,513.80 53 Backsplash,Formica,4"-Rem/Reset 22.74 $4.31 IF $98.01 $0.00 $98.01 54 Countertop,Laminate(SF)Good-Rem/Reset 19.68 $9.06 SF $178.30 $0.00 $178.30 55 Garbage Disposal Good-Rem/Reset 1 $27.90 EA $27.90 $0.00 $27.90 56 Reset Appliance Dishwasher 1 $32.17 EA $32.17 $0.00 $32.17 57 Reset Appliance Range 1 $28.99 EA $28.99 $0.00 $28.99 58 Faucet,Kitchen Single Handle,Good-Rem/Reset 1 $56.77 EA $56.77 $0.00 $56.77 59 Sink,Kitchen,Stainless Steel Double Bowl,Good- 1 $98.08 EA $98.08 $0.00 $98.08 Rem/Reset 60 Refrigerator with Water Supply Line-Rem/Reset 1 $91.68 EA $91.68 $0.00 $91.68 61 Blinds(SF)Vinyl,Mini-Rem/Reset 12.00 $1.96 SF $23.52 $0.00 $23.52 Q or other window treatment 62 Supply Line Sink,Flexible-Replace 4 $16.07 EA $64.28 $0.00 $64.28 63 P-Trap&Fittings,Sink-Rem/Reset 1 $22.05 EA $22.05 $0.00 $22:05 I 64 Microwave/Range Hood Good-Recn/Reset 1 $36.16 EA $36.16 $0.00 $36.16 Claim 2016FL029277 Page 6 of 8 10/07/2016 16Di . . 1 ' Description Quantay Unit Price Per RC Depredation ACV ESTIMATE Structure(UPC Insurance) Claim#2016FL029277,PIERRE A BORGELA 'Completed ! KGtchen(con't) 65 Valve,Water Shutoff Angle 1/2"-Rem/Reset 4 $35.86 EA $143.44 $0.00 $143.44 IGtchen-Subtotal $4,745.69 3 Bedroom 3 Length: 11' Width: 13'6" Height 8'Fiat Walls: 392.00 SF Walls-subs: 350.00 SF Walls-subs-cas-bsbd: 336.44 SF Doors: 16.67 SF Windows: 0.00 SF Openings: 25.33 SF Missing Walls: 0.00 SF Floor: 148.50 SF Ceiling: 148.50 SF Perim(F): 46.50 LF Perim(C): 35.50 IF 66 Drywall,Up to 2'From Floor,Taped-Replace 11.66 $3.44 LF $40.11 $1.29 V $38.82 • Includes 6%waste on quantity. 67 Base Molding Colonial,4 1/2"-Replace 11.66 $3.15 LF $36.73 $2.51 V $34.22 • Includes 6%waste on quantity. 68 Prep&Mask For Painting(SF) 336.44 $0.20 SF $67.29 $0.00 $67.29 69 Contents,Move&Protect 1 $3138 HR $31.38 $0.00 $31.38 70 Walls 1 Coat,Roller-Paint 336.44 $0.35 SF $117.76 $11.22 V/ $106.54 71 Carpet,Wall to Wall,Good-Replace 163.35 $L82 SF $297.29 $192.75 V $104.54 C Includes 10%waste on quantity. 72 Carpet Pad,Good-Replace 155.93 $0.54 SF $84.20 $48.34 V $35.86 ❑ Indudes 5%waste on quantity. 73 Texture,Walls Knockdown-Replace 84.79 $0.48 SF $40.71 $0.68 V $40.03 74 Base Molding Colonial,41/2'-Paint 46.50 $0.99 IF $46.04 $232 V $43.72 75 Reset Switch/Outlet Plate 2 $2.66 EA $5.32 $0.00 $5.32 76 Floor,Cover&Protect 95.88 $0.16 SF $15.34 $0.00 $15.34 77 Floor,Cover&Protect 95.88 $0.16 SF $15.34 $0.00 $15.34 78 Carpet&Pad,Good-Tear Out 148.50 $0.16 SF $23.76 $0.00 $23.76 79 Carpet Pad,Good-Replace 155.93 $0.57 SF $88.88 $0.00 $88.88 j O Includes 5%waste on quantity. 80 Carpet,Wall to Wall,Good-Replace 163.35 $1.91 SF $312.00 $0.00 $312.00 • Includes 10%waste on quantity. 81 Contents,Move&Protect 1 $3152 HR $31.52 $0.00 $31.52 82 Paint Textured Walls Brush-Paint 336.44 $0.77 SF $259.06 $0.00 $259.06 83 Prep&Mask For Painting(SF) 336.44 $0.20 SF $67.28 $0.00 $67.28 84 Reset Switch/Outlet Plate 1 $2.70 EA $2.70 $0.00 $2.70 85 Floor protection 148.50 $0.16 SF $23.76 $0.00 $23.76 Bedroom 3-Subtotal $1,347.36 Floorplan-Subtotal $7,937.52 Claim 2016F1029277 Page 7 of 8 10/07/2016 rp .L 6 Li • ESTIMATE:Structure(UPC Insurance) aaim#2016FL029277,PIERRE A BORGELA 1,Completed Total Materials: $4,145.21 Total Labor: $3,995.94 Total Equipment: $338.29 Total Market Conditions: $0.00 Subtotal: $8,479.44 Add 10.00%overhead: $847.94 Add 10.00%profit: $847.94 Subtotal: $10,175.32 Sales Tax 6.000%(applies to materials only): $298.46 Replacement Cost Value: $10,473.78 Less Recoverable Depredation(indudes taxes): $(574.44) Less Non-Recoverable Depredation(includes taxes): $0.00 Net ACV Estimate: $9,899.34 Deductible: $(2.500.00) Net Estimate: $7,399.34 Total Net Recoverable Depredation: $574.44 Net Estimate if Depreciation Is Recovered: $7,973.78 "This adjuster,the author of this estimate,has no authority to:(1)approve or deny daims;or,(2)bind UPC as to coverage for your daim or the amount of your loss,if any.A copy of this estimate does not constitute a settlement of this daim or any representation on the part of UPC.The estimate is subject to the review,modification and approval of UPC,induding,but not limited to,the application of policy limitations,exclusions and deductible provisions.Any additional repairs to,or replacement of,items not induded in this estimate are also subject to UPCs prior approval.You are required to keep all records,cancelled d,edcs,inspection reports,etc.,as proof of repair/replacement in the event of any future loss and pursuant to your post-loss duties under your insurance policy.This estimate Is not an authorization of repair.The hiring of a contractor is strictly the dedsion of the UPC policyholder." Finalization Claim 2016FL029277 Page 8 of 8 10/07/2016 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP • TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO a, 0 Q THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE , Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the exception of the Chairman's signature,draw a line through routinglines#1 through#2,complete the checklist,and forward to the County Attorney Office. Route to Addressee(s)(List in routing order) Office Initials Date 1. Jennifer A. Belpedio,ACA County Attorney Office 1'2.1t#1tk 2. BCC Office Board of County Commissioners S/ .kkq`t(e-, 3. Minutes and Records Clerk of Court's Office . ' g PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above,may need to contact staff for additional or missing information. Name of Primary Staff Don Luciano,CHS Phone Number 239-252-25 Contact/ Department Agenda Date Item was June 12,2012 Agenda Item Number 16D10 Approved by the BCC Type of Document Insurance Claim Check Endorsement for Number of Original I Attached Jean,Gesnal Documents Attached PO number or account number if document is N IA to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. I •pplicable) 1. Does the document require the chairman's original signature? 2. Does the document need to be sent to another agency for additional signatures? If yes, // N/A provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. All/0 3. Original document has been signed/initialed for legal sufficiency. (All documents to be N/A signed by the Chairman,with the exception of most letters,must be reviewed and signed ,,r� by the Office of the County Attorney. I�( 4. All handwritten strike-through and revisions have been initialed by the County Attorney's ,,JJ, N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's signature and initials are required. moi. 10 7. In most cases(some contracts are an exception),the original document and this routing slip N/A should be provided to the County Attorney Office at the time the item is input into SIRE. .f Some documents are time sensitive and require forwarding to.Tallahassee within a certain N I time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on and all changes made during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC,all changes directed by the BCC have been made,and the document is ready for th Chairman's signature. I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12 16010 THIS-DOCUMENT HAS A VOIDPANTOGRAPH,MICROPRINTING,A COIN REACTIVE ARTIFICIALWATERMAR$K� ln AND'THERMOCHROMATIC INK. L/U t' Fs '`'`." _$ r^x�y, -} -i 'U4k's , F ., ,,'tom - L it NSI x i4 N it 1 ' li: t: 2�:13FL '-`66t. :; 7313,2 November07,:20'16 1t osS..f it/E.-a-4' 1:� . UPC Insurance i • 12ia P.0 0 ;;456 ? l r r -, I,fir.` ,: rte ainf=Pet�rsb"�rg f \345 68 � ,�' �� I.A. i • i a4, t : 4 I kV040 2 1 QO P011a s ' . $71,249 2Q ��A�On P I o�span -Two ��,lur�d: d�or� ine��f :� r .TO TH GE8'I AL:_JEAN and IABI A` `" ' R H.:1 NI,TY1- nd E .: o e�$i9n..• I� 1ti�.{ Welles a � , � i e `' Authorized slyn� ,� i San F4dso, 4 I e� . . p 1 I i F t } � I F m < o e� g z - rt O. . a Q 2 \. m " a m 9 Fo >Z CO CI 11 ?1, . of 0 r'� c s =_ m9 Z '0 2 .g E § 21 M rTI 'S"&..1 $r c E u)c � Z t P m v 0. C, CN j • g • Collier County Community and Human Services Division (CHS) Homeowner Insurance Check Endorsement Policy Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients.As long as the recipient continues to own and occupy the assisted property during the term of the mortgage/lien,then the loan will not have to be repaid. On occasion,the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and receive money to make the repairs.If the insurance claim check is made payable to the homeowner and Collier County,then the homeowner can request.in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to CHS at the address below for check endorsement consideration: 1. Copy of Homeowner's current insurance policy-Declaration Page. 2. Copy of insurance company's claim report with worksheet including description of repairs and costs. 3.Copy of photos of claim damage. • 4.Copy of Insurance check(s)payable to homeowner,first lien holder and Collier County. Homeowner Name: G es,,Q.r J61.1 Homeowner Address: Ae93/ 44/".° 7elywce 4.52-) A1t„/es / F-7/ 3-j/fes Primary Contact Number: ,ZS -2oo 37 Homeowner Email: ce /a�`� 1/��a�'� coir Okkfa. t //(e Reviewed CHS-Grant Coordinator Date )21 19+(j, ): Approved • CHS Director Date Denied 1 6 0 k4emorandum To: Kimberly Grant, CHS Director CC: Jennifer Belpedio, Assistant County Attorney From: Donald Luciano,Grant Support Specialist,Community and Human Services Date: 12/16/2016 Re: Homeowner Insurance claim check endorsement- Jean, Gesnal 2831 44th Terrace SW,Naples, FL 34116 The Homeowner Insurance Check Endorsement Policy approved by the Board on June 12, 2012 (16.D.10)authorizes the Board Chairman or Vice Chairman to endorse homeowner insurance claim checks for recipients assisted with Purchase Assistance and/or rehabilitation program funds as Collier County is named as Second Mortgagee on their insurance policies. The attached check in the amount of$1,249.20 is for disbursement of the claim funds requiring endorsement by Board Chairmaniakror Vice Chairman. The check names Habitat for Humanity as the first mortgage lender and Collier County SHIP as subordinate lien holder. In order for the check to be properly processed,proper signatures/endorsement for all parties listed on check must be obtained. This is a time-sensitive item and must be endorsed as soon as possible as homeowner is waiting to pay for work to be performed on home. Attachments: Insurance claim check(#73852) $1,249.20 Insurance claim report& photos of damage Collier County Second Mortgage loan I riv (foociP›o1a Non !(p.o• Io EXECUTIVE SUMMARY Recommendation to approve a homeowner insurance check endorsement policy for all borrowers assisted with purchase assistance and/or rehabilitation housing program funds and authorizes Board Chairman or Vice Chairman, in his absence to endorse two homeowner insurance claim checks. OBJECTIVE: To allow homeowners in good standing with the State Housing Initiatives Partnership (SHIP) program to deposit their homeowner insurance claim check into the bank so they can use the funds to repair their damaged homes. CONSIDERATION: On July 25, 2008,the subject homeowners purchased a home located at 2505 41st Ave NE, Naples, FL 34120. Collier County approved down payment assistance through the SHIP program and the borrowers signed a second mortgage for SHIP down payment assistance on July 25, 2008. On January 20,2012,the homeowners filed a homeowner's insurance claim due to water seepage damage to their home.The total claim for damages was $9,935.68. The insurance company paid the claim minus the homeowner's $1,000 deductible, in two separate checks. Check #1 in the amount of$7,964.41 and check#2 in the amount of$971.37. The insurance company made the checks payable to the homeowner, Bank of America and Collier County since all parties have an interest in the property. According to the SHIP loan documents and SHIP local housing administrative plan(LHAP)the homeowner is not required to pay back any funds to Collier County unless the homeowners sell, refinance or lose their homestead exemption on the property. None of these triggering events have occurred and the homeowner's second mortgage loan with Collier County is in good standing. Therefore, Collier County has no claim to the homeowner's insurance claim money that was provided to make repairs to the home. The homeowner has expressed frustration in having to wait for her checks to be endorsed because her house is in urgent need of repairs. Accordingly, Housing staff has developed a proposed Homeowners Insurance Check Endorsement Policy for similar circumstances in the future. If this item is approved,the Board Chairman or Vice Chairman, in his absence may endorse a check only if certain enumerated documentation is provided and the homeowner is in compliance with the SHIP and/or Single Family Home Rehabilitation program. The proposed Homeowners Insurance Check Endorsement Policy is attached as back-up for Board consideration. FISCAL IMPACT: There is no fiscal impact associated with this Executive Summary. GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact associated with this Executive Summary. LEGAL CONSIDERATIONS: This item is legally sufficient and requires a majority vote for Board action. -JBW RECOMMENDATION: That the Board of County Commissioners approves a homeowner insurance check endorsement policy for all borrowers assisted with purchase assistance and/or rehabilitation housing program funds and authorizes the Board Chairman or Vice Chairman, in his absence to endorse two homeowner insurance claim checks. PREPARED BY: Lisa Carr/Housing Outreach Coordinator,Housing Human and Veteran Services November 7th,2016 Gesnal Jean 2831 44th Terrace SW Naples, FL 34116 Re: Insured: Gesnal Jean Claim Number: 2016FL032664 Policy Number: UHV281 1 02404 Date of Loss: 10/20/2016 Cause of Loss: Water • Loss Location: 2831 44th Terrace SW Naples, FL 34116 Por favor leak)cuidadosamente. La informacion en esta carta afecta sus derechos cubiertos por Ia poliza de seguro que se menciona abajo. Si usted no puede leer esta carta o no entiende alguna pardon de Ia misma,es muy importante que usted solicite consejo de alguna persona que lo pueda interpretar y explicarle el contenido de este documento. SETTLEMENT OF DAMAGES Dear Mr. Gesnal Jean Enclosed is our estimate in the amount of$1,249.20.The payment represents settlement of damages under the following Coverage(s): Building-Mold Other Contents ALE/FRV Total Structures Replacement $2,249.20 $2,249.20 Cost Recoverable $0.00 $0.00 Depreciation Non- Recoverable Depreciation Prior Payments/ Advances Deductible $1,000.00 $1,000.00 Net Payment $1,249.20 $ $ $ $1,249.20 This settlement check represents the unrestricted tender of the amount we believe you are owed as a result of your loss. You are permitted to use this check at this time If your mortgage holder has been shown as a payee on your check, please understand we are obligated to do so according to the terms of your policy. Please contact your mortgage holder regarding their procedures for endorsing payments. Should have any additional questions regarding the settlement,or have any other information you would like for us to consider in regards to this claim, please contact the undersigned at the information shown below. 16üi ri tj Sincerely, Christopher Hooker Claim Adjuster United Insurance Management, LC , Servicing claims on Behalf of United Property&Casualty Insurance Company Ph: (727)895-7737 x 2094 Fax: (800) 380-5053 Email: claims( ..uacinsurance.com Enc: Estimate of Damages F.S. 817.234(1)(b)Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree. If this document contains an excerpt from a UPC Insurance Company Policy("the Policy")it is provided here for informational purposes only. This excerpt is not the official version of the Policy. The official version of the Policy is the policy issued to the insured on the policy effective date. In the event there is inconsistency between this document and the Policy, the Policy shall serve as the of 1 6 n i n " U pc c..LI% tK p UPC Insuranct 0e PO Box 1011 St.Petersburg,FL 33731 INSURANCE Promise" 1-888-CLM-DEPT Description Quantity Unit Price Per RC Depreciation ACV ESITMAM Structure(WMW-Adjusters) aaim#2016FL032664,GESNAL JEAN and MAGDALA JEAN Completed {� � .. '''''''el! c ' 3s F �C •z; 'x p �wh teg i ,�ry a 4r t, , 1 --,�,y;. sr .',.�,�,..,�w,,,�}, � ..�k , sm�` '..:c k..s-sr._ MFF ,:min 1- ., £;.. . t, .�.,4,,,to,-* ,kilo s>'s.s.;tt (ssa, t. .:):f.K,a"+#^:3-},.,. �. 1's `'C5,,.F.s.: i. Q IDEdien Length: 9'11" Width: 14'5" Height: 8'Flat Walls: 254.66 SF Walls-subs: 247.16 SF Walls-subs-cas-bsbd: 234.34 SF 1 1 Doors: 0.00 SF Windows: 7.50 SF Openings: 0.00 SF Missing Walls: 134.66 SF Floor: 142.97 SF Ceiling: 142.97 SF Perim(F): 31.84 LF Perim(C): 31.84 LF 1 Contents,Move&Protect 1 $31.52 HR $31.52 $0.00 $31.52 2 Floor,Cover&Protect 142.97 $0.16 SF $22.88 $0.00 $22.88 3 Drywall,Wall 5/8",Taped-Replace 31.80 $1.48 SF $47.07 $0.00 $47.07 0 Indudes 6%waste on quantity. 4 Texture Ceiling,Popcorn Heavy-Remove 111.17 $0.32 SF $35.57 $0.00 $35.57 5 Seal Ceiling, 1 Coat Average-Seal 142.97 $0.42 SF $60.05 $0.00 $60.05 6 Texture Ceiling,Popcorn Heavy-Replace 142.97 $0.52 SF $74.35 $3.58 Ilf $70.77 7 Prep&Mask For Painting(SF) 234.34 $0.20 SF $46.87 $0.00 $46.87 8 Clean&Paint Room Roller 377.31 $0.60 SF $226.39 $20.44'" $205.95 Kitchen-Subtotal •_ Kitchen .-.__._ ..._._.._..._ mewi Length: 6'11" Width: 10'9" Height: 8'Flat Walls: 227.33 SF Walls-subs: 207.33 SF Walls-subs-cas-bsbd: 195.15 SF Doors: 20.00 SF Windows: 0.00 SF Openings: 0.00 SF Missing Walls: 55.33 SF Floor: 74.35 SF Ceiling: 74.35 SF Perim(F): 24.84 LF Perim(C): 28.42 LF 9 Floor,Cover&Protect 74.35 $0.16 SF $11.90 $0.00 $11.90 10 Texture Ceiling,Popcorn Heavy-Remove 74.35 $0.32 SF $23.79 $0.00 $23.79 11 Seal Ceiling, 1 Coat Average-Seal 74.35 $0.42 SF $31.22 $0.00 $31.22 12 Texture Ceiling,Popcorn Heavy-Replace 74.35 $0.52 SF $38.67 $1.86 iie $36.81 13 Prep&Mask For Painting(SF) 195.15 $0.20 SF $39.03 $0.00 $39.03 ... .................................................. 14 Clean&Paint Room Roller 137.00 $0.60 SF $82.20 $7.42 V $74.78 Kitchen-Subtotal b bK;;yt Q Living Room Length: 28'5" Width: 14'11" . Height: 8'Flat --„--I Walls: 613.99 SF Walls-subs: 501.32 SF Walls-subs-cas-bsbd: 462.99 SF Doors: 76.67 SF Windows: 16.00 SF Openings: 20.00 SF Missing Walls: 79.33 SF Floor: 423.88 SF Ceiling: 423.88 SF Perim(F): 61.02 LF Perim(C): 74.26 LF 15 Contents,Move&Protect 1 $31.52 HR $31.52 $0.00 $31.52 Claim 2016FL032664 Page 1 of 6 11/07/2016 1 6D 0 Description Quantity Unit Price Per RC Depredation ACV ESTIMATE:Structure(RJMW-Adjusters) Claim#2016EL032664,GESNAL JEAN and MAGDALA JEAN Completed Q Living Room(con't) 16 Floor,Cover&Protect 423.88 $0.16 SF $67.82 $0.00 $67.82 17 Prep&Mask For Painting(SF) 462.99 $0.20 SF $92.60 $0.00 $92.60 18 Clean&Paint Room Roller 886.87 $0.60 SF $532.12 $48.041/ $484.08 Living Room-Subtotal6 I 42 Q Hallway Length: 3'6" Width: 6'2" Height: 8'Flat Wails: 154.66 SF Walls-subs: 74.66 SF Walls-subs-cas-bsbd: 58.65 SF Doors: 60.00 SF Windows: 0.00 SF Openings: 20.00 SF Missing Walls: 0.00 SF Floor. 21.58 SF Ceiling: 21.58 SF Perim(F): 6.18 LF Perim(C): 16.84 LF 19 Floor,Cover&Protect 21.58 $0.16 SF $3.45 $0.00 $3.45 20 Prep&Mask For Painting(SF) 58.65 $0.20 SF $11.73 $0.00 $11.73 21 Clean&Paint Room Roller 80.23 $0.60 SF $48.14 $4.35 V $43.79 Hallway-Subtotal ai General Items 22 Trucking&Hauling, 1/2 Ton 1 $106.25 LD $106.25 $0.00 $106.25 General Items-Subtotal ' g1,000**,'; • Claim 2016FL032664 Page 2 of 6 11/07/2016 . 1 t", p 1 n , ...) , ESTIMATE:Structure(RJMW-Adjusters) Claim#2016FL032664,GESNAL JEAN and MAGDALA JEAN , Completed 4."0 Walls # DO alls Walls and Ceilings ;:;::::;:111;"':;1;t;.::!:.;,iiror Floors Floor Perimeter Ceilings 4 zY3 ''° `� Ceiling Perimeter . . .. ,,•.a... , .t:.... :Y Walls . Walls and Ceilings Floors 4' ' r � Floor Perimeter LF Ceilings "�78 Ceiling Perimeter - ' �Q� � i.'-.+ ry^ Vtft?x saw^ -g> W'�ci'�" r £ .ti .. t .—rc/Re061..a� :... ' . i .. . exeig..wP-1.00:i .,.....r::$i.wµ,,.ept.rsa4,44 i-„,,,,rw-,..r-K,,t,:k s-3,,s„,.4 .„'Si•1 gmi,.v I`3r7 Walls Walls and Ceilings Floors ''.:§38A9* Floor Perimeter 4.44.56410# i Ceilings S i Ceiling Perimeter ,:138.70” Recap by Area Total Cost Percentage Kitchen $544.70 32.71% Kitchen $226.81 13.62% Living Room $724.06 43.48% Hallway $63.32 3.80% General Items $106.25 6.38% Kitchen $0.00 0.00% Dining Room $0.00 0.00% Garage $0.00 0.00% Master Bath $0.00 0.00% General Items $0.00 0.00% Total,all areas �� 100.00% Recap by Category Total Cost Percentage CPS-Contents-Packing,Handling,Storage $63.04 3.79% DMO-General Demolition $106.25 6.38% DRY-Drywall-DRY-Ceiling&Walls $219.45 13.18% PNT-Painting-PNT-Ceiling $91.27 5.48% PNT-Painting-PNT Other $190.23 11.42% PNT-Painting-PNT-Walls $888.85 53.38% TMP-Temporary Repairs $106.05 6.37% Total,all categories $ 14 100.00% Claim 2016FL032664 Page 3 of 6 11/07/2016 M 1 6 LI 1 ) ESTIMATE:Structure(UMW-Adjusters) Claim #20168032664,GESNAL JEAN and MAGDALA JEAN S Completed Recap by Coverage Total Cost Percentage Covg A-Homeowner Dwelling $1,665.14 100.00% Total,all coverages 31.10004-0054 100.00% Claim 2016FL032664 Page 4 of 6 11/07/2016 l6DlQ ESTIMATE:Structure(RJMW-Adjusters) Claim #2016FL032664,GESNAL JEAN and MAGDALA JEAN i} Completed �y,�� .MATE r c;..; s i ,. .:'1-.tf; .-s ..<.. �. ili'.h-,.,'.'.R Clean&Paint Room Roller 1,481.41 SF n/a $192.58 Drywall,Wall 5/8",Taped(Replace) 31.80 SF n/a $14.63 Floor,Cover&Protect 662.78 SF n/a $39.76 Prep&Mask For Painting(SF) 951.13 SF n/a $28.53 Seal Ceiling, 1 Coat Average(Seal) 217.32 SF n/a $15.21 Texture Ceiling,Popcorn Heavy(Replace) 217.32 SF n/a $21.74 Trucking&Hauling, 1/2 Ton 1 LD n/a $29.70 z • „:40.0.k.:' : .. _ :', ' . . !. I t ,.�_.. rye .... � # ** Total..: 1 DRY&1 PLSTR .0.66 hrs $49.28 $32.44 1 LABORER .5.98 hrs $31.52 $188.69 1 LABORER ".2.00 hrs $31.52 $63.04 1 PAINTER .6.14 hrs $51.12 $313.83 1 PAINTER&1 LABORER 18.23 hrs $37.95 $696.27 27::; " 04-Es■ ;. ...:;:l i:1, :.t-_ «.a« s .iy rAta kikKiinatiii* i, . .;i ;z !,d$.;s a_ k.4' Seal Ceiling, 1 Coat Average(Seal) 217.32 SF $2.17 Texture Ceiling,Popcorn Heavy(Replace) 217.32 SF $13.04 Trucking&Hauling, 1/2 Ton 1 LD $13.51 .... Claim 2016FL032664 Page 5 of 6 11/07/2016 .�' +�*� .1-�.i hQ �� ESTIMATE:Structure(UMW-Adjusters) Claim#201.6FL032664,GESNAL JEAN and MAGDALA JEAN I} Completed Total Materials: $342.15 Total Labor: $1,294.27 Total Equipment: $28.72 Total Market Conditions: $0.00 Subtotal: $1,665.14 Adjustments for minimum charges(O&P and taxes are applied): Minimum Charge,Drywall 2 Trips: $177.99 Subtotal: $1,843.13 Add 10.00%overhead: $184.31 Add 10.00%profit: $184.31 Subtotal: $2,211.75 Sales Tax 6.000%(applies to materials only): $37.45 Replacement Cost Value: $2,249.20 Replacement Cost on Coverage Covg A-Homeowner Dwelling: $2,249.20 Less Recoverable Depreciation(indudes taxes): $(90.83) Net ACV on Coverage Covg A-Homeowner Dwelling: $2,158.37 Amount Payable on Coverage Covg A-Homeowner Dwelling: $2,158.37 Net Coverage Covg A-Homeowner Dwelling after Deductible if Depreciation Is Recovered: $2,249.20 Amount Payable on Coverage Covg A-Homeowner Dwelling if Depreciation Is Recovered: $2,249.20 Deductible: $(1,000.00) Net Estimate: $1,158.37 Total Net Recoverable Depreciation: $90.83 Net Estimate if Depreciation is Recovered: $1,249.20 Finalization Claim 2016FL032664 Page 6 of 6 11/07/2016 • INSTR 4741161 OR 4836 PG 3630 RECORDED 9/19/2012 10:56 AM PAGES 5 DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT, COLLIER COUNTY FLORIDA DOC@OBLD 52 570.00 REC 544.00 1 6 0 1 0 OBLD 520,000.00 STATE HOUSING INITIATIVES PARTNERSHIP (SHIP) PROGRAM SECOND MORTGAGE THIS SECOND MORTGAGE("Security Instrument")is given on /(1 day of Cy,ff 4 e f ,2012.The Second Mortgagor is: Geanal Jean and Magdala O. Joan, a married couple ("Borrower"). This Security Instrument is given to Collier County-SHIP ("Lender",which is organized and existing under the laws of the linked States of America,and whose address is 3339 E. Taaiami Trail, Naples, Florida 34112. Borrower owes Lender the sum of Twenty Thousand and 00/100 Dollars (920,000.00). This debt Is evidenced by Borrower's Note dated the same date as this Security Instrument("Second Mortgage"),which provides for monthly payments,with the fun debt,If not paid earlier,due upon sale If sold within the fifteen year term. If sold within fifteen years then the loan will be forgiven in three equal parts each five years so that at the end of the fifteen year term the balance owed is zero.If sold after the fifteen year term,no repayment is required. As long es the recipient continues to own and occupy the assisted property during the term of the mortgage,then the loan will not have to be repaid. This Security Instrument secures to Lender.(a)the repayment of the debt evidenced by the Note,with interest,and all renewals,extensions and modifications;(b)the payment of all other sums,with interest advanced under paragraph 7 to protect the security of the Security Instrument;and(c)the performance of Borrowers covenants and agreements under this Security Instrument and the Note. For this purpose, Borrower does hereby second mortgage,grant and convey to Lender the following described property located in Collier County,Florida. As more particularly described as Golden Gate Unk 3 Blk 100 Lot 11,of the Public Records of Collier County,Florida and which has the address of: ("Property Address"): 2831 44 Terrace SW Naples FL 34116 (Address) (City) (State) (Zip) TOGETHER WITH all the improvements now or hereafter erected on the property,and all easements,rights,appurtenances,rents, royalties,mineral,oil and gas rights and profits,water rights and stock and all fixtures now or hereafter a part of the property. All replacements and additions shall also be covered by the Security Instrument. • • .,•• `••• ••is referred to in this Security Instrument as the"Property". BORROWER COVENANTS that Borrower is I= • i."1. '•' •r2 '- y conveyed and has the right to mortgage,grant and convey the Property and that the Property is unencumbe• •'• :,.• ,•;;» ,• cord. Borrower warrants and will defend generally the title to the Property against all claims end deman• t1' o any encumbran.=• c• THIS SECURITY INSTRUMENT combs - `covenants for national use- • nkorm covenants with limited variation by jurisdiction to constitute a uniform security In . - : .party UNIFORM COVENANTS. Borrower an. - •.r. , allows: 1. Payment of Principal and Interest •ayment an• Borrows promptly pay when due the principal of and Interest on the debt evidenced by the Note. -fi 2. Taxes. The Mortgagor win pay all ss lie. • to the accrual of any penalties or interest thereon. y`{ The Mortgagor shall pay or cause to•- v'I• a• •.l- .•-- e, ►j .all taxes and governmental charges of an kind whatsoever which may at any time be lawfu aced or levied against - p-. '•• Property,(2)all utility and other charges,y Including"service charges",incurred or imposed operation,maintenance, . . pkeep and improvement of the Property,and (3)alt assessments or other governmental charg lawfully be pald in r 3`I • • .4. -period of years,the Mortgagor shall be obligated under the Mortgage to pay or cause to be such Instalments as e- - -• o be paid during the term of the Mortgage,and shall,promptly after the payment of any of the forego to Mortgagee evlde..- • payment 3.Application of Payments.ayments. Unless appllce• a othe ,� - • ,• •nts received by Lender shall be applied;first,to Interest due;end,to principal due;and last,to any late cha••-* •• 4. Charges;Liens. Borrower shall pay alt taxes, • • ^.- - „•T and Impositions attributable to the Property which may attain priority over this Security Instrument,and leasehold payments or ground rents,if any. Borrower shall promptly furnish to Lender all notices of amounts to be paid under this paragraph,and all receipts evidencing the payments. Borrower shall promptly discharge any lien which has priority over this Security Instrument unless Borrower.(a)agrees In writing to the payment of the obligation secured by the lien in a manner acceptable to Lender;(b)contests in good faith the lien by,or defends against enforcement of the lien in,legal proceedings which In the Lenders opinion operate to prevent the enforcement of the lien;or(c)secures from the holder of the lien en agreement satisfactory to Lender subordinating the lien to this Security Instrument If Lender determines that any part of the Property Is subject to a lien which may attain priority over the Security Instrument,Lender may give Borrower a notice identifying the lien. Borrower shall satisfy the lien or take one or more of the actions set forth above within 10 days of the giving of notice. 5. Hazard or Property Insurance. Borrower shall keep the Improvements now existing or hereafter erected on the Property Insured against loss by fire,hazards included within the term"extended coverage"and any other hazards,including floods or flooding,for which Lender requires insurance. This Insurance shad be maintained In the amounts and for the periods that Lender requires. The insurance carrier providing the Insurance shall be chosen by Borrower subject to Lender's approval which shall not be unreasonably withheld. If Borrower fans to maintain coverage described above,Lender may,at Lender's option,obtain coverage to protect Lender's rights In the Property In accordance with paragraph 7. At all times that the Note is outstanding,the Mortgagor shall maintain insurance with respect to the Premises against such risks and for such amounts as are customarily insured against and pay,as the same become due and payable,all premiums in respect thereto, including,but not limited to,all-risk insurance protecting the interests of the Mortgagor and Mortgagee against loss or damage to the Premises by fire,lightning,and other casualties customarily insured against(including boiler explosion,If appropriate),with a uniform standard extended coverage endorsement,including debris removal coverage. Such insurance at all times to be in en amount not less than the full replacement cat of the Premises,exclusive of footings and foundations, All insurance policies and renewals shall be acceptable to Lender and shall include a standard mortgage clause. Lender shall have the right to hold the policies end renewals. if Lender requires,Borrower shall promptly give to Lender all receipts of paid premiums and renewal notices. In the event of loss,Borrower shall give prompt notice to the Insurance carrier and Lender. Lender may make proof of less if not made promptly by Borrower. • Unless Lender and Borrower otherwise agree in writing,insurance proceeds shall be applied to restoration or repair of the Property damaged,lithe restoration or repair is economically feasible and Lenders security Is not lessened. If the restoration or repair Is not economically feasible or Lender's security would be lessened,the insurance proceeds shall be applied to the sums secured by the Security instrument,whether or not then due,with any excess paid to Borrower. If Borrower abandons the Property,or does not answer within 30 days a notice from Lender that the insurance carrier has offered to settle a claim,then Lender may collect the insurance proceeds. Lender may use the proceeds to repair or restore the Property or to pay sums secured by this Security Instrument,whether or not then due. The 30-day perod will begin when the notice la mailed. Unless Lender and Borrower otherwise agree in writing,any application of proceeds to principal shall not extend or postpone the due date of the monthly payments referred to in paragraph 1 or change the amount of the payments. If under paragraph 21 the Property is acquired by Lender,Borrowers right to any Insurance policies and proceeds resulting from damage to the Property prior to the acquisition shall pass to Lender to the extent of the sums secured by this Security Instrument immediately prior to the acquisition. 6. Occupancy,Preservation.Maintenance and Protection of the Property;Borrower's Loan Application,Leaseholds. Borrower shall occupy,establish,and use the Property as Borrower's principal residence within sixty days after the execution of this Security Instrument and shall continue to occupy the Property as Borrower's principal residence for at least one year after the date of occupancy,unless Lender otherwise agrees In writing,which consent shall not be unreasonably withheld,or unless extenuating circumstances exist which are beyond Borrowers control. Borrower shall not destroy,damage or impair the Property,allow the Property to deteriorate,or commit waste on the Property. Borrower shall be In default if any forfeiture action or proceeding,whether civil or criminal,is begun that in Lenders good faith judgment could result In forfeiture of the Property or otherwise materially impair the lien created by this Security Instrument or Lender's security OR 4836 PG 3631 T 6 Li 1 interest. Borrower may cure such a default and reinstate,as provided in paragraph 18,by causing the action or proceedng to be dismissed with a ruling that,in tender's good faith determination,precludes forfeiture of the Borrower's interest in the Property or other material impairment of the lien created by this Security Instrument or Lender's security Interest Borrower shall also be in default If Borrower,during the loan application process,gave materially false or inaccurate information or statements to Lender(or failed to provide Lender with any material information)in connection with the loan evidenced by the Note,Including,but not limited to,representations concerning Borrowers occupancy of the Property as a principal residence. If this Security Instrument Is on a leasehold,Borrower shall comply with all the provision of the lease. If Borrower acquires fee title to the Property,the leasehold and the fee title shall not merge unless Lender agrees to the merger kr writing. 7. Protection of Lender's Rights In the Property. If Borrower fails to perform the covenants and agreements contained in this Security Instrument,or there is a legal proceeding that may significantly effect Lender's rights In the Property(such as a proceeding In bankruptcy,probate,for condemnation or forfeiture or to enforce laws or regulations),then Lender may do and pay for whatever is necessary to protect the value of the Property and Lender's rights in the Property. Lender's actions may include paying any sums secured by a lien which has priority over this Security Instrument,appearing kr court,paying reasonable attorneys'fees and entering on the Property to make repairs. Although Lender may take action under this paragraph 7,Lender does not have to do so. Any amounts disbursed by Lender under this paragraph 7 shall become additional debt of Borrower secured by this Security Instrument Unless Borrower end Lender agree to other terms of payment,these amounts shall bear interest from the date of disbursement at the Note rate and shall be payable,with interest,upon notice from Lender to Borrower requesting payment 8, Mortgage Insurance. If Lender required mortgage insurance as a condition of making the loan secured by this Security Instrument,Borrower shall pay the premiums required to maintain the mortgage Insurance In effect. If,for any reason,the mortgage Insurance coverage required by Lender lapses or ceases to be in effect,Borrower shall pay the premiums required to obtain coverage substantially equivalent to the mortgage Insurance previously In effect,at a cost substantially equivalent to the cost to Borrower of the mortgage Insurance previously in effect,Iran an alternate mortgage Insurer approved by Lender. If substantially equivalent mortgage insurance coverage is not available,Borrower shall pay to Lender each month a sum equal to one-twelfth of the yearly mortgage insurance premium being paid by Borrower when the insurance coverage lapsed or ceased to be In effect Lender will accept use and retain these payments as a loss reserve In lieu of mortgage insurance. Loss reserve payment°may no longer be required,at the option of Lender,if mortgage insurance coverage(In the amount and for the period that Lender requires)provided by an insurer approved by Lender again becomes available and is obtained. Borrower shall pay the premiums required to maintain mortgage insurance In effect,or to provide a loss reserve,until the requirement for mortgage insurance ends In accordance with any written agreement between Borrower and Lender or applicable law. 9.Inspection. Lender or Its agent may make reasonable entries upon and Inspections of the Property. Lender shall give Borrower notice at the lime of or prior to an inspection specifying reasonable cause for the Inspection. 10. Condemnation.The proceeds of any award or claim for damages,direct or consequential,in connection with any condemnation or other taking of any part of the Property,or for conveyance in lieu of condemnation,are hereby assigned and shall be paid to Lender. In the event of a total taking of the Property,the proceeds shall be applied to the Bums secured by this Security Instrument,whether or not then due, with any excess paid to Borrower. In the event of a partial taking of,,.- - h in which the fair market value of the Property immediately before the taking is equal to or greater than the amount of the,,. ,-,' v Instrument immediately ediatey before the taking,unless Borrower and Lender otherwise agree In writing,the sum. ,• a;• '. •,- shall be reduced by the amount of the proceeds multiplied by the following fraction:(a)the total amount• secured Imm n' .. • ,the taking,divided by(b)the fair market value of the Property immediately before the taking.Any•. -••• II be paid to Borrower. • - - nt of a partial taking of the Properly in which the fair market value of the Property Immediately•-• - ,n•is leas then the amou •f th-sums secured immediately for the taking, unless Borrower and Lender otherwise agree in •• •• u, • • • t. -nurse•••v'•- ,the proceeds shall be applied to the sums secured by this Security Instrument whether or n• - -urns re -nder- •Bo • -r otherwise agree in writing,any application of proceeds to principal shall not ext: •4 d - .referred to in paragraphs 1 or change the amount of such payments. g"J 11. Borrower Not Released,Forbes e t .for payment or nrodiflcetlon of amortization of the sums secured by this Secu A 4,14....,.• - to an•t - . Interest of Borrower shall not operate to release the liability of the original Borrower or:• a - -• n : Le - required to commence proceedings against any successor In Interest or refuse to- .-1•70;-for payment or othe mod �'h:•?, •n of the stens secured by this Security Instrument by reason of any demand made by the• .I Borrower or Borrower'! -• r crest Any forbearance by Lender in exercising any right or remedy shall not be a waive`141• rude the exercise o r • •• ' edy. 12.Successors and Assigns Bound;J' ' everal Liability;Co-SI•• ••- r -covenants end agreements of this Security Instrument shall bind and benefit the successors and a nder and:• • 1•,-.to the Provisions of paragraph 17. Borrower's covenants and a• , •- c - J. Any Borrower who co-signs this Security I Instrument but does not execute the Note;(a)is co-signing th,- �•7t, , 1j ' 'y to mortgage,grant and convey that Borrower's interest in the Property under the terms of thls Security Instrument;(b)is no •- -- ligated to pay the sums secured by this Security Instrument; and(c)agrees that Lender and any other Borrower may agree to extend,modify,forbear or make any accommodations with regard to the terms of this Security Instrument or the Note without that Borrower's consent 13.Loan Charges. If the loan secured by this Security Instrument is subject to a law which sets maximum loan charges,and that law Is finally interpreted so that the Interest or other loan charges collected or to be collected in connection with the loan exceed the permitted limits,then:(a)any such loan charge shall be reduced by the amount necessary to reduce the charge to the permitted knit and(b)any sums already collected from Borrower which exceeded permitted Units will be refunded to Borrower. Lender may choose to make this refund by reducing the principal owed under the Note or by making a direct payment to Borrower. If a refund reduces principal,the reduction will be treated as a partial prepayment without any prepayment charge under the Note. 14. Notices.Any notice to Borrower provided for in this Security Instrument shall be given by delivering it or by mailing it by first class mall unless applicable law required use of another method. The notice shall be directed to the Property Address or any other address Borrower designates by notice to Lender. Any notice to Lender shall be given to Borrower or Lender when given as provided in this paragraph. 15.Governing Law;Severability.This Security Instrument shall be governed by federal law and the law of the jurisdiction In which the Property is located. In the event that any provision or clause of this Security Instrument or the Note conflicts with applicable law,such conflict shell not affect other provisions of this Security Instrument or the Note which can be given effect without the conflicting provision. To this end the provisions of this Security Instrument and the Note are declared to be severable. 18. Borrower's Copy. Borrower shall be given one conformed copy of the Note and of this Security Instrument 17.Transfer of the Property or a Beneficial Interest In Borrower. If all or any part of the Property or any interest in It is sold or transferred(or if a beneficial interest in Borrower is sold or transferred and Borrower is nota natural person)without Lender's prior written consent,Lender may,at its option,require immediate payment in full of all sums secured by this Security Instrument However,this option shall not be exercised by Lender If exercise Is prohibited by federal law as of the date of this Security Instrument. If Lender exercised this option,Lender shall give Borrower notice of acceleration. The notice shell provide a period of not less than 30 days from the date the notice is delivered or mailed within which Borrower must pay all sums secured by this Security Instrument. If Borrower fails to pay these sums prior to the expiration of this period,Lender may invoke any remedies permitted by this Security Instrument without further notice or demand on Borrower. 18. Borrower's Right to Reinstate. If Borrower meets certain conditions,Borrower shall have the right to have enforcement of this Security Instrument discontinued at any time prior to the earlier of:(a)5 days(or such other period as applicable law may specify for reinstatement)before sale of the Property pursuant to any power of sale contained In this Security Instrument or(b)entry of a judgment enforcing this Security Instrument Those condition are that Borrower:(e)pays Lender all sums which then would be due under this Security Instrument and the Note as if no acceleration had occurred;(b)cures and default of any other covenants or agreements;(c)pays alt expenses incurred In enforcing this Security Instrument,Including,but not limited to,reasonable attorney's fees;and(d)takes such action as Lender may reasonably require to assure that the lien of this Security Instrument,Lender's rights In the Property and Borrower's obligation to pay the sums secured by this Security Instrument shall continue unchanged. Upon reinstatement by Borrower,this Security Instrument and the obligations secured hereby shall remain fully effective as if no acceleration had occurred. However,this right to reinstate shall not apply In the case of acceleration under paragraph 17. 19. Sale of Note;Change of Loan Servicer. The Note ora partial Interest in the Note(together with this Security Instrument)may be sold one or more times without prior notice to Borrower.A sale may result in a change in the entity(known as the"Loan Servicer')that collects monthly payments due under the Note and this Security Instrument There also may be one or more changes of the Loan Servicer unrelated to a sale of the Note. If there is a change of the Loan Servicer,Borrower will be given written notice of the change in accordance with paragraph 14 and applicable law. The notice will state the name end address of the new Loan Servicer end the address to which payments should be made. The notice will also contain any other information required by applicable law. OR 4836 PG 3632 to 1 0 • 20. Hazardous Substances. Borrower shall not cause or permit the presence,use,disposal,storage,or release of any Hazardous Substances on or In the Property. Borrower shall not do,nor allow anyone else to do,anything affecting the Property that la in violation of any Environmental Law. The preceding two sentences shall not apply to the presence,use,or storage on the Property of small quantities of Hazardous Substances that are generally recognized to be appropriate to normal residential uses and to maintenance of the Property. Borrower shall promptly give Lender written notice for any Investigation,claim,demand,lawsuit or other action by any governmental or regulatory agency or private party Involving the Property end any Hazardous Substance or Environmental Law of which Borrower has actual knowledge. If Borrower learns,or is notified by any governmental or regulatory authority,that any removal or other remediation of any Hazardous Substance affecting the Property Is necessary,Borrower shall promptly take all necessary remedial actions In accordance with Environmental Law. As used in this paragraph 20,"Hazardous Substances"are those substances defined as toxic or hazardous substances by Environmental Law and the following substances:gasoline,kerosene,other flammable or toxic petroleum products,toxic pesticides and herbicides,volatile solvents,materials containing asbestos or formaldehyde,and radioactive materials. As used in this paragraph 20,"Environmental Law"means federal laws and laws of the jurisdiction where the Property Is located that relate to health,safety or environmental protection. 21.Acceleration;Remedies. Lender shall give notice to Borrower prior to acceleration following Borrower's breach of any covenant or agreement In thie Security Instrument(but not prior to acceleration under paragraph 17 unless applicable law provides otherwise).The notice shall specify. (a)the default;(b)the action required to cure the default(c)a date,not less than 30 days from the date the notice is given to Borrower,by which the default must be cured;and(d)that failure to cure the default on or before the date specified in the notice may result in acceleration of the sums secured by this Security Instrument,foreclosure by judicial proceeding and sale of the Properly. The notice shall further inform Borrower of the right to reinstate after acceleration and the right to assert in the foreclosure proceeding the non-existence of a default or any other defense of Borrower to acceleration and foreclosure. If the default is not cured on or before the date specified in the notice, Lander,at Its option,may require Immediate payment In fuN of all sums secured by this Security Instrument without further demand and may foreclose this Security Instrument by judicial proceeding. Lander shall be entitled to collect all expenses incurred in pursuing the remedies provided in this paragraph 21,Including,but not limited to,reasonable attorneys fees and costa of the title evidence. 22. Release. Upon payment of all sums secured by this Security Instrument,Lender shall release this Security Instrument,without charge,to Borrower. Borrower shall pay any recordation costs. 23.Attorneys'Fees.As used in this Security Instrument and the Note,"attorneys'fees"shall include any attorneys'fees awarded by an appellate court. 24. Riders to this Security Instrument If one or more riders are executed by Borrower and recorded together with this Security Instrument,the covenants and agreements of each such rider shall be Incorporated into and shall amend and supplement the covenants and agreements of this Security Instrument as If the riders)were a part of this Security Instrument (Check Applicable Box) ❑Adjustable Rate Rider ❑Rate Improvement R• 0 Condominium Rider ❑Graduated Payment Rider ❑1-4 Family Rider 3 R COti S.II Second Home Rider ❑Balloon Rider 0 B'rweeky Pa et'n. .�.►. ned Unit Development Rider ❑Other(s)(specify SIGNING BELOW,Borrower accepts and agree- o. terms e •.•y- •ts conteed in th S-• rlty Instrument end in any rider(s)executed by Borrower and recorded with it J. Signed,sealed and delivered in the Presence of n(C 0 di�7,ts • Witnesses: I t2 s �U •ature:.«b.-- Bo r; -r vie Jean Slgnature/� ' s rl ear• .• W tneasf2: Norms OB- r . Slgnatu• r %r.—_ i • Pl' ''- C• gdala/O. Jean Signature:sal i�— T.[n c x L� `� Address: 2831 44th Terrace SW Naples, FL 34116 STATE OF FLORIDA COUNTY OF COLLIER I hereby certify that on this day,Gesnal Jean and Magdala 0. Jean before me,an officer duty authorized In the state aforesaid and in the county aforesaid to take acknowledgements,personally appeared to me known to be the person(s)described in and who executed the foregoing Instrument and acknowledged before me that(He/else/they)executed the same for the purpose therein expressed. WITNESS my hand and official seal in the County and State af�orereessaiidddtthis Al day of SCP rem de' 2012. My Commission Expires: sial tns� N ry Pubads S nature (Seal) ovM,�LO;;.r Norma Lora-Trejo 9..A:\ '' Notary's Printed Name e A lit et an 7 /8 %G P SHIP ' (••t''1 Prepared by. • Collier Cotmty Housing,Human&Veterans Department 3339 E.Tamiami Trail,Bldg H,Suite 211 Naples,FL 34112 i • OR 4836 PG 3633 16010 1 n STATE HOUISING INITIATIVES PARTNERSHIP (SHIP) PROGRAM PROMISSORY NOTE Date: September I , 2012 Borrower: Gesnal Jean and Magdala O. Jean 2831 44th Terrace SW Naples FL 34116 (Property Address) (City) (State) (Zip) • 1. BORROWERS) PROMISE TO PAY: I/We promise to pay Twenty Thousand and 00/100 Dollars ($20,000.00) (this amount will be called "principal") to the order of Collier County- SHIP or to any other holder of this Note (the "Lender"), whose address is 3339 E. Tamiami Trail, Naples, Florida 34112. I/We understand that the Lender may transfer the Promissory Note. The Lender or anyone who takes this Note by transfer and who is entitled to receive payments under this Note will be called the "Note Holder". 2. INTEREST: Interest on this Note shall be zero percent (0%) per annum; except that if I/We fail to pay this Note as required, the interest rate shall be twelve percent (12%) per annum from the date when payment of this Note is due until I/We pay it in full. 3. PAYMENTS: Payment in full is due upon sale if sold within the fifteen year term. •If sold within fifteen years then the loan will be forgiven in three equal parts each five years so that at the end of the fifteen year term the balance owed is zero. If sold after the fifteen year term, no repayment is required. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage, then the loan will not have to be repaid. My/Our total payment shall be U.S. $20,000.00. 4. BORROWER'S RIGHT TO PREPAY: I CQ • to make payments of principal at any time before they are due. A (��,t. • pr n • is known as a "prepayment". When I/We make a prepayment, I/we 14 ell the Note • d', n writing that I/we am doing so. I/We may make a full prep t •• • =•ayme t ergs. The Note Holder will use all of my prepayments to -•-ce .-,.• t o he pr nci.al that I owe under this Note. If I/We make a partial . . , --.-.e ha.ges in the due date or in the amount of my monthly pa . , ) T re-= in writing to those changes. If I/We make a partial �• , n., h r •• re,-ayment penalty adhering to or associated with such pre,. •�- •� 5. LOAN CHARGES: If a law, h applies to th' loa. a --1. ich sets maximum loan charges, is finally interpreted a• :• t the interest • h- •an charges collected or to be collected in connection w- . is loan excee:' i tted limits; then (i) any such loan charges shall be redthe amount n ..y to reduce the charges to the permitted limit; and (ii) a. •t already c• from me which exceeded permitted limits will be refunded to me e.:- ,;��{•.:. may choose to make this refund by reducing the principal that I/We -:, •. .... S`��' Note or by making a direct payment to me/us. If a refund reduces princip= , e reduction will be treated as a partial prepayment. 6. SUBORDINATION: Lender and Borrower acknowledge and agree that this Security Instrument is subject and subordinate in all respects to the liens, terms, covenants and conditions of the First Deed of Trust and to all advances heretofore made or which may hereafter be made pursuant to the First Deed of Trust including all sumo advanced for the purpose of (a) protecting or further securing the lien of the First Deed of Trust, curing defaults by the Borrower under the First Deed of Trust or for any other purpose expressly permitted by the First Deed of Trust or (b) constructing, renovating, repairing, furnishing, fixturing or equipping the Property. The terms and provisions of the First Deed of Trust are paramount and controlling, and they supersede any other terms and provisions hereof in conflict therewith. In the event of a foreclosure or deed in lieu of foreclosure of the First Deed of Trust, any provisions herein or any provisions in any other collateral agreement restricting the use of the Property to low or moderate income households or otherwise restricting the Borrower's ability to sell the Property shall have no further force or effect on subsequent owners or purchasers of the Property. Any person, including his successors or assigns (other than the Borrower or a related entity of the Borrower), receiving title to the Property through a foreclosure or deed in lieu of foreclosure of the First Deed of Trust shall receive title to the Property free and clear from such restrictions. Further, if the Senior Lien Holder acquires title to the Property pursuant to a deed in lieu of foreclosure, the lien of this Security Instrument shall automatically terminate upon the Senior Lien Holder's acquisition of title, provided that (i) the Lender has been given written notice of a default under the First Deed of Trust and (ii) the Lender shall not have cured the default under the First Deed of Trust within the 30-day period provided in such notice sent to the Lender. 7. BORROWER(S) FAILURE TO PAY AS REQUESTED: (A) Default If I/we do not pay the full amount as required in Section 3 above, I/we will be in default. If I am in default, the Note Holder may bring about any actions not prohibited by applicable law and require me/us to pay the Note Holder's cost and expenses as described in (B) below. 1 *** OR 4836 PG 3634 *** . �+ ,f bq n f 4 (B) Payment of Note Holder's Cost and Expenses If the Note Holder takes such actions as described above, the Note Holder will have the right to be paid back for all of its costa and expenses, including, but not limited to, j reasonable attorneys' fees. 8. GIVING OF NOTICES: Unless applicable law required a different method, any notice that must be given to me/us under the Note will be given by delivering it or by mailing it by first class mail to me at the Property Address on Page 1 or at a different address if I/we give the Note Holder a notice of my/our different address. Any notice that must be given to the Note Holder under this Note will be given by mailing it by first class mail to the Note Holder at the address stated in Section 3(A) or at a different address if I/we have been given a notice of that different address. 9. OBLIGATIONS OF PERSONS UNDER THIS NOTE: If more than one person signs this Note, each person is fully and personally obligated to keep all of the promises made in this Note, including the promise to pay the full amount owed. Any person who is a guarantor, surety or endorser of this Note is also obligated to do these things. Any person who takes over these obligations, including the obligations of a guarantor, surety or endorser of this Note, is also obligated to keep all of the promises made in this Note. The Note Holder may enforce its rights under this Note against each person individually or against all of us together. This means that any one of us may be required to pay all of the amounts owed under this Note. 10. WAIVERS: I and any other person who has obligations under this Note waive the rights of presentment and notice of dishonor. "Presentment" means the right to require the Note Holder to demand payment of amounts due. "Notice of Dishonor" means the right to require the Note Holder to give notice to other persona that amounts due have not been paid. 11. UNIFORM SECURED NOTE: This Note is a uniform instrument with limited variations in some jurisdictions. In addition to the protection given to the Note Holder under this Note, a Mortgage, Dead of Trust or Security Deed (the "Security Instrument"), dated the same date as this Note, protects the Note Ho +I..• •7• ble losses which might result if I/we do not keep the promises which I/wK, I'4" That Security Instrument describes gi how and under what conditions be re•• t14,' . make immediate payment in full of all amounts I/we owe under t• -- e. Some of th. - :..ditions are described as follows: Transfer of the Property o •e•e c : • er--t in =or .wer. If all or any part of the property or any interest 't .ld .r t a•sferr:. .r if a beneficial interest in Borrower is sold or tra - r,- : . ..r. - n-tural person) without Lender's prior written consent, i• T('ir: immediate payment in full or all auras secured by t uri y I s �t .` eve , this option shall not be exercised by Lender if e : o.iJaf_d law as of the date of this Security Instrument. Q! If Lender exercises this .1.. , Lender shall-J.-•e =• er notice of acceleration. The notice shall provide a pert! • not leas than , ~j') days from the date the notice is delivered or mailed, wi Il R ch Borrower mus all sums secured by this Security Instrument. If Borrower(s) • pay th - prior to the expiration of this period, Lender may invoke any -” -.L - •-i•, .y this Security Instrument without further notice or demand on Borrow- Notwithstanding the above, the Lender's rights to collect and apply the insurance proceeds hereunder shall be subject and subordinate to the rights of the Senior Lien Holder to collect and apply such proceeds in accordance with the First Deed of Trust. 12. This note is governed and construed in accordance with the Laws of the Stab of Florida. WITNESS NAND(S) AND SEALS) OF THE UNDERSIGNED. (Seal) Bor er Gesnal Jean ea O . 2-f+9,•,.. (Seal) "ig7Itger Magdala O. Jean RETURN TO: Collier County Rousing, Human and Veteran Services Department SHIP DOWN PAYMENT AND CLOSING COST ASSISTANCE PROGRAM 3339 E. Tamiami Trail, Building H, Suite 211 Naples, Florida 34112 SHIP FilUS:11-019 2 .4 0 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP z TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the exception of the Chairman's signature,draw a line through routinLlines#1 through#2,complete the checklist,and forward to the County Attorney Office. Route to Addressee(s) (List in routing order) Office Initials Date 1. Jennifer A. Belpedio,ACA County Attorney Office >'pvQ, 1-2,/co it Co 2. BCC Office Board of County j F tom- Commissioners , r\ '< 3. Minutes and Records Clerk of Court's Office NOTE: Clerk's attestation is not required. Please do not route this item to Clerk's Board Minutes and Records. CAO please scan document after execution by Chairman and email them to Clerk's Minute and Records for its records. PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above,may need to contact staff for additional or missing information. Name of Primary Staff Don Luciano,CHS Phone Number 239-252-250 Contact/ Department Agenda Date Item was June 12,2012 V Agenda Item Number 16D10\ Approved by the BCC Type of Document Second Insurance Claim Check Number of Original Attached Endorsement for Pierre A.Borgela Documents Attached PO number or account number if document is to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Ipitial) Applicable) 1. Does the document require the chairman's original signature? e 2. Does the document need to be sent to another agency for additional signatures? If yes, • N/A provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be N/A signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the — N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's 7r7s. N/A signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip N/A should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! - 8. The document was approved by the BCC on 06/12/2012 and all changes made during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes,if applicable. r fi. krr 9. Initials of attorney verifying that the attached document is the version approved by the 4,,t-"E 3e*t BCC,all changes directed by the BCC have been made,and the document is ready for the/7 Chairman's signature. ' I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12 16j0 THIS DOCUMENT HAS AVOID PANTOGRAPH;MICROPRINTING,A COIN REACTIVE ARTIFICIAL WATERMARK AND THERMOCHROMATIC INK. fal �fiEc a a Elate- { INs k 0 977 • N C , ,, . 2.29i (�16FL 2 4 77-353 • November 10,2016 ,'i I ;=UPC Insurance.. _ ; ' �� ., " P.9.4.oar 145fi8 �r A $ i -za 3 `§am Petersburg ,33-45.8z. 0 zt ` : E'A Nit'11-..-1`. , housan: Nine Nun•.4.s igh Three anc 26/10(1 Dollars $7.,'.! 9,983.26 TO THE F�IERRE A BORG�L and Hb SI '.G O. N 8� TERAN ORD FbflF ERVI =arid FIFTkt TI IR©>°°k ANG RP I~S�4 q gin'° AIL-Quail, Inc nutnortzed Signature . 9i4,4 ''' - - _ ,=, �s4�Wells- arga B�.k N.X. ,*4"' ��... *' � �.' '� San Is iso to ' ` a' .n'',`* �' e 1 r , Mu.,� nn�k . n 0 _ - .,, Authorized_,.natur E,.. lilt 1 I 1 P. Eli m o l i m'.' i oz c �1.3 ` in a r 6,..... ;mm�ca ms - D c m _.ifi. m = B s 3 2 D o W ' < 0 S 7 ,0 � mza m omoi,' =iam a fi,^og a oml'o yp 9XO W 1A Nmo 33! i2Fd ti m I " = z coz m 1 i 161110 Collier County Community and Human Services Division (CHS) Homeowner Insurance Check Endorsement Policy Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage/lien,then the loan will not have to be repaid. On occasion,the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and receive money to make the repairs. If the insurance claim check is made payable to the homeowner and Collier County,then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to CHS at the address below for check endorsement consideration: 1. Copy of Homeowner's current insurance policy-Declaration Page. 2. Copy of insurance company's claim report with worksheet including description of repairs and costs. 3. Copy of photos of claim damage. 4. Copy of Insurance check(s)payable to homeowner,first lien holder and Collier County. Homeowner Name: A ,.e 4: ;�, J e. Homeowner Address: l7///t3 7 .��7-41;ke rVc' A/ 45 F./ JAW Primary Contact Number: CA ) .233 35:537(c. . 39 Homeowner Email: OFFICE USE ONLY — Reviewed CHS- Grant Coor mator Dat /A Si)1 - Approved CHS Director Date Denied 1b D1 t Memorandum To: Kimberly Grant, CHS Director CC: Jennifer Belpedio,Assistant County Attorney From: Donald Luciano,Grant Support Specialist, Community and Human Services Date: 12/01/2016 Re: Homeowner Insurance claim check endorsement-Borgela, Pierre 4437 54th Avenue NE,Naples,Florida 34120 The Homeowner Insurance Check Endorsement Policy approved by the Board on June 12, 2012 (16.D.10)authorizes the Board Chairman or Vice Chairman to endorse homeowner insurance claim checks for recipients assisted with Purchase Assistance and/or rehabilitation program funds as Collier County is named as Second Mortgagee on their insurance policies. The attached check in the amount of$9,983.26 is the second disbursement of the claim funds requiring endorsement by Board Chairman Fiala or Vice Chairman. The check names Fifth Third Bancorp ISAOA as the first mortgage lender and Housing Human & Veteran Service,now known as,Community and Human Services, as subordinate lien holders. In order for the check to be properly processed,proper signatures/endorsement for all parties listed on check must be obtained. This is a time-sensitive item and must be endorsed as soon as possible as homeowner is waiting to pay for work to be performed on home. Attachments: Homeowners insurance policy-Declaration Page Insurance claim check(#77353) $9,983.26 Insurance claim report&photos of damage Collier County Second Mortgage loan 1 Ifi : 'l ' d tiW y 6c e a fp(0-01 (0. I). D1/94 iiivia * /Ie. D. ib EXECUTIVE SUMMARY Recommendation to approve a homeowner insurance check endorsement policy for all borrowers assisted with purchase assistance and/or rehabilitation housing program funds and authorizes Board Chairman or Vice Chairman, in his absence to endorse two homeowner insurance claim checks. OBJECTIVE: To allow homeowners in good standing with the State Housing Initiatives Partnership (SHIP) program to deposit their homeowner insurance claim check into the bank so they can use the funds to repair their damaged homes. CONSIDERATION: On July 25,2008,the subject homeowners purchased a home located at 2505 41st Ave NE, Naples, FL 34120. Collier County approved down payment assistance through the SHIP program and the borrowers signed a second mortgage for SHIP down payment assistance on July 25, 2008. On January 20,2012,the homeowners filed a homeowner's insurance claim due to water seepage damage to their home.The total claim for damages was$9,935.68. The insurance company paid the claim minus the homeowner's $1,000 deductible, in two separate checks. Check#1 in the amount of$7,964.41 and check#2 in the amount of$971.37. The insurance company made the checks payable to the homeowner, Bank of America and Collier County since all parties have an interest in the property. According to the SHIP loan documents and SHIP local housing administrative plan(LHAP)the homeowner is not required to pay back any funds to Collier County unless the homeowners sell, refinance or lose their homestead exemption on the property. None of these triggering events have occurred and the homeowner's second mortgage loan with Collier County is in good standing. Therefore, Collier County has no claim to the homeowner's insurance claim money that was provided to make repairs to the home. The homeowner has expressed frustration in having to wait for her checks to be endorsed because her house is in urgent need of repairs. Accordingly,Housing staff has developed a proposed Homeowners Insurance Check Endorsement Policy for similar circumstances in the future. If this item is approved,the Board Chairman or Vice Chairman, in his absence may endorse a check only if certain enumerated documentation is provided and the homeowner is in compliance with the SHIP and/or Single Family Home Rehabilitation program. The proposed Homeowners Insurance Check Endorsement Policy is attached as back-up for Board consideration. FISCAL IMPACT: There is no fiscal impact associated with this Executive Summary. GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact associated with this Executive Summary. LEGAL CONSIDERATIONS: This item is legally sufficient and requires a majority vote for Board action. -JBW RECOMMENDATION: That the Board of County Commissioners approves a homeowner insurance check endorsement policy for all borrowers assisted with purchase assistance and/or rehabilitation housing program funds and authorizes the Board Chairman or Vice Chairman, in his absence to endorse two homeowner insurance claim checks. PREPARED BY: Lisa Carr/Housing Outreach Coordinator,Housing Human and Veteran Services UPC(-1A HOMEOWNERS DECLARATION INSURANCE POLICY NUMBER POLICY PERIOD UNITED PROPERTY&CASUALTY INS CO From To P.O.Box 51149 Sarasota, FL 34232-0330 UHV 2801254 04 01 08/29/2016 08/29/2017 12:01 a.in.at the residence premises. RENEWAL DECLARATION Effective: 08/29/2016 Date Issued:07/11/2016 INSURED: AGENT: 9960049 PIERRE A BORGELA BRIGHTVVAY INSURANCE,INC. 4437 54TH AVE NE PO Box 5700 NAPLES FL 34120 Jacksonville FL 32247 Telephone:239-867-1275 Telephone:239-676-8199 The residence premises covered by this policy is located at the address listed below. 4437 54TH AVE NE NAPLES FL 34120 IF PAYMENT IS NOT RECEIVED ON OR BEFORE THE POLICY RENEWAL EFFECTIVE DATE, THIS POLICY WILL NOT BE IN FORCE. Coverage is provided where premium and limit of liability is shown. Flood coverage is not provided and is not a part of this policy. SECTION I COVERAGE LIMIT OF LIABILITY PREMIUMS A. DWELLING $234,000.00 $1,023.00 B. OTHER STRUCTURES $4,680.00 INCLUDED C. PERSONAL PROPERTY $117,000.00 INCLUDED D. LOSS OF USE $46,800.00 INCLUDED SECTION II COVERAGE E. PERSONAL LIABILITY $300,000.00 $18.00 F. MEDICAL PAYMENTS $1,000.00 INCLUDED OPTIONAL COVERAGES Premium charge for Hurricane Exposure: $686.00 The above coverages are subject to a 2% / $4,680 Hurricane Deductible. The above coverages are subject to a 10% / $23,400 Sinkhole Deductible per sinkhole loss. The above coverages are subject to a $2,500 All Other Peril Deductible. TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES: $1,068.00 The amount of premium increase due to approved rate increase is $47.00 The amount of premium increase due to coverage increase is $37.00 COVERAGES HAVE BEEN INCREASED TO HELP KEEP PACE WITH RISING REPLACEMENT COSTS. PLEASE CONTACT YOUR AGENT IF THERE ARE ANY QUESTIONS PERTAINING TO YOUR POLICY. FORMS AND ENDORSEMENTS HO 0003 (05/11) HO 0334 (05/13) COUNTERSIGNED DATE 07/11/2016 HO 0350 (06/97) HO 0355 (05/13) HO 0446 (10/00) HO 0496 (04/91) �L . %. 6- HO 2370 (05/13) HO 2386 (05/13) BY " J Continued on Forms Schedule ADDITIONAL INTERESTS MORTGAGEE SECOND MORTGAGEE FTB0010-0414814699 FIFTH THIRD BANCORP ISAOA HOUSING HUMAN&VETERAN SERVIC AT1MA 3339 E TAMIAMI TRL BLDG H 211 PO BOX 598 NAPLES FL 34112 AMELIA OH 45102 UPC 119 12 12 AGENT COPY Page 1 of 4 .tY ,4 ( 0 UPCf HOMEOWNERS DECLARATION INSURANCE POLICY NUMBER POLICY PERIOD UNITED PROPERTY&CASUALTY INS CO From To P.O. Box 51149 UHV 2801254 04 01 08/29/2016 Sarasota,FL 34232-0330 08/29/2017 12:01 a.m auto residence premises. RENEWAL DECLARATION Effective: 08/29/2016 Date Issued:07/11/2016 INSURED: AGENT:9960049 PIERRE A BORGELA BRIGHTWAY INSURANCE, INC. 4437 54TH AVE NE PO Box 5700 NAPLES FL 34120 Jacksonville FL 32247 Telephone:239-867-1275 Telephone:239-676-8199 The residence premises covered by this policy is located at the above Insured address unless otherwise stated below: 4437 54TH AVE NE NAPLES FL 34120 Premium: SECTION I, SECTION II AND OPTIONAL PREMIUMS $1,041.00 EMERGENCY MANAGEMENT TRUST FUND SURCHARGE $2.00 MANAGING GENERAL AGENCY (MGA) POLICY FEE $25.00 TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES $1,068.00 NOTE: The portion of your premium for Hurricane Coverage is: 686.00 The portion of your premium for All Other Coverages is: $355.00 An adjustment of -5.8%is included to reflect the Building Code grade for your area.Adjustments range from 1% surcharge to 46.1%credit Your policy includes endorsement HO 04 46 Inflation Guard-which automatically increases the amount of Dwelling Coverage by the annual percentage amount shown on the declaration page (but not less than 4%). Therefore your Hurricane deductible may be higher than indicated on the policy when a hurricane loss occurs due to application of the endorsement. FLOOD CARRIER N/A FORM TYPE HO-3 YEAR BUILT 2005 TOWN/ROW HOUSE N/A CONSTRUCT TYPE M CONSTRUCT SUPERIOR N NUMBER OF FAMILIES 00001 AOP TERRITORY 551 PROTECTION CLASS 03 USE CODE P MUNICIPAL CODE 999999 COUNTY CODE 021 PROT DEVICE/BURGLAR N PROT DEVICE/FIRE N PROT DEV/SPRINKLER N PROT DEV/SHUTTER N WIND/HAIL EXCLUSION N REPLACEMENT COST Y OCCUPANCY CODE OWNER FLOOD CREDIT N SINKHOLE COVERAGE I WIND TERRITORY 551A WATER PREVENTION CR N INFLATION GUARD 4% UPC 119 12 12 AGENT COPY Page 2 of 4 1 6 ' 4 UPC" \ HOMEOWNERS DECLARATION dSy� f INSURANCE POLICY NUMBER POLICY PERIOD UNITED PROPERTY&CASUALTY INS CO From To P.O.Box 51149 UHV 2801254 04 01 08/29/2016 08/29/2017 Sarasota,FL 34232-0330 12:01 a.m.at the residence premises. RENEWAL DECLARATION Effective: 08/29/2016 Date Issued: 07/11/2016 INSURED: AGENT:9960049 PIERRE A BORGELA BRIGHTWAY INSURANCE,INC. 4437 54TH AVE NE PO Box 5700 NAPLES FL 34120 Jacksonville FL 32247 Telephone:239-867-1275 Telephone:239-676-8199 The residence premises covered by this policy is located at the above insured address unless otherwise stated below: 4437 54TH AVE NE NAPLES FL 34120 LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE FROM THE NATIONAL FLOOD INSURANCE PROGRAM. WITHOUT THIS COVERAGE, YOU MAY HAVE UNCOVERED LOSSES. PLEASE DISCUSS THESE COVERAGES WITH YOUR INSURANCE AGENT. Coinsurance Contract: The rate charged in this policy is based upon the use of the coinsurance clause attached to this policy, with the consent of the insured. A rate adjustment of 81% of wind premium is included to reflect the windstorm mitigation features of your dwelling.Adjustments range from 0% to 89% credit subject to verification that your home meets the windstorm mitigation characteristics of the 2001 Florida Building Code. THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES, WHICH MAY RESULT IN HIGH OUT OF POCKET EXPENSES TO YOU. 'k*'""""****"' Additional Information ************* This replaces all previously issued policy declarations, if any.This policy applies to accidents, occurrences, or losses which happen during the policy period shown above. In case of loss under Section I,only that part of loss over the stated deductible applies.The declarations page together with all policy provisions and any other applicable endorsements completes your policy. UPC 119 12 12 AGENT COPY Page 3 of 4 1613q UPC INSURANCE POLICY NUMBER POLICY PERIOD UNITED PROPERTY&CASUALTY INS CO From To P.O,Box 51149 UHV 2801254 04 01 08/29/2016 08/29/2017 Sarasota,FL 34232-0330 12:01 a.m.at the residence premises. FORMS SCHEDULE (continued from page 1) *HPINSTALL(11/14) *01R011655(02/10) *OIRB11670(01/06) *UIM 424 (06/01) UPC 105 (07/14) *UPC 107 (08/99) UPC 112 (08/99) *UPC 155 (01/06) *UPC 160 (10/05) UPC 164 (06/06) UPC 174 (09/08) UPC 176 (10/12) *UPC 191 (08/15) UPC 192 (07/14) UPC 601 (02/14) UPC 602 (02/14) UPC 603 (12/14) *UPCNCPT (01/16) UPC 119 12 12 AGENT COPY Page 4 of 4 4111:imi.a , . . 1 %jpriil‘t : Keep UPC Insurance t w.�. i the PO Box 1011 St Petersburg,FL 33731 INSURANCE : Promise- 1-888-CLM-DEPT CLAIM NO.:2016FL029277 Reinspectionn P:'1:1-'1;-:.1t,1El;- _ '' :, Policy No.: UHV280125404 PIERRE A BORGELA Date of Loss: 09/10/2016 12:01 PM 4437 54TH AVE NE NAPLES FL 34120 Type of Loss: Water-Pipes Home phone: (392)445-3555 Deductible: $2,500.00 Business phone: Mobile phone: 1 (239)245-0108 Year Built: Cat No.: Bus.Fax: (392)445-3555 Adjuster: Robert Erwin Contact Phone: (904)425-4240 Loss address: 4437 54TH AVE NE Email: terwin@lozanoadjusters.com NAPLES FL 34120 "This adjuster,the author of this estimate,has no authority to:(1)approve or denydaimr,or,(2)bind UPC as to coverage for your claim or the amount of your loss,if any.A copy of this estimate does not constitute a settlement of this daim or any representation on the part of UPC.The estimate is subject to the review,modification and approval of UPC,including,but not limited to,the application of policy limitations,exclusions and deductible provisions.Any additional repairs to,or replacement of,items not included in this estimate are also subject to UPCs prior approval.You are required to keep all records,cancelled checks,inspection reports,etc.,as proof of repair/replacement in the event of any future loss and pursuant to your post-loss duties under your insurance policy.This estimate is not an authorization of repair.The hiring of a contractor Is strictly the decision of the UPC policyholder." • Claim 2016FL029277 Page 1 of 8 10/07/2016 1. (7) n 1 Up cioN th ect UPC Insurance PO Box 1011 ; the St.Petersburg,FL 33731 INSURANCE Promise' 1-888-CLM-DEPT Description Quantity Unit Price Per RC Depreciation ACV ESTIMATE:Structure(UPC Insurance) Claim #2016FLO29277, PIERRE A BORGELA z Completed .] FLOORPLAN: Floorplan 0 General Items 1 Dumpster 5 Yard 1 $320.43 EA $320.43 $0.00 $320.43 General Items-Subtotal $320.43 T Closet Length: 9'10" Width: 2'6" Height: 8'Flat Walls: 197.34 SF Walls-subs: 157.34 SF Walls-subs-cas-bsbd: 146.25 SF f Doors: 40.00 SF Windows: 0.00 SF Openings: 0.00 SF Missing Walls: 0.00 SF - I, Floor: 24.58 SF Ceiling: 24.58 SF Perim(F): 18.08 LF Perim(C): 24.66 LF 2 Contents,Move&Protect 1 $31.38 HR $31.38 $0.00 $31.38 3 Carpet,Wall to Wall,Good-Replace 27.04 $1.82 SF $49.22 $31.91 V $17.31 ❑ Includes 10%waste on quantity. 4 Carpet Pad,Good-Replace 25.81 $0.54 SF $13.94 $8.00 V $5.94 Indudes 5%waste on quantity. 5 Carpet&Pad,Good-Tear Out 24.58 $0.16 SF $3.93 $0.00 $3.93 Closet-Subtotal $58.56 Bedroom 2 Length: 9'10" Width: 14'1" Height: 8'Flat Walls: 382.68 SF Walls-subs: 310.01 SF Walls-subs-cas-bsbd: 283.26 SF Doors: 56.67 SF Windows: 16.00 SF Openings: 0.00 SF Missing Walls: 0.00 SF Floor: 138.49 SF Ceiling: 138.49 SF Perim(F): 38.16 LF Perim(C): 47.82 LF iii 6 Drywall,Up to 2'From Floor,Taped-Replace 11.66 $3.44 LF $40.11 $1.29 V $38.82 ❑ Indudes 6%waste on quantity. 7 Base Molding Colonial,4 1/2"-Replace 11.66 $3.15 LF $36.73 $2.51 V $34.22 Q Indudes 6%waste on quantity. 8 Prep&Mask For Painting(SF) 283.26 $0.20 SF $56.65 $0.00 $56.65 9 Contents,Move&Protect 1 $31.38 HR $31.38 $0.00 $31.38 ....._..... . 10 Walls 1 Coat,Roller-Paint 283.26 $0.35 SF $99.14 $9.44 V $89.70 11 Carpet,Wall to Wall,Good-Replace 152.34 $1.82 SF $277.26 $179.76 V $97.50 O Indudes 10%waste on quantity. 12 Carpet Pad,Good-Replace 145.41 $0.54 SF $78.52 $45.08 V $33.44 Indudes 5%waste on quantity. 13 Texture,Walls Knockdown-Replace 88.00 $0.48 SF $42.24 $1.06 V $41.18 14 Reset Switch/Outlet Plate 2 $2.66 EA $5.32 $0.00 $5.32 15 Carpet&Pad,Good-Tear Out 138.49 $0.16 SF $22.16 $0.00 $22.16 16 Prep&Mask For Painting(SF) 283.26 $0.20 SF $56.65 $0.00 $56.65 Claim 2016FL029277 Page 1 of 6 10/29/2016 "%t 171 r) U Description Quantity Unit Price Per RC Depreciation ACV ESTIMATE:Structure(UPC Insurance) Claim #2016FL029277, PIERRE A BORGELA [;. Completed Q Bedroom 2(con't) 17 Base Molding Colonial,3 1/4"-Replace 14.92 $2.43 LF $36.26 $0.00 $36.26 0 Includes 6%waste on quantity. 18 Base Molding Colonial,3 1/4"-Paint 38.16 $1.00 IF $38.16 $0.00 $38.16 19 Reset Switch/Outlet Plate 3 $2.70 EA $8.10 $0.00 $8.10 20 Paint Textured Walls Brush-Paint 283.26 $0.77 SF $218.11 $37.7711 $180.34 21 Door,Closet,Bi-Fold,Panel 6'-Rem/Reset 2 $42.97 EA $85.94 $0.00 $85.94 22 Blinds(SF)Vinyl,Mini-Rem/Reset 16.00 $1.96 SF $31.36 $0.00 $31.36 ❑ or other window treatment 23 Insulation,Wall,Batt,Faced 6"-Replace 47.00 $1.05 SF $49.35 $4.7911 $44.56 Bedroom 2-Subtotal $931.74 11 Laundry Room Length: 10'3" Width: 4'11" Height: 8'Flat Walls: 242.66 SF Walls-subs: 226.55 SF Walls-subs-cas-bsbd: 215.76 SF Doors: 16.11 SF Windows: 0.00 SF Openings: 0.00 SF Missing Walls: 0.00 SF / Floor: 50.40 SF Ceiling: 50.40 SF Perim(F): 27.63 LF Perim(C): 30.34 LF 1 24 Contents,Move&Protect 1 $31.52 HR $31.52 $0.00 $31.52 25 Paint Textured Walls Brush-Paint 215.76 $0.77 SF $166.13 $28.77 V $137.36 26 Prep&Mask For Painting(SF) 215.76 $0.20 SF $43.15 $0.00 $43.15 27 Base Molding Colonial,3 1/4"-Replace 5.22 $2.43 LF $12.68 $0.00 $12.68 ❑ Indudes 6%waste on quantity. 28 Base Molding Colonial,3 1/4"-Paint 27.63 $1.00 LF $27.63 $0.00 $27.63 29 Floor protection 50.40 $0.16 SF $8.06 $0.00 $8.06 30 Reset Switch/Outlet Plate 1 $2.70 EA $2.70 $0.00 $2.70 31 Insulation,Wall,Batt,Faced 6"-Replace 20.00 $1.05 SF $21.00 $2.0411 $18.96 32 Drywall,Up to 4'From Floor,Taped-Replace 11.66 $3.53 LF $41.16 $1.9811 $39.18 ❑ Indudes 6%waste on quantity. 33 Texture,Walls Knockdown-Replace 37.90 $0.49 SF $18.57 $0.46 V $18.11 34 Reset Appliance Dryer 1 $14.69 EA $14.69 $0.00 $14.69 35 Reset Appliance Washer 1 $14.69 EA $14.69 $0.00 $14.69 Laundry Room-Subtotal $368.73 Q Dining Area Length: 12'4" Width: 9'10" Height: 8'Flat Walls: 279.34 SF Walls-subs: 154.91 SF Walls-subs-cas-bsbd: 123.46 SF IA Doors: 16.67 SF Windows: 0.00 SF Openings: 107.75 SF Missing Walls: 75.33 SF a Floor: 121.28 SF Ceiling: 121.28 SF Perim(F): 22.57 LF Perim(C): 18.90 LF 36 Prep&Mask For Painting(SF) 123.46 $0.20 SF $24.69 $0.00 $24.69 37 Contents,Move&Protect 1 $31.38 HR $31.38 $0.00 $31.38 38 Walls 1 Coat, Roller-Paint 123.46 $0.35 SF $43.21 $4.12 V $39.09 Claim 2016FL029277 Page 2 of 6 10/29/2016 mmimmo► 1 6 0 1 Description Quantity Unit Price Per RC Depreciation ACV ESTIMATE:Structure(UPC Insurance) Claim #2016FL029277, PIERRE A BORGELA Completed Q Dining Area(con't) 39 Reset Switch/Outlet Plate 2 $2.66 EA $5.32 $0.00 $5.32 40 Floor,Cover&Protect 95.88 $0.16 SF $15.34 $0.00 $15.34 41 Countertop,Laminate(SF)Good-Rem/Reset 6.42 $9.06 SF $58.17 $0.00 $58.17 Dining Area-Subtotal $173.99 Q Hallway • Length: 9'10" Width: 12'1" Height: 8'Flat Walls: 275.34 SF Walls-subs: 209.22 SF Walls-subs-cas-bsbd: 187.52 SF `i / Doors: 66.12 SF Windows: 0.00 SF Openings: 0.00 SF Missing Walls: 75.33 SF Floor: 49.55 SF Ceiling: 49.55 SF Perim(F): 22.75 LF Perim(C): 34.41 LF 42 Floor protection 49.55 $0.16 SF $7.93 $0.00 $7.93 Hallway-Subtotal $7.93 j IGtchen ......._..... ,� Length: 9' Width: 9'10" Height 8'Flat _ p� Walls: 301.34 SF Walls-subs: 230.92 SF Walls-subs-cas-bsbd: 143.69 SF C{ r. {, Doors: 0.00 SF Windows: 12.00 SF Openings: 58.42 SF Missing Walls: 0.00 SF , ,- Floor: 88.50 SF Ceiling: 88.50 SF Perim(F): 34.58 LF Perim(C): 27.83 LF ' -11;f: "`41;. 43 Contents,Move&Protect 1 $31.52 HR $31.52 $0.00 $31.52 44 Paint Textured Walls Brush-Paint 143.69 $0.77 SF $110.64 $19.1611 $91.48 45 Prep&Mask For Painting(SF) 143.69 $0.20 SF $28.74 $0.00 $28.74 46 Base Molding Colonial,3 1/4"-Replace 22.44 $2.43 LF $54.53 $0.00 $54.53 tj Indudes 6%waste on quantity. 47 Base Molding Colonial,3 1/4" Paint 21.17 $1.00 LF $21.17 $0.00 $21.17 48 Floor protection 88.50 $0.16 SF $14.16 $0.00 $14.16 49 Reset Switch/Outlet Plate 3 $2.70 EA $8.10 $0.00 $8.10 50 Drywall,Up to 4'From Floor,Taped-Replace 43.46 $3.53 LF $153.41 $7.391( $146.02 ❑ Indudes 6%waste on quantity. 51 Texture,Walls Knockdown-Replace 44.45 $0.49 SF $21.78 $0.53 V $21.25 52 Cabinet,Base(LF)Good-Remove 20.51 $8.86 LF $181.72 $0.00 $181.72 53 Cabinet,Base(LF)Good-Replace 17.75 $166.82 LF $2,961.05 $764.83 V $2,196.22 54 Cabinet,Wall(LF)24"H,Good-Remove 13.92 $9.91 LF $137.95 $0.00 $137.95 55 Insulation,Wall,Batt,Faced 6"-Replace 34.00 $1.05 SF $35.70 $3.47 V $32.23 56 Cabinet,Wall(LF)24"H,Good-Replace 13.92 $108.75 LF $1,513.80 $374.46 V $1,139.34 57 Backsplash,Formica,4"-Rem/Reset 27.91 $4.31 LF $120.29 $0.00 $120.29 58 Countertop,Laminate(SF)Good-Rem/Reset 24.37 $9.06 SF $220.80 $0.00 $220.80 59 Garbage Disposal Good-Rem/Reset 1 $27.90 EA $27.90 $0.00 $27.90 60 Reset Appliance Dishwasher 1 $32.17 EA $32.17 $0.00 $32.17 61 Reset Appliance Range 1 $28.99 EA $28.99 $0.00 $28.99 62 Faucet,Kitchen Single Handle,Good-Rem/Reset 1 $56.77 EA $56.77 $0.00 $56.77 Claim 2016FL029277 Page 3 of 6 10/29/2016 Deception I Quantity I Unit Price I Per 1 RC Depredation ACV ESTIMATE:Structure(UPC Insurance) Claim #2016FL029277, PIERRE A BORGELA f Completed Q IGtchen(con't) 63 Sink,Kitchen,Stainless Steel Double Bowl,Good- 1 $98.08 EA $98.08 $0.00 Rem/Reset $98.08 64 Refrigerator with Water Supply Line-Rem/Reset 1 $91.68 EA $91.68 $0.00 $91.68 65 Blinds(SF)Vinyl,Mini-Rem/Reset 12.00 $1.96 SF $23.52 $0.00 $23.52 ❑ or other window treatment 66 Supply Line Sink,Flexible-Replace 4 $16.07 EA $64.28 $0.00 $64.28 67 P-Trap&Fittings,Sink-Rem/Reset 1 $22.05 EA $22.05 $0.00 $22.05 68 Microwave/Range Hood Good-Rem/Reset 1 $36.16 EA $36.16 $0.00 $36.16 69 Valve,Water Shutoff Angle 1/2"-Rem/Reset 4 $35.86 EA $143.44 $0.00 $143.44 Kitchen-Subtotal $5,070.56 Q Bedroom 3 Length: 11' Width: 13'6" Height: 8'Flat Wails: 392.00 SF Walls-subs: 350.00 SF Wails-subs-cas-bsbd: 336.44 SF -i' Doors: 16.67 SF Windows: 0.00 SF Openings: 25.33 SF Missing Walls: 0.00 SF Floor: 148.50 SF Ceiling: 148.50 SF Perim(F): 46.50 LF Perim(C): 35.50 LF 70 Drywall,Up to 2'From Floor,Taped-Replace 11.66 $3.44 LF $40.11 $1.29 V $38.82 ❑ Includes 6%waste on quantity. 71 Base Molding Colonial,4 1/2"-Replace 11.66 $3.15 LF $36.73 $2.51 V $34.22 CI Includes 6%waste on quantity. 72 Prep&Mask For Painting(SF) 336.44 $0.20 SF $67.29 $0.00 $67.29 73 Contents,Move&Protect 1 $31.38 HR $31.38 $0.00 $31.38 74 Walls 1 Coat,Roller-Paint 336.44 $0.35 SF $117.76 $11.22 V $106.54 75 Carpet,Wall to Wall,Good-Replace 163.35 $1.82 SF $297.29 $192.75 V $104.54 ❑ Indudes 10%waste on quantity. 76 Carpet Pad,Good-Replace 155.93 $0.54 SF $84.20 $48.34 V $35.86 Indudes 5%waste on quantity. 77 Texture,Walls Knockdown-Replace 84.79 $0.48 SF $40.71 $1.02 V $39.69 78 Base Molding Colonial,4 1/2"-Paint 46.50 $0.99 LF $46.04 $2.32 $43.72 79 Reset Switch/Outlet Plate 2 $2.66 EA $5.32 $0.00 $5.32 80 Floor,Cover&Protect 95.88 $0.16 SF $15.34 $0.00 $15.34 81 Floor,Cover&Protect 95.88 $0.16 SF $15.34 $0.00 $15.34 82 Carpet&Pad,Good-Tear Out 148.50 $0.16 SF $23.76 $0.00 $23.76 83 Carpet Pad,Good-Replace 155.93 $0.57 SF $88.88 $0.00 $88.88 CI Indudes 5%waste on quantity. 84 Carpet,Wall to Wall,Good-Replace 163.35 $1.91 SF $312.00 $0.00 $312.00 ❑ Includes 10%waste on quantity. 85 Contents,Move&Protect 1 $31.52 HR $31.52 $0.00 $31.52 86 Paint Textured Walls Brush-Paint 336.44 $0.77 SF $259.06 $44.86 V $214.20 87 Prep&Mask For Painting(SF) 336.44 $0.20 SF $67.28 $0.00 $67.28 88 Reset Switch/Outlet Plate 1 $2.70 EA $2.70 $0.00 $2.70 89 Floor protection 148.50 $0.16 SF $23.76 $0.00 $23.76 Claim 2016FL029277 Page 4 of 6 10/29/2016 lirrIlawl.1 n L Description Quantity Unit Price Per RC Depreciation ACV ESTIMATE:Structure(UPC Insurance) Claim #2016FL029277, PIERRE A BORGELA Completed Q Bedroom 3(con't) 90 Insulation,Wall,Batt,Faced 6"-Replace 22.00 $1.05 SF $23.10 $2.24 V $20.86 Bedroom 3-Subtotal $1,323.02 Floorplan-Subtotal $8,254.96 Claim 2016FL029277 Page 5 of 6 10/29/2016 ESTIMATE:Structure(UPC Insurance) Claim#2016FLO29277, PIERRE A BORGELA . Completed Total Materials: Total Labor: $5,206.50 $4,545.54 Total Equipment: $338.29 Total Market Conditions: Subtotal: $0.00 $10,090.33 Add 10.00%overhead: $1,009.03 Add 10.00%profit: $1,009.03 Subtotal: $12,108.39 Sales Tax 6.000%(applies to materials only): $374.87 Replacement Cost Value: $12,483.26 Less Recoverable Depreciation(indudes taxes): $(1,945.49) Less Non-Recoverable Depredation(indudes taxes): $0.00 Net ACV Estimate: $10,537.77 Deductible: $(2,500.00) Net Estimate: $8,037.77 Total Net Recoverable Depreciation: $1,945.49 Net Estimate if Depreciation is Recovered: $9,983.26 "This adjuster,the author of this estimate,has no authority to:(1)approve or deny daims;or,(2)bind UPC as to coverage for your claim or the amount of your loss,if any.A copy of this estimate does not constitute a settlement of this daim or any representation on the part of UPC.The estimate is subject to the review,modification and approval of UPC,including,but not limited to,the application of policy limitations,exclusions and deductible provisions.Any additional repairs to,or replacement of,items not included in this estimate are also subject to UPC's prior approval.You are required to keep all records,cancelled checks,inspection reports,etc.,as proof of repair/replacement in the event of any future loss and pursuant to your post-loss duties under your insurance policy.This estimate is not an authorization of repair.The hiring of a contractor is strictly the dedsion of the UPC policyholder." 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V9,tf3i y y, ,• — `' ,_ z P `. , S : \ \ '',,,•_. fi r / . ir } .f r 'i a ' . ;�; f a\h n Sent from my iPhone Under Florida Law,e-mail addresses are public records.If you do not want your e-mail address released in response to a public records request,do not send electronic mail to this entity.Instead,contact this office by telephone or in writing. 7 INSTR 4746554 OR 4841 PG 1595 RECORDED 10/2/2012 1:23 PM PAGES 4 • DWIGHT P. BROCK, CLERK OF THE CIRCUIT COURT COLLIER COUNTY FLORIDA .$- ice, DOC@.35 $106.0INT@. 002 $60.60 REC $35.50 OBBLLD $30,300.00 0311 $30,300.00 g .g NEIGHBORHOOD STABILIZATION PROGRAM Property Address: 4437 54Th AVENUE NE,NAPLES,FL 34120 Folio Number: 39027360008 C..I I i an-'' ‘/C.-.J — b I og RECORD AND RETURN TO: COLLIER COUNTY HOUSING,HUMAN&VETERAN SERVICES 3339 TAMIAMi TRAIL EAST,SUITE 212 .-1.- NAPLES,FL 34112 '6.0,Le° ' 1 .., -. PURCHASE MONEY SECOND MORTGAGE THIS PURCHASE MONEY SECOND MORTGAGE ("Security Instrument")is given on.2S day of5-C>:'7t7i1 2012. The ttllll_ Purchase Money Second Mortgagor is PIERRE A.BORGELA and YOLANDE BORGELA,husband and wife,("Borrowers"). This Security Q' Instrument is given to COLLIER COUNTY,a Political Subdivision of the State of Florida("Lender"),whose address is 3335 Tamiaml Trail Q East,Suite 101,Naples,Florida 34112-5356. Borrower owes Lender the sum of THIRTY THOUSAND,THREE-HUNDRED AND NO/100 DOLLARS ($30,300.00) in US currency. This debt is evidenced by Borrower's Note dated the same date as this Security Instrument ("Purchase Money Second Mortgage"),which provides for monthly payments,with the full debt,if not paid earlier,due and payable upon sale of property,refinance,or loss of homestead exemption. This Security Instrument secures to Lender.(a)the repayment of the debt evidenced by the Note, with interesti. , and all renewals, extensions and modifications; (b) the payment of ail other sums, with Interest advanced under •f paragraph 7 to protect the security of the Security Instrument and(c)the performance of Borrower's covenants and agreements under this Security Instrument and the Note. For this purpose, Borrower does hereby mortgage, grant and convey to Lender the following described property located in Collier County,Florida. ( p As more particularly described as The West 75 feet of E`gsfr. c IlaCIq. 3 of Golden Gate Estates Unit No.45,according to the plat thereof as recorded in Plat Book 7,Pa A,6} t51 Public Recor•` p er County,Florida and which has the address of: ("Properly Address"): 4437 54th Avenue NE,Nap E F da 34120. f" TOGETHER WITH arill the improveme is n. + o , afte he prop= y,a d all easements,rights,appurtenances,rents, 4 -� royalties,mineral,oil and gas rights and profits wat=r rights an.'-to - d all�fixt res now.r he eafter a partof the property. All replacements and additions shall also be covered by the Sec rity .r••e t. f+ to I this Security Instrument as the"Property". BORROWER COVENANTS that Bo owe s, •:d .f st :y conv'yed and has the right to mortgage,grant and convey the Property and that the Property is nen• red ex•*. for a !tram •f re ¢rd. Borrower warrants and will defend generally the title to the Property against all claims and • -•t. . - , 'Isar -� - 'rfif �1L THIS SECURITY INSTRUMENT co •'we- unr orm covenants or t.-doral se t •n-uniform covenants with limited variation by jurisdiction to constitute a uniform security Inst r- covering real property. UNIFORM COVENANTS. Borrower a .ercovenant and ogre- �:.Ilorws• 1, Payment of Principal and interest; - ment and Late Charg s. parr`WW shall promptly pay when due the principal of and interest on the debt evidenced by the Note. 2. Taxes. The Mortgagor will pay all taxes, .' s •its,sewer re .- • , -t- ratesprior to the accrual of thereon. v any penalties or interest The Mortgagor shall pay or cause to be paid, as t'- ,= • eQpee•'t�•ecome due,(a)all taxes and governmental charges of any kind whatsoever which may at any time be lawfully assessed or lev-• -garnst or with respect to the Property,(b)all utility and other charges, including"service charges",incurred or imposed for the operation,maintenance,use,occupancy,upkeep and improvement of the Property,and (c)all assessments or other governmental charges that may lawfully be paid in.installments over a period of years,the Mortgagor shall be obligated under the Mortgage to pay or cause to be paid only such installments as are required to be paid during the term of the Mortgage. 3. Application of Payments. Unless applicable law provides otherwise,all payments received by Lender shall be applied;first,to interest due;and,to principal due;and last,to any late charges due under the Note, 4. Charges;Liens. Borrower shall pay all taxes,assessments,charges,fines and impositions attributable to the Property which may attain priority over this Security Instrument,and leasehold payments or ground rents,if any. Borrower shall promptly discharge any lien which has priority over this Security Instrument unless Borrower:(a)agrees in writing to the payment of the obligation secured by the lien in a manner acceptable to Lender,(b)contests in good faith the lien by,or defends against enforcement of the lien in,legal proceedings which in the Lender's opinion operate to prevent the enforcement of the lien;or(c)secures from the holder of the lien an agreement satisfactory to Lender subordinating the lien to this Security Instrument. If Lender determines that any part of the Property Is subject to a lien which may attain priority over the Security Instrument,Lender may give Borrower a notice identifying the lien. Borrower shall satisfy the lien or take one or more of the actions set forth above within 10 days of the giving of notice. 5. Hazard or Property Insurance. Borrower shall keep the improvements now existing or hereafter erected on the Property insured against loss by fire,hazards included within the term"extended coverage"and any other hazards,including floods or flooding,for which Lender requires insurance. This insurance shall be maintained in the amounts and for the periods that Lender requires. The insurance carrier providing the insurance shall be chosen by Borrower subject to Lender's approval which shall not be unreasonably withheld. If Borrower fails to maintain coverage described above, Lender may,at Lender's option, obtain coverage to protect Lender's rights in the Property in accordance with paragraph 7. At all times that the Note is outstanding,the Mortgagor shall maintain insurance with respect to the Premises against such risks and for such amounts as are customarily insured against and pay,as the same become due and payable,all premiums in respect thereto, including,but not limited to,all-risk insurance protecting the interests of the Mortgagor and Mortgagee against loss or damage to the Premises by fire,lightning,and other casualties customarily insured against,with a uniform standard extended coverage endorsement,including debris removal coverage. Such insurance at all times to be in an amount not less than the full replacement cast of the Premises,exclusive of footings and foundations. KB I OR 4841 PG 1596 • • 1, A ri 1 . .‘,,:. ,- , i / 1 All insurance policies and renewals shall be acceptable to Lender. Lender shall have the right to hold the policies and renewals. If1 Lender requires,Borrower shall promptly give to Lender all receipts of paid premiums and renewal notices. in the event of loss,Borrower shall give prompt notice to the Insurance carrier and Lender. Lender may make proof of loss if not made promptly by Borrower. Unless Lender and Borrower otherwise agree in writing,insurance proceeds shall be applied to restoration or repair of the Property damaged, if the restoration or repair is economically feasible and Lender's security is not lessened. If the restoration or repair is not economically feasible or Lender's security would be lessened,the insurance proceeds shall be applied to the sums secured by the Security Instrument,whether or not then due,with any excess paid to Borrower. If Borrower abandons the Property,or does not answer within 30 days a notice from Lender that the insurance carrier has offered to settle a claim,then Lender may collect the insurance proceeds. Lender may use the proceeds to repair or restore the Property or to pay sums secured by this Security Instrument,whether or not then due. The 30-day period will begin when the notice is mailed. Unless Lender and Borrower otherwise agree in writing,any application of proceeds to principal shall not extend or postpone the due date of the monthly payments referred to in paragraph 1 or change the amount of the payments. If under paragraph 21 the Property is acquired by Lender,Borrower's right to any insurance policies and proceeds resulting from damage to the Property prior to the acquisition shall pass to Lender to the extent of the sums secured by this Security Instrument immediately prior to the acquisition, 6. Occupancy, Preservation, Maintenance and Protection of the Property; Borrower's Loan Application, Leaseholds. Borrower shall occupy,establish,and use the Property as Borrower's principal residence within sixty days after the execution of this Security Instrument and shall continue to occupy the Property as Borrower's principal residence for full term as described in the note,unless Lender otherwise agrees in writing;which consent shall not be unreasonably withheld,or unless extenuating circumstances exist which are beyond Borrower's control. Borrower shall not destroy, damage, or impair the Property, allow the Property to deteriorate, or commit waste on the Property. Borrower shall be in default if any forfeiture action or proceeding, whether civil or criminal, is begun that in Lender's good faith judgment could result in forfeiture of the Property or otherwise materially impair the lien created by this Security Instrument or Lender's security interest. Borrower may cure such a default and reinstate,as provided in paragraph 18,by causing the action or proceeding to be dismissed with a ruling that, in Lender's good faith determination, preclud- •.-iture of the Borrower's interest in the Property or other material impairment of the lien created by this Security Instrument or - • ,-e ori, - •at. Borrower shall also be in default if Borrower,during the loan application process,gave materially false or inacc : e f. :'t•,. .,ist e': to Lender(or failed to provide Lender with any material information)in connection with the loan evidenced b - ncluding,but • i ,representations concerning Borrower's occupancy of the Property as a principal residence. if this Se r 'J s't'rum'ent is on a leaseho •'If Borrower acquires fee title to the Property,the I--self id and the fee title shall not me•e un ess Lender shall r agrees to allwith the merger in writing lease. 7. Protection of Lender's Rights I the •r •.-°'t''grty If�B.• f.'- to pe �nn t covenants and agreements contained in this Security Instrument, or there is a legal pro =-din• that r'`ia"'signif.- tly a e t Lende rig is in the Property(such as a proceeding in bankruptcy,probate,for condemnation or forte'ure..r • -. •r � N or.-•- -'., -rid may do and pay for whatever is necessary to protect the value of the Property and Lender' righ s'in h- • o rt . e •- s . 'on-p a incl de paying any sums secured by a lien which has priority over this Security Instrument,app arin• in ourt p in re -. .•a a i.rn s' -es Ind entering on the Property to make repairs. Although Lender may take action under this rf,'-p, 7 n e d - 5 have• ,o s. paragraph 7 shall become additional debt of er red rs - t. r4 ss Borrower e Y amounts ridisburse end ba rento under this other terms of payment,these amounts shall bear interest ; ), he date of disbursement-�the otea d shall be payable,with interest upon notice payment. from Lender to Borrower requestingC?' 8. Mortgage Insurance. If Lender mortgage insurance= . c. of making the loan secured by this Security instrument Borrower shall pay the premiums requr to •-intain the mortgage ins • ' effect. If,for any reason,the mortgage insurance ip coverage required by Lender lapses or ceases to n --i Borrower sha • t remiums required to obtain coverage substantially equivalent to the mortgage insurance previously in effeeCt�• a b • r ,I i ent to the cost to Borrower of the mortgage insurance previously in effect, from an alternate mortgage insurer ap`pr. :. Le.-' Iy available, Borrower shall pay to Lender each month a sum u. • stheti yearly emortgage insuranceainsurance m being paid isnot Borrower when the insurance coverage lapsed or ceased to be effect. Lender willfth faccee t use and retain th se payments u as ao s reserve in lieu of mortgage insurance. Loss reserve payments may no longer be required,at the option of Lender,if mortgage insurance coverage(in the amount and for the period that Lender requires)provided by an insurer approved by Lender again becomes available and is obtained. Borrower shall pay the premiums required to maintain mortgage insurance In effect, or to provide a loss reserve, until the requirement for mortgage insurance ends in accordance with any written agreement between Borrower and Lender or applicable law. 9. Inspection. Lender or its agent may make reasonable entries upon and inspections of the Property. Lender shall give Borrower notice at the time of or prior to an inspection specifying reasonable cause for the inspection, 10. Condemnation. The proceeds of any award or claim for damages,director consequential,in connection with any condemnation or other taking of any part of the Property,or for conveyance in lieu of condemnation,are hereby assigned and shall be paid to Lender. In the event of a total taking of the Property,the proceeds shall be applied to the sums secured by this Security Instrument,whether or not then due, with any excess paid to Borrower. In the event of a partial taking of the Property,in which the fair market value of the Property immediately before the taking is equal to or greater than the amount of the sums secured by this Security Instrument immediately before the taking,unless Borrower and Lender otherwise agree In writing,the sums secured by this Security Instrument shall be reduced by the amount of the proceeds multiplied by the following fraction:(a)the total amount of the sums secured immediately before the taking,divided by(b)the fair market value of the Property immediately before the taking. Any balance shall be paid to Borrower. In the event of a partial taking of the Properly in which the fair market value of the Property immediately before the taking is less than the amount of the sums secured immediately for the taking, unless Borrower and Lender otherwise agree in writing or unless applicable law otherwise provides,the proceeds shall be applied to the sums secured by this Security Instrument whether or riot the sums are then due. Unless Lender and Borrower otherwise agree in writing, any application of proceeds to principal shall not extend or postpone the due date of the monthly payments referred to in paragraphs 1 or change the amount of such payments. 11. Borrower Not Released, Forbearance by Lender Not a Waiver. Extension of the time for payment or modification of amortization of the sums secured by this Security Instrument granted by Lender to any successor in interest of Borrower shall not operate to release the liability of the original Borrower or Borrower's successors in interest. Lender shall not be required to commence proceedings against any successor in interest or refuse to extend time for payment or otherwise modify amortization of the sums secured by this Security Instrument by reason of any demand made by the original Borrower or Borrower's successors in interest. Any forbearance by Lender in exercising any right or remedy shall not be a waiver of or preclude the exercise of any right or remedy. 2 P/3 \s2� OR 4841 PG 1597 • 1 6 ri 1 0 12. Successors and Assigns Bound;Joint and Several Liability;Co-Signers. The covenants and agreements of this Security Instrument shall bind and benefit the successors and assigns of Lender and Borrower,subject to the Provisions of Paragraph 17. Borrowers covenants and agreements shall be joint and several. Any Borrower who co-signs this Security Instrument but does not execute the Note;(a)is co-signing this Security Instrument only to mortgage,grant and convey that Borrower's interest in the Property under the terms of this Security Instrument; (b) is not personally obligated to pay the sums secured by this Security Instrument;and (c) agrees that Lender and any other Borrower may agree to extend,modify,forbear or make any accommodations with regard to the terms of this Security Instrument or the Note without that Borrower's consent. 13. Loan Charges. If the loan secured by this Security Instrument is subject to a law which sets maximum loan charges,and that law is finally interpreted so that the interest or other loan charges collected or to be collected in connection with the loan exceed the permitted limits,then:(a)any such loan charge shall be reduced by the amount necessary to reduce the charge to the permitted limit;and(b)any sums already collected from Borrower which exceeded permitted limits will be refunded to Borrower. Lender may choose to make this refund by reducing the principal owed under the Note or by making a direct payment to Borrower. If a refund reduces principal,the reduction will be treated as a partial prepayment without any prepayment charge under the Note. 14. Notices. Any notice to Borrower provided for in this Security instrument shall be given by delivering it or by mailing it by first class mail unless applicable law required use of another method. The notice shall be directed to the Property Address or any other address Borrower designates by notice to Lender. Any notice to Lender shall be given to Borrower or Lender when given as provided in this paragraph. 15. Governing Law;Severability. This Security Instrument shall be governed by federal law and the law of the jurisdiction in which the Property is located. In the event that any provision or clause of this Security Instrument or the Note conflicts with applicable law,such conflict shall not affect other provisions of this Security Instrument or the Note which can be given effect without the conflicting provision. To this end the provisions of this Security instrument and the Note are declared to be severable. 16. Borrower's Copy. Borrower shall be given one conformed copy of the Note and of this Security instrument 17. Transfer of the Property or a Beneficial Interest I :•..wer. If all or any part of the Property or any interest in it is sold or transferred (or if a beneficial interest in Borrower is sold 9y.-t ..sfe•e•'"agdv:t•-. er is not a natural person)without Lender's prior written consent,Lender may,at its option,require immediate p,aYsV e i .I:t •es not be exercised by Lender if exercise is prohibited by/f=• t� '• ..bthis Security Instrument. However,this option shall If Lender exercised this option, Lender shall give Bd .•.,� �� as of the da e� t i� •» city Instrument. 9 notice of acceleration. it o`t(ce shall provide a period of not less than 30 days from the date the notice is delivered or mailed wit in Borrower must pay all sum ecur$$d by this Security Instrument. If Borrower fails to pay these sums prior to the expiration of this riod er ma • n4 •medie •emi'tted by this Security Instrument without further notice or demand on Borrower. 18. Borrowers Right to Reinstate If BBrrower, e- -.-rta• •r di i• •. • er all have the right to have enforcement of this Security Instrument discontinued at any tim pri r to th -artier o. reinstatement)before safe of the Property p rsu t t any ( l - (o c oteh r period as applicable or(b)law mayf judgment for power of- le' ai'�d ,th Se urity Instrument; or entry of a enforcing this Security Instrument. Those co ar t :or,�ro�we )(rays Le de all fon which then would be due under this Security Instrument and the Note as if no acceleration , p incurred in enforcing this Security Instrument,i ��!l (b)not limited to,anrf ca ult of t• .t = es;aO takes such ac)pays all expensesLenderm reasonably require to assure that the lien of thi�e t ty Instrument,Lender able tto .'- .+tees;and takes such action to as smos secured by this Security Instrument shall contin e, ranged. Upon reinstate' 4. arty and Borrowers Instrument t paythesums secured hereby shall remain fully effective as if n c`cee anon had occurred. Ho.ire, is reight ht to reinstat,this e shall not applanthe of acceleration under paragraph 17. y g apply 19. Sale of Note;Change of Loan Servicer. They.r- . . '• j• the Note(together with this Security Instrument)may be sold one or more times without prior notice to Borrowe. collects monthly payments due under the Note and this Security �� - changelsomay inthe entibe one ty mre(known changeste of the Loan ServicerSethat unrelated to a sale of the Note. If there is a change of the Loan Servicer,Borrowers will be gien written notice of the ch change in accordance ih paragraph 14 and applicable law The notice will state the name and address of the new Loan Servicer and the address to which payments should be made. The notice will also contain any other information required by applicable law. 20, Hazardous Substances. Borrower shall not cause or permit the presence,use,disposal,storage,or release of any Hazardous Substances on or in the Property. Borrower shall not do,nor allow anyone else to do,anything affecting the Property that is in violation of any Environmental Law. The preceding two sentences shall not apply to the presence, use, or storage on the Property of small quantities of Hazardous Substances that are generally recognized to be appropriate to normal residential uses and to maintenance of the Property. Borrower shall promptly give Lender written notice for any investigation, claim, demand, lawsuit or other action by any governmental or regulatory agency or private party involving the Property and any Hazardous Substance or Environmental Law of which Borrower has actual knowledge. If Borrower learns, or is notified by any governmental or regulatory authority, that any removal or other remediation of any Hazardous Substance affecting the Property is necessary, Borrower shall promptly take all necessary remedial actions in accordance with Environmental Law. As used in this paragraph 20, "Hazardous Substances" are those substances defined as toxic or hazardous substances by Environmental Law and the following substances: gasoline, kerosene, other flammable or toxic petroleum products, toxic pesticides and herbicides, volatile solvents, materials containing asbestos or formaldehyde, and radioactive materials. As used in this paragraph 20, "Environmental Law"means federal laws and laws of the jurisdiction where the Property is located that relate to health,safety or environmental protection, 21. Acceleration;Remedies. Lender shall give notice to Borrower prior to acceleration following Borrower's breach of any covenant or agreement in this Security Instrument(but not prior to acceleration under paragraph 17 unless applicable law provides otherwise). The notice shall specify; (a)the default;(b)the action required to cure the default;(c)a date,not less than 30 days from the date the notice is given to Borrower,by which the default must be cured;and(d)that failure to cure the default on or before the date specified in the notice may result in acceleration of the sums secured by this Security Instrument,foreclosure by judicial proceeding and sale of the Property. The notice shall further inform Borrower of the right to reinstate after acceleration and the right to assert in the foreclosure proceeding the non-existence of a default or any other defense of Borrower to acceleration and foreclosure. If the default is not cured on or before the date specified in the notice, Lender,at its option,may require immediate payment in full of all sums secured by this Security Instrument without further demand and may 3 ?r8 *** OR 4841 PG 1598 *** d 1d foreclose this Security Instrument by judicial proceeding. Lender shall be entitled to collect all expenses incurred in pursuing the remedies provided in this paragraph 21,including,but not limited to,reasonable attorneys fees and costs of the title evidence. 22. Release. Upon payment of all sums secured by this Security Instrument,Lender shall release this Security Instrument,without charge,to Borrower. Borrower shall pay any recordation costs. 23. Attorneys'Fees. As used in this Security Instrument and the Note,"attorneys'fees"shall include any attorneys'fees awarded by an appellate court. 24. Special Covenants. I. Subsidy Retention, a. Fair Market Value:Fair Market Value is the market value of the Property as reasonably determined by appraisal. Lender and Homeowner shall mutually select an appraiser whose determination shall be deemed Fair Market Value. If Lender and Homeowner cannot mutually agree on an appraiser,each shall select an appraiser who shall each submit an appraisal. If the two appraisals differ, then the average of the two appraisals shall be deemed the Fair Market Value. All costs of appraisal shall be borne by Homeowner. b. Term:The Subsidy Retention requirement shall commence upon transfer of title to the Property to Homeowner and shall end on the later of(i)the original maturity date of the Note;or(ii)fifteen(15)years. c. Purpose:The subsidy retention amount is the amount necessary to reduce the purchase price to an affordable level for the qualifying Homeowner having an income below one hundred twenty percent(120%)of the Area Median Income('AMI). d. Index: U.S. Department of Labor Bureau of Labor Statistics consumer Price Index—All Urban Consumers Miami-Fort Lauderdale,Florida Area,effective date of proposed transfer. e. Appreciation Limitation: Should Homeowner desire to transfer the Property prior to maturity date of the Note and Mortgage,appreciation shall be limited to the •• i-: : .-se price plus annual appreciation based upon the Index defined in section(I)(d)of this Mortgage. For s m= 75,000 and there is a 3%annual income inflation as dete ve. ..+•- • . •-� nd omaowner f five years the housurchases the home e wr$1 be worth$202 873.00 representing the projected Home• rap-. of$27,873. No• '• -n•*rig that the Property could be sold for a greater Fair Market Value than$202,873,$ + ill be the maximum allow.•e pu ase price the house can be sold for,and only to an income qualified Applicant, -ppr• by r`.niti r County Housing a •Hu •an Services. f. Joint and Several Liability Eac 1)6 -._-xec is., .. gage a Ho eowner shall be jointly and severally liable for each and every obligation ar sing ereunder. 1 SIGNING BELOW,Borrower accepts and agr-es t• =term a d v by Borrower and recorded with it. ••nta fed n t S= city Instrument and in any rider(s)executed Signed,seated and delivered in the presence o �� ( 1 j a` . � Witness#1: Li3,� Iv• i -p Signature: . ef/ j Borrower PI--•:- 7 BORGELA Signature: (7 —C2V1 `/1 Q., 0,44,, \- `-. p aMu :.. . -i I Witness#2: I Q Borrower •LANDE GORGE: Signature: 1 ...... 4011k11111. STATE OF FLORIDA „II ' II % Address: 1141 Eisenhower Boulevard,Lehigh Acres,FL 33974 COUNTY OF COLLIER I hereby certify that on this day, before me, an officer duly authorized in the state aforesaid and in the county aforesaid to take acknowledgements,personally appeared PIERRE A.BORGELA and YOLANDE BORGELA to me known to be the persons described in and who executed the foregoing instrument and acknowledged before me that they executed the same for the purpose therein expressed. WITNESS my hand and official seal in the County and State aforesaid this day o ...,.- , ,2012. My Commission Expires: 1W,r •ate. •71"a"s gnat . �' ` (Seal) ---..7_,.... '!- 1, Ct��f\/ ., �:4 t. 7A mist OR J � ��„„,,.,„,„ Cnmmission>*'DD 891857 cxpires May 21,2013 r..4•]Thu T.ry Fan hs,+arce'3).115-7613 4 ` ,5 1 • . .. ... ....- . .. ' «t. el 0 1";...,h..k.- .-1-.. ,, ••« .t -4." '.- J - ''.°-'' .-A-iilf;,::/:" '. -'r:', ‘,...:a,..•'.......?,.:-;"-;41;*-14-4.;,_::'*• •'''. ' . -•.:-_ - .,,p!, 4., .= ...,.., ..1 • , •• •V..:<ist''' Ani,',....',.: ' ' . " ' '.."-1«t:;' '' -..‘.`r-'..;,-A.,..,• '", " ",, -;74,,k7: ;'.._' • -'.; . .',.i1::._:•1,-,...„.A. :, ,,:.41-;.!..,Aii..trii,,'„ ,,,:Aik-i.4,.": --' . - .-. ...k g...,.. , ........ . , , • ,.• . ..,.. -..,. ,. - ' . lir.451hOn .1 VillhIr' f'...-t'i'.. ;,. .•'(..::' - ,. Z7 ersies tow"11--,- - ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. Complete routing lines # i through #2 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the exception of the Chairman's signature. draw a line through routine lines # 1 through #2- comnlete the checklist- and forward to the Cnnnty Attnrnev ntt;ee Route to Addressees (hist in routing order) Office Initials Date 1. Jennifer A. Bel edio, ACA County Attorney Office Initial Applicable) 2. BCC Office Board of County Commissioners Dtlz_ 16.D.10 3. Minutes and Records Clerk of Court's Office PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above. may need to contact staff for additional or missing information- Name of Primary Staff Elizabeth Hernandez, CHS Phone Number 239-252-2338 Contact / Department appropriate. Initial Applicable) Agenda Date Item was June 12, 2012 Agenda Item Number 16.D.10 Approved by the BCC Does the document need to be sent to another agency for additional signatures? If yes, Type of Document Insurance Claim Check Endorsement for Number of Original Attached Jean, Gesnal Documents Attached N/A PO number or account m4wo0rC=•s�r�� number if document is N/A to be recorded �'p\ N/A INSTRUCTIONS & CHECKLIST I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12 Initial the Yes column or mark "N/A" in the Not Applicable column, whichever is Yes N/A (Not appropriate. Initial Applicable) 1. Does the document require the chairman's original signature? 2. Does the document need to be sent to another agency for additional signatures? If yes, provide the Contact Information Name; Agency; Address; Phone on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be N/A signed by the Chairman, with the exception of most letters, must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike -through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's signature and initials are required. 7. In most cases (some contracts are an exception), the original document and this routing slip N/A should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 06/12/2012 and all changes made during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes, if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC, all changes directed by the BCC have been made, and the document is ready for the Chairman's signature. I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12 Ann P. Jennejohn From: Patricia L. Morgan Sent: Wednesday,August 09, 2017 3:03 PM To: Minutes and Records Subject: FW:YY-1456 BCC Meeting 11/13/12 and prior meetings Agenda Items - post board review of items: Attachments: Item 16-D-10 (6_12_12) Insurance Claim Check- NOT.pdf Follow Up Flag: Follow up Flag Status: Completed Item for Backup Documentation for Item#16D10 from June 12, 2012. Please redact the banking account information. Thank you, Trish Morgan, BMR Director Clerk to the Board &VAB Board Minutes& Records Dept. 239-252-8399 Phone 239-252-8408 Fax From: NeetVirginia [mailto:VirginiaNeet@colliergov.net] Sent: Wednesday,August 09, 2017 2:55 PM To: Patricia L. Morgan <patricia.morgan@collierclerk.com>; HernandezElizabeth<ElizabethHernandez@colliergov.net> Cc: Belpedio,Jennifer<JenniferBelpedio@colliergov.net> Subject:YY-1456 BCC Meeting 11/13/12 and prior meetings Agenda Items- post board review of items: Trish: Jennifer Belpedio asked that I email the attached to you for the Clerk's records. This is in regards to an insurance claim check endorsed by the Chairman today. Please call if you have any questions. Elizabeth: The check and backup documents are ready for pickup at our front desk. Dinny Virginia A. Neet, FRP Office of the Collier County Attorney Telephone (239)252-8066 - Fax (239) 252-6600 Under Florida Law,e-mail addresses are public records.If you do not want your e-mail address released in response to a public records request,do not send electronic mail to this entity.Instead,contact this office by telephone or in writing. 1 Joy �' Cheek No Check Rate - 1747 145718 May 11, 2017 11-24 1.210 f., f �y_I r07 �o 4" 4 ,6. D. EXECUTIVE SUMMARY Recommendation to approve a homeowner insurance check endorsement policy for all borrowers assisted with purchase assistance and/or rehabilitation housing program funds and authorizes Board Chairman or Vice Chairman, in his absence to endorse two homeowner insurance claim checks. OBJECTIVE: To allow homeowners in good standing with the State Housing Initiatives Partnership (SHIP) program to deposit their homeowner insurance claim check into the bank so they can use the funds to repair their damaged homes. CONSIDERATION: On July 25, 2008, the subject homeowners purchased a home located at 2505 41st Ave NE, Naples, FL 34120. Collier County approved down payment assistance through the SHIP program and the borrowers signed a second mortgage for SHIP down payment assistance on July 25, 2008, On January 20, 2012, the homeowners filed a homeowner's insurance claim due to water seepage damage to their home. The total claim for damages was $9,935.68. The insurance company paid the claim minus the homeowner's $1,000 deductible, in two separate checks. Check #1 in the amount of $7,964.41 and check #2 in the amount of $971.37. The insurance company made the checks payable to the homeowner, Bank of America and Collier County since all parties have an interest in the property. According to the SHIP loan documents and SHIP local housing administrative plan (LHAP) the homeowner is not required to pay back any funds to Collier County unless the homeowners sell, refinance or lose their homestead exemption on the property. None of these triggering events have occurred and the homeowner's second mortgage loan with Collier County is in good standing. Therefore, Collier County has no claim to the homeowner's insurance claim money that was provided to make repairs to the home. The homeowner has expressed frustration in having to wait for her checks to be endorsed because her house is in urgent need of repairs. Accordingly, Housing staff has developed a proposed Homeowners Insurance Check Endorsement Policy for similar circumstances in the future. If this item is approved, the Board Chairman or Vice Chairman, in his absence may endorse a check only if certain enumerated documentation is provided and the homeowner is in compliance with the SHIP and/or Single Family Home Rehabilitation program. The proposed Homeowners Insurance Check Endorsement Policy is attached as back-up for Board consideration. FISCAL EWACT: There is no fiscal impact associated with this Executive Summary. GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact associated with this Executive Summary. LEGAL CONSIDERATIONS: This item is legally sufficient and requires a majority vote for Board action. - JBW RECOMMENDATION: That the Board of County Commissioners approves a homeowner insurance check endorsement policy for all borrowers assisted with purchase assistance and/or rehabilitation housing program funds and authorizes the Board Chairman or Vice Chairman, in his absence to endorse two homeowner insurance claim checks. PREPARED BY: Lisa Carr/Housing Outreach Coordinator, Housing Human and Veteran Services Collier County Community and Human Services Division (CHS) Homeowner Insurance Check Endorsement Policy Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients. As long as the recipient continues to own and occupy the assisted property during the term of the nrtn-tgageilien, then the loan will not have to be repaid. On occasion, the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and receive money to make the repairs. If the insurance claim check is made payable to the homeowner and Collier County, then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to CHS at the address below for check endorsement consideration: 1. Copy of Homeowner's current insuranCC policy -Declaration Page. 2. Copy of insurance company's claim report with worksheet including description of repairs and costs. 3. Copy of photos of claim damage. 4. Copy of Insurance check(s) payable to homeowner, first lien holder and Collier County_ Homeowncr Name:()Ntt, (� 1 I Iomeo«-ner Address: Primary Contact Number:, - U- HomeowncrLiliail:i�0L (Yi��` OFFICE USE ONLY CHS Director //9 / 7 Date Va l Date Reviewed Approved Denied To: Kimberly Grant, CHS Director CC: Jennifer Belpedio, Assistant County Attorney From: Elizabeth Hernandez, Grant Support Specialist, Community and Human Services Date: 07/31/2017 Re: Homeowner Insurance claim check endorsement- Jean, Gesnal 283144 th Terrace SW, Naples, FL 34116 The Homeowner Insurance Check Endorsement Policy approved by the Board on June 12, 2012 (16.D.10) authorizes the Board Chairman or Vice Chairman to endorse homeowner insurance claim checks for recipients assisted with Purchase Assistance and/or rehabilitation program funds as Collier County is named as Second Mortgagee on their insurance policies. The attached check in the amount of $6,959.78 is for disbursement of the claim funds requiring endorsement by Board Chairman Taylor or Vice Chairman. The check names Habitat for Humanity as the first mortgage lender and Collier County SHIP as subordinate lien holder. In order for the check to be properly processed, proper signatures/endorsement for all parties listed on check must be obtained. This is a time -sensitive item and must be endorsed as soon as possible as homeowner is waiting to pay for work to be performed on home. Attachments: Homeowners Insurance Policy -Declaration Page Insurance Claim Check (#145718) $6,959.78 Insurance Claim Report & photos of damage Collier County Second Mortgage UPC HOMEOWNERS DECLARATION l N S U R A ;POLIO—NUMBER POLICY RERIOQ UNITED PROPERTY & CASUALTY INS CO Fram - Ta P.O. Box 51149 UHV 281102403 01 09/14/2015 09/14/2016 Sarasota, FL 34232-0330 12:01 a.m. a tt a resideme prtmises. RENEWAL DECLARATION Effective: 09/14/2015 Date Issued:07117/2015 aNSUFiED ; .;:; ......:...:•: .. . . :AGENT': 2003090 .:.:.........:.:: GESNAL JEAN BRUCE HENDRY INSURANCE INC MAGDALA JEAN 711 W MAIN ST 2831 44TH TER SW IMMOKALEE FL 34142-3938 NAPLES FL 34116 N/A Telephone: 239.200-3464 Telephone. 239-657-3614 The residence premises covered by this policy is located at the AMVQ IIffiUTAd Addirm UIgA9S etha ica Stgtod below., 2831 44TH TER SW NAPLES FL 34116 SECTION I, SECTION II AND OPTIONAL PREMIUMS ]EMERGENCY MANAGEMENT TRUST FUND SURCHARGE MANAGING GENERAL AGENCY (MGA) POLICY FBS Premium: $1,044.00 $2.00 $25.00 TOTAL POLICY PREMMUM INCLUDING ASSESSMENTS AND ALL SURCHARGES $1,071.00 $672.00 NOTE: The portion of your premium for Hurricane Coverage is: The portion of your premium for All Other Coverages is: $347.00 An adjustment of 0% is included to reflect the Building Code grade for your area. Adjustments range from 1% surcharge to 46.1% credit. Your policy includes endorsement HO 04 46 Inflation Guard- which automatically Increases the amount of Dwelling Coverage by the annual percentage amount shown on the declaration page (but not less than 4%). Therefore your Hurricane deductible may be higher than indicated on the policy when a hurricane loss occurs due to application of the endorsement. FLOOD CARRIER N/A FORM TYPE HO -3 YEAR BUILT 1978 TOWN/ROW HOUSE N/A CONSTRUCT TYPE F CONSTRUCT SUPERIOR N NUMBER OF FAMILIES 00001 AOP TERRITORY 551 PROTECTION CLASS 04 USE CODE P MUNICIPAL CODE 999999 COUNTY CODE 021 PROT DEVICE/BURGLAR N PROT DEVICE/FIRE N PROT DEWSPRINKLER N PROT DEV/SHUTTER N WIND/HAIL EXCLUSION N REPLACEMENT COST N OCCUPANCY CODE OWNE FLOOD CREDIT N SINKHOLE COVERAGE I WIND TERRITORY 551A WATER PREVENTION CR N INFLATION GUARD 4% i ipr a 1 INRI IRFn T:r1PY Page 2 of 5 HOMEOWNERS DECLARATION INSURANCE POLICY NUMBER... :POLICY PERIOD•. - UNITED PROPERTY & CASUALTY INS CO from: _ .. • • .`: To P.O- Bax 51149 UHV 2011024 03 01 09119(2015 09/14/2016 Sarasota, FL 34232-0330 12:01 a.m, a1 ub revoorm prams -S, RENEWAL DECLARATION Effective: 09/14/2015 Date Issued: 07/17/2015 :INSURED,:>.. :::... ;, ..'A09NT; 200.3090. . GESNAL JEAN BRUCE HENDRY INSURANCE INC MAGDALA JEAN 711 W MAIN ST ' 2831 44TH TER SW IMMOKALEE FL 34142-3938 NAPLES FL 34116 Telephone: 239-200-3464 Telephone: 239-657-3614 The residence premises covered by this policy is located at the above insured address unless otherwise stated below: 2631 44TH TER SW NAPLES FL 34116 LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. YOU MAI ALSO NEED TO CONSIDER THE PURCHASE OF FLOOL INSURANCE FROM THE NATIONAL FLOOD INSURANCE PROGRAM. WITHOUT THIS COVERAGE, YOU MAY HAVE UNCOVERED LOSSES. PLEASE DISCUSS THESE COVERAGE% WITH YOUR INSURANCE AGENT. Coinsurance Contract: The rate charged in this policy is based upon the use of the coinsurance clause attached to this policy, with the consent of the insured. A rate adjustment of 78% of wind premium is included to reflect the windstorm mitigation features of your dwelling. Adjustments range from 0% to 89% credit subject to verification that your home meets the windstorm mitigation characteristics of the 2001 Florida Building Code. THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES, WHICH MAY RESULT IN HIGH OUT OF POCKET EXPENSES TO YOU. ************* Additional Information This replaces all previously issued policy declarations, if any. This policy applies to accidents, occurrences, or losses which happen during the policy period shown above. In case of loss under Section I, only that part of loss over the stated deductible applies. The declarations page together with all policy provisions and any other applicable endorsements completes your policy. UPC 119 12 12 INSURED COPY Page 3 of 5 HEREvz*—" }E{NOOR8_CK y+� - 'FEDERAL RESERVE BOARD OF GOVERNDRS REG. C.C. .; R'.A face of document is blue. Document secerily includes: I; void pantograph, microprintieg, coin reactive simulated watermark and themrochromalic ink. ' PAdlock Qa11gn Is 2 c"Iffl811an mark ai 1110 Choc: P21mienl SW -0, Armlagm PCKeep UPC Insurance the PO Box 1011 t. FL INSURANCE° Promise" 1-888-CLM DEPT 33731 CLAIM Policy No.: 1 1 � _ . - ' . ❑ UHV281102404 x F GESNAL JEAN Date of Loss: 02/26/2017 3:00 AM 2831 44TH TER SW NAPLES FL 34116Home Type of Loss: Water -Pipes phone: Deductible: $1,000.00 Business phone: Year Built: 1978 Cat No,: Mobile phone: 1 (239) 200-3464 Bus. Fax: Adjuster: Tracy Moreno Contact: Phone: Loss address: 2831 44TH TER SW Email: tmoreno@upcinsurance.com NAPLES FL 34116 '"this adjuster, the author of this estimate, has no authority to: (1) approve or deny claims; or, (2) bind UPC as to coverage for your claim or the amount of your loss, if any. A copy of this estimate does not constitute a settlement of this claim or any representation on the part of UPC. The estimate is subject to the review, modification and approval of UPC, including, but not limited to, the application of policy limitations, exclusions and deductible provisions. Any additional repairs to, or replacement of, items not included in this estimate are also subject to UPC; prior approval. You are required to keep all records, cancelled checks, inspection reports, etc., as proof of repair/replacement in the event of any future loss and pursuant to your post -loss duties under your insurance policy. This estimate Is not an authorization of repair. The hiring of a contractor is strictly the decision of the UPC policyholder." Claim 2017FLO21747 Page 1 of 7 04/26/2017 Descri Pilon Quan ty Unit Price Per *Total O&P *Total Taxes *RC *Depredation I *ACV Inh r'StrucliLlri�(R7N�WI YAdjusters)�Claim~#2017FL0217,47;. GESNAL JEAN WOMAN: Roofplan 2 Roof Roof area: 2,637.86 SF Squares: 26.4 SQ Soffit: 419.25 SF Gutters: 187.25 LF Ridge: 53.58 LF Valley: 39.38 LF Hip rafter: 98.40 LF 1 No apparent related 1 $0.00 EA $0.00 $0.00 $0.00 $0.00 $0.00 damage Roof - Subtotal (1 item) $0.00 $0.00 $0.00 $0.00 $0.00 Roofplan 2 -.Subtotal (1 Item) $0.00 $0.00 $0.00 $0.00 $0.00 �] FLOORPLAN: Floorplan 2 Q Kitchen Length: 9'11" Width: 14'5" Height: 8' Flat Walls: 254.66 SF Wails -subs: 245.66 SF Walls-subs-cas-bsbd: 115.93 SF Doors: 0.00 SF Windows: 9.00 SF Openings: 0.00 SF Missing Walls: 134.66 SF _+ Floor. 142.97 SF Ceiling: 142.97 SF Perim (F): 31.84 LF Perim (C): 31.84 LF I" G KC1119CICILVI, W/ 1 V11 L Freezer Good - Rem/Reset 3 Microwave/Range 1 Hood Good - Rem/Reset 4 Range, Freestanding, 1 Electric 1 Oven, +Burner, Good - Rem/Reset 5 Dishwasher Good - 1 Rem/Reset 6 Draperies - 1 Rem/Reset 7 Clean Ceramic Tile 100.97 Light 8 Contents, Move & 1 Protect 9 Fixture, Recessed 4", 4 Good - Tear Out 10 Fixture, Recessed 4", 4 Good - Replace 11 Ceiling/Paddle Fan 1 Good -Tear Out ;[i.li to $10.86 $0.00 $65.20 $0.00 $65.20 $36.12 EA $7.22 $0.00 $43.34 $0.00 $43.34 $27.17 EA $5.44 $0.00 $32.61 $0.00 $32.61 $43.77 EA $8.76 $0.00 $52.53 $0.00 $52.53 $29.42 EA $5.88 $0.00 $35.30 $0.00 $35.30 $0.20 SF $4.04 $0.36 $24.60 $0.00 $24.60 $31.52 HR $6.30 $0.00 $37.82 $0.00 $37.82 $14.18 EA $11.34 $0.00 $68.06 $0.00 $68.06 $78.93 EA $63.14 $10.01 $388.87 $5.90 ✓ $382.97 $18.28 EA $3.66 $0.00 $21.94 $0.00 $21.94 Claim 2017FLO21747 Page 2 of 7 04/26/2017 G KC1119CICILVI, W/ 1 V11 L Freezer Good - Rem/Reset 3 Microwave/Range 1 Hood Good - Rem/Reset 4 Range, Freestanding, 1 Electric 1 Oven, +Burner, Good - Rem/Reset 5 Dishwasher Good - 1 Rem/Reset 6 Draperies - 1 Rem/Reset 7 Clean Ceramic Tile 100.97 Light 8 Contents, Move & 1 Protect 9 Fixture, Recessed 4", 4 Good - Tear Out 10 Fixture, Recessed 4", 4 Good - Replace 11 Ceiling/Paddle Fan 1 Good -Tear Out ;[i.li to $10.86 $0.00 $65.20 $0.00 $65.20 $36.12 EA $7.22 $0.00 $43.34 $0.00 $43.34 $27.17 EA $5.44 $0.00 $32.61 $0.00 $32.61 $43.77 EA $8.76 $0.00 $52.53 $0.00 $52.53 $29.42 EA $5.88 $0.00 $35.30 $0.00 $35.30 $0.20 SF $4.04 $0.36 $24.60 $0.00 $24.60 $31.52 HR $6.30 $0.00 $37.82 $0.00 $37.82 $14.18 EA $11.34 $0.00 $68.06 $0.00 $68.06 $78.93 EA $63.14 $10.01 $388.87 $5.90 ✓ $382.97 $18.28 EA $3.66 $0.00 $21.94 $0.00 $21.94 Claim 2017FLO21747 Page 2 of 7 04/26/2017 ;[i.li to $10.86 $0.00 $65.20 $0.00 $65.20 $36.12 EA $7.22 $0.00 $43.34 $0.00 $43.34 $27.17 EA $5.44 $0.00 $32.61 $0.00 $32.61 $43.77 EA $8.76 $0.00 $52.53 $0.00 $52.53 $29.42 EA $5.88 $0.00 $35.30 $0.00 $35.30 $0.20 SF $4.04 $0.36 $24.60 $0.00 $24.60 $31.52 HR $6.30 $0.00 $37.82 $0.00 $37.82 $14.18 EA $11.34 $0.00 $68.06 $0.00 $68.06 $78.93 EA $63.14 $10.01 $388.87 $5.90 ✓ $382.97 $18.28 EA $3.66 $0.00 $21.94 $0.00 $21.94 Claim 2017FLO21747 Page 2 of 7 04/26/2017 Claim 2017FLO21747 Page 2 of 7 04/26/2017 Go xsPrwn Qteantity Unit Price IMATE,'TSfrucCu (r ft7NIW . Adjilstie s7' _ ' Completed :: ` ' Per *TOW O&P *Total Takes *RC - •DePredatlon I *ACV aalm`#2017FL021747, GESfVAL 7EAN Q WItchen(con't) 12 Ceiling/Paddle Fan 1 $253.91 EA $50.78 $11.07 $315.76 $4.66 V $311.10 Good - Replace 13 Floor, Cover & Protect 142.97 $0.16 SF $4.58 $0.62 $28.08 $0.00 $28.08 14 Tape & Drape Wall 267.39 $0.14 SF $7.48 $1.54 $46.45 $0.00 $46.45 © Includes 5% waste on quantity. 15 Drywall, Ceiling 1/2", 90.00 $0.27 SF $4.86 $0.00 $29.16 $0.00 $29.16 Taped - Tear Out 16 Drywall, Ceiling 1/2", 94.50 $1.54 SF $29.10 $2.59 $177.22 $0.51V $176.71 Taped - Replace Q Includes 5% waste on quantity. 17 Texture Ceiling, 60.97 $0.14 SF $1.70 $0.00 $10.24 $0.00 $10.24 Popcorn Medium - Tear Out 18 Seal Ceiling, 1 Coat 142.97 $0.42 SF $12.02 $0.72 $72.79 $0.88 V $71.91 Roller - Seal 19 Texture Ceiling, 142.97 $0.44 SF $12.58 $0.93 $76.42 $0.68 V $75.74 Popcom Medium - Replace 20 Cabinet, Wall (LF) 16.00 $3.77 LF $12.06 $0.00 $72.38 $0.00 $72.38 Good - Tear Out 21 Cabinet, Wall (LF) 16.00 $100.19 LF $320.60 $87.46 $2,011.10 $965.70 V $1,045.40 Good - Replace 22 Sink, Kitchen, 1 $172.98 EA $34.60 $0.00 $207.58 $0.00 $207.58 Stainless Steel Double, With Faucet, Good - Rem/Reset 23 Countertop, Laminate 18.00 $1.84 LF $6.62 $0.00 $39.74 $0.00 $39.74 (LF) Good - Tear Out 24 Countertop, Laminate 18.00 $34.24 LF $123.26 $20.89 $760.47 $230.68 V $529.79 (LF) Good - Replace 25 Badcsplash, Formica, 18.00 $0.63 LF $2.26 $0.00 $13.60 $0.00 $13.60 4" - Tear Out 26 Badcsplash, Formica, 18.00 $6.41 LF $23.08 $2.86 $141.32 $31.63 V $109.69 4" - Replace 27 Cabinet, Base (LF) 16.00 $3.32 LF $10.62 $0.00 $63.74 $0.00 $63.74 Good - Tear Out 28 Cabinet, Base (LF) 16.00 $165.24 LF $528.76 $163.64 $3,336.24 $1,806.87 V $1,529.37 Good - Replace 29 Cabinet Toe Kids 19.00 $4.07 LF $15.46 $1.19 $93.98 $13.14 9/ $80.84 Veneer Wrapped - Replace 30 Cabinet Hardware, 25 $9.72 EA $48.60 $8.15 $299.75 $90.03V $209.72 Pulls/Handles Good - Replace Claim 2017FLO21747 Page 3 of 7 04/26/2017 /0001 /1 Price I Per I *Total O&P *Total Taxes I *RC I •OeP�ettstlon •AN Claim ;#2017FL021747, Gt_SNAL , Q Kitchen(cont) - 31 Clean & Paint Walls 115.93 $0.52 SF $12.06 $1.00 $73.34 $1.23 ✓ $72.11 Roller 32 Cleaning Laborer 1 $24.78 HR $4.96 $0.00 $29.74 $0.00 $29.74 (HR) Kitchen - Subtotal (31 items) $1,392.68 $313.03 $8,669.37$3,151.91 $5,517.46 Q Dining Room Length: 611" Width: 10'9" Height, 8' Flat Wails: 227.33 SF Walls -subs: 171.33 SF Walls-subs-cas-bsbd: 150.26 SF Doors: 40.00 SF Windows: 16.00 SF Openings: 0.00 SF Missing Walls: 55.33 SF Floor. 74.35 SF Ceiling: 74.35 SF Perim (F): 21.26 LF Perim (C): 28.42 LF 33 Contents, Move & 1 $31.52 HR $6.30 $0.00 $37.82 $0.00 $37.82 Protect 34 Draperies - 1 $29.42 EA $5.88 $0.00 $35.30 $0.00 $35.30 Rem/Reset 35 Clean Ceramic Tile 74.35 $0.20 SF $2.98 $0.27 $18.12 $0.00 $18.12 Light 36 Ceiling Fixture Goad - 1 $45.89 EA $9.18 $0.00 $55.07 $0.00 $55.07 Rem/Reset 37 Floor, Cover & Protect 74.35 $0.16 SF $2.38 $0.32 $14.60 $0.00 $14.60 38 Tape & Drape Wall 238.70 $0.14 SF $6.68 $1.38 $41.48 $0.00 $41.48 ® Includes 5% waste on quantity. 39 Texture Ceiling, 74.35 $0.14 SF $2.08 $0.00 $12.49 $0.00 $12.49 Popcorn Medium - Tear Out 40 Seal Ceiling, 1 Coat 74.35 $0.42 SF $6.24 $0.37 $37.83 $0.45 ✓ $37.38 Roller - Seal 41 Texture Ceiling, 74.35 $0.44 SF $6.54 $0.48 $39.74 $0.35 ✓ $39.39 Popcorn Medium - Replace 42 Clean & Paint Walls 150.26 $0.52 SF $15.62 $1.30 $95.05 $1.59 ✓ $93.46 Roller 43 `Helie, ing Laborer 1 $24.78 HR $4.96 $0.00 $29.74 $0.00 $29.74 Dining Room -Subtotal (11 items) $68,84 $4.12 $417.24 $2.39 $414.85 Claim 2017FLO21747 Page 4 of 7 04/26/2017 i"`1 /"`N Description Quantity Unit Price Per *Total O&P *Total Taxes *RC *Depredation *ACV ESTIMATE.,S11G12]�(W{!�Wi�iAiljUSbelS) t Claim:#2017FL021747, GESNAL]FAN L Q Living Room HR $12.60 Length: 28'5" Width: 14'11" Height: 8' Hat -'"--j $0.00 Walls: 613.99 SF Walls -subs: 501.32 SF Walls-subs-cas-bsbd: 463.00 SF Protect Doors: 76.67 SF Windows: 16.00 SF Openings: 20.00 SF Missing Walls: 79.33 SF / I Floor. 423.88 SF Ceiling: 423.88 SF Perim (F): 61.02 LF Perim (C): 74.26 LF 44 1-onu3nts, Move & L $31.52 HR $12.60 $0.00 $75.64 $0.00 $75.64 Protect 45 Blinds, Door, Vertical 1 $146.41 EA $29.28 $9.28 $184.97 $0.00 $184.97 - Replace 46 Draperies - 2 $29.42 EA $11.76 $0.00 $70.60 $0.00 $70.60 Rem/Reset 47 Blinds, Window, 1 $112.15 EA $22.44 $6.81 $141.40 $0.00 $141.40 Vertical - Replace 48 Clean Ceramic Tile 423.88 $0.20 SF $16.96 $1.53 $103.26 $0.00 $103.26 Light 49 Floor, Cover & Protect 423.88 $0.16 SF $13.56 $1.83 $83.21 $0.00 $83.21 50 Clean & Paint Walls 463.00 $0.52 SF $48.16 $4.00 $292.92 $4.91 ✓ $288.01 Roller 51 Cleaning Laborer 1 $24.78 HR $4.96 $0.00 $29.74 $0.00 $29.74 (HR) Living Room - Subtotal (8 items) $159.72 : $23A5 $981.74 $4.91 $976.83 Q Hallway Length: 6'2" Width: TV Height: 8' Flat Walls: 154.66 SF Walls -subs: 117.99 SF Walls-subs-cas-bsbd: 109.19 SF Doors: 16.67 SF Windows: 0.00 SF Openings: 20.00 SF Missing Walls: 0.00 SF Floor. 21.58 SF Ceiling: 21.58 SF Perim (F): 13.76 LF Perim (C): 16.84 LF ;c rnnx, wvt:r a rrorea u.Na $U.16 5F $0.70 $0.09 $4.24 $0.00 $4.24 53 Clean & Paint Wails 109.19 $0.52 SF $11.36 $0.94 $69.08 $1.151/ $67.93 Roller 54 Cleaning Laborer 1 $24.78 HR $4.96 $0.00 $29.74 $0.00 $29.74 (HR) Hallway - Subtotal (3 items) $17.02 1, $1.03 $103.06 $1.15 $101.91 90 General Items 55 Dumpsber 10 Yard 1 $402.81 EA $80.56 $0.00 $483.37 $0.00 $483.37 56 Insulation, Ceiling, 142.97 $0.50 SF $14.30 $0.00 $85.79 $0.00 $85.79 Blown Fiberglass, 12" - Tear Out © Allowed fear replacing wet insulation overy the kitchen Claim 2017FLO21747 Page 5 of 7 04/26/2017 I MO Quantity Price - Per Total d&P Total Taxes RC oepreAanon +pCy - --- eSriMPA't'� .Structure (R]ivlW :AdjusteUnit �� Claim #201 7FL021747GESNAL JEAN k ; 57 Insulation, Ceiling, 142.97 $1.03 SF $29.46 $6.07 $182.79 $0.00 $182.79 Blown Fiberglass, 12" - Replace General Items - Subtotal (3 items) — $124.32 $6.07 $751.95 $0.00 $751.95 Floorplan 2 - Subtotal (56 items) $1,762.58 $347.70 $10,923.36$3,160.36 $7,763.00 * The O&P and taxes amount calculated for each line item is an approximate amount based on the overall O&P and tax rates set for the estimate. Claim 2017FLO21747 Page 6 of 7 04/26/2017 W EsrnHgE'�Struckure(1ls rAd�ust) y, Claim #2017FL021747, GESNAL JEAN "'l+glli�?Ie4YU'5i,7 I Uldl MdLend15: Total Labor: Total Equipment: Total Market Conditions: Subtotal: Adjustments for minimum charges (O&P and taxes are applied): Minimum Charge, Drywall 2 Trips: Minimum Charge, Plumbing: Subtotal: Add 10.00% overhead: Add 10.00% profit: Subtotal: Sales Tax 6.000% (applies to materials and 0&P): Replacement Cost Value: Replacement Cost on Coverage Covg A -Homeowner Dwelling: Less Recoverable Depredation (includes taxes): Net ACV on Coverage Covg A -Homeowner Dwelling: Amount Payable on Coverage Covg A -Homeowner Dwelling: Net Coverage Covg A -Homeowner Dwelling after Deductible if Depredation Is Recovered: Amount Payable on Coverage Covg A -Homeowner Dwelling if Depredation Is Recovered: Deductible: Net Estimate: Total Net Recoverable Depredation: Net Estimate if Depredation is Recovered: Finalization $4,829.32 $3,540.05 $443.71 $0.00 $8,813.08 $113.03 $41.64 $8,967.75 $896.78 $896.78 $10,761.31 $358.85 $11,120.16 $11,120.16 $(3,160.38) $7,959.78 $7,959.78 $11,120.16 $11,120.16 $(1,000.00) $6,959.78 $3,160.38 $10,120.16 Claim 20178021747 Page 7 of 7 04/26/2017 T � ,, nrref; f. I I d lip IIN P i k ih„yf t�j k WMA fiq iidy •� ij {�i k Alm MW `�1�4L 4 Epp �t}s t 'r k$ YT S: �I M f � fq „rCJ 4 y� j { ,q�t r ;fix rad � Y I 41.. i i w # # a fM' t� w�3�r ttf n � r� t tl f - te�;ii 1 ?, 71 f f4 " i�r Cif � r+ � A t m i t � y iii 9 it{b 9t}! { N r f a fM' t� w�3�r ttf r� te�;ii 1 � r+ t �k rryr:. INSTR 4741161 OR 4836 PG 3630 RECORDED 9/19/2012 10:56 AM PAGES 5 DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT, COLLIER COUNTY FLORIDA DOC@.35 $70.00 REC $44.00 OBLD $20,000.00 STATE HOUSING INITIATIVES PARTNERSHIP (SHIP) PROGRAM SECONDMORTGAGE f THIS SECOND MORTGAGE ("Security Instrument") is given on 17(, day of ��f K''L 2012. The Second Mortgagor is: Gesnal Jean and Magdala O. Jean, a married couple ("Borrower'). This Security Instrument is given to Collier County -SHIP ("Lender"), which is organized and existing under the laws of the United States of America, and whose address is 3339 E. Tamiami Trail, Naples, Florida 34112. Borrower owes Lender the sum of Twenty Thousand and 00/100 Dollars ($20,000.00). This debt is evidenced by Borrowers Note dated the same date as this Security Instrument ("Second Mortgage'), which provides for monthly payments, with the full debt, if not paid earlier, due upon sale if sold within the fifteen year term. If sold within fifteen years then the loan will be forgiven in three equal parts each five years so that at the end of the, fifteen year term the balance owed is zero. If sold after the fifteen year term, no repayment is required. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage, then the loan will not have to be repaid. This Security Instrument secures to Lender: (a) the repayment of the debt evidenced by the Note, with interest, and all renewals, extensions and modifications; (b) the payment of all other sums, with interest advanced under paragraph 7 to protect the security of the Security Instrument; and (c) the performance of Borrowers covenants and agreements under this Security instrument and the Note. For this purpose, Borrower does hereby second mortgage, grant and convey to Lender the following described property located in Collier County, Florida. As more particularly described as Golden Gate Unit 3 Blk 100 Lot 11, of the Public Records of Collier County, Florida and which has the address of: ("Property Address"): 2831 44 Terrace SW Naples FL 34116 (Address) (City) (State) (zip) TOGETHER WITH all the improvements now or hereafter erected on the property, and all easements, rights, appurtenances, rents, royalties, mineral, oil and gas rights and profits, water rights and stock and all fixtures now or hereafter a part of the property. All replacements and additions shall also be covered by the Security Instrument. 911-af is referred to in this Security Instrument as the "Property". BORROWER COVENANTS that Borrower is Iawf if e h t y conveyed and has the right to mortgage, grant and convey the Property and that the Property is unencumbe nc cord. Borrower warrants and will defend generally the title to the Property against all claims and demand ,I o any encumbran r THIS SECURITY INSTRUMENT combine n covenants for national use d n -uniform covenants with limited variation by jurisdiction to constitute a uniform security instrum too perty. UNIFORM COVENANTS. Borrower an Len r cbue tan ag slows: 1. Payment of Principal and Interest Pre yment an arges. Borrowe shal promptly pay when due the principal of and interest on the debt evidenced by the Note. J thereon. 2. Taxes, The Mortgagor will pay all t xes j s as nt , s w e o w to to prio to the accrual of any penalties or interest The Mortgagor shall pay or cause to b a p6 beco e, all taxes and governmental charges of any kind whatsoever which may at any time be lawfu ssed or levied against ith re pe Property, (2) all utility and other charges, including "service charges", incurred or imposed operation, maintenance, o up pkeep and improvement of the Property, and (3) all assessments or other governmental charge ay lawfully be paid in r m nt r period of years, the Mortgagor shall be obligated under the Mortgage to pay or cause to be such installments as an, re o be paid during the term of the Mortgage, and shall, promptly after the payment of any of the foregor to Mortgagee evide f s h payment. 3. Application of Payments. Unless appiica as the I ants received by Lender shall be applied; first, to interest due; and, to principal due; and last, to any late cha s r. 4. Charges; Liens. Borrower shall pay all taxes, ass mes and impositions attributable to the Property which may attain priority over this Security Instrument, and leasehold payments or ground rents, if any. Borrower shall promptly fumish to Lender all notices of amounts to be paid under this paragraph, and all receipts evidencing the payments. Borrower shall promptly discharge any lien which has priority over this Security Instrument unless Borrower. (a) agrees in writing to the payment of the obligation secured by the lien in a manner acceptable to Lender, (b) contests in good faith the lien by, or defends against enforcement of the lien in, legal proceedings which In the Lenders opinion operate to prevent the enforcement of the lien; or (c) secures from the holder of the lien an agreement satisfactory to Lender subordinating the lien to this Security Instrument. If Lender determines that any part of the Property is subject to a lien which may attain priority over the Security Instrument, Lender may give Borrower a notice identifying the lien. Borrower shall satisfy the lien or take one or more of the actions set forth above within 10 days of the giving of notice. 6. Hazard or Property Insurance. Borrower shall keep the Improvements now existing or hereafter erected on the Property insured against loss by fire, hazards included within the term "extended coverage" and any other hazards, including floods or flooding, for which Lender requires insurance. This insurance shall be maintained in the amounts and for the periods that Lender requires. The insurance carrier providing the insurance shall be chosen by Borrower subject to Lenders approval which shall not be unreasonably withheld. If Borrower fails to maintain coverage described above, Lender may, at Lenders option, obtain coverage to protect Lenders rights in the Property in accordance with paragraph 7. At all times that the Note is outstanding, the Mortgagor shall maintain insurance with respect to the Premises against such risks and for such amounts as are customarily insured against and pay, as the same become due and payable, all premiums in respect thereto, including, but not limited to , all-risk insurance protecting the interests of the Mortgagor and Mortgagee against loss or damage to the Premises by fire, lightning, and other casualties customarily insured against (including boiler explosion, if appropriate), with a uniform standard extended coverage endorsement, including debris removal coverage. Such Insurance at all times to be in an amount not less than the full replacement cost of the Premises, exclusive of footings and foundations. All insurance policies and renewals shall be acceptable to Lender and shall Include a standard mortgage clause. Lender shall have the right to hold the policies and renewals. If Lender requires, Borrower shall promptly give to Lender all receipts of paid premiums and renewal notices. In the event of loss, Borrower shall give prompt notice to the insurance carrier and Lender. Lender may make proof of loss if not made promptly by Borrower. Unless Lender and Borrower otherwise agree in writing, insurance proceeds shall be applied to restoration or repair of the Property damaged, if the restoration or repair is economically feasible and Lenders security is not lessened. If the restoration or repair Is not economically feasible or Lenders security would be lessened, the insurance proceeds shall be applied to the sums secured by the Security Instrument, whether or not then due, with any excess paid to Borrower. if Borrower abandons the Property, or does not answer within 30 days a notice from Lender that the insurance carrier has offered to settle a claim, then Lender may collect the insurance proceeds. Lender may use the proceeds to repair or restore the Property or to pay sums secured by this Security Instrument, whether or not then due. The 30 -day period will begin when the notice is mailed. Unless Lender and Borrower otherwise agree in writing, any application of proceeds to principal shall not extend or postpone the due date of the monthly payments referred to in paragraph 1 or change the amount of the payments. If under paragraph 21 the Property is acquired by Lender, Borrowers right to any insurance policies and proceeds resulting from damage to the Property prior to the acquisition shall pass to Lender to the extent of the sums secured by this Security Instrument immediately prior to the acquisition. G. Occupancy, Preservation, Maintenance and Protection of the Property; Borrowers Loan Application, Leaseholds. Borrower shall occupy, establish, and use the Property as Borrowers principal residence within sixty days after the execution of this Security Instrument and shall continue to occupy the Property as Borrowers principal residence for at least one year after the date of occupancy, unless Lender otherwise agrees in writing, which consent shall not be unreasonably withheld, or unless extenuating circumstances exist which are beyond Borrowers control. Borrower shall not destroy, damage or impair the Property, allow the Property to deteriorate, or commit waste on the Property. Borrower shall be in default if any forfeiture action or proceeding, whether civil or criminal, is begun that in Lenders good faith judgment could result in forfeiture of the Property or otherwise materially impair the lien created by this Security Instrument or Lenders security OR 4836 PG 3631 interest. Borrower may cure such a default and reinstate, as provided in paragraph 18, by causing the action or proceeding to be dismissed with a ruling that, in Lenders good faith determination, precludes forfeiture of the Borrowers interest in the Property or other material impairment of the lien created by this Security Instrument or Lenders security Interest. Borrower shall also be in default if Borrower, during the loan application process, gave materially false or inaccurate information or statements to Lender (or failed to provide Lender with any material information) in connection with the loan evidenced by the Note, including, but not limited to, representations concerning Borrowers occupancy of the Property as a principal residence. If this Security Instrument is on a leasehold, Borrower shall comply with all the provision of the lease. If Borrower acquires fee title to the Property, the leasehold and the fee title shall not merge unless Lender agrees to the merger in writing. 7. Protection of Lender's Rights in the Property. If Borrower fails to perform the covenants and agreements contained in this Security Instrument, or there is a legal proceeding that may significantly affect Lenders rights in the Property (such as a proceeding in bankruptcy, probate, for condemnation or forfeiture or to enforce laws or regulations), then Lender may do and pay for whatever is necessary to protect the value of the Property and Lenders rights in the Property. Lenders actions may include paying any sums secured by a lien which has priority over this Security Instrument, appearing in court, paying reasonable attorneys' fees and entering on the Property to make repairs. Although Lender may take action under this paragraph 7, Lender does not have to do so. Any amounts disbursed by Lender under this paragraph 7 shall become additional debt of Borrower secured by this Security Instrument. Unless Borrower and Lender agree to other terms of payment, these amounts shall bear interest from the date of disbursement at the Note rate and shall be payable, with interest, upon notice from Lender to Borrower requesting payment. 8. Mortgage Insurance. If Lender required mortgage insurance as a condition of making the loan secured by this Security Instrument, Borrower shall pay the premiums required to maintain the mortgage insurance in effect. If, for any reason, the mortgage insurance coverage required by Lender lapses or ceases to be in effect, Borrower shall pay the premiums required to obtain coverage substantially equivalent to the mortgage Insurance previously in effect, at a cost substantially equivalent to the cost to Borrower of the mortgage insurance previously in effect, from an alternate mortgage insurer approved by Lender. If substantially equivalent mortgage insurance coverage is not available, Borrower shall pay to Lender each month a sum equal to one -twelfth of the yearly mortgage insurance premium being paid by Borrower when the insurance coverage lapsed or ceased to be in effect. Lender will accept, use and retain these payments as a loss reserve in lieu of mortgage Insurance. Loss reserve payments may no longer be required, at the option of Lender, if mortgage insurance coverage (in the amount and for the period that Lender requires) provided by an insurer approved by Lender again becomes available and is obtained. Borrower shall pay the premiums required to maintain mortgage insurance in effect, or to provide a loss reserve, until the requirement for mortgage insurance ends in accordance with any written agreement between Borrower and Lender or applicable law. 9. Inspection. Lender or its agent may make reasonable entries upon and Inspections of the Property. Lender shall give Borrower notice at the time of or prior to an inspection specifying reasonable cause for the inspection. 10. Condemnation. The proceeds of any award or claim for damages, direct or consequential, in connection with any condemnation or other taking of any part of the Property, or for conveyance In lieu of condemnation, are hereby assigned and shall be paid to Lender. In the event of a total taking of the Property, the proceeds shall be applied to the sums secured by this Security Instrument, whether or not then due, with any excess paid to Borrower. In the event of a partial taking is pelt in which the fair market value of the Property immediately before the taking is equal to or greater than the amount of the r b tj� curity Instrument immediately before the taking, unless Borrower and Lender otherwise agree in writing, the sums of – ent shall be reduced by the amount of the proceeds multiplied by the following fraction: (a) the total amount rrfs secured immer k?b re the taking, divided by (b) the fair market value of the Property immediately before the taking. Any all be paid to Borrower. t. 0 ent of a partial taking of the Property in which . the fair market vacua of the Property Immediately b ore t Lakin is less than the amour of lh sums secured immediately for the taking, unless Borrower and Lender otherwise agree in wr ing u ss apply bla.la"t rwise p Ovid , the proceeds shall be applied to the sums secured by this Security Instrument whether or n the ums are n d Unless ander a Bo ower otherwise agree in writing, any application of proceeds to principal shall not exte d or, p t d h yme is referred to in paragraphs 1 or change the amount of such payments. 11. Borrower Not Released, Forbea anc By end r of v xt si of he ti a for payment or modification of amortization of the sums secured by this Securit t d y e d to any u ces . interest of Borrower shall not operate to release the liability of the original Borrower or Bo s cess int Len II required to commence proceedings against any successor In interest or refuse to ext a for payment or otherwi mod y a tion of the sums secured by this Security Instrument by reason of any demand made by the n I Borrower or Borrower s terest. Any forbearance by Lender in exercising any right or remedy shall not be a waive y� eclude the exercise o y'p p edy. 12. Successors and Assigns Bound; Jor t(an everal Liability Co -Sig e�sst T e covenants and agreements of this Security Instrument shall bind and benefit the successors and a rider and Bo U t to the Provisions of paragraph 17. Borrowers covenants and a e a8-1 n, rat. Any Borrower who co-signs this Security Instrument but does not execute the Note; (a) Is co-signing tht rf� Ir st �Ijb y to mortgage, grant and convey that Borrowers interest in the Property under the terms of this Security Instrument; (b) is no rsanatf o ligated to pay the sums secured by this Security Instrument; and (c) agrees that Lender and any other Borrower may agree to extend, modify, forbear or make any accommodations with regard to the terms of this Security Instrument or the Note without that Borrowers consent. 13. Loan Charges. If the loan secured by this Security Instrument is subject to a law which sets maximum loan charges, and that law Is finally Interpreted so that the interest or other loan charges collected or to be collected in connection with the loan exceed the permitted limits, then: (a) any such loan charge shall be reduced by the amount necessary to reduce the charge to the permitted limit; and (b) any sums already collected from Borrower which exceeded permitted limits will be refunded to Borrower. Lender may choose to make this refund by reducing the principal owed under the Note or by making a direct payment to Borrower. If a refund reduces principal, the reduction will be treated as a partial prepayment without any prepayment charge under the Note. 14. Notices. Any notice to Borrower provided for in this Security Instrument shall be given by delivering it or by mailing it by first class mail unless applicable law required use of another method. The notice shall be directed to the Property Address or any other address Borrower designates by notice to Lender. Any notice to Lender shall be given to Borrower or Lender when given as provided in this paragraph. 15. Governing Law; Severability. This Security Instrument shall be governed by federal law and the law of the jurisdiction in which the Property Is located. In the event that any provision or clause of this Security Instrument or the Note conflicts with applicable taw, such conflict shall not affect other provisions of this Security Instrument or the Note which can be given effect without the conflicting provision. To this end the provisions of this Security Instrument and the Note are declared to be severable. 16. Borrower's Copy. Borrower shall be given one conformed copy of the Note and of this Security Instrument. 17. Transfer of the Property or a Beneficial Interest In Borrower. If all or any part of the Property or any interest in it is sold or transferred (or if a beneficial interest in Borrower is sold or transferred and Borrower is not a natural person) without Lenders prior written consent, Lender may, at its option, require immediate payment in full of all sums secured by this Security Instrument. However, this option shall not be exercised by Lender if exercise is prohibited by federal law as of the date of this Security Instrument. If Lender exercised this option, Lender shall give Borrower notice of acceleration. The notice shall provide a period of not less than 30 days from the date the notice Is delivered or mailed within which Borrower must pay all sums secured by this Security Instrument. If Borrower fails to pay these sums prior to the expiration of this period, Lender may invoke any remedies permitted by this Security Instrument without further notice or demand on Borrower. 18. Borrower's Right to Reinstate. If Borrower meets certain conditions, Borrower shall have the right to have enforcement of this Security Instrument discontinued at any time prior to the earlier of : (a) 5 days (or such other period as applicable law may specify for reinstatement) before sale of the Property pursuant to any power of sale contained in this Security Instrument; or (b) entry of a judgment enforcing this Security Instrument. Those conditions are that Borrower: (a) pays Lender all sums which then would be due under this Security Instrument and the Note as if no acceleration had occurred; (b) cures and default of any other covenants or agreements; (c) pays all expenses incurred In enforcing this Security Instrument, including, but not limited to, reasonable attorney's fees; and (d) takes such action as Lender may reasonably require to assure that the lien of this Security Instrument, Lenders rights in the Property and Borrowers obligation to pay the sums secured by this Security Instrument shall continue unchanged. Upon reinstatement by Borrower, this Security Instrument and the obligations secured hereby shall remain fully effective as if no acceleration had occurred. However, this right to reinstate shall not apply in the case of acceleration under paragraph 17. 19. Sale of Note; Change of Loan Servicer. The Note or a partial interest in the Note (together with this Security Instrument) may be sold one or more times without prior notice to Borrower. A sale may result in a change in the entity (known as the "Loan Servicer') that collects monthly payments due under the Note and this Security Instrument. There also may be one or more changes of the Loan Servicer unrelated to a sale of the Note. If there Is a change of the Loan Servicer, Borrower will be given written notice of the change in accordance with paragraph 14 and applicable law. The notice will state the name and address of the new Loan Servicer and the address to which payments should be made. The notice will also contain any other information required by applicable law. OR 4836 PG 3632 20. Hazardous Substances. Borrower shall not cause or permit the presence, use, disposal, storage, or release of any Hazardous Substances on or In the Property. Borrower shall not do, nor allow anyone else to do, anything affecting the Property that Is in violation of any Environmental Law. The preceding two sentences shall not apply to the presence, use, or storage on the Property of small quantities of Hazardous Substances that are generally recognized to be appropriate to normal residential uses and to maintenance of the Property. Borrower shall promptly give Lender written notice for any investigation, claim, demand, lawsuit or other action by any governmental or regulatory agency or private party involving the Property and any Hazardous Substance or Environmental Law of which Borrower has actual knowledge. If Borrower leams, or is notified by any governmental or regulatory authority, that any removal or other remediation of any Hazardous Substance affecting the Property is necessary, Borrower shall promptly take all necessary remedial actions in accordance with Environmental Law. As used in this paragraph 20, "Hazardous Substances" are those substances defined as toxic or hazardous substances by Environmental Law and the following substances: gasoline, kerosene, other flammable or toxic petroleum products, toxic pesticides and herbicides, volatile solvents, materials containing asbestos or formaldehyde, and radioactive materials. As used in this paragraph 20, "Environmental Lav" means federal laws and laws of the jurisdiction where the Property Is located that relate to health, safety or environmental protection. 21. Acceleration; Remedies. Lender shall give notice to Borrower prior to acceleration following Borrower's breach of any covenant or agreement In this Security Instrument (but not prior to acceleration under paragraph 17 unless applicable law provides otherwise). The notice shall specify: (a) the default; (b) the action required to cure the default; (c) a date, not less than 30 days from the date the notice is given to Borrower, by which the default must be cured; and (d) that failure to cure the default on or before the date specified in the notice may result In acceleration of the sums secured by this Security Instrument, foreclosure by Judicial proceeding and sale of the Property. The notice shall further Inform Borrower of the right to reinstate after acceleration and the right to assert In the foreclosure proceeding the non-existence of a default or any other defense of Borrower to acceleration and foreclosure. If the default is not cured on or before the date specified in the notice, Lender, at its option, may require immediate payment in full of all sums secured by this Security Instrument without further demand and may foreclose this Security Instrument by judicial proceeding. Lender shall be entitled to collect all expenses incurred in pursuing the remedies provided in this paragraph 21, including, but not limited to, reasonable attorney's fees and costs of the title evidence. 22. Release. Upon payment of all sums secured by this Security Instrument, Lender shall release this Security Instrument, without charge, to Borrower. Borrower shall pay any recordation costs. 23. Attorneys' Fees. As used in this Security Instrument and the Note, "attorneys' fees" shall include any attorneys' fees awarded by an appellate court. 24. Riders to this Security Instrument. If one or more riders are executed by Borrower and recorded together with this Security Instrument, the covenants and agreements of each such rider shall be incorporated into and shall amend and supplement the covenants and agreements of this Security Instrument as if the rider(s) were a part of this Security Instrument. (Check Applicable Box) ❑ Adjustable Rate Rider ❑ Rate Improvement I ❑ Graduated Payment Rider ❑ 1-4 Familnthterm�s Rider ❑ Balloon Rider ❑ BiweekPa ❑ Other(s) (specify SIGNING BELOW, Borrower accepts and agrees by Borrower and recorded with it. Signed, sealed and delivered in the presence Witness#1: iC -RI w bucct W Witness#2: Norm,--, !—ora— - Ora - N Signature:ili�r_ STATE OF FLORIDA COUNTY OF COLLIER CLJ Condominium Rider �tlr Second Home Rider �� nned Unit Development Rider �E and in any rider(s) executed Jean O. Jean Address: 2831 44e' Terrace SW Naples, FL 34116 I hereby certify that on this day, Gesnal Jean and Magidala O. Jean before me, an officer duly authorized in the state aforesaid and In the county aforesaid to take acknowledgements, personally appeared to me known to be the person(s) described in and who executed the foregoing instrument and acknowledged before me that (He/ she/ they) executed the same for the purpose therein expressed. WITNESS my hand and official seal in the County and State aforesaid this A/ day of S,Cp kM �cr 2012. My Commission Expires: (Seal) SHIP Notary Public's Signature Norma Lora-Trejo Notary's Printed Name Prepared by-r'yrd" rey�w" Collier County Housing, Human & Veterans Department 3339 E. Tamiami Trail, Bldg H, Suite 211 Naples, FL 34112 1b010 Patricia L. Morgan From: NeetVirginia <Virginia.Neet@colliercountyfl.gov> Sent: Tuesday, January 02, 2018 2:25 PM To: Patricia L. Morgan; HernandezElizabeth Cc: BelpedioJennifer Subject: YY-1456 BCC Meeting 11/13/12 and prior meetings Agenda Items - post board review of items: Attachments: Item 16-D-10 (6_12_12) Insurance Claim Check- NOT(1).pdf Trish: Jennifer Belpedio asked that I email the attached to you for the Clerk's records. This is in regards to an insurance claim check endorsed by the Chairman today. Please call if you have any questions. Elizabeth: The check and backup documents are ready for pickup at our front desk. Dinny Virginia A. Neet, FRP Office of the Collier County Attorney Telephone (239)252-8066 - Fax (239) 252-6600 Under Florida Law,e-mail addresses are public records.If you do not want your e-mail address released in response to a public records request,do not send electronic mail to this entity.Instead,contact this office by telephone or in writing. 1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1�1 L D THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE V 1 Q Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office. Route to Addressee(s) (List in routing order) Office Initials Date 1. Jennifer A. Belpedio, ACA County Attorney Office sj l.Z 2. BCC Office Board of County Commissioners \cis / \\7 <i> 3. Minutes and Records Clerk of Court's Office l NOTE: Clerk's attestation is not required. Please do not route this item to Clerk's Board Minutes and Records. CAO please scan document after execution by Chairman and email them to Clerk's Minute and Records for its records. PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above,may need to contact staff for additional or missing information. Name of Primary Staff Elizabeth Hernandez,CHS Phone Number 239-252-2338 Contact/ Department Agenda Date Item was Agenda Item Number Approved by the BCC Type of Document Insurance Claim Check Endorsement for Number of Original Attached Javier and Maria Sendejas Documents Attached C.� PO number or account number if document is N/A to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature? 2. Does the document need to be sent to another agency for additional signatures? If yes, provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. ,� 3. Original document has been signed/initialed for legal sufficiency. (All documents to be N/A signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip N/A should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 06/12/2012 and all changes made during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes,if applicable. R n• F a o 9. Initials of attorney verifying that the attached document is the version approved by the BCC,all changes directed by the BCC have been made,and the document is ready for the Cil)..laP Chairman's signature. 1:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12 1 6 D 1 a .. .. . . - ^TO-VERIFY-AUTHENTICITY,.SEE REVERSESIOEFOR OESCRIFTICN OFTHE 11 SECURITY FEATURES" `_.. • `.. - p:- a s co,Qr. Heritage PBCfnsarance Company IV x ;,'Bank of Tampa CHECK NUMBER .µ...r ,«�r .. e s 4 2600 McConn,FL 8.37580";''uite 300 14s, x, , Tampao FL 33601 0000102741 CHECK DATE 63-868/631 10/30/17 PaY'AOTEN : O(7S%AND SEVEN HUNDRE6f-IFTY DOLLARS.41.531t(14; � A.;. _,tip. < •5. • i ;:, : .'Oi q. .14:A• :I, • $***"10,750.53 TO THE ORDER OF: + aier Sendjas and Maria Send`e a5 handR9ttt4 At IaCta tor Humanity of CoTler :County 14n . JLLIER COUNTY HOUSING HUMAN'•&NETERAM SERVICES '"" '1', • Immokalee. FL 34114 • • & mm• a ; oaOg � vvvp ¢y 7 �' E.a a c o ,• o Ate' m'a, T, c . ° ° a „ 3 m tab O m . = a ; m 5`0 - 3 n. c c, S1 • :2: Rpt o F. n 8 8 b v m g.N W i N j y 3 E N ?. a £ a , ' ' 13' �S r• o b w ° gmal. rt - A °@ atE33n nxmb .ed m .. H = a Dm fl Et F ° l ^9 x : :. 1 6° m 7 1 i j 1 I t • I • 16010 Collier County Community and Human Services (CHS) Homeowner Insurance Check Endorsement Policy Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage/lien,then the loan will not have to be repaid. On occasion,the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and receive money to make the repairs. If the insurance claim check is made payable to the homeowner and Collier County,then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to CHS at the address below for check endorsement consideration: 1. Copy of Homeowner's current insurance policy-Declaration Page. 2. Copy of insurance company's claim report with worksheet including description of repairs and costs. 3. Copy of photos of claim damage. 4. Copy of Insurance check(s)payable to homeowner,first lien holder and Collier County. Community and Human Services, 3339 Tamiami Trail E,Room 211. If approved,the CHS staff will contact you to schedule an appointment to endorse the insurance claim check. OFFICE USE ONLY • File Name: -f}V le-r. S a-al da j p-s z 4A-a) 62-m de/p-s File# /a C ti a.. /05-6y )444jes-frc Crj'cJ 0VAp41 FL 3‘11/ti /alb/17 UliCriew CH • tall Date GLGS G,i cp fr LYe • Ki •1.�/Ade i G-Yaiff /cJI �//-7 Approved CHS D ector Date 0 Denied f ja \\\---7 0 Review Asst.County Attorney Date • 16010 LopezMaggie From: GrantKimberley Sent: Wednesday, December 20, 2017 9:58 AM To: PelletierLouise; LopezMaggie; GiblinCormac; KemnerCynthia; SonntagKristi Subject: Delegation Due to my working remotely today and tomorrow(12/20 and 12/21),Maggie Lopez is Acting Director for signatures or any physical authorizations needed. I can authorize via email if that is an acceptable method for the particular item. Thank you. Respectfully Kim Grant, MBA, CPM Director Co ler County Community and Human Services Making our Community Stronger: One life,one home,one project at a time. 3339 East Tamiami Trail, Building H, Room 211, Naples, Fl 34112 Phone: 239-252-6287 Cell: 239-450-3672 Kim berlev.Grant@colliercountvfl.gov Under Florida Law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by telephone or in writing. 1 16D10i7 Memorandum To: Kimberly Grant, CHS Director CC: Jennifer Belpedio,Assistant County Attorney From: Elizabeth Hernandez, Grant Support Specialist, Community and Human Services Date: 12/19/17 Re: Homeowner Insurance claim check endorsement-Javier and Maria Sendej as 10564 Majestic Circle,Naples,FL 34114 The Homeowner Insurance Check Endorsement Policy approved by the Board on June 12, 2012 (16.D.10) authorizes the Board Chairman or Vice Chairman to endorse homeowner insurance claim checks for recipients assisted with Purchase Assistance and/or rehabilitation program funds as Collier County is named as Second Mortgagee on their insurance policies. The attached check in the amount of$10,750.53 is for disbursement of the claim funds requiring endorsement by Board Chairman Taylor or Vice Chairman. The check names Habitat for Humanity as the first mortgage lender and Collier County SHIP as subordinate lien holder. In order for the check to be properly processed,proper signatures/endorsement for all parties listed on check must be obtained.This is a time-sensitive item and must be endorsed as soon as possible as homeowner is waiting to pay for work to be performed on home. Attachments: Homeowners Insurance Policy-Declaration Page Insurance Claim Check(#0000102741) $10,750.53 Insurance Claim Report&photos of damage Collier County Second Mortgage fi1 1601 !Heritage Property and Casualty Heritage Property and Casualty Insurance Company InsuranceHERITAGE Company , Homeowners Declarations Page 2600 McCormick Dr.,Ste 300 it Agent Name: Bruce Hendry Insurance Inc Clearwater,FL33759 d n s u r a n c e Address: 711 W Main Street If you have any questions regarding this policy Immokalee,FL 34142 which your agent is unable to answer,please contact us at 1-855-620-9978. Agent Phone: (239)657-3614 Agency Code: H4613 • Policy Number: H0H132108 Insuring Company: Heritage Property and Casualty Insurance Company Named insured: Javier Sendejas 2600 McCormick Dr.,Ste 300 Clearwater,FL 33759 Mailing Address: 10564 Majestic Cir Immokalee,FL 34114 Phone Number. 239-877-1084 • Effective Dates: From:05/23/2017 12:01 am To:05/23/2018 12:01 am Effective date of this transaction: 5/23/2017 12:01am Activity: Renewal Co-Applicant Maria M Sendejas Insured Location: 10564 Majestic Cir Naples,FL 34114 Collier County Coverage at the residence premises is provided only where a limit of liability is shown or a premium Is stated. Coverages& Coverage Section Limits Non-Hurricane Hurricane Total Premiums: A.Dwelling •132600 619.00 2324.00 2943.00 B.Other Structures 2652 Included C.Personal Property 39780 -18.00 -44.00 -62.00 D.Loss of Use 13260 Included E.Personal Liability 100000 Included F.Medical Payments to Others 1000 Included Policy Fee 25.00 25.00 Emergency Management Preparedness and 2.00 2.00 Assistance Trust Fund Fee "Coverage A Increased due to an Inflation Factor Total of Premium Adjustments: (272.00) (1958.00) (2230.00) SEE PAGE 3 FOR DETAILED DESCRIPTION OF PREMIUM ADJUSTMENTS Total Policy Premium: $678 Deductible: All Other Perils: $1,000 Hurricane Deductible: 2% _ $2,652 Law and Ordinance: Law and Ordinance=$ 0 • Special Messages: THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES, WHICH MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU. If your policy contains replacement cost on dwelling,the amount of coverage will not exceed the stated policy value. 04/03/2017 Ernie Garateix Authorized Signature U Page 1 of 3 HPCHO3 DEC2 07 12 16D1l - Any person who knowingly and with intent to injure,defraud or deceive any insurer files a statement or an application containing false,incomplete or misleading information is guilty of a felony in the third degree. Forms HPC NCPT 0214 HPCHP 06 CLP 0712 HPC OSLC0712 HPCHO 09 WBU 0712 and HPC HOJ 0214 HPC CGCC 07 12 HPCHO 09 OTL 07 12 HPCH03 PPS 12 13P OIR6116700106 HPCHO 09 ED 07 12' HPC WE 0712 • HPC HDR 0113 Endorsements: OIR 61 1655 02 10 HPCHO 09 ELE 1213 HPC CE 0712 HPCH03 IDX 0712 HO 04 9604 91 HO 03 010106 H0 00 03 04 91 HPCHO REI OLR0313 HPCHO 23 70 07 12 HPCH03 09 SP 08 16 HPC PRI 0214 HO 04 21 10 94 HPCHO 09 DN 0712 HPC OLN 0313 HPCHO 09 IDT 0319 Pay Plan: Number of Payments: 2 0111 to: MORTGAGEE Rating Program: H03 Construction Type: Frame • Information: Territory: 134 Year Constructed: 2014 Scheduled Property: Description: LAW AND ORDINANCE COVERAGE IS AN IMPORTAN' COVERAGE THAT YOU MAY WISH TO PURCHASE YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE FROM THE NATIONAL FLOG[ INSURANCE PROGRAM. WITHOUT THIS COVERAGE YOU MAY HAVE UNCOVERED LOSSES . PLEASE DISCUSS THESE COVERAGES WITH YOUF INSURANCE AGENT. In the event of a claim,please call toll free 1-855-415-7120. We are available 24 hours a day,7 days a week. This replaces all previously issued policy declarations,if any.This policy applies only to accidents,occurrences or losses which happen during the policy period shown above.In case of property loss,only that part of loss over stated deductibles applies.If payment is not received on or before the policy effective date,this policy will no longer be in force.This declaration page together with all policy provisions and any other applicable endorsements completes your policy. A rate adjustment of 6%is included to reflect the Building Code Enforcement Grade in your area.Adjustments range from 5% surcharge to 46%credit. A rate adjustment of 78%credit is included to reflect the Windstorm Mitigation Device Credit.This credit applies only to the wind portion of your premium. Adjustments range from 0%to 90%., On Property Coverage limit increased at renewal due to an inflation factor of 4%,as determined by a national index of construction costs to maintain insurance to the approximate replacement cost of your home. This policy does not protect you against loss due to flood.Flood Insurance is available through the Federal Government. Contact your agent to apply for coverage. • • Page 2 of 3 3, HPCH03 DEC2 07 12 16010 Coverage Section Limits Non-Hurricane Hurricane Total Windstorm Loss Mitigation Credit -14.00 -1704.00 -1718.00 Building Code Effectiveness Grading -7.00 -139.00 -146.00 Increase Deductibles(NHR/HUR) -52.00 -115.00 167.00 Loss Assessment Coverage 1000 Included Limited Fungi Property/Liability Coverage 10000 Included Water Back-up and Sump Overflow 5000. 25.00 25.00 Identity Theft Coverage 25000 25.00 25.00 Financial Responsibility Credit -198.00 -19800 Jewelry,Watches and Furs 1000 Included Silverware,Goldware,and Pewterware 2500 Included Age of Dwelling Factor -51.00 -51.00 Dollar amount of the premium increase due to rate increase: $0.00 Dollar amount of the premium increase due to coverage changes: $24.00 Policy Interest: NAME ADDRESS INTEREST TYPE BILL TO REFERENCE# HABITAT FOR HUMANITY OF 11145 TAMIAMI TRAIL E MORTGAGEE YES 1235 COLLIER COUNTY NAPLES,FL 34113 COLLIER COUNTY HOUSING 3339 TAMIAMI TRAIL E BLD H SUIT 211 MORTGAGEE NO 1235 HUMAN&VETERAN SERVICES NAPLES,FL 34112 II Page 3 of 3 HPCHO3 DEC2 0712 1 6010 Heritage CAT Team Insurance�� HERITAGE" Heritage Property&Casualty Insurance Company P.O.Box 6417 , Clearwater,FL 33758 LJ Telephone:855-415-7120 I Facsimile: 866-929-4530 Pillars of Strength and Character. Email:claimsC)heritaoeoci.com 10/22/2017 Javier Sendejas and Maria Sendejas 10564 Majestic Circle Naples, Florida 34114 RE: Policyholder(s): Javier Sendejas and Maria Sendejas Claim Number: HP161167 Policy Number: HOH 132108 Date of Loss: 9/10/2017 Dear Javier Sendejas and and Maria Sendejas: Please allow this to serve as a follow up to the claim filed for Hurricane Irma damage and Heritage's coverage determination for the claim referenced above. Coverage Determination: As a result of its investigation, Heritage determined that the claimed damage was caused by Hurricane Irma, for which the policy provides coverage. The amount of your claim payment is calculated as follows: Coverage A—Dwelling $ 13,375.53 Coverage B—Other Structures $ 0.00 Coverage C—Personal Property $ 0.00 Coverage D—Loss of Use $ 0.00 Gross Loss $ 13,375.53 Less uRecoverale,Depreciation $ z :0 00 , > an'RT'# } P L - 'V 1� I y t )+�, 3 S ,� 2 85200 a"'�, s w,•� v� .�'+h5 �a y t1 -re Pm'�r �w Less ffvrarae De�uc�t+bye �T J<< � # 'i�k as 3>``kf 1 . t, � sf � � rt3 Less P ov ous Pa'm nts , t r} 0r , Q©0 ryr {s iia/^ ^k 9 } ! .a . 5' .s.7& 'X yk Et Yz`.'� 7 '!• {4mou { } �� i SI 4 x) ,yA #.PSS k , l ��f $ � u �� '.10�7�Os53 Please refer to the Declarations page of your policy for additional information regarding your Hurricane deductible. Please note that this payment is an initial payment for the damages associated with your claimed loss. We ask that you please provide your contractor(s) with a copy of the enclosed estimate before your repairs begin. If your contractor believes there is additional damage attributed to this loss that is not included in this estimate, or if your contractor discovers additional damages during Wage . 16010 the reconstruction and repair process, please contact us immediately for consideration of a supplement to your claim. Nothing herein constitutes, nor should it be construed by you as a waiver of any of the rights of Heritage Property and Casualty Insurance Company under its policy of insurance, nor is it the purpose of this letter to waive any of the policy terms and/or conditions. When a dispute exists regarding your claim, or when we have denied payment of your claim, Florida Law requires we notify you of your right to participate in the Property Insurance Mediation Program established by the Department of Financial Services. The Chief Financial Officer for the State of Florida has adopted a rule to facilitate the fair and timely handling of residential property insurance claims. The rule gives you the right to attend a mediation conference with your insurer in order to settle any claim you have with your insurer.An independent mediator, who has no connection with your insurer,will be in charge of the mediation conference.You can start the mediation process after receipt of this notice by calling the Department of Financial Services at 1 (877)693-5236.The parties will have 21 days from the date of the notice to otherwise resolve the dispute before a mediation hearing can be scheduled. Should you have any questions or concerns regarding this matter, please contact us at (855) 415- 7120 and choose the prompt for our Resolution Team or send inquiries via email at resolution@heritagepci.com. Sincerely, Heritage CAT Team Enclosures: Check Estimate DFS Mediation Brochure cc: DDD 21Page 16010 .HnsuERITAGrancE'e Heritage I Home: (239)877-1084 Insured: Sendejas,Javier Cell: (239)877-1083 Property: 10564 Majestic Cir Naples,FL 34114 E-mail: marlasendejas@yahoo.com Home: 10564 Majestic Cir Naples,FL 34114 Claim Rep.: Les Lammers Company: MAS Adjusting Estimator: Les Lammers Company: MAS Adjusting Claim Number: HP 161167 Policy Number: HOH132108 Type of Loss: Wind Date Contacted: 9/22/2017 Date of Loss: 9/10/2017 Date Received: 9/17/2017 Date Inspected: 10/3/2017 Date Entered: 9/21/2017 3:36 PM Date Est.Completed: 10/23/2017 2:07 PM Price List: FLNA7X_SEP17 Restoration/Service/Remodel Estimate: SENDEJAS_JAVIER 161310 jti HERITAGE' Heritage gi Insurance This is an estimate of repair for the damages to your property covered by your insurance policy with Heritage Property& Casualty Insurance Company.The prices used are the prevailing rates for your geographic location. The represented values within this estimate do not constitute a settlement of your claim. Authorization to repair or guarantee of payment must come from the owner of the property.No adjuster or appraiser has the authority to authorize or guarantee payment.Heritage assumes no responsibility for the quality of repairs made to the property. No supplemental payment will be considered without the prior approval of Heritage.If your contractors estimate is greater or additional damages are found,please contact us prior to signing any contracts or proceeding with the work. You can fax the paperwork to: 866-929-4530 Or you can mail it to us at: Heritage Claims PO Box 6417 Clearwater,Fl.33758 Please make sure to include your name and claim number on any paperwork submitted(Please list the claim number and your name on every page). In accordance with the Mortgage Clause provision of your policy,your Mortgage Company or Lien holder may be included as a payee. If you incur costs related to permits or fees from building officials for the repair of covered damages,and this amount is not already provided for in our estimate,please submit the invoice to Heritage. Additionally,if the building department requires code upgrades for the repair of covered damages,please forward the documentation from the building department to Heritage for consideration.Payments for Ordinance and Law items are based on an incurred basis. Thank you for insuring your property with Heritage Property&Casualty Insurance Company . "Pursuant to s.817.234,Florida Statutes,any person who,with the intent to injure,defraud,or deceive any insurer or insured, prepares,presents,or causes to be presented a proof of loss or estimate of cost or repair of damaged property in support of a claim under an insurance policy knowing that the proof of loss or estimate of claim or repairs contains any false,incomplete,or misleading information concerning any fact or thing material to the claim commits a felony of the third degree,punishable as provided in s.775.082,s.775.083,or s.775.084,Florida Statutes." Les Lammers 1 SENDEJAS_JAVIER 10/23/2017 Page:2 i 16010 InsuranHERITAGE.ce Heritage SENDEJAS_JAVIER Main Level FI(A) Roofl { 1644.41 Surface Area 16.44 Number of Squares 185.17 Total Perimeter Length 26.00 Total Ridge Length 64.21 Total Hip Length r , . DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 1. Gutter/downspout-Detach&reset 185.17 LF 2.34 0.00 86.66 519.96 (0.00) 519.96 2. Remove Laminated-comp.shingle rfg.- 16.44 SQ 57.09 0.00 187.72 1,126.28 (0.00) 1,126.28 w/felt 3. R&R Sheathing-plywood-5/8"CDX 128.00 SF 2.77 6.14 72.14 432.84 (0.00) 432.84 4. R&R Drip edge 185.17 LF 2.60 7.44 97.78 586.66 (0.00) 586.66 5. Roofing felt-301b. 16.44 SQ 39.47 13.11 132.40 794.40 (0.00) 794.40 6. Asphalt starter-universal starter course 185.17 LF 2.12 6.33 79.78 478.67 (0.00) 478.67 7. R&R Flat roof exhaust vent/cap- 2.00 EA 86.89 3.24 35.40 212.42 (0.00) 212.42 gooseneck 8" 8. R&R Flashing-pipe jack-lead 4.00 EA 70.83 7.68 58.20 349.20 (0.00) 349.20 9. Laminated-comp.shingle rfg.-w/out 19.33 SQ 204.51 97.13 810.06 4,860.37 (0.00) 4,860.37 felt 10. Ridge cap-High profile-composition 69.41 LF 5.64 11.24 80.54 483.25 (0.00) 483.25 shingles 11. Continuous ridge vent-aluminum 20.80 LF 8.26 3.67 35.10 210.58 (0.00) 210.58 Totals: Roofl 155.98 1,675.78 10,054.63 0.00 10,054.63 Living/dining LxWxH 14'10"x 13'9"x 8' • 338.67 SF Walls 203.96 SF Ceiling 542.63 SF Walls&Ceiling 203.96 SF Floor 22.66 SY Flooring 42.33 LF Floor Perimeter 118.67 SF Long Wall 110.00 SF Short Wall 42.33 LF Ceil.Perimeter Missing Wall-Goes to Floor/Ceiling 14'10"X 8' Opens into Exterior DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 12. Contents-move out then reset-Extra 1.00 EA 119.53 0.00 23.90 143.43 (0.00) 143.43 large room 13. Floor protection-corrugated cardboard 203.96 SF 0.53 2.33 22.08 132.51 (0.00) 132.51 and tape SENDEJAS_JAVIER 10/23/2017 Page;3 1bDi0 irk Insurance HERITAGE' Heritage CONTINUED-Living/dining DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 14. R&R 5/8"drywall-hung,taped,heavy 203.96 SF 2.41 7.71 99.84 599.09 (0.00) 599.09 texture,ready for paint 15. R&R Batt insulation-10"-R30- 203.96 SF 1.54 10.65 64.96 389.71 (0.00) 389.71 paper faced 16. Paint the ceiling-two coats 203.96 SF 0.86 2.33 35.54 213.28 (0.00) 213.28 Totals: Living/dining 23.02 246.32 1,478.02 0.00 1,478.02 Hallway LxWxH 30'1"x 3'x 8' 0 505.33 SF Walls 90.25 SF Ceiling 595.58 SF Walls&Ceiling 90.25 SF Floor 10.03 SY Flooring 63.17 LF Floor Perimeter 240.67 SF Long Wall 24.00 SF Short Wall 63.17 LF Ceil.Perimeter Missing Wall-Goes to Floor/Ceiling 3'X 8' Opens into Exterior DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 17. Floor protection-corrugated cardboard 90.25 SF 0.53 1.03 9.76 58.62 (0.00) 58.62 and tape 18. R&R 5/8"drywall-hung,taped,heavy 90.25 SF 2.41 3.41 44.18 265.09 (0.00) 265.09 texture,ready for paint 19. R&R Batt insulation-10"-R.30- 90.25 SF 1.54 4.71 28.74 172.44 (0.00) 172.44 paper faced 20. Paint the ceiling-two coats 90.25 SF 0.86 1.03 15.72 94.37 (0.00) 94.37 Totals: Hallway 10.18 98.40 590.52 0.00 590.52 1 SENDEJAS_JAVIER 10/23/2017 Page:4 1 16010 HnsuranceERITAeritage IGE' H ill Kitchen Formula 12'3"x 11' 1"x 8' i 275.33 SF Walls 135.77 SF Ceiling 411.10 SF Walls&Ceiling 135.77 SF Floor 15.09 SY Flooring 34.42 LF Floor Perimeter 98.00 SF Long Wall 88.67 SF Short Wall 34.42 LF Cell.Perimeter Missing Wall-Goes to Floor/Ceiling 12'3"X 8' Opens into Exterior DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 21. Contents-move out then reset-Large 1.00 EA 59.77 0.00 11.96 71.73 (0.00) 71.73 room 22. Floor protection-corrugated cardboard 135.77 SF 0.53 1.55 14.72 88.23 (0.00) 88.23 and tape 23. R&R 5/8"drywall-hung,taped,heavy 135.77 SF 2.41 5.13 66.46 398.80 (0.00) 398.80 texture,ready for paint 24. R&R Batt insulation-10"-R30- 135.77 SF 1.54 7.09 43.24 259.42 (0.00) 259.42 paper faced 25. Paint the ceiling-two coats 135.77 SF 0.86 1.55 23.68 141.99 (0.00) 141.99 Totals: Kitchen 15.32 160.06 960.17 0.00 960.17 i Exterior DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 26. Soffit-vinyl 72.00 SF 3.29 6.61 48.70 292.19 (0.00) 292.19 Totals: Exterior 6.61 48.70 292.19 0.00 292.19 Total: Main Level 211.11 2,229.26 13,375.53 0.00 13,375.53 Line Item Totals: SENDEJAS_JAVIER 211.11 2,229.26 13,375.53 0.00 13,375.53 SENDEJAS_JAVIER 10/23/2017 Page:5 1 6 D10 IHnsuERITAranGcE' Heritage e Grand Total Areas: 1,119.33 SF Walls 429.98 SF Ceiling 1,549.31 SF Walls and Ceiling 429.98 SF Floor 47.78 SY Flooring 139.92 LF Floor Perimeter 457.33 SF Long Wall 222.67 SF Short Wall 139.92 LF Ceil.Perimeter 0.00 Floor Area 0.00 Total Area 0.00 Interior Wall Area 97.73 Exterior Wall Area 0.00 Exterior Perimeter of Walls 1,644.41 Surface Area 16.44 Number of Squares 0.00 Total Perimeter Length 26.00 Total Ridge Length 64.21 Total Hip Length SENDEJAS_JAVIER 10/23/2017 Page: 6 16010 aHERITAGnceE" Heritage Insur Summary for Dwelling Line Item Total 10,935.16 Material Sales Tax 211.11 Subtotal 11,146.27 Overhead 1,114.63 Profit 1,114.63 Replacement Cost Value $13,375.53 Net Claim $13,375.53 Les Lammers SENDEJAS_JAVIER 10/23/2017 Page:7 16010 (HERITInsuraAGncE' Heritage e Recap of Taxes,Overhead and Profit Overhead(10%) Profit(10%) Material Sales Tax Laundering Tax(2%) Manuf.Home Tax Storage Rental Tax (6%) (6%) (6%) Line Items 1,114.63 1,114.63 211.11 0.00 0.00 0.00 Total 1,114.63 1,114.63 211.11 0.00 0.00 0.00 SENDEJAS_JAVIER 10/23/2017 Page: 8 II 1 6010 lnsurenHERITAGcE. Heritage e Recap by Room Estimate:SENDEJAS_JAVIER Area:Main Level Roofl 8,222.87 75.20% Living/dining 1,208.68 11.05% Hallway 481.94 4.41% Kitchen 784.79 7.18% Exterior 236.88 2.17% Area Subtotal: Main Level 10,935.16 100.00% Subtotal of Areas 10,935.16 100.00% Total 10,935.16 100.00% SENDEJAS_JAVIER 10/23/2017 Page: 9 -1-6-0 1 0 HERITsuraAGnceE` Heritage In Recap by Category O&P Items Total CONTENT MANIPULATION 179.30 1.34% GENERAL DEMOLITION 1,444.72 10.80% DRYWALL 859.96 6.43% INSULATION 507.38 3.79% PAINTING 597.68 4.47% ROOFING 6,675.94 49.91% SOFFIT,FASCIA,&GUTTER 670.18 5.01% O&P Items Subtotal 10,935.16 81.75% Material Sales Tax 211.11 1.58% Overhead 1,114.63 8.33% Profit 1,114.63 8.33% Total 13,375.53 100.00% SENDEJAS_JAVIER 10/23/2017 Page: 10 , 1 6 D 1 0 � 34; J Ir 41.7, .iE-4Yj W. '" ...4 +pe'. ,. ,<<: .f s ..e! WY" 4.i.,`„,,,sr:P,.t.. 4-- I�.t F ivy It I . , i _ ofi z • -, 4 3ti Maria M.Sendejas 2 INSTR 4989692 OR 5043 PG 2349 RECORDED 6/2/2014 1:49 PM PAGES 5 DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT, COLLIER COUNTY FLORIDA 16010 DOC@.35 570.00 REG 544.00 OBLD 520,000.00 I Prepared by and Return to: Collier County Housing,Human and Veteran Services Department 3339 E.Tamiami Trail,Building H,Suite 211 Naples,Florida 34112 STATE HOUSING INITIATIVES PARTNERSHIP (SHIP) PROGRAM SECOND MORTGAGE THIS SECOND MORTGAGE("Security Instrument")Is given on 9..3 day of r/)10 fJ ,2013. The Second Mortgagor is: / Javier Sendejas and Maria M. Sendejas, a married couple ("Borrower"). This Security Instrument is given to Collier County— SHIP ("Lender"),which is organized and existing under the laws of the United States of America,and whose address is 3339 E. Tamiami Trail, Naples, Florida 34112. Borrower owes Lender the sum of Twenty Thousand and 00/100 Dollars ($20,000.00). This debt is evidenced by Borrower's Note dated the same date as this Security Instrument("Second Mortgage"),which does not provide for monthly payments.The full debt,If not paid earlier,is due upon sale of the property within the fifteen year term.If sold after the fifteen year tern,no repayment is required.As long as the borrower continues to own and occupy the assisted properly during the term of the mortgage,then the loan will not have to be repaid. This Security Instrument secures to Lender.(a)the repayment of the debt evidenced by the Note,with interest,and all renewals,extensions and modifications;(b)the payment of all other sums,with interest advanced under paragraph 7 to protect the security of the Security Instrument;and(c)the performance of Borrower's covenants and agreements under this Security Instrument and the Note, For this purpose, Borrower does hereby second mortgage,grant and convey to Lender the following described property located in Collier County,Florida. As more particularly described as:REGAL ACRES LOT 178 and ...' • - e address of: ("Property Address"): 10564 Ma'estic Circl= V.R Cop-1-y FL 34114 (Address) (_,— ( I (State) (Zip) TOGETHER WITH all the improvemen} n• of.herea.- erected on the pro. ,a•d all easements,rights,appurtenances,rents, royalties,mineral,oil and gas rights and profits ate rigt�aedd sto - • , ures no or b'reafier a part of the property. All replacements and additions shall also be covered by the Se rity strument, I• forego' g Is rate ed t in this Security Instrument as the"Properly". BORROWER COVENANTS that Boo : --•`I .. - �a :: e•,rcnv ed and has the right to mortgage,grant and convey the Property and that the Property is nen•m re.,-x.-p fo ,r br)) - •r- ord. Borrower warrants and will defend generally the title to the Property against all claims and a ds su do qny t tan 1.o re rd. THIS SECURITY INSTRUMENT co i •• -d••B.; -tions_s=•n don niform covenants with limited variation by jurisdiction to constitute a uniform security ins e,t covering real property. N UNIFORM COVENANTS. BorrowerrtL.ndercovenant and agre tot•ws: 1 1. Payment of Principal and Interessk' e•ayment and Late Ch."-}'Y--. : /all promptly pay when due the principal of and interest on the debt evidenced by the Note. 2.Taxes.The Mortgagor will pay all taxis - ments,sewer rents o i"f.es prior to the accrual of any penalties or interest thereon. \ The Mortgagor shall pay or cause to be paid,ams$1� -est't.k •• a due,(A)(1)all taxes and governmental charges of any kind whatsoever which may at any time be lawfutly assessed'b TA., al I : ith respect to the Property,(2)all utility and other charges, Including"service charges",Incurred or imposed for the operation,maintenance,use,occupancy,upkeep and Improvement of the Property,and (3)all assessments or other governmental charges that may lawfully be paid in installments over a period of years,the Mortgagor shall be obligated under the Mortgage to pay or cause to be paid only such installments as are required to be paid during the term of the Mortgage,and shall,promptly after the payment of any of the foregoing,forward to Mortgagee evidence of such payment. 3. Application of Payments. Unless applicable law provides otherwise,all payments received by Lender shall be applied;first,to interest due;and,to principal due;and last,to any late charges due under the Note. 4. Charges;Liens. Borrower shall pay all taxes,assessments.charges,fines and impositions attributable to the Property which may attain priority over this Security Instrument,and leasehold payments or ground rents,If any. Borrower shall promptly furnish to Lender all notices of amounts to be paid under this paragraph,and all receipts evidencing the payments. Borrower shall promptly discharge any lien which has priority over this Security Instrument unless Borrower.(a)agrees in writing to the payment of the obligation secured by the lien in a manner acceptable to Lender,(b)contests In good faith the lien by,or defends against enforcement of the lien in,legal proceedings which in the Lender's opinion operate to prevent the enforcement of the lien;or(c)secures from the holder of the lien an agreement satisfactory to Lender subordinating the lien to this Security Instrument. If Lender determines that any part of the Property is subject to a lien which may attain priority over the Security Instrument,Lender may give Borrower a notice identifying the lien. Borrower shall satisfy the lien or take one or more of the actions set forth above within 10 days of the giving of notice. 5. Hazard or Property Insurance. Borrower shall keep the improvements now existing or hereafter erected on the Property insured against loss by fire,hazards included within the term"extended coverage"and any other hazards,including floods or flooding,for which Lender requires insurance. This insurance shall be maintained in the amounts and for the periods that Lender requires.The insurance carrier providing the insurance shall be chosen by Borrower subject to Lender's approval which shall not be unreasonably withheld. If Borrower fails to maintain coverage described above,Lender may,at Lender's option,obtain coverage to protect Lender's rights in the Property in accordance with paragraph 7. At all times that the Note is outstanding,the Mortgagor shall maintain insurance with respect to the Premises against such risks and for such amounts as are customarily insured against and pay,as the same become due and payable,all premiums in respect thereto, including,but not limited to,all-risk insurance protecting the Interests of the Mortgagor and Mortgagee against loss or damage to the Premises . by fire,lightning,and other casualties customarily insured against(including boiler explosion.if appropriate),with a uniform standard extended coverage endorsement,including debris removal coverage. Such insurance at all times to be in an amount not less than the full replacement cost of the Premises,exclusive of footings and foundations. All Insurance policies and renewals shall be acceptable to Lender and shall include a standard mortgage clause. Lender shall have the right to hold the polities and renewals. If Lender requires,Borrower shall promptly give to Lender an receipts of paid premiums and renewal notices. In the event of toss,Borrower shall give prompt notice to the Insurance carrier and Lender. Lender may make proof of loss If not made promptly by Borrower. Unless Lender and Borrower otherwise agree in writing,insurance proceeds shall be applied to restoration or repair of the Property damaged,if the restoration or repair is economically feasible and Lender's security is not lessened. If the restoration or repair is not economically feasible or Lender's security would be lessened,the Insurance proceeds shall be applied to the sums secured by the Security Instrument,whether or not then due,with any excess paid to Borrower. If Borrower abandons the Property,or does not answer within 30 days a notice from Lender that the insurance carrier has offered to settle a claim,then Lender may collect the Insurance proceeds. Lender may use the proceeds to repair or restore the Property or to pay sums secured by this Security Instrument,whether or not then due. The 30-day period will begin when the notice is mailed. Unless Lender and Borrower otherwise agree In writing,any application of proceeds to principal shall not extend or postpone the due date of the monthly payments referred to in paragraph 1 or change the amount of the payments. If under paragraph 21 the Property is acquired by Lender,Borrower's right to any insurance policies and proceeds resulting from damage to the Property prior to the acquisition shall pass to Lender to the extent of the sums secured by this Security Instrument Immediately prior to the acquisition. meas,_ OR 5043 PG 2350 16010 6. Occupancy,Preservation,Maintenance and Protection of the Property;Borrower's Loan Application,Leaseholds. Borrower shall occupy,establish,and use the Property as Borrower's principal residence within sixty days after the execution of this Security Instrument and shall continue to occupy the Property as Borrower's principal residence for at least one year after the date of occupancy,unless Lender otherwise agrees in writing,which consent shall not be unreasonably withheld,or unless extenuating circumstances exist which are beyond Borrower's control. Borrower shall not destroy,damage or Impair the Property,allow the Property to deteriorate,or commit waste on the Property. Borrower shall be in default if any forfeiture action or proceeding.whether civil or criminal,is begun that In Lender's good faith judgment could result In forfeiture of the Property or otherwise materially impair the lien created by this Security instrument or Lender's security Interest. Borrower may cure such a default and reinstate,as provided in paragraph 18,by causing the action or proceeding to be dismissed with a ruling that,in Lender's good faith determination,precludes forfeiture of the Borrower's interest in the Property or other material impairment of the lien created by this Security Instrument or Lenders security interest Borrower shall also be In default if Borrower,during the loan application process,gave materially false or inaccurate information or statements to Lender(or failed to provide Lender with any material information)in connection with the loan evidenced by the Note,Including,but not limited to,representations concerning Borrower's occupancy of the Property as a principal residence. If this Security Instrument is on a leasehold,Borrower shall comply with all the provision of the lease. II Borrower acquires fee title to the Property,the leasehold and the fee title shall not merge unless Lender agrees to the merger in writing. 7. Protection of Lender's Rights In the Property.if Borrower fails to perform the covenants and agreements contained In this Security Instrument,or there is a legal proceeding that may significantly affect Lenders rights in the Property(such as a proceeding in bankruptcy,probate,for condemnation or forfeiture or to enforce laws or regulations),then Lender may do and pay for whatever Is necessary to protect the value of the Property and Lender's rights in the Property. Lender's actions may include paying any sums secured by a lien which has priority over this Security Instrument,appearing In court,paying reasonable attorneys'fees and entering on the Property to make repairs. Although Lender may take action under this paragraph 7,Lender does not have to do so.Any amounts disbursed by Lender under this paragraph 7 shall become additional debt of Borrower secured by this Security Instrument. Unless Borrower and Lender agree to other terms of payment,these amounts shall bear interest from the date of disbursement at the Note rate and shall be payable,with interest,upon notice from Lender to Borrower requesting payment. 8. Mortgage Insurance. If Lender required mortgage insurance as a condition of making the loan secured by this Security Instrument,Borrower shall pay the premiums required to maintain the mortgage insurance in effect. If,for any reason,the mortgage insurance coverage required by Lender lapses or ceases to be in effect,Borrower shall pay the premiums required to obtain coverage substantially equivalent to the mortgage insurance previously in effect,at a cost substantially equivalent to the cost to Borrower of the mortgage insurance previously in effect,from an alternate mortgage insurer approved by Lender. If substantially equivalent mortgage insurance coverage is not available.Borrower shall pay to Lender each month a sum equal to one-twelfth of the yearly mortgage insurance premium being paid by Borrower when the insurance coverage lapsed or ceased to be in effect. Lender will accept,use and retain these payments as a loss reserve In lieu of mortgage insurance. Loss reserve payments may no longer be required,at the option of Lender,If mortgage insurance coverage(in the amount and for the period that Lender requires)provided by an Insurer approved by Lender again becomes available and is obtained. Borrower shall pay the premiums required to maintain mortgage insurance in effect,or to provide a loss reserve,until the requirement for mortgage insurance ends in accordance with any written agr twee •• r and Lender or applicable law. 9. Inspection.Lender or its agent may make n Wes • spectios of the Property. Lender shall give Borrower notice at the time of or prior to an inspection specifyi b cat r- 111 o •- •n. 10. Condemnation.The proceeds of a ... j claim for damages, •ct.. onsequential,in connection with any condemnation or other taking of any part of the Property,or for fly-eTnce in lieu of condemnation,-e he by assigned and shall be paid to Lender. In the event of a total taking of the Properly,the procertds s•-II a app i • re su secure•by th Security Instrument,whether or not then due, with any excess paid to Borrower. In the even of a•artia '.of th Pro•- y in which he f-it market value of the Property immediately before the taking is equal to or greater than th am-u • •e s „...cc. -• • t i ScourIns ment immediately before the taking,unless Borrower and Lender otherwise agree in writi'g,th1 su s - ur hi u . In t'-nt s all be reduced by the amount of the proceeds multiplied by the following fraction:(a)the tot 1 am!un.of th s s • e•!u•e•'.1-,'•_•ret a taking,divided by(b)the fair market value of the Property immediately before the taking al.n a b p-d to Morro 3. th event of a partial taking of the Property in which the fair market value of the Property immedia W to- eta' -Lt the •• •t.f sums secured immediately for the taking, unless Borrower and Lender otherwise agree r g or unless applicable :c, othe ise•livres,the proceeds shall be applied to the sums secured by this Security Instrument whether or •., -sums are then due, U.. - -nd a orrower otherwise agree in writing,any application of proceeds to principal shall not ext +fir•ostpone the due date•(I•e,o• 4U•.yments referred to in paragraphs 1 or change the amount of such payments. 11. Borrower Not Released,Forbearan Q ••er Not a Waiver y of the time for payment or modification of amortization of the sums secured bythis Security Ins ••ant luted-by-Len r• lrccessor In interest of Borrower shall not operate to release the liability of the original Borrower or Borrowers • cE ire% • der shall not be required to commence proceedings against any successor In interest or refuse to extend time for pa se modify amortization of the sums secured by this Security Instrument by reason of any demand made by the original Borrower or Borrower's successors in interest. Any forbearance by Lender in exercising any right or remedy shall not be a waiver of or preclude the exercise of any right or remedy. 12. Successors and Assigns Bound;Joint and Several Liability;Co-Signers.The covenants and agreements of this Security Instrument shall bind and benefit the successors and assigns of Lender and Borrower,subject to the Provisions of paragraph 17. Borrower's covenants and agreements shall be joint and several. Any Borrower who co-signs this Security Instrument but does not execute the Note;(a)is co-signing this Security Instrument only to mortgage,grant and convey that Borrower's interest In the Property under the terms of this Security Instrument;(b)is not personally obligated to pay the sums secured by this Security Instrument; and(c)agrees that Lender and any other Borrower may agree to extend,modify,forbear or make any accommodations with regard to the terms of this Security Instrument or the Note without that Borrower's consent 13. Loan Charges. If the loan secured by this Security Instrument Is subject to a law which sets maximum loan charges,and that law is finally interpreted so that the Interest or other loan charges collected or to be collected In connection with the loan exceed the permitted limits,then:(a)any such loan charge shall be reduced by the amount necessary to reduce the charge to the permitted limit;and(b)any sums already collected from Borrower which exceeded permitted limits will be refunded to Borrower. Lender may choose to make this refund by reducing the principal owed under the Note or by making a direct payment to Borrower. If a refund reduces principal,the reduction will be treated as a partial prepayment without any prepayment charge under the Note. 14. Notices.Any notice to Borrower provided for in this Security Instrument shall be given by delivering it or by mailing It by first class mail unless applicable law required use of another method. The notice shall be directed to the Property Address or any other address Borrower designates by notice to Lender. Any notice to Lender shall be given to Borrower or Lender when given as provided in this paragraph. 15.Governing Law;Severabi0ty.This Security Instrument shall be governed by federal law and the law of the jurisdiction In which the Property is located. In the event that any provision or clause of this Security Instrument or the Note conflicts with applicable law,such conflict shall not affect other provisions of this Security Instrument or the Note which can be given effect without the conflicting provision. To this end the provisions of this Security Instrument and the Note are declared to be severable, 16. Borrower's Copy. Borrower shall be given one conformed copy of the Note and of this Security Instrument. 17. Transfer of the Property or a Beneficial Interest In Borrower. If all or any part of the Property or any Interest in It is sold or transferred(or if a beneficial interest In Borrower is sold or transferred and Borrower is not a natural person)without Lender's prior written consent,Lender may,al its option,require immediate payment in full of all sums secured by this Security Instrument. However,this option shall not be exercised by Lender if exercise is prohibited by federal law as of the date of this Security Instrument. If Lender exercised this option,Lender shall give Borrower notice of acceleration. The notice shall provide a period of not less than 30 days from the date the notice Is delivered or mailed within which Borrower must pay all sums secured by this Security Instrument. If Borrower fails to pay these sums prior to the expiration of this period,Lender may Invoke any remedies permitted by this Security Instrument without further notice or demand on Borrower. 18. Borrower's Right to Reinstate. If Borrower meets certain conditions,Borrower shall have the right to have enforcement of this Security Instrument discontinued at any time prior to the earlier of:(a)5 days(or such other period as applicable law may specify for reinstatement)before sale of the Property pursuant to any power of sale contained in this Security Instrument;or(b)entry of a judgment enforcing this Security Instrument. Those conditions are that Borrower.(a)pays Lender all sums which then would be due under this Security Instrument and the Note as if no acceleration had occurred;(b)cures and default of any other covenants or agreements;(c)pays all expenses incurred in enforcing this Security Instrument,including,but not limited to,reasonable attorney's fees;and(d)takes such action as Lender may reasonably secured by this Security Instrument shall continue unchanged. Upon ref statement by Borrower,this Security Instrument and the obligations oe 5043 PG 2351 1 6 010 secured hereby shall remain fully effective as if no acceleration had occurred. However,this right to reinstate shall not apply in the case of acceleration under paragraph 17. 19.Sale of Note;Change of Loan Servicer. The Note or a partial interest in the Note(together with this Security Instrument)may be sold one or more times without prior notice to Borrower, A sale may result In a change in the entity(known as the"Loan Servicer")that collects monthly payments due under the Note and this Security Instrument. There also may be one or more changes of the Loan Servicer unrelated to a sale of the Note. If there Is a change of the Loan Servicer,Borrower will be given written notice of the change in accordance with paragraph 14 and applicable law.The notice will state the name and address of the new Loan Servicer and the address to which payments should be made. The notice will also contain any other information required by applicable law. 20. Hazardous Substances. Borrower shall not cause or permit the presence,use,disposal,storage,or release of any Hazardous Substances on or in the Property. Borrower shall not do,nor allow anyone else to do,anything affecting the Property that is in violation of any Environmental Law.The preceding two sentences shall not apply to the presence,use,or storage on the Property of small quantities of Hazardous Substances that are generally recognized to be appropriate to normal residential uses and to maintenance of the Property. Borrower shall promptly give Lender written notice for any investigation,claim,demand,lawsuit or other action by any governmental or regulatory agency or private party involving the Property and any Hazardous Substance or Environmental Law of which Borrower has actual knowledge. If Borrower learns,or is notified by any governmental or regulatory authority,that any removal or other remediation of any Hazardous Substance affecting the Property is necessary,Borrower shall promptly take all necessary remedial actions in accordance with Environmental Law. As used in this paragraph 20,"Hazardous Substances"are those substances defined as toxic or hazardous substances by Environmental Law and the following substances: gasoline,kerosene,other flammable or toxic petroleum products,toxic pesticides and herbicides,volatile solvents,materials containing asbestos or formaldehyde,and radioactive materials. As used in this paragraph 20,"Environmental Law'means federal laws and laws of the jurisdiction where the Property is located that relate to health,safety or environmental protection. 21.Acceleration;Remedies. Lender shall give notice to Borrower prior to acceleration following Borrower's breach of any covenant or agreement in this Security Instrument(but not prior to acceleration under paragraph 17 unless applicable law provides otherwise). The notice shall specify: (a)the default;(b)the action required to cure the default;(c)a date,not less than 30 days from the date the notice Is given to Borrower,by which the default must be cured;and(d)that failure to cure the default on or before the date specified in the notice may result in acceleration of the sums secured by this Security Instrument,foreclosure by judicial proceeding and sale of the Property. The notice shall further inform Borrower of the right to reinstate after acceleration and the right to assert in the foreclosure proceeding the non-existence of a default or any other defense of Borrower to acceleration and foreclosure. If the default Is not cured on or before the date specified in the notice, Lender,at its option,may require immediate payment In full of all sums secured by this Security Instrument without further demand and may foreclose this Security Instrument by judicial proceeding. Lender shall be entitled to collect all expenses incurred in pursuing the remedies provided in this paragraph 21,including,but not limited to,reasonable attorney's fees and costs of the title evidence. 22. Release. Upon payment of all sums secured by this Security Instrument.Lender shall release this Security Instrument,without charge,to Borrower. Borrower shall pay any recordation co 23.Attorneys'Fees.As used in this Securi natturtkitWriel n,omeys'fees"shall Include any attorneys'fees awarded by an appellate court. ti `Y 24. Riders to this Security Instrumen jb*: more riders are exec...4, orrower and recorded together with this Security Instrument,the covenants and agreements of ea s)t•rider shall be incorporated I an hall amend and supplement the covenants and agreements of this Security Instrument as if the 'der of this Sec rity Inst men (Check Applicable Box) D Adjustable Rate Rider 0 Ra,im• •,,—t II •nd minium Rider ❑Graduated Payment Rider ❑1 •Fe •y•'del !i eco Home Rider Balloon Rider ❑B' eakt P-- m Ri. i, ifs -it.nn d Unit Development Rider Other(s)(specify 1 C'+ SIGNING BELOW,Borrower accepts and agree veg+ .terms and covenants cis ai :•I tb Security Instrument and in any rider(s)executed by Borrower and recorded with it. L Signed,sealed and delivered in the presence of: 0'• -?' IECI—C' � Signature: ..— Signature: �i�/'/ 2 _41 ) 7 C i Borrower Javier Sendejas Co-Borrower'Maria M. Sendejas Address: 10564 Majestic Circle Naples, Florida 34114 STATE OF FLORIDA COUNTY OF COLLIER I hereby certify that, Javier and Maria M. Sendejas personally appeared to me known to be the person(s)described in and who executed the foregoing instrument and acknowledged before me that(He/she/they)executed the same for the purpose therein expressed. /� WITNESS my hand and official seal in the County and State aforesaid this /nay'• day of / 41/ ,20l . My Commission Expires; fl g' 2-'1-1 y r (Seal) Notary`- • - • - / /V NOVA- lCLA,°L e f 1 t Notary's Printed Name SHIP File#: 12-042 SHIP Purchase Assistance Program UTING ORIGINAL DOCUMENTS CHECKLIST 71 RO SENT TO SLIP TO ACCOMPANY ALL ORIGINAL THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE ments are to at ht on pink paper. Attach to on the inal agendau All completed routing slips and original documentment. The completed routing slip and original s must be received be v n the County Attorney OfficeeoOlaf r at the time the Item s p than Monday preceding the Board meeting. **NEW** ROUTING SLIP - I f the document is al y corn e with the Complete roue Chairman's unct92 as ure draw a lineate throuadd outinl si lines # 1 throuaw res, iCS #2. corn leorm te the checkii to and forward to the Count Attomeet0fiice. exce tion of Initials Date Route to Addressees (List in routing order) CouOffpe -_ 1. Jennifer A. Bel edio, ACA Count Attorne Office 2. BCC Office Board of County PES Commissioners 3. Minutes and Records Clerk of Court's Office NOTE: Clerk's attestation is not required. Please do not route an and to themBoard to Clerk's Minute andRecords. CAO please scan document after execution y and Records for its records. PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above ma need to contact staff for additional or missinginformation. phone Number 239-252-2338 Name of Primary Staff Elizabeth Hernandez, CHS Contact 1 De artment Agenda Item Number Agenda Date Item was ,� A roved b the BCC - Type of Document Insurance Claim Check Endorsement for Npocubment er of Original Attached Attached Pierre Bor ela PO number or account number if document is N/A to be recorded _ INSTRUCTIONS & CHECKLIST initial the Yes column or mark "NIA" in the Not Applicable column, whichever is 1. Does the document require the chairma s original ignatury 2. Does the document need to be sent to another agency for additional signatures? If yes, rovide the Contact information Name; A enc ; Address; Phone on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be signed by the Chairman, with the exception of most letters, must be reviewed and signed b the Office of the Count Attorne . 4. All handwritten strike -through and revisions have been initialed by the County Attorney's Office and all other parties exce t the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of SCG approval of the document or the final ne3rotiated contract date whichever is applicable. 6. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's si nature and in'stials are re uired. 7. In most cases (some contracts are an exception), the original document and this routing slip should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of ijour deadlines'. 8. The document was approved by the BCC on a6/1� and all changes made during the meeting have been incorporated in the attached document. The County Attorne 's office has reviewed the chap es, if a Aicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC, all changes directed by the BCC have been made, and the document is ready for the Chairman's signature. I 'Chcck Yes N/A (Not I FA is not an option fak This line. _ 1: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip wWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05; Revised 11130112 0 O LW 0- 0 O r w A � N m OO a � n m c •�a9epossy sWals:tg lua111AEd �0947 a4i;o Anew aogeol"ae a sl ufi!sap yIoWed "H,JI QgLU01U Lw ea pue }pOUa,eM pajelnWIS a,v,seai uloo 6upuudojolu 'udei6cued pion ril sapnpu, 44! mas Iueuu %oG an,q sl uaWnaop tc aoe j ty S80NC3A00 30 3dH09 ]A.d3S3H IVIAC3d. J:?l^•l35d00iJ3 YPib'9 MHOliSOd30 S:H !VtOl dV1iv1S,'NOISr311yMION 0 1V3H OJ, 03SOdX3 Ho G388f ,2 H3H•A 8V3ddV36 ❑NV bV3dd VSIO 111M 3b3H NO3HO 3SHOC Memorandum To: Kimberly Grant, CHS Director CC: Jennifer Belpedio, Assistant County Attorney From: Elizabeth Hernandez, Grant Support Specialist, Community and Human Services Date: 2/6/18 Re: Homeowner Insurance claim check endorsement -Pierre A. Borgela 443754 1h Avenue NW, Naples, FL 34120 The Homeowner Insurance Check Endorsement Policy approved by the Board on June 12, 2012 (16.1). 10) authorizes the Board Chairman or Vice Chairman to endorse homeowner insurance claim checks for recipients assisted with Purchase Assistance and/or rehabilitation program funds as Collier County is named as Second Mortgagee on their insurance policies. The attached check in the amount of $3,542.86 is for disbursement of the claim funds requiring endorsement by Board Chairman Taylor or Vice Chairman. The check names Fifth Third Bancorp as the first mortgage lender and Collier County SHIP as subordinate lien holder. In order for the check to be properly processed, proper signatures/endorsement for all parties listed on check must be obtained. This is a time -sensitive item and must be endorsed as soon as possible as homeowner is waiting to pay for work to be performed on home. Attachments: Homeowners Insurance Policy -Declaration Page Insurance Claim Check (#311906, $3,542.86) Insurance Claim Report & photos of damage Collier County Second Mortgage Collier County Community and Human Services Division (CHS) Homeowner Insurance Check Endorsement Policy Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage/lien, then the loan will not have to be repaid. On occasion, the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and receive money to make the repairs. If the insurance claim check is made payable to the homeowner and Collier County, then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to CHS at the address below for check endorsement consideration: 1. Copy of Homeowner's current insurance policy -Declaration Page. 2. Copy of insurance company's claim report with worksheet including description of repairs and costs. 3. Copy of photos of claim damage. 4. Insurance check(s) payable to homeowner, first lien holder and Collier County. Homeowner Name: Pierre A. Borgela Homeowner Address: 4437 50 Avenue NW. Na les FL 34120 Primary Contact Number: 239-245-3555 Homeowner Email: pierre4977(-7a,aol.com OFFICE USE ONLY 0&� CHS- Grant Coordinator Ll- J 1 1 _ CHS Director Date dReviewed Approved Denied UPC HOMEOWNERS DECLARATION INSURANCE POLICY NUMBER POLICY PERIOD UNITED PROPERTY & CASUALTY INS CO From To P.O. Box 51149 UHV 2801254 05 01 0812912017 08129/2018 Sarasota, FL 34232-0330 12:01 a ra. at the residence premises. a P b RENEWAL DECLARATION Effective: 08129/2017 Date issued: 06129/2017 INSURED:' :...' A.GICNT:3:9fi4t349 PIERRE A SORGELA BRIGHTWAY INSURANCE, INC. 4437 54TH AVE NE PO Box 5700 NAPLES FL 34120 Jacksonville FL 32247 Telephone: 239-867-1275 Telephone: 239-676-8199 (05113) (05113) (04191) (05113) The residence premises covered by this policy is located at the address listed below. COUNTERSIGNED DATE 06/29/2017 7'L�Lt,g�jL BY J 4437 54TH AVE NE NAPLES FL 34120 ADDITIONAL INTERESTS IF PAYMENT IS NOT RECEIVED ON OR BEFORE THE POLICY RENEWAL EFFECTIVE DATE, THIS POLICY WILL NOT BE IN FORCE. Coverage is provided where premium and limit of liability is shown. Flood coverage is not provided and is not a part of this policy. SECTION I COVERAGE LIMIT OF LIABILITY PREMIUMS A. DWELLING $243,000-00 $1,156.00 B. OTHER STRUCTURES $4,860.00 INCLUDED C. PERSONAL PROPERTY $121,500.00 INCLUDED D. LOSS OF USE $48,600.00 INCLUDED SECTION II COVERAGE $18. 00 E. PERSONAL LIABILITY $300,000.00 INCLUDED F. MEDICAL PAYMENTS $1,000-00 OPTIONAL COVERAGES PO BOX 598 Premium charge for Hurricane Exposure: $774.00 The above coverages are subject to a 2% of Coverage A I $4.860 Hurricane Deductible per calendar year. The above coverages are subject to a 10% of Coverage A 1 $24,300 Sinkhole Deductible per sinkhole loss. The above coverages are subject to a $2,500 All Other Peril Deductible. TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES: $1,201.00 The amount of premium change due to approved rate 'increase is $92.00 $41.00 The amount of premium change due to coverage change is COVERAGES HAVE BEEN INCREASED TO HELP KEEP PACE WITH RISING REPLACEMENT COSTS. PLEASE CONTACT YOUR AGENT IF THERE ARE ANY QUESTIONS PERTAINING TO YOUR POLICY. FORMS': A N D"ENDORSEMENTS HO 0003 (050 1) HO 0334 HO 0350 (06197) HO 0355 HO 0446 (10100) HO 0496 HO 2370 (05113) HO 2386 Continued on Forms Schedule (05113) (05113) (04191) (05113) COUNTERSIGNED DATE 06/29/2017 7'L�Lt,g�jL BY J ADDITIONAL INTERESTS MORTGAGEE SECOND MORTGAGEE FTBOO10-0414814699 FIFTH THIRD BANCORP ISAOA HOUSING HUMAN & VETERAN SERVIC ATIMA 3339 E TAMIAMi TRL BLDG H 211 PO BOX 598 NAPLES FL 34112 AMELIA OH 45102 UPC 119 05 16 INSURED COPY Page 1 of 4 UPC INSURANCE UNITED PROPERTY & CASUALTY INS CO P.O. Box 51149 Sarasota, FL 34232-0330 RENEWAL DECLARATION HOMEOWNERS DECLARATION rvuu.. nvtv�.ca�n r v".. .. _. ... From .. m UHV 2801254 05 01 08/29/2017 08/29/2018 v 12:01 a.m. at the residence premises. - o ....... ._.-. ..... ...._ ..._. ...... .._ ....... ... .... .... ..: .... ... ... .... .. .... _ .. ... ._. ..... ..... ..._ .._. ..:. .... _... .. ... p Effective: 08/29/2017 Date Issued: 06/29/2017 INSURED _ AGfi11T 9960049: -� PIERRE A BORGELA BRIGHTWAY INSURANCE, INC. 4437 54TH AVE NE PO Box 5700 NAPLES FL 34120 Jacksonville FL 32247 Telephone: 239-867-1275 Telephone: 239-676-8199 r The residence premises covered by this policy is located at the above insured address unless otherwise stated below: 1 4437 54TH AVE NE NAPLES FL 34120 1 LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE FROM THE NATIONAL FLOOD INSURANCE PROGRAM. WITHOUT THIS COVERAGE, YOU MAY HAVE UNCOVERED LOSSES. PLEASE DISCUSS THESE COVERAGES WITH YOUR INSURANCE AGENT. (YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM.) A rate adjustment of 81 % of wind premium is included to reflect the windstorm mitigation features of your dwelling. Adjustments range from 0% to 89% credit subject to verification that your home meets the windstorm mitigation characteristics of the 2001 Florida Building Code. THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES, WHICH MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU. IN CASE OF A LOSS TO COVERED PROPERTY, YOU MUST TAKE REASONABLE EMERGENCY MEASURES SOLELY TO PROTECT THE PROPERTY FROM FURTHER DAMAGE IN ACCORDANCE WITH THE POLICY PROVISIONS (MAY NOT EXCEED THE GREATER OF $3000 OR 1 % OF YOUR COVERAGE A LIMIT OF LIABILITY UNLESS YOU CALL US FIRST AND RECEIVE APPROVAL). PROMPT NOTICE OF THE LOSS MUST BE GIVEN TO US OR YOUR INSURANCE AGENT. EXCEPT FOR REASONABLE EMERGENCY MEASURES, THERE IS NO COVERAGE FOR REPAIRS THAT BEGIN BEFORE THE EARLIER OF - (A) 72 HOURS AFTER WE ARE NOTIFIED OF THE LOSS, (B) THE TIME OF LOSS INSPECTION BY US, OR (C) THE TIME OF OTHER APPROVAL BY US. TO REPORT A LOSS OR CLAIM CALL 1(888) 256-3378. ************* Additional Information ************* This replaces all previously issued policy declarations, if any. The declarations page together with all policy provisions and any other applicable endorsements completes your policy. UPC 119 05 16 INSURED COPY Page 3 of 4 UPC INSURANCE UNITED PROPERTY & CASUALTY INS CO P.O. Box 51149 Sarasota, FL 34232-0330 HOMEOWNERS POLICY NUMBER POLICY PERIOD: From TO UHV 2$01254 45 01 08129/2017 08/29/2018 12:01 am Eastern Standard Time at the mailing address shown below INSURED COPY Date Issued: 06/30/2017 INSURED:;:: . AGENT: 9960049 PIERRE A BORGELA BRiGHTWAY INSURANCE, INC. 4437 54TH AVE NE PO Box 5700 NAPLES FL 34120 Jacksonville FL 32247 Telephone: 239-867-1275 Property Address: 4437 54TH AVE NE Informational File Copy, Lienholder has been billed INST DATE TRANSAC'T'ION 01 06/29/2017 -Renewal Premium 01 06/29/2017 Fee Telephone: 239-676-$199 NAPLES FL 34120 AMOUNT $1,174.00 $27.00 AMOUNT DUE: $ 1,201.00 PAYMENT DUE 08/29/2017 POLICY BALANCE $ 1,201.00 IMPORTANT NOTICE_ FOR COVERAGE TO CONTINUE, YOUR PAYMENT MUST REACH OUR OFFICE BY THE DUE DATE. IF PAYMENT IS NOT RECEIVED ON OR BEFORE THAT DATE, THIS POLICY WILL NOT BE IN FORCE. P R E M I U M N O T I C E- M O R T G A G E E --------******DETACH HERE****** - -------------------------- - ************DO NOT PHOTOCOPY************ YOUR MORTGAGE COMPANY HAS BEEN SENT A COPY OF THIS NOTICE. POLICY NUMBER: UHV 2801254 05 00 01 9960049 AMOUNT DUE NOW $1, 201..00 LOAN NUMBER: F FB0010-0414814699 PLEASE REMIT PAYMENT TO: PIERRE A BORGELA UPC Insurance 4437 54TH AVE NE P.O. Box 31512 NAPLES FL 34120 Tampa, FL 33631-3512 UPCO001UHV28012540508291708291700001201003 UPC 113 7404 U pGj!� N 5 t1 R R N.0 E'. �':':•s IIuited Property & Casualty Co 804 2ND Ave S. St. Petersburg, FL 33702 Insured: PIERRE A BORGELA Property: 4437 54TH AVE NE NAPLES, FL 34120 Home: 4437 54TH AVE NE NAPLES, FL 34120 Claim Rep.: Erica Purdy Estimator: Erica Purdy Claim Number: 2017FLO44912 Date Contacted: 9/23/2017 Date of boss: 9/12/2017 Date Inspected: 10/7/2017 '71J., 5-01797534=, Policy Number: UHV280125405 Price List: FLNABX_IAN 18 Restoration/S a ry i ce/Remode i Estimate: PIERRE A BORGELA • other: (239) 245-3555 Type of Loss: Wind Date Received: 9/19/2017 Date Entered: 1/24/2418 8:27 AM We completed an estimate of repair for covered damages to your property. Please note, depreciation may he applied to your estimate based on the age and/or condition of the damaged property. If your policy provides for replacement cost coverage, refer to your policy for specific time limits to make claim for recoverable depreciation. Your applicable policy deductible will be deducted from any payment. We do not direct or warranty the work of any contractor/repair providers, whether referred by us or not. It is your decision on who to hire and to ensure any repairs are done to your satisfaction. If you believe repairs will exceed this estimate, contact us immediately. No additional payment will be issued without our review and approval. Approval must be provided by us prior to any repair. Should you receive a repair estimate which exceeds this estimate, please forward this information to us at: Address: UPC insurance, P.0 Box 1011, St. Petersburg, FL 3373 1 -1011 Email: claims@upcinsurance.com, Thank you for the opportunity to service your claim. If you have any questions, please contact us 45, �IA_ L%PCIS z"f United Pro er & C J4, � 7 5�»��t _ :, x p tY Casualty Co 800 2ND Ave S. St. Petersburg, FL 33702 PIERRE_A_BORGELA PIERRE A BORGELA DESCRIPTION I. Remove Tear off, haul and dispose of comp, shingles - Laminated QTY UNIT PRICE TOTAL 2. Laminated - comp. shingle rfg. - wlout felt 25.12 S Q @ 70.27 ` 1,513.98 3. Roofing felt - 15 lb. 29.00 SQ @ 211-07 = 6,121-03 4. R&R Drip edge 26.38 SQ ® 33.26 = 877.40 5. R&R Flashing - pipe jack -lead 243.95 LF @ 2.70 = 658.664,00 6. Valley meta] EA @ 72.97 = 291.88 7. R&R Roof vent -off ridge type - 4' 53.77 LF @ 5.34 = 287.08I.OQ 8. R&R Ridge cap - composition shingles EA @ _ 124 26 - 124.26 9. Digital satellite system - Detach & reset 241.64 LF @ 7.00 = 1,411.48 10. Digital satellite system -alignment and calibration only 2.00 EA @ 27.81 = 55.62 11. R&R Flashing - pipe jack - split boot 2.00 EA @ 83.41 17 1.00 EA @ 77.29 = Added to estimate, Erica Purdy, 1/24/2018 per photo on page 8 of photo report from inspection. 77.297.29 This item did not previously exist or expands the scope of repairs, but is requiredbyurreen bng de payable when incurred, subject to limits. building codes. Thome upgrade pg a cost is s Coverage Item Total ACV Total p/o Covg A -Homeowner Dwelling 11,585.50 100.00% 14,316.48 100.00% Covg A -Homeowner Dwelling - Code 0.00 0.00% Upgrade 0.44 0.40°/a Total 11,5 85.50 100.00% 10,316.48 100.00% PIERRE A BORGELA 1/24/2018 Page:2 UPCt=0N__ &�aA* IN S U RAN CE United Property & Casualty Co 800 2ND Ave S. St. Petersburg, FL 33702 Line Item Total Material Sales Tax Subtotal Overhead Profit Replacement Cost Value Less Depreciation Actual Casts Value Less Deductible Net Claim Total Recoverable Depreciation Net Claim if DtPreciation is Recovered PIERRE A BORGELA Summary for Covg A -Homeowner Dwelling Erica Purdy 11,585.50 193.75 11,779.25 1,177.94 1,177.94 $14,135.13 (3,819.05) $10,316.08 (4,860.00) S5,4S6.08 -* 3,819.05 $9,275.13 1/24/2018 Page:3 a i r N N zb CL a - ,w /^a L+l w 0 T- o m Lli Q w crW E- u t W �L j�c V C a � a U C 3 LL ot w co co L rl I, -- .m .m RJ co ru s ru ❑ ru .w Al �r X ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines # l through #2 as appropriate for additional signatures, dates, and/or information needed. if the document is already complete with the exception of the Chairman's signature, draw a line through routinglines # l through #2 corn fete the checklist and forward to the Count Attorney Office Route to Addressees (List in routing order) Office Initials Date 1. Jennifer A. Bel edio, ACA County Attorney Office Initial Applicable) 2. BCC Office Board of County Commissioners 1p� 12 "� 3. Minutes and Records Clerk of Court's Office —l(l NOTE: Clerk's attestation is not required. Please do not route this item to Clerk's Board Minutes and Records. CAO please scan document after execution by Chairman and email them to Clerk's Minute and Records for its records. PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above, may need to contact staff for additional or missing information Name of Primary Staff Elizabeth Hernandez, CHS Phone Number 239-252-2338 Contact 1 Department a ro riate. Initial Applicable) Agenda Date Item was Does the document require the chairman's original signature? Agenda Item Number _A2proyed by the BCC Z —l(l Type of Document Insurance Claim Check Endorsement for Number of Original N Attached Jason Gore Documents Attached I PO number or account signed by the Chairman, with the exception of most letters, must be reviewed and signed number if document is NIA to be recorded All handwritten strike -through and revisions have been initialed by the County Attorney's NIA INSTRUCTIONS & CHECKLIST U 1: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WW5 Original 9.03.04, Revised 1.26.05, Revised 224.05; Revised 11/30/12 Initial the Yes column or mark "NIA" in the Not Applicable column, whichever is Yes NIA (Not a ro riate. Initial Applicable) 1. Does the document require the chairman's original signature? 2. Does the document need to be sent to another agency for additional signatures? If yes, provide the Contact Information Name; Agency; Address; Phone on an attached sheet. N 3. Original document has been signed/initialed for legal sufficiency. (All documents to be NIA signed by the Chairman, with the exception of most letters, must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike -through and revisions have been initialed by the County Attorney's NIA Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the NIA document or the final negotiated contract date whichever is applicable. 6. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's signature and initials are required. 7. In most cases (some contracts are an exception), the original document and this routing slip NIA should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 06/12/2012 and all changes made during _ N/A is not the meeting have been incorporated in the attached document. The County an option for Attorney's Office has reviewed the changes, if applicable. j this line. 9. Initials of attomey verifying that the attached document is the version approved by the BCC, all changes directed by the BCC have been made, and the document is ready for the s; 0.6 l Chairman's signature. U 1: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WW5 Original 9.03.04, Revised 1.26.05, Revised 224.05; Revised 11/30/12 O O O O O Ln� Ln Ln _ ru _ O O O ru r 133 r ru LU -j O Ln r O ru 2#=u >#o> 0w>LA m IU Z LA r*j r- ;0 r�w > /Z/� 9 q2 2� /Z -n 0. oy f> LA H Z> c� kk «r �H mm kn LAE m «� q m LA n t j \ v� / ) I D n »?« CO.,, / 2 c y $ 2. ) Q0 M rn rn Ln ENDORSE HERE RESERVED FOR FINANCIAL INSTITUTION USE ' verBank Aulteft?L"�� By: Document Security Features- _ . Toner Retention • MiCro Printing • Chemically Sensitized Paper • Artificial Watermark - Hold at angle to view • Laid Unes sv.clak d-V•a pMcalm� WCM kPr nis "ijSl.�i wysxWm 0000 000889 (Rei 09 " FEDERAL RESERVE BOARD OF GOVERNORS REG. CC Collier County Community and Human Services Division (CHS) Homeowner Insurance Check Endorsement Policy Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage/lien, then the loan will not have to be repaid. On occasion, the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and receive money to make the repairs. If the insurance claim check is made payable to the homeowner and Collier County, then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to CHS at the address below for check endorsement consideration: 1. Copy of Homeowner's current insurance policy -Declaration Page. 2. Copy of insurance company's claim report with worksheet including description of repairs and costs. 3. Copy of photos of claim damage. 4. Copy of Insurance check(s) payable to homeowner, first lien holder and Collier County. Homeowner Name: Jason Gore Homeowner Address: 4473 201h Place SW, Naples FL 34116 Primary Contact Number: 239-293-0608 Homeowner Email: igzore62(a_),gmail.com OFFICE USE ONLY - Cf In 1 0� Reviewed CH - Grant Coordinator Date / �rAproved S irector Date nied Memorandum To: Kimberly Grant, CHS Director CC: Jennifer Belpedio, Assistant County Attorney From: Elizabeth Hernandez, Grant Support Specialist, Community and Human Services Date: 01/10/18 Re: Homeowner Insurance claim check endorsement -Jason Gore 4473 20the Place SW, Naples, FL 34116 The Homeowner Insurance Check Endorsement Policy approved by the Board on June 12, 2012 (16.1). 10) authorizes the Board Chairman or Vice Chairman to endorse homeowner insurance claim checks for recipients assisted with Purchase Assistance and/or rehabilitation program funds as Collier County is named as Second Mortgagee on their insurance policies. The attached check in the amount of $3,701.66 is for disbursement of the claim funds requiring endorsement by Board Chairman Taylor or Vice Chairman. The check names EVER13ANK as the first mortgage lender and Collier County SHIP as subordinate lien holder. In order for the check to be properly processed, proper signatures/endorsement for all parties listed on check must be obtained. This is a time -sensitive item and must be endorsed as soon as possible as homeowner is waiting to pay for work to be performed on home. Attachments: Homeowners Insurance Policy -Declaration Page Insurance Claim Check (#19555, $3,701.66) Insurance Claim Report & photos of damage Collier County Second Mortgage Security FirstInsurance- -,, a Florida Home') P.D. Box 20010 Miami, FL 33102-0010 Security First Insurance Company Report a Claim: Call toll-free 24hrslday 877-581-4862 (international callers dial, 386-673-5308) or log into the customer portal, My Security First, at www -U_ SFl.cam, To report an identity theft claim, call 8a0-676-5696. Servicing Questions: Please tail your agent [contact info below]. CU'LBERTSON AGENCY, INC. DAVID CANTONI 8855 IMMOKALEE RD #4 NAPLES. FL 34120 Phone: (239) 210-7710 Email: uwa@7culbertsonagency.com Agency ID: 24253 Agent License #: W016812 Named Insured: JASON GORE Mailing Address: 4473 20TH PL SW, NAPLES, FL 34116-6417 Email Address: jgore62@gmail.com Phone: (239) 293-0608 Insured Property Location 4473 20TH PL SW NAPLES, FL 34116-6417 County: COLLIER Your Policy Declarations Policy Type: Homeowners H03 Policy Number: P000302160 Policy Effective Date: 12/01/2017 12:01 AM Policy Expiration Date: 12/01/2018 12:01 AM Date Printed: 10/12/2017 12:01 AM Total Premium Amount: $1,460.00 Non -Hurricane Premium: $583 Hurricane Premium: $850 Total Policy Charges: $1,433 Total Policy Fees: $27.00 Renewal Premium Change: $162 See additional premium detail on page 2 Coverage A (Dwelling) Coverage 8 (Other Structure) Coverage C (Personal Property)Personal Property Replacement Cost Loss Settlement Included Coverage D (Loss of Use) Ordinance or Law $159,000 $1,028.00 $3,180 Included $79,500 Included $15,900 Included 25% of Coverage A $67 Amount All Other Perils Deductible $2,500 Hurricane Deductible $3,180 (2% of Coverage A) Sinkhole Deductible Excluded Section 11- Liability Coverages Coverage E (Personal Liability) $300,000 $15 Coverage F {Medical Payments) $5,000 $10 y See important notices beginning on page 3 that apply to this policy. S SFI FL H03 DEC 08 16 O Security First Insurance Company www.SecurityFirstFlorida.com Page 1 of 4 TRA2 • I3.0039731005553 ACV2 C6 S 1 -EF -M 1-C 00001 Gulfs#roam SAM, FMWR—I" k r.v iWmr•eHm INS AND RISK MGMT SVCS INC 8950 FONTANA DEL SOL WAY #200 NAPLES, FL 34109 NFIP Policy Number: 0000012727 Company Policy Number: 0000012727 Agent: TINA JOANN WHITNEY Policy Term: 12!07/2017 12:01 AM through 12/07/2018 12:01 AM Renewal Billing Payor: FIRST MORTGAGEE ro report a claim https:llgulfstream-ins-managemyfocdpolicy.com Agency Phone: (239) 649-1444 'visit or call us at: {877] 254-6819 RENEWAL FLOOD INSURANCE POLICY DECLARATIONS NEWLY MAPPED POLICY - DWELLING FORM DELIVERY ADDRESS JASON GORE 4473 20TH PL SW NAPLES, FL 34116 COMPANY MAILING ADDRESS GULFSTREAM PROPERTY & CASUALTY INSURANCE CO. PO BOX 912308 DENVER, CO 80291-2308 RATING INFORMATION $321-00 ORIGINAL NEW BUSINESS DATE: 1 210 712 4 1 2 REINSTATEMENT DATE: NIA BUILDING OCCUPANCY- SINGLE FAMILY CONDOMINIUM INDICATOR: NOT A CONDO NUMBER OF UNITS: NIA PRIMARY RESIDENCE: YES AD D ITI O NSIE X TE NSI O N S' SELECT BUILDING TYPE: ONE FLOOR BASEME:NTIENCLOSUREICRAWLSPACE TYPE: NO BASEMENT INSURED NAME{S} AND MAILING ADDRESS JASON GORE 4473 20TH PL SW NAPLES, FL 34116 PROPERTY LOCATION 4473 20TH PL SW NAPLES, FL 34116-6417 DESCRIPTION: NIA DATE OF CONSTRUCTION: COMMUNITY NUMBER: COMMUNITY NAME: CURRENT FLOOD ZONE: GRANDFATHERED: FLOOD RISIURATED ZONE: ELEVATION DIFFERENCE: ELEVATED BUILDING TYPE MORTGAGEE 1 ADEHTlONAL INTEREST INFORMATION FIRST MORTGAGEE: EVERBANK F.S.A. ISAOA PO BOX 620138 ATLANTA, GA 34362 SECOND MORTGAGEE: COLLIER COUNTY BOARD OF COMMISSIONERS CIO HOUSING HUMAN $ VETERAN SERVICES 3299 TAMIAMI TRAIL EAST, SUITE 303 NAPLES, FL 34112 ADDITIONAL INTEREST: DISASTER AGENCY: PREMIUM CALCULATION — COVERAGE DEDUCTIBLE BUILDING $700,000 $1,250 CONTENTS $80,040 $1,250 Coverage limitations may apply. See your policy farm for details 0 01/01/1968 120067040-4H REGULAR PROGRAM COLLIER COUNTY AH NO X NIA NON -ELEVATED LOAN NUMBER: 9000780236 LOAN NUMBER: X LOAN NUMBER: NIA CASE FILE NUMBER: NIA DISASTER AGENCY: Newly Mapped Property NEWLY MAPPED BASE PREMIUM: $321-00 NEWLY MAPPED MULTIPLIER: 1.150 ANNUAL SUBTOTAL: $369.00 INCREASED COST OF COMPLIANCE: $5.00 COMMUNITY RATING DISCOUNT: 0% $0.00 RESERVE FUND ASSESSMENT: 15.0% $56-00 PROBATION SURCHARGE: $0.00 ANNUAL PREMIUM: $430.00 HFIAA SURCHARGE: $25.40 FEDERAL POLICY SERVICE FEE: $50.00 TOTAL: $505.00 iN WITNE55 WHEREOF, i have signed this policy below and herebyenter into this InsuranceAgTwient Zero Balance Due This Is Not A Bill *fchalengsworth This declarations page along with the Standard Flood Insurance Policy Form constitutes your flood insurance policy. Policy issued by GULFSTREAM PROPERTY & CASUALTY INSURANCE CO. Company MAIC Illlljy II IIJill IIINI1I File: 9044710 Page 1 of 2 1111111 IIIII I111111[II DoclD: 65422850 12237 Gulfstr am Pmperty aiH! C.111�,.lIY 1 n�urAKa Cnmla�ny S,Lmv PPWrK- N !c +1Y. uea-YC'Ia0— Gulfstream Insurance Co. Flood Processing Center P.D. BOX 912308 Denver, CO 80291-2398 November 18, 2017 Jason Gore 4473 20"' Pl SW Naples, FL 34116-6417 Policy Number: 0000012727 Property Address: 4473 20`h PI SW, Naples, FL 34116-6417 Date of Loss: September 10, 2017 Building Covered Damages: $4,836.42 Recoverable Depreciation: $ 115.24+ Building Deductible:1$ 250M - Building Payable Amount: $3,701.66= Please note: Claims payments are mailed separately. Dear Jason Gore: We are sorry for your food loss due to Hurricane Irma and hope your flood insurance policy through the National Flood Insurance Program (NFIP) will help you recover as quickly as possible. At this time, we have determined you are owed $3,701.66 under your flood insurance policy. A check for this amount and an adjuster's report explaining the basis for this payment have been sent separately. Please carefully review this report. By accepting this payment, you agree the information in the adjuster's report is true and correct to the best of your knowledge and belief. Accepting this payment does not waive any of your rights to seek further payments under your flood insurance policy, You may request additional payments by submitting a Proof of Loss within one year following the date of foss. We will help you to complete and submit a Proof of Loss if you believe you are owed more under your flood insurance policy. You can learn more about requesting payments under your policy by visiting https:llwww.fema.gov/nfg-file-your-claim. The Adjuster's Final Report indicates no covered personal property damage was observed, and none is being claimed by you at this time. The Standard Flood Insurance Policy (SFIP) allows coverage for direct physical loss by or from flood. Because there was no flood damages to your covered personal property and none being claimed, the policy will not allow us to assist you with your personal property portion of your flood claim, and your flood claim for personal property is denied pursuant to the SFIP. Please review the following policy excerpt: III. PROPERTY COVERED B. COVERAGE B PERSONAL PROPERTY 1. If you have purchased personal property coverage, we insure... against direct physical loss by or from flood to personal property... We recommend you keep in a safe place, out of the reach of future flooding, all repair receipts and invoices documenting the completion of the building repairs. Thus, in the event you are flooded again, the adjuster will be better able to verify the building repairs were completed. This will greatly expedite the handling of any future flood claims. The Standard Flood Insurance Policy is a Federal Policy issued pursuant to the National Flood Insurance Act of 1968 and applicable federal regulations in Title 44 of the Code of Federal Regulations. Federal assistance may be available to you if you flood loss is within a city or county included in a disaster declaration by the President of the United States. In such cases you may contact FEMA at (804)-621-3362 or register online at http:llfema.gov. If you have any questions, have additional documentation for us to review, or need additional assistance, please contact your adjuster or our Claims Representatives at (877) 254-6819. We will be happy to assist you. To access the electronic copy of your SFIP form, please visit; https://www,fema.gov/national-flood- i nsurance-nroeramistandard-flood-insurance-nolicv-forms. Sincerely, Gulfstream Property & Casualty Insurance Company Flood Claims Department Jessica LaPierre — Senior Claims Examiner Cc: Insurance and Risk Management. Services, Inc. Advanced Adjusting, LTD SAW Wvf INS AND RISK MGMT SVCS INC 8950 FONTANA DEL SOL WAY #200 NAPLES, FL 34109 III"III'I'II'll'I'll'll'1111'llllllll'1'111111"III'lllllllll�ll JASON GORE 4473 20TH PL SW NAPLES, FL 34116 THIS IS NOT A BILL Payor: First Mortgagee Insured Property Location 4473 20TH PL SW NAPLES, FL 34116-6417 Property Description: Policy Expiration Date : 12/07/2017 Policy Number: 0000012727 Loan Number: 9000780236 Billing Date: 10/09/2017 Agent: TINA JOANN WHITNEY INS AND RISK MGMT SVCS INC 8950 FONTANA DEL SOL WAY #200 NAPLES, FL 34109 239-649-1444 RENEWAL NOTICE Your flood insurance policy will expire on the date shown above. Please follow renewal instructions on the remittance coupon below. Building Contents Building Contents A. Current coverage 200,000.00 80,000.00 1,250.00 1,250.00 505.00 B. Increased coverage 250,000.00 100,000.00 1,250.00 1,250.00 535.00 C. Maximum available 250,000.00 100,000.00 1,250.00 1,250.00 535.00 Effective June 1, 2014, the minimum deductibles available for the Standard Flood Insurance Policy (SFIP) have changed. Please see the reverse side for additional information regarding deductibles and other important messages related to your policy. This renewal offer is being made on behalf of GULFSTREAM PROPERTY $ CASUALTY INSURANCE CO. Follow the instructions below to pay your renewal premium online with a credit card or electronic check. • Log on to https://gulfstream-ins.managemyfloodpolicy.com and select "Pay Renewal Online". • Enter your policy information and follow the instructions to select your payment type and available coverage amounts if applicable. • You will immediately receive a copy of your renewal declarations page. See reverse of this notice for important additional information IF PAYING BY CHECK OR MONEY ORDER PLEASE DETACH HERE AND SEND THIS PORTION WITH YOUR PAYMENT. _M777i TV 7. To pay by check or money order: • Make payment for the exact amount of the coverage option you selected. • Full payment is required for the option selected. • Write your policy number on your check or money order. • Return this portion in the attached return envelope. Make check or money order payable to: 000008216196 000064264486 7 Insured. Name: JASON GORE Renewal Date: 12/07/2017 Policy No: 0000012727 Bill ID : 8216196-64264486 Select One: O Option A O Option B O Option C $505 $535 $535 Amount« • 1910000 ■■■ 11 GULFSTREAM PROPERTY $ CASUALTY PO BOX 912308 DENVER, CO 80291-2308 Ri. Gulfstroam o �t G] . INS AND RISK MGMT SVGS INC 8950 F0NTANA DEL SOL WAY #200 NAPLES, FL 34109 November 28, 2017 Ill��lll��li�ll'lllll�lIIII IIIdlIIII IIII I III IIII till IIII III. -Ill JASON GORE 4473 20TH PL SW NAPLES, FL 34116 Policy Number: Insured(s) 1411114I1I47MM MR JASON GORE Property Location: 4473 20TH PL SW NAPLES, FL 34116-6417 Flood Insurance Policy Packet This packet includes: • Your Flood Insurance Declarations Page • A National Flood Insurance Program Summary of Coverage • Claims Guidelines in Case of a Flood If you would like to electronically view or print a copy of the Standard Flood Insurance Policy, visit https:llgulfstream- ins.managemyflocdpolicy.com. Your consent to this policy delivery option is assumed, unless you contact us to request a mailed or e-mailed copy of the policy. If you would like a copy of the Standard Flood Insurance Policy e-mailed or mailed to you, please contact our customer service team at 877-625-8251 or guIfstream-inscs@torrentcorp.com. Important Information About The National Flood Insurance Program Federal law requires insurance companies that participate in the National Flood Insurance Program to provide you with the enclosed Summary of Coverage. It's important to understand that the Summary of Coverage provides only a general overview of the coverage afforded under your policy. You will need to review your flood insurance policy, Declarations Page, and any applicable endorsements for a complete description of your coverage. The enclosed Declarations Page indicates the coverage you purchased, your policy limits and the amount of your deductible. You will soon receive additional information about the National Flood Insurance Program. This information will include a Claims Handbook, a history of flood losses that have occurred on your property as contained in FEMA's data base, and an acknowledgement letter. If you have any questions about your flood insurance policy, please contact your agent or your insurance company. Page 1 of 2 ADVANCED ADJl15TIme LTD, INSURED : Jason Gore LOCATION 4473 20th PI. SW. Naples, FL 34116 COMPANY :Gulfstream Type of Building: Type of Foundation Exterior Walls: Type of Roof: Interior Walls: Building Age: Basement: Elevated: Total Square Feet: Value PSF: PSF Source: DATE OF REPORT 1 1 1412 0 1 7 DATE OF LOSS :9/1012017 POLICY NUMBER :0000012727 CLAIM NUMBER :172517 OUR FILE NUMBER :33862 ADJUSTER NAME : Mark Whidden BUILDINGESTIMATE BUILDING INFORMATION ...................... ......... �.............................. ......... I BUILDING VALUATION Estimated Total Value: $106,471.75 Depreciation: $10,647.17 Estimated Actual Cash Value: $95,824.57 Residential Concrete Slab Concrete Block Shingle Wood Studs 10.0 None Non -Elevated 1288.0 82.664402 BCM Database ESTIMATE RECAP _ Estimate Totals Before Taxes: $4,748.22 Applicable Sales Tax: $247.86 Estimate Grand Totals: $4,996.08 Total Depreciation: ($159.66) Recoverable Depreciation: A.C.V. Estimate Totals: $4,836.42 Non -Recoverable Depreciation: Policy Deductible: ($1,250.00) Total Depreciation: Final Totals: $3,586.42 _ ESTIMATE COMMENTS All claims are subject to the approval of the insurance company and no representation is given or implied by this estimate. This estimate is subject to change or modification by Advanced Adjusting LTD, or any of its clients. ESTIMATE VITALS Database: Complete Building Repair Registry Location Factors: User Override(176Ll125M111 OE) Price Table: 4th Quarter Pricing 2617 Dep Table: User Defined (Materials Only) Local Mod Table: None ShowOverrides: Off This is an estimate oftecordeddamages andis subject to review andfinal approvalbyfhe insurance carrier. $115.24 $44.42 $159.66 SIMsoL® Cover Page Form EST -718.0 INSURED : Jason Gore DATE OF REPORT :111412017 LOCATION :4473 20th PI. SW. DATE OF LOSS :9/1012017 : Naples, FL 34116 POLICY NUMBER :0000012727 ADVANCED COMPANY : Gulfstream CLAIM NUMBER :172517 ADJUSTING LM OUR FILE NUMBER :33852 ADJUSTER NAME Mark Whidden (Estimate Section: Exterior Exterior...... .... ................................ I......................... 40'x 45'x 8' ....................................................... I .......... .. 9' 11.0" x 11' x 8' 1.0" Door....... ............ .............................................. ... 8'x 7' Offset .................................................................... 2' 6.0" x 2' 10.0" x 8' Door.................................................................... 5'x 6'8.0" Door.................................................................... 2@2'6.0"x6'8.0" .......... .......... ....... I ............. ......... 2'x T6.0" x 8' LowerPerimeter: 152.00 LF Floor SF: 1800.00 SF Wall SF: 1237.30 SF UpperPerimeter: 170.00 LF Floor SY: 200.00 SY Ceiling SF: 1800.00 SF # Quantity Descri tion unit Cost RCV DEP Materials ACV 1 1.0 EA CleanCondensingUnit $52.48 SF $52.48 411.70 $52.48 UpperPerimeter: 49.70 LF Floor SY: 14.58 SY Clean and inspect HVAC condenser 131.20 SF # I Quantity Descri ion 2 154.7 SF Clean Exterior Wall (100.0% 1 1.0') $0.68 ACV4 $105.20 131.2 SF $105.20 3 1.0 EA CY Solid Waste ContainerDumpster $77.41 $7741 5 131.2 SF MildewcideFloorTreatment(100.0%0) 114 Rental $412.50 $412.50 $412.50 $52.48 Totals For Exterior 131.2 SF NFIP Dry -out Allowance with HVAC (100.0 5570.18 $0.001 $570.18 Estimate Section: Office Office ....................................................... I .......... .. 9' 11.0" x 11' x 8' 1.0" Offset .................................................................... 2' 6.0" x 2' 10.0" x 8' Closet.............. .......... .......... ....... I ............. ......... 2'x T6.0" x 8' Opening: 5' 10.0" x 6' 8.0" Door.................................................................. 2'6.0"x6'80" Window ......... ........... .................. I...................... 2 @ Tx 4' (Sill @ 3') LowerPerimeter: 51.70 LF Floor SF: 131.20 SF Wall SF: 411.70 SF UpperPerimeter: 49.70 LF Floor SY: 14.58 SY Ceiling SF: 131.20 SF # I Quantity Descri ion RCV DEP Materials ACV4 131.2 SF FloodLossClean-up(100.0%fl) $77.41 $7741 5 131.2 SF MildewcideFloorTreatment(100.0%0) rUnit $52.48 $52.48 6 131.2 SF NFIP Dry -out Allowance with HVAC (100.0 $78.72 $78.72 7 131.2 SF Method 1 Remove Carpeting (Per SF) (100.0%) $0.16 $20.99 $20.99 8 140.4 SF Replace Carpeting (Per SF) (100.0%) $3.76 $5 $37.07 $4 .83 9 131.2 SF Remove Carpet Pad (Per SF) (100.0%) $0.07 $9.18 $9 $9.90 $9'18 10 131.2 SF Replace Carpet Pad (Per SF) (100.0%) $0.86 $112.83 $7.35 $105.48 11 50.9 SF Clean and Treat Wall Framing System (100.0% 1 1.0') $0.74 $37.67 $37.67 12 203.7 SF Remove Wall Drywall on Wood Framing (100.0%14.0') $0.88 $179.26 $179.26 13 203.7 SF Replace Wali Drywall on Wood Framing (100.0% 14.0') $1.90 $387.03 $12.22 $374.81 14 254.7 SF Texture Walls (100.0% 15.0') $0.97 $247.06 $7.13 $239.93 15 411.7 SF Add 1 foot for overlap Paint Walls (1 Coat) (100.0% 18.1') $0.74 $304.66 $4.12 $300.54 16 254.7 SF Seal and Paint Walls (1 coat) (100.0% 15.0') $1.10 $280.17 $6.62 $273.55 17 51.7 LF Add 1 foot for overlap Remove Base Moulding 100.0°I° $0.53 $27.40 $27.40 *' This is a n estimate of recorded damages and is subject to review a ndfinal approval by the insurance carrier. Page: 4 SIMSOIOO Form GEST-118.0 Estimate Section: Office - Continued.., # Qua nti Description 18 51.7 LF Replace Base Moulding (100.0%) 19 51.7 LF !Paint/ Finish Base Moulding (100,0%) 20 1.0 EA Remove 6' Pairof Wood Birch Hollow Core By-pass Closet Doors 21 1.0 EA Replace 6' Pair of Wood Birch Hallow Core By-pass Closet Doors 22 1.0 EA Paintl Finish 6' Pairof Wood Birch Hollow Core By-pass Closet Doors 23 1.0 EA Remove Pre -hung Hollow Core Interior Door 24 1.0 EA Replace Pre -hung Hollow Core Interior Door 25 1.0 EA: Paint/ Finish Pre -hung Hollow Core Interior Door 26 1.0 EA; Remove and Reinstall Doorknob wlKeyless Lack 27 1.0 EA Remove Interior Door Casing /Trim Set 28 1.0 EA Replace Interior Door Casing /Trim Set 29 1.0 EA Paint 1 Finish Interior Door Casing /Trim Set 30 1.0 EA Remove Double Width Interior Door Casing 1 Trim Set 31 1.0 EA Replace Double Width Interior Door Casing! Trim Set Closetdoor 32 1,0 EA Paint/ Finish Double Width Interior Door Casing /Trim Set Totals For Office Repair Item Totals LessNon-OHPTrades SubTotal For OHP General Contractor's Overhead (10.0%) General Contractor's Profit (10.0%) Plus Non -OHP Trades Estimate Totals With OHP Applicable Sales Tax Estimate Grand Totals Policy Deductible BUILDING FINAL TOTALS Recovera bleDe preci ation Non-RecoverableDepreciation DATE OF REPORT DATE OF LOSS POLICY NUMBER CLAIM NUMBER OUR FILE NUMBER ADJUSTER NAME Unit Cost $2.971 $1.21' $52.16 $440.46 I f f "fI v If 9/10/2017 :0000012727 :172517 :33862 Mark Whidden RCV DEP {Materials $153.55 $10.03 $62.56 $1.16 $52.16 $440.461 $28.38 $94.41 $94.41; $26.08 $26.08 $154.76 $154.76 $64.93 $41.91 $9.02 $37.56 $11.54 $11.141 $44.371 $13.571 $64.93 $41.91 $9.02 $37.56 $11.54 $11.14 $44.37 $1 ACV $143.52 $61.40 $52.16 $412.08 INSURED : Jason Gore $3,997.21 LOCATION :4473 20th PI. SW. 7A02FINGED : Naples, FL 34116 $3,086.27 COMPANY : Gulfstream LTD $10.61 Estimate Section: Office - Continued.., # Qua nti Description 18 51.7 LF Replace Base Moulding (100.0%) 19 51.7 LF !Paint/ Finish Base Moulding (100,0%) 20 1.0 EA Remove 6' Pairof Wood Birch Hollow Core By-pass Closet Doors 21 1.0 EA Replace 6' Pair of Wood Birch Hallow Core By-pass Closet Doors 22 1.0 EA Paintl Finish 6' Pairof Wood Birch Hollow Core By-pass Closet Doors 23 1.0 EA Remove Pre -hung Hollow Core Interior Door 24 1.0 EA Replace Pre -hung Hollow Core Interior Door 25 1.0 EA: Paint/ Finish Pre -hung Hollow Core Interior Door 26 1.0 EA; Remove and Reinstall Doorknob wlKeyless Lack 27 1.0 EA Remove Interior Door Casing /Trim Set 28 1.0 EA Replace Interior Door Casing /Trim Set 29 1.0 EA Paint 1 Finish Interior Door Casing /Trim Set 30 1.0 EA Remove Double Width Interior Door Casing 1 Trim Set 31 1.0 EA Replace Double Width Interior Door Casing! Trim Set Closetdoor 32 1,0 EA Paint/ Finish Double Width Interior Door Casing /Trim Set Totals For Office Repair Item Totals LessNon-OHPTrades SubTotal For OHP General Contractor's Overhead (10.0%) General Contractor's Profit (10.0%) Plus Non -OHP Trades Estimate Totals With OHP Applicable Sales Tax Estimate Grand Totals Policy Deductible BUILDING FINAL TOTALS Recovera bleDe preci ation Non-RecoverableDepreciation DATE OF REPORT DATE OF LOSS POLICY NUMBER CLAIM NUMBER OUR FILE NUMBER ADJUSTER NAME Unit Cost $2.971 $1.21' $52.16 $440.46 I f f "fI v If 9/10/2017 :0000012727 :172517 :33862 Mark Whidden RCV DEP {Materials $153.55 $10.03 $62.56 $1.16 $52.16 $440.461 $28.38 $94.41 $94.41; $26.08 $26.08 $154.76 $154.76 $64.93 $41.91 $9.02 $37.56 $11.54 $11.141 $44.371 $13.571 $64.93 $41.91 $9.02 $37.56 $11.54 $11.14 $44.37 $1 ACV $143.52 $61.40 $52.16 $412.08 $11.14 $2.49 $41.88 $0.45 S" 3.1 33.751 $3,427.03 $4,130.96 $133.75 $3,997.21 $2.28, ($44.42) $92.13 $3,086.27 $89.33 $26.08 $10.61 $8.94 $144.15 $1.32 $8.94 $63.61 $1,044.69 $44,42 $41.91 $4,748.22 $151.63 $9.02 $2.141 $8.03 $35.42 $0.381 $159.66 $11.16 $11.14 $2.49 $41.88 $0.45 S" 3.1 33.751 $3,427.03 $4,130.96 $133.75 $3,997.21 {$1,044.69} ($44.42) {$1,000.27} $3,086.27 $89.33 $2,996.94 $308.63 $8.94 $299.69 $308.63 $8.94 $299.69 $1,044.69 $44,42 $1,000.27 $4,748.22 $151.63 $4,596.59 $247.86 $8.03 $239.83 $4,996.08 $159.66 $4,836.42' {$1,250.00} ($1,250.00): $3,746.08 $3,586.42; $115.24 $44,42 " This is an estimate of recordeddamages an dis subject to reviewandfinalapprovalby the insurance carrier. SIMSOL® Page: 2 Form CEST-li&0 INSURED : Jason Gore DATE OF REPORT :111412017 LOCATION4473 20th Pl. SW. DATE OF LOSS :911012017 Naples, FL 34116 POLICY NUMBER :0000012727 ADVANCED COMPANY : Gulfstream CLAIM NUMBER :172517 AI} STING LTO, OUR FILE NUMBER :33862 $2,995.94 ADJUSTER NAME Mark Whidden ESTIMATETOTALS ESTIMATE TOTAL PAGE ITEMS RCV DIFF ACV' Repair Item Totals $4,130.96 $133.75 $3,997.21 Less Excluded O&P Trade(s) ($1,044.69) ($44.42) ($1,000.27) Subtotal For O&P % $3,086.27 $89.33 $2,995.94 General Contractor Overhead (10.0%) $308.63 $8.94 $299.69 General Contractor Profit (10.0%) $308.63 $8.94 $299.69 Plus Excluded O&P Trades $1,044.69 $44.42 $1,000.27 Estimate Totals With O&P $4,748.22 $151.63 $4,596.59 Applicable Sales Tax $247.86 $8.03 $239.83 Rate: 6.0000% (Includes M,L,E) Estimate Grand Totals $4,996.08 $159.66 $4,836.42 Less Deductible ($1,250.00) {$1,250.00} BUILDING FINAL TOTALS $31746.08 $159.66 $3,585.42 RECOVERABLE DEPRECIATION * $115.24 NON-RECOVERABLED EPRECIATION $44.42 I 'This amount represents the total recoverable depreciation for this estimate. Any payable recoverable depreciation is subject to policy coverage limit. Please check plicy coveraae_limit prior t0 issuing any recov_erahle depreclativn reimbursements. _. Sales Tax Legend: M - Materials, L - Labor, E - Equipment The adjuster has no authority to approve or deny claims. RIR means: Remove and Replace damaged item. A copy of this estimate does not constitute a settlement of this claim. This estimate is subject to review and approval by your carrier, any additional repair to or replacement of items not included in this estimate is also subject to the insurance company's prior approval. You are required to keep all receipts, cancelled checks, inspection reports, etc. as proof of repair/replacement in the event of any future loss. This is not an authorization for repairs. The hiring of a contractor is strictly the decision of the policyholder. This is an estimate ofrecordeddamagesandissubject toreviewandfinalapprovalbytheinsurancecarrier. Total Page SIMSOL® Form ESTAM0 INSURED : Jason Gore LOCATION :4473 20th PI. SW. Naples, FL 34116 ADVANCED COMPANY :Gulfstream ADJUSTING LTD. DATE OF REPORT :11/4/2017 DATE OF LOSS :9/10/2017 POLICY NUMBER :0000012727 CLAIM NUMBER :172517 OUR FILE NUMBER :33862 ADJUSTER NAME : Mark Whidden SIMSDIA PHOTO.118.0 (Mote: Images have been downsamPled to 640 x 480.) Photo ID : front elevation Section Photo # : 1 Date : 11/3/17 Taken By : Adjuster Comment Not damaged Photo ID address Section Photo # : 2 Date : 1113117 Taken By : Adjuster Comment Address as per loss notice page 1 04* ADVANCED ADJUSTING LTC, INSURED : Jason Gore LOCATION : 4473 20th PI. SW. Naples, FL 34116 COMPANY : Gulfstream DATE OF REPORT :11/412017 DATE OF LOSS : 9/1012017 POLICY NUMBER :0000012727 CLAIM NUMBER :172517 OUR FILE NUMBER :33862 ADJUSTER NAME Mark Whidden _l .... 9 s b' I SIMSOL® PHOTO -1/8.0 (Note! Images have been downsamp led to 640 x 480.) Photo ID : left elevation Section Photo # : 3 Date : 11/3/17 Taken By : Adjuster Comment Not damaged Photo ID : rear elevation Section Photo # : 4 Date : 1113117 Taken By : Adjuster Comment Not damaged page 2 A. .... 9 s b' I SIMSOL® PHOTO -1/8.0 (Note! Images have been downsamp led to 640 x 480.) Photo ID : left elevation Section Photo # : 3 Date : 11/3/17 Taken By : Adjuster Comment Not damaged Photo ID : rear elevation Section Photo # : 4 Date : 1113117 Taken By : Adjuster Comment Not damaged page 2 ON ADVANCED AOOUSTIHG LT©, INSURED : Jason Gore LOCATION : 4473 20th PI. SW. Naples, FL 34116 COMPANY : Gulfstream DATE OF REPORT -111412017 DATE OF LOSS : 9/10/2017 POLICY NUMBER :0000012727 CLAIM NUMBER :172517 OUR FILE NUMBER :33862 ADJUSTER NAME : Mark Whidden ai SIMSOLS PHOT04A0 (Note: Images have been downsampled to 640 x 480.) Photo ID : right elevation Section Photo # : 5 Date : 1113117 Taken By : Adjuster Comment Not damaged Photo ID : exterior waterline Section Photo # : 6 Date : 1913117 Taken By : Adjuster Comment Exterior waterline right elevation page 3 INSURED : Jason Gore LOCATION : 4473 20th PI. SW. Naples, FL 34116 ADVANCED COMPANY :Gulfstream ADJUSTING LTD, DATE OF REPORT :1114/2017 DATE OF LOSS :9/10/2017 POLICY NUMBER :0000012727 CLAIM NUMBER :172517 OUR FILE NUMBER :33862 ADJUSTER NAME Mark Whidden SIMSOLS PHOTO -118,0 [Note: Images have been downs ampled to 690 x 480J Photo ID : exterior waterline Section Photo # : 7 Date :11!3!17 Taken By : Adjuster Comment Exterior waterline 2 inches Photo ID : exterior waterline Section Photo # : 8 Date :1113!17 Taken By : Adjuster Comment Exterior waterline right elevation 2 inches page 4 INSURED Jason Gore LOCATION : 4473 20th PI. SW. Naples, FL 34116 ADVANCED COMPANY : Gulfstream ADJUVIHG LTD DATE OF REPORT :1114/2017 DATE OF LOSS :9110/2017 POLICY NUMBER :0000012727 CLAIM NUMBER :172517 OUR FILE NUMBER :33862 ADJUSTER NAME : Mark Whidden (,L- F SIMSOLO PHOTO.1f8.0 (Note: Images have been downsampled to 640 x 480.) Photo ID office Section Photo # : 9 Date :1113!17 Taken By : Adjuster Comment Carpeting drywall baseboards doors damaged Photo ID office Section : Photo # :10 Date :11/3/17 Taken By : Adjuster Comment Carpeting removed before we arrived damaged baseboards drywall page 5 INSURED : Jason Gore DATE OF REPORT :11/4/2017 LOCATION 4473 20th PI. SW. DATE OF LOSS :9/10/2017 Naples, FL 34116 POLICY NUMBER 0000012727 AIDVANCED COMPANY Gulfstream CLAIM NUMBER :172517 ADJUSTING LTD, OUR FILE NUMBER :33862 ADJUSTER NAME Mark Whidden Photo ID office Section Photo # : 11 Date : 11/3/17 Taken By : Adjuster Comment : Closet area damaged page 6 S4MSOLO PHOTO.118.0 (Nate: Images have been downsampled to 640 x 480.) INSTR 4356516 OR 4504 PG 759 DWIGHT E. BROCK, COLLIER COUNTY DOC@.35 $56.70 INT@.002 $32.35 OBLD $16,173.00 OBLI $16,173.00 RECORDED 10/28/2009 9:55 AM PAGES 5 CLERK OF THE CIRCUIT COURT REC $44.00 SECOND MORTGAGE THIS SECOND MORTGAGE ("Security Instrument") Is given on& day of _IV .2009. The Second Mortgagor Is: Jason P. Gore, a single man ("Borrower'). This Security Instrument is given to Collier County ('Lender), which Is organized and existing under the laws of the United Slates of America, and whose address is 3301 E. Tamiami Trial #211 Naples Florida 34112. Borrower owes Lender the sum of Sixteen Thousand One Hundred Seventy Three Dollars (U.S. $ i6,173.00). This, debt Is evidenced by Borrower's Note dated the same date asthis Security Instrument ('Second Mortgage'), which provides for monthly payments, with the full debt, if not paid earlier, due and payable on sale of property, refinance, or loss of homestead exemption. This Security Instrument secures toLender (a)the repayment ofthe debt evidenced by the Note, with interest, and all renewals, extensions and modifications; (b) the payment of a0 other sums, with Interest advanced under paragraph 7 to protect the security of the Security Instrument; and (c) the performance of Borrowers covenants and agreements under this Security Instrument and the Note. For this purpose, Borrower does hereby second mortgage, grant and convey to Lender the following described property located In Collier County, Florida. More particularly described as: GOLDEN GATE UNIT 2, BLOCK 32, LOT 27, PLAT BOOK 5, PAGE 65, PUBLIC RECORDS OF COLLIER COUNTY, FLORIDA. R FOLIO by h has 00001 and which has the address of ("Property Address"): c, TOGETHER WITH all th mpro men reatte' 'reded on th property, an all a mems, rights, appurtenances, rents, royalties, mineral, oil and gas righ and p silts, water rights to nd ail fixt as now or h efts part of the properly. The Security Instrument shall also cover all rep cem ti n e is S r1ty Instrument as the "Property'. BORROWER COVEN IS Bo w Is II el f e s e er n d a d has the right to mortgage, grant and convey the Property and tha the P is une cu , e t f m n of co rd. orrower warrants and will defend generally the title to the Property gains If d ims de an s, b any en b nee re rd. 'p THIS SECURITY INS T"'1� u o fo tional an o h covenants with limited variation by jurisdiction to constitute a uniform In ent cove real prope UNIFORM COVENANT CBo wer and Lender covenant and ag as foil 1. Payment of Principal rest; Prepayment and Late Cha . B slta6¢ mptly pay when due the principal of and interest on the dell evidenced 'ty,�'jJ e. 1. Taxes. TheMortgagorw a xes,assessments,sewer rents r r e o the accrual of any penalties or interest thereon. i l The Mortgagor shall pay or cau to as the same respeo0vey beya e, )(1) all taxes and governmental charges of any kind whatsoever which they al any time y seed or levied gai65j dY, 'th sped to the Properly, (2) all utility and other charges, Inducting "service charges",incurred pose r a to se, occupancy, upkeep and Improvement of the Property, and (3) all assessments or other govern al s a'( a paid In Installments over a period of years, the Mortgagor shall be obligated under the Mortgage to pay o b uch installments as are required lobe paid during the term of the Mortgage, and shall, promptly after the payment of any of the foregoing, forward to Mortgagee evidence of such payment. 3. Application of Payments. Unless applicable law provides otherwise, all payments received by Lender shall be applied; first, to interest due; and, to principal due; and last, to any late charges due under the Note. 4. Charges; Liens. Borrower shall pay all taxes, assessments, charges, fines and impositions attributable to the Property which may attain priority over this Security Instrument, and leasehold payments or ground rents, if any. Borrower shall promptly furnish to Lender all notices of amounts to be paid under this paragraph, and all receipts evidencing the payments. Borrower shall promptly discharge any lien which has priority over this Security Instrument unless Borrower. (a) agrees in writing to the payment of the obligation secured by the lien in a manner acceptable to Lender, (b) contests in good faith the lien by, or defends against enforcement of the lien In, legal proceedings which in the Lenders opinion operate to prevent the enforcement of the lien; or (c) secures from the holder of the lien an agreement satisfactory to Lender subordinating the lien to this Security Instrument. if Lender deterndnes that any part of the Property is subject to alien, which may attain priority over the Security Instrument, Lender may give Borrower a notice identifying the lien. Borrower shall satisfy the lien or take one or more of the actions set forth above within 10 days of the giving of notice. 5. Hazard or Property Insurance. Borrower shall keep the improvements now existing or hereafter erected on the Property insured against loss by fire, hazards induded within the term "extended coverage' and any other hazards, including floods or flooding, for which Lender requires insurance. This insurance shall be maintained in the amounts and for the periods that Lender requires. The Insurance carrier providing the insurance shall be chosen by Borrower subject to Lenders approval, which shall not be unreasonably withheld. If Borrower fails to maintain coverage described above. Lender may, at Lenders option, obtain coverage to protect Lenders rights in the Property in accordance with paragraph 7. At all times that the Note is outstanding, the Mortgagor shall maintain insurance with respect to the Premises against such risks and for such amounts as are customarily insured against and pay, as the same become due and payable, all premiums in respect thereto, Including, but not limited to, all-risk insurance protecting the interests of the Mortgagor and Mortgagee against loss or damage to the Premises by fire, lightning, and other casualties customarily insured against (including boiler explosion, if appropriate), with a uniform standard extended coverage endorsement, including debris removal coverage. Such insurance at an times to be in an amount not less than the full replacement cost of the Premises, exclusive of footings and foundations. All Insurance policies and renewals shall be acceptable to Lender and shall include a standard mortgage clause. Lender shall have the right to hold the policies and renewals. If Lender requires, Borrower shall promptly give to Lender all receipts of paid premiums and renewalnotices. In the event of loss, Borrower shall give prompt notice to the Insurance center and Lender. Lender may make proof of loss if not made promptly by Borrower. Unless Lender and Borrower otherwise agree in writing, insurance proceeds shall be applied to restoration orrepair of the Property damaged, if the restoration or repair Is economically feasible and Lenders security Is not lessened. K the restoration or repair is not economically feasible or Lenders security would be lessened, the insurance proceeds shall be applied to the sums secured by the Security Instrument, whether or not then due, with any excess paid to Borrower. K Borrower abandons the Property, or does not answer within 30 days a notice from Lenderthat the Insurance carrier has offered to settle a claim, then Lender may ceflect the Insurance proceeds. Lender may use the proceeds to repair or restore the Property or to pay sums secured by this Security Instrument, whether or not then due, The 3Q day period will begin when the notice is mailed. Unless Lender and Borrower otherwise agree M writing, any application of proceeds to principal shall not extend or postpone the due date of the monthly payments referred to In paragraph 1 or change the amount of the payments. If under paragraph 21 the Property Is acquired by Lender, Borrowers right to any Insurance policies and proceeds resulting from damage to the Property prior to the acquisition shall pass to Lender to the extent of the sums secured by this Security Instrument immediately prior to the acquisition. OR 4504 PG 760 FORK c S. Occupancy, Pros arvallon, MmInto nonce and Proteclion of the Property; Borrower's Loan Application, Leaseholds. Borrower shall Occupy, establish, and use the Property as Borrower's principal resldance within Sixty days afler the execution of this Security instrument and shalt continue to occupy the Property as Borrowers principal residence for at least one year after the date of occupancy, unless Lender otherwise agrees in writing, which consent shall not be unreasonably withine Id, or unless extenuating dreumslances exist which are beyond Borrower's control. eDinower shall not destroy damage or impair the Property, allows the Property to deteriorate, or commit waste on the Property. Borrower shall be In default If any forfeiture action or proceeding, whether dvll or criminal, is begun That In Lenders goad faith judgment could result in forfeiture of the property or otherwise materially impair The 11 an created by this Security Inslrumant or Lender's security Interest. Borrower may cure such a dafaulf and reinstate, as provided in paragraph 18. by causing the action orpmcesding to be dismissed wish a ruling that, in Lenders good faith delermination, precludes forfelture of the Borrowers inlerosl in the Property or other maleriat impaimrent of the lien seated by Ibis Security InsW Ment or Lenders securityinleresl. f3orrowershall at so be in default if Borrower, during Ne loan application process, gave materially false or lnacrxurata Information or slatereen is to Lender (orfaifad to provide Lender with any material information) in connection with the loan evidenced by the Note, including, but not limited to, representations conceming Borrowers Occupancy of the Property as a principal residence. If this Security Instrument Is on leasehold, Borrower than comply Wath all the provision of the lease. It Borrower acquires fee title to the Property, the leasehold and the fee title shall not merge utress Lender agrees to tie merger in writing. 7. Preto cLon of tonder'a Rights In the Property, if Borrower falls to perform the covenants and agreements conrarned in this Security Instrument, or there is a legal proceeding that may significantly affect Lenders rights In the Property (such as a proceeding in bankruptcy, probate, for eondeFin natlon or forfeiture or to enforce laws or rogulations), then Lender may do and pay for whatever is necessary to proted the value of the Property and Lender's rights in the Property. Lenders adions may induce paying any sums secured by a lien, which has priority over this Security Instrument, appearing in court, paying reasonable attorneys' fees and enlering on the Property to make repairs. Although Lender may take action under this paragraph 7, Lender Wes not have to do so. Any amounls disbursed by Lender under Ibis paragraph 7 shall become additional debt of Borrower seared by this Security Instrument Unlass Borrower and Lender agree to other Terms of payment, these amounts shell bear interest from the date of disbursement al the Note rate and shall be payable. Win interest, upon nolice tram Lender to Borrower requesting payment. t. Mortgage Insurance. IF Lender requi ¢rhm dap ,i�� +}c� c,onditien of making the to" secured by this Security Instrument, Borrower shalt pay She premiums re � r U111.U111. e�grage�ahgance in effect If. for any reason, the mortgage Insurance coverage required by Lander laps gr ce �/(rri{tr R ay the premiums required to obtain coverage substantially equivalent to the mortgage i ously in eted, at a equivalent to the cost to Borrower of The mortgage insurance previously in effect r emate mortgage insurer appro t:e er, If substantially equivalent mortgage Insurance coverage Is not available, B 11 pay to Lender eerh month a sum aq to one elflh of the yearly mortgage insurance pro mium being paid by Borrower wh Main rpuce wvzrage Lapsed or ceased ra be in act L der will accept, use and retain these payments as a loss reserve in lieu Meng go i�rhh,{urance. Lora-rosa ru is may no ger required, at The option of Lender, if mortgage insurance coverage (in a amo nt ands'ioh'�is gn1 ! t Lender r Tres] pro ' d by insurer approved by Lender again becomes available and Is oblain Ba r shall pay the ims wired to aintain mo age i urance in effect, or to pfovlde a loss reserve, until the requirement forrnortg a amen between Borrower and Lender or applicable law. g. Inspection. Lend or Its e ay ak na I en o nd ap ions t me Pmparty. Lender shall give Borrower notice at the time of or rior to in ecii spa -fyi g r e cause th IF on, 16. Condemnation. e n d damage di on uenti.,. in connection with any condemnation or other taking Of a �p[ the dy, or ro7canweyanceTnr�h.�iOU of Con emnatprt 4 ereby assigned and shall be paid m Lender. in the event of a total skin W the roperty, the proceeds shall be app d to the ms secure trythls Security Instrument, whether or not then due, with any excess p id'l6' r. in the event O} a partial l oT e P which the fair market value of the 13roperlyimmediately Wale lhataki � 1toorgreater lhant heamounk` wrtsu 3b Ihis Secudtytnstrumentimmediatery before Ne taking, unless Borrower an in r therwiso agree In writing, Ina sums tied+ ewrlty lnslnument shall be reduced by the amount of the proceeds multiplied a b ing fraction: (a) the total amount secured Immedlateiy before the taking, divided by (b) the fair market value or the op 1�tely before the taking. hall be paid to Borrower, In The event of a partial taking of Ne Property In which the fair lu Lhe Prnpertyima taking is les sITT an the amount of the sums secured Immediately for the taking, unless Bon an epdgr�t8n4ts.0 inPpFL or unless applicable lawothemise provides, the proceeds 311 ;111 be applied to the sums secured S �n ii or not the sums are then due. Unless Lender and Borrower otherwise agree in writing, any application o t all not expend or postpone the due date of the monthly payments referred to in paragraphs t or changa rhe amount o} such paymonls. 11. Borrower Not Released, Forbearance By Lender Not a Waiver. Extension of the tme for payment or modification of amonizatlon of the sums secured by this Security Instrument granted by Lender to any successor in Interest of Borrower shall natoperate to rete a se the (lability of the original Borrower or Borrowers successors in interest. Lender shall not be required to commence proceedings ago insl any successor In interest or refuse to extend time for payment or otherwise modify amorlizallon of the sums secured by this Security Instrument by reason of any demand made by the original Borrower or Borrower's successors in interest. Any forbearance by Lender in exercising any right or remedy shall not be a waiver d or preclude the exercise of any right or remedy. 12. Succago Ora and Assigns Bound; Joint and Several LlahlIIty; CoSignars. Th0covenants and agreements oftfiisSaw rity instrument shall bind and benefit the successors and assigns of Lender and Borrower, subjectto the Provisions ofparagraph 17. Borrowers covenants and agreements shall bejolnt and several. Any Borrower who co-signs this Sew" Instrument but does that execute the Note; (a) is co-signing Ihis Security Instrument only to mortgage, grant and convey that Borrower's interest In tie Property under Ne terms of this Security rnstrument: (b) is not personally obligated to pay the sums secured by this Security Instrument; and (c) agrees that Le niter and any ether Borrower may agree Io extend, modify, forbear or make any accommodations with regard to The terms of this Security instrument or the Nato without that Borrowers consent. 13. Loan Charges. If me loan secured by this Security Instrument is subject to a Iaww hlch sets maximum loan charges, and that law Is fin ally Interpreted so that the interest or othair loan charges collected or to be collected In connection whim the loan exceed the permitted limits, then: (a) any such tsars charge an all be reduced by the amount necessary to reduce tha charge to Ire permitted limit; and (b) any sums already cdlleded from Borrower which exceeded permitted Iimits will be refund ad to Borrower. Lender may choose to make this refund by reducing the principal owed under the Note or by making a direct payment to Borrower. Ila refund reduces principal, the reduction will be treated as a partial prepayment without any prepayment charge under rhe Nola. 14. Notices. Any notice to Borrower provided Tor In this Secunty Instrument shall be given by delivering it or by mailing it by first doss mail unless applicable law required use of another method. The notlea shall be directed to the Property Address or any atheraddress Borrower deslgnales by nolice to Lender, Any notice to Lender shall be given 10 Borrower or Lender when given as provided In this paragraph, 15. Governing Law; Severability. Federal law and the law of the jurisdlcton in which tha Property is located shall govern this Security Inshumeni. In the event that any provision or dause of this Security Instrument or the Note conflicts wish applicable taw, such conflld shalt not affect other provislant of this Security Instrument or Ire Note which can be given effect without the conflicting provision. To this end the provisions of this Security Instrument and the Note are dedarW to be severable. 16. Borrower's copy. Borrower shall be given one conformed copy of the Nola and of this Security Instrument. IT. 7 ra nsfe r of the Property ora Sa nett la i to terest in Borrower. If all or any pan of the Property or any interest In 11 Is sold or transferred (or II a beralydal Interest in Borrower is sold or transferred and Borrower is not a natural person) without Lenders prior written con sen 1, Lender may, at its option, require Immediate payrrherht In Tull of all sums secured by this Security Instrument. However, Lender than not exerdse this optlon If federal law as of the date of this Security Instrument prohibts exercise. if Lender exerdsed this option, Lender shall give Barrowernolice of acceleration. The notice snail provide a period of not less than 30 days from the date the notice Is delivered or mailed within which Borrower mu sr pay all sums secured by Ihis SamFity Instrument. 118orrower fails to pay these sums prior To the expiration of this period, Lender may Invoke arty remedies permitted by this Security Instrument without further notice or demand on Borrower. ... ed. up OR 4504 PG 761 1e. Borrowers Rlg hi to Reinstate. If Borrower meets certain conditions, Borrower shall have the right to have enforcement of this Security tnstrument discontinued at any time prior io me earlier of : (a) 5 days (or such other period as applicable law may specify for reinslalement) before sale of Ne Property pursuant to any power of sale contained in this Secudly instrument. or (b) entry of a judgment enfurcing this Security Instrument. Those conditions are that Borrower: (a) pays Lender ah sums which then would be due under this Security Instrument and the Note as if no acceleration had occurred; (b) cures and default of any other covenants or agreements: (c) pays all expenses Incurred in enforcing this Security InslnlMen' , Inducing, but not Ilmlted to, toasonabfe attometrsfees; and (d) takes such action as L"der may re a sona bly require to assure Ihat the lien of this Security Instrument, Lenders rights in the Property and Borroweesobligation to pay the sums secured by this Security Instrument shall Continue unchanged. Upon reinstatement by Borrower, this Security Instrument and the obligations secured hereby shall remain fully effective as if no acceleration had occu red. However, this right to roinatato shall not apply In the rase of acceleration under paragraph 17. 14. Sale of Note; Change of Loari Servicer. The Note ora partial interest in the Note (togaNerwith this Security Instrument) may be sold one or more times without prier notice to Borrower. A sale may result in a change in the entity (known as the "Loan Servicer) that collecls monthly payments due under the Nola and this Security instrument. There also may be one or more changes rR the Loan Servicer unrelated to a sale of the Note. if there is a change of the Loan Servioer, Borrower will be given written nolice of the change in accordance with paragraph 14 and applicable law. The notice will state the name and address of trio new Loan Servicar and the address to which payments should be made. The notice will also contain any other Inlomhation required by applicable law. 20. Hazardous Substances. Borrower shall not cause or permit the presence, use, disposal, storage, or release of any Hazardous Subsiances on or in the Property. Borrower shall not do, nor allow anyone else to cid, anything affecting the property that is In violallon of any Environmental Lew. The preceding two sentences shall not apply to tha presence, use, or storage on the Property of smart quantities of Hazardous Substances that are generally recognized to be appropriate to normal rasidentlal uses and to main lenence of the Property. Bempwer shall promptly give Lender wrllien notice for any investigation, claim, demand, lawsuit or Other action by any governmental or regulatory agency or pdvate party involving the Property and any Hazardous Substance or Envlronmenlal Law of which Borrower has actual knowledge. I10orrowerIsame, of Is notified by arty governmental or regulalory authority, that any removal or other remediation of any Hazardous Substance affecting the Property is necessary, Borrower shall promptly lake all necessary remedlat actions in accordance with Environmental Law. As used In this paragraph 20. "Hazardous Substances" are those substances defined as toxic or hazardous substances by Environmental Law and the foil ovnng substances: gasoline,, k�[gs¢rtg otharflammable or toxic petroleum products, toodCpasticldes and herbicides, volatile sotvenls, materials containing asb stolf-dma�Ideh e,.."dio"ve materials. As used in this paragraph 20, "Environmental Law' means federal laws and of �1u�5gicSRp, � ihparty to located that relate to health, safety or environmental protection. 21. Acceleration; Remedios. / ve notice m Borrowed'r leration foltowing Borrowers breach of any covenant or agreement in this Seco ity,lh (bul not prior to acceleration der raph 17 unless applicable law pmvldes otherwise). The notice shall specity, ( he t; (b) the action required to cure the d ull: (c) dale, not less than 30daysiromthe dale the notice Is given to Borrovrer, by r1In the d a lilRtlS �rrred; and (d) [hat failure to �e Ne fault on or befora the date spedred in the notice may result N acceleraao or the m semrad by bylAiszewri llnst meat, fore nsure Judicial proceeding and sale of the Property. The nolice shall }urther nfarm orrow�oFtih�nght to reinstate Tl acceleratl and a right to assert in the foreclosure preceding the non -ejer" a of a fault any other defenf h1 o werto a oration and re re. If the default Is net cured on or before the date specified in the n Lice, re full all sums secured by this Security Instrument without further demon and To do !s Iy S t by ca ing. nder shall be entitled to col fact all expenses incurred In pursuing N fame s vided Thi par gra 1, I ng, t limit dto, r asonabls attorneys fees and costs of the elle evidence. 22. Release. Vponpa d i a ri trume an sottisSecurity Instrument, %9MouI charge, to Borrower. Borrower sh Q y ny dalion 23. Attomays' Fees. used l this Security Instrument and the ,'alto 're ssrr� include any aaomeW fees awarded by an appellate Court. r-�� 24. Riders to this Sacurlant None er more riders aree d B "�k d recorded together with this Security Instrument, the covenants anti agree s ch such rider shall be incorpora � ,fSa�' end and supplement the covenants and agreements of this Security instrument fie^'� or(s) were a part of this Security In �cl! heck Applicable Box) ❑ Adjustable Rale Rlder `Jn ❑ Rate Imp ( It ❑ Condominium Rider ❑ Graduated Payment Rider rrT� ` rs'daPa7sIder' ❑ Second Home Rider ❑ Balloon Rider mree :ry Payment Rider ❑ Planned unit Development Rider ❑ Other(s) (specify SIGNING 8ELOW. Borrower a and agrees 10 the terms and covenants contained in this Severity Instrument and in any nder(s) executed by Borrower and rerdetl 4th il. Signed, sealed and delivered in the @son Witness Signature! Signature: alllll&!59�.Z� 1 � Borrower / jaeon F. kq.x&/ Witness Print C f Signature: Borrower Wlness hgnalu Witness t Name: Address: 4473 28u` Place SW Naples, RL 34115 STATE OF FLORIDA COUNTY OF COLLIER I hereby certify Ihat on this day, before me, an ortOer duly authorized in the State aforesaid and in the county aforesaid Id take accnowledgemems, personally appeared Jason P. Gore to me known to be the parson(s) described in and who executod the foregoing instrument and acknowledged before me that HEI SHE/ THEY execuled the same for the purpose therein expressed. W ITNESS my hand and official seal In the County and Slate �re id Nis day , z0�, J Ally Commission Expires: „ �d-p DONALD IC ROSS, A MY COMMiSSQN 1 DD 7001501 EVIRFS; October 7, 2011 Bondly i7w Notify Pt* Viklanrrllers SonntagKristi From: CarnellSteve Sent: Monday, January 8, 2018 5:13 PM To: LopezMaggie; SonntagKristi; KemnerCynthia; GiblinCormac; PelletierLouise; HutchinsonBarbetta Cc: GrantKimberley; HenryTodd; CallahanSean Subject: CHS Operations This Week In follow up to our discussion today regarding Kim's absence, the assigned authorizations to act on behalf of her this week are as follows: MAGGIE LOPEZ: • Payroll Time • Purchase Requisitions • P -card transactions • Position postings (in section) CYNTHIA KEMPER: • Respond to single audit inquiries (copy Steve and Kim) • Position postings (in section) CORMAC GIBLIN: • Impact fee deferrals • Re -scheduling of Friday meeting with IBTS • Position postings (in section) KRISTI SONTAG: • Pay requests for all grant programs • Minute Trak agenda items • Check endorsements and subordinations %�7 • Project environmentals • Position postings (in section) LOUISE PELLETIER: • Unclaimed burials (co-sign with Steve) • Position postings (in section) As referenced above, please forward any approved position postings to me directly. Should other HR -related actions arise that require immediate attention, please reach out to me. We will re -visit the status of this arrangement on Friday. Thank you, Steve 1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines # 1 through #2 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the exception of the Chairman's signature, draw a line through routine lines # 1 through #2, complete the checklist, and forward to the County Attorney Office. Route to Addressees (List in routing order) Office Initials Date 1. Elizabeth Hernandez CHS Initial y / $ 2. Jennifer Belpedio County Attorney OfficeIs) dis S 3. BCC Office Board of County Commissioners q5) N/A NOTE: Clerk's attestation is not required. Please do not route this item to Clerk's Board Minutes and Records. CAO please scan document after execution by Chairman and email them to Clerk's Minute and Records for its records. PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above. may need to contact staff for additional or missing information. Name of Primary Staff Elizabeth Hernandez, CHS Phone Number 239-252-2338 Contact / Department a ro riate. Initial Applicable) Agenda Date Item was 06/12/2012 Agenda Item Number Approved by the BCC Does the document need to be sent to another agency for additional signatures? If yes, N/A Type of Document Insurance Claim Check Endorsement for Number of Original 1 check Attached Angel Cabrera Documents Attached N/A PO number or account signed by the Chairman, with the exception of most letters, must be reviewed and signed number if document is N/A to be recorded All handwritten strike -through and revisions have been initialed by the County Attorney's N/A INSTRUCTIONS & CHECKLIST I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12 Initial the Yes column or mark "N/A" in the Not Applicable column, whichever is Yes N/A (Not a ro riate. Initial Applicable) 1. Does the document require the chairman's original signature? 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A provide the Contact Information(Name; Agency; Address; Phone on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be N/A signed by the Chairman, with the exception of most letters, must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike -through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's ^ aa signature and initials are required. 0.� 7. In most cases (some contracts are an exception), the original document and this routing slip N/A should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 06/12/2012 and all changes made during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes, if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the n BCC, all changes directed by the BCC have been made, and the document is ready for the �J1> Chairman's signature. I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12 r 'MPeG uo sllsle0 /{-1 'PaPnlaui inleej,Qji—S _...-.._ t 5� T, c N ad z to zm U) � U3 LL W' w m 2 H } z j.. z < K N LL m Q g w V � � .ctwo J LL Z F a Z n W U ir ;. J Q a m Im w ... N C C � m o rn c o N 3 z c m o w r LL Lu Q N J ul W .J I- P. LU l�i.f H- Z�X00' 0= Ln O Ln O O .-a .a Lo O -7 i t -f Memorandum To: Kimberly Grant, CHS Director CC: Jennifer Belpedio, Assistant County Attorney From: Elizabeth Hernandez, Grant Support Specialist, Community and Human Services Date: June 1, 2018 Re: Homeowner Insurance claim check endorsement -Angel Cabrera 769 Waterloo Court, Naples, FL 34120 The Homeowner Insurance Check Endorsement Policy approved by the Board on June 12, 2012 (16.D.10) authorizes the Board Chairman or Vice Chairman to endorse homeowner insurance claim checks for recipients assisted with Purchase Assistance and/or rehabilitation program funds as Collier County is named as Second Mortgagee on their insurance policies. The attached check in the amount of $14,668.81 is for disbursement of the claim funds requiring endorsement by Board Chairman Solis or Vice Chairman. The check names Fifth Third Bancorp as the first mortgage lender and Collier County SHIP as subordinate lien holder. In order for the check to be properly processed, proper signatures/endorsement for all parties listed on check must be obtained. This is a time -sensitive item and must be endorsed as soon as possible as homeowner is waiting to pay for work to be performed on home. Attachments: Homeowners Insurance Policy -Declaration Page Insurance Claim Check (#127171, $14,668.81) Insurance Claim Report & photos of damage Collier County Second Mortgage 1 Collier County Community and Human Services Division (CHS) Homeowner Insurance Check Endorsement Policy Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage/lien, then the loan will not have to be repaid. On occasion, the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and receive money to make the repairs. If the insurance claim check is made payable to the homeowner and Collier County, then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to CHS at the address below for check endorsement consideration: 1. Copy of Homeowner's current insurance policy -Declaration Page. 2. Copy of insurance company's claim report with worksheet including description of repairs and costs. 3. Copy of photos of claim damage. 4. Copy of Insurance check(s) payable to homeowner, first lien holder and Collier County. Homeowner Name: Angel Cabrera Homeowner Address: 769 Waterloo Court, Naples, FL 34120 Primary Contact Number Homeowner Email: CH - Grant Coordinator 786-499-6072 OFFICE USE ONLY C 7: �V - - _�� CHS Director w l Da e Date Reviewed Approved Denied a Homeowners Declaration Page Named Insured: ANGEL CABRERA 769 WATERLOO CT NAPLES, FL 34120 Effective Date of This Transaction Activity of This Transaction: Residence Premises: 769 WATERLOO CT NAPLES, FL 34120 2/14/2018 Add Optional Coverage PROGRESSIVE PROPERTY INSURANCE CORP 1 ASI Way St. Petersburg, FL 33702 Total Policy Premium: $1,516 Policy Number: ARK105460 Agent: Brightway Insurance P.O. Box 5700 Jacksonville, FL 32247 Agent Code: 418771 For Policy Service, Call: (888)254-5014 Policy Period: From: 01/04/2018 To: 01/04/2019 (At 12:01 AM Standard Time at the residence premises) Plan Type: H03 Coverage at the residence premises is provided only where a limit of liability is shown or a premium is stated. Coverages and Limits of Liability Limit Premium SECTION I: A. Dwelling Coverage $255,000 4389.40 B. Other Structures $2,550 -12.89 C. Personal Property $63,750 -127.08 D. Loss of Use $25,500 Included SECTION II: E. Personal Liability - Each Occurrence $300,000 15.00 F. Medical Payments to Others - Each Person $5,000 10.00 OTHER COVERAGES AND ENDORSEMENTS: (Printed on the following page) Deductibles: HURRICANE: 2%-$5100 ALL OTHER COVERED PERILS: $2500 Mortgagee: 1st Mort¢aeee• FIFTH THIRD BANCORP ISAOA/ATIMA PO BOX 598 Amelia, OH 45102 Loan #0416568988 Escrow: Yes 2nd Morteazee: COLLIER COUNTY- SHIP HOUSING HUMAN AND VETERAN SERVICES 3339 E TAMIAMI TRAIL BLDG H. RM 211 NAPLES, FL 34112 Loan #TBD Countersigned by Authorized Representative St. Petersburg, Florida Date: 02/14/2018 ASI HO FL DEC 08 16 The ASI Group is an affiliate of The Progressive Corporation Page 1 of 2 Named Insured(s): ANGEL CABRERA Policy Number: ARK105460 Other Coverages And Endorsements: Form Number Limit Premium Catastrophic Ground Cover Collapse Coverage ASI HO 09 CG 08 12 Table Of Contents ASI HO 09 COV 0198 Hurricane Deductible Endorsement ASI HO 09 HD 05 05 Homeowners Policy Outline ASI HO 09 OTL 01 10 Special Provisions For Florida ASI HO 09 SP 08 12 Ordinance or Law Coverage Notification ASI HO FL OLR 08 16 Homeowners3 Special Form HO 00 03 04 91 Home Day Care Explanation HO 04 96 04 91 BCEG -129.34 Tier Factor Premium -357.59 Burglar Protection ASI HO 09 PA 06 07 -67.26 Windstorm Loss Reduction -958.41 NHR Deductible 2500 -371.51 HUR Deductible 5100 -140.78 Ordinance or Law ASI HO FL OL 08 16 25500 170.28 Limited Screen Enclosure/Carport Coverage ASI HO 09 WSE 12 07 10000 144.90 PC / Construction Factor -625.60 Limited Fungi,Mold,Wet/Dry Rot ASI HO 09 FCE 0105 $10,000 Included Age of Dwelling -358.26 Number of Stories -91.45 Fees and Assessments: Managing General Agent Fee 25.00 Emergency Management Preparedness Assistance Fee 2.00 Scheduled Items: Category Description of Property Value Premium The Hurricane Coverage portion of your Total Premium is: $570 The Non -Hurricane Coverage portion of your Total Premium is: $946 Additional Insured: Additional Interest: Interest: Rating Information: Construction Type: Masonry Type of Residence: Single Family Total Square Feet: 1,950 Year Built: 1998 ASI Territory: 464C Roof Year: 1998 County: COLLIER Notes: Added O&L 10% per signed form. Page 2 of 2 The ASI Group is an affiliate of The Progressive Corporation ASI HO FL DEC 0816 I N S U R A N C E March 13, 2018 ANGEL CABRERA 769 WATERLOO CT NAPLES FL 34120 Re: Claim Number: 488091-171011 Policy Number: ARK105460 Date of Loss: September 9, 2017 Date Reported: September 12, 2017 Underwriting Co: Ark Royal Insurance Company Insured Location: 769 Waterloo CT Naples, FL 34120 Dear Angel Cabrera: This letter is in response to the claim you submitted to Ark Royal Insurance Company on the above referenced policy and loss address for the peril of Wind. We have received the inspection report from the independent adjusting firm in regards to the reported damage to your property for this loss. Attached is the estimate prepared by the inspecting adjuster. No other damage has been reported or identified. Please notify our office immediately if our understanding of your loss is incorrect in any way. Enclosed is our check in the amount of $14,668.81 and a copy of the estimate of damage. A recap of the claim is as follows: Coverage Damage A -Dwelling $16,619.91 B -Other Structures $4,164.07 Gross Claim $20,783.98 Prior Payments ($1,075.17) Policy Deductible ($5,040.00) Net Payment $14,668.81 We have received the second adjusters estimate regarding the reported damage to your property for this loss, and he advised the roof was repairable. We also sent an engineer to your home to investigate the cause and origin of the damages to the dwelling. The engineer report revealed wind damage to the roof covering involved approximately 20 cap tiles, and 29 field tiles. The engineer states that the amount of damage is only 3 percent of the overall roof area and the engineer also determined the wind damage to your roof was repairable. The engineer's report also documented 42 field roof tiles that had been previously replaced with a different surface color then the rest of the roof. P.O. Box 20089 • St. Petersburg, FL 33742 Phone: (866) 274-5677 • Fax: (866) 840-1905 • www.AmericanStrategic.com Page 1 of 6 ARK ROYAL I N S U R A N C 1 (b) Less than $2500; we will settle the loss according to the provisions of b.(1) and b.(2) above whether or not actual repair or replacement is complete. If a total loss, we will pay the replacement cost amount without deduction of depreciation. A claim supplement is a request for an additional payment on a claim. Our goal is to address any claim supplement requests as soon as possible. If your contractor discovers additional damage not reported on our initial estimate, we may request your assistance in gathering the information needed to address the claim supplement. If a claim supplement is requested, you or your contractor may be asked to provide the documents listed below via email to cat _asicorg.org along with any claim supplement request details. Once received, the documents will be reviewed for consideration of payment. Claim supplement documents include: 1. A copy of your contractor's itemized estimate and invoice(s) including unit costs and quantities. 2. A comparison of the Ark Royal Insurance Company estimate and your contractor's estimate. This comparison should detail each item that does not match and the reason for the difference in cost. 3. Color photographs of damage relating to all requested supplement items. Each photograph should include a description caption. 4. Copies of any paid invoices or receipts. 5. Supplemental items requested because of building codes, ordinances, or building requirements should include a copy of the local ordinance detailing the governing building department's requirements. The Recoverable Depreciation, if any, that has been applied to this loss means that once the repairs have been completed you will need to submit itemized receipts or invoices from your contractor along with a signed contract showing that those repairs have been finished and the actual cost of such repairs. The Non-recoverable Depreciation, if any, that has been applied to this loss means that once the repairs have been completed the depreciation isnot recoverable. This type of depreciation is typically applied to fences and other structures. There may be a condition, limitation or provision in your policy concerning the application of Non - Recoverable Deprecation as it pertains to this loss. Your policy provides for the actual cost of the repairs less your deductible and any non-recoverable depreciation up to the amount of coverage. Should the actual repairs be less than our estimated costs the final payment due, if any, will be based on the actual cost incurred to repair or replace your property. If your mortgage holder has been listed as a payee on your check, please understand we are obligated to do so under the terms of your policy. Please contact the claims department of your mortgage company to inquire as to their procedure for disbursement of the settlement funds. Your policy contains conditions, limitations, or provisions that limits coverage for the following items reported as damaged under this claim: P.O. Box 20089 • St. Petersburg, FL 33742 Phone: (866) 274-5677 • Fax: (866) 840-1905 • www.AmericanStrategic.com Page 3 of 6 I N S U R A N C E 1. Ordinance or Law, meaning any ordinance or law: a. Requiring or regulating the construction, demolition, remodeling, renovation or repair of property, including removal of any resulting debris. This exclusion 1.a. does not apply to the amount of coverage that may be provided for under the ADDITIONAL COVERAGE of Glass or Safety Glazing Material for ordinance or law, or to the limits you purchased of Ordinance or Law coverage; b. The requirements of which result in a loss in value to property; or c. Requiring any "insured" or others to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, pollutants. Pollutants means any solid, liquid, gaseous or thermal irritant or contaminant, including but not limited to smoke, vapor, soot, fumes, acids, alkalis, chemicals, and waste. Waste includes but is not limited to materials to be recycled, reconditioned or reclaimed. 11. Existing Damage a. Damages which occurred prior to policy inception regardless of whether such damages were apparent at the time of the inception of this policy or discovered at a later date; or b. Claims or damages arising out of workmanship, repairs or lack of, which occurred prior to policy inception. Because of this policy language, we are unable to provide coverage or issue payment for the above stated limitation(s) and/or exclusion(s) for this loss. Ark Royal Insurance Company's position set out above is based upon the information we have to date. Should you have any other information that you would like for Ark Royal Insurance Company to consider or that you feel would affect Ark Royal Insurance Company's coverage investigation and subsequent coverage decision in this matter, please do not hesitate to send that information directly to me as soon as possible. Furthermore, should there be a dispute in the amount of damages due to a covered loss as provided by the policy or if there are any damages discovered during in the covered reconstruction and repair of the above mentioned property, you can submit supplemental claims. I will be happy to review the information and reevaluate the decision in this matter as necessary. P.O. Box 20089 • St. Petersburg, FL 33742 Phone: (866) 274-5677 • Fax: (866) 840-1905 • www.AmericanStrategic.com Page 5 of 6 / 600� 0 ARK. ROYAL I N S U R A N C E March 14, 2018 ANGEL CABRERA 769 WATERLOO CT NAPLES FL 34120 Re: Claim Number: 488091-171011 Policy Number: ARK105460 Date of Loss: September 9, 2017 Date Reported: September 12, 2017 Underwriting Co: Ark Royal Insurance Company Insured Location: 769 Waterloo CT Naples, FL 34120 Dear Angel Cabrera: The Chief Financial Officer for the State of Florida has adopted a rule to facilitate the fair and timely handling of residential property insurance claims. The rule gives you the right to attend a mediation conference with your insurer in order to settle any claim you have with your insurer. An independent mediator, who has no connection with your insurer, will be in charge of the mediation conference. You can start the mediation process after receipt of this notice by calling the Department of Financial Services at (877) 693-5236. The parties will have 21 days from the date of the notice to otherwise resolve the dispute before a mediation hearing can be scheduled. If after you start the mediation process as explained above, and the claim is not settled within 21 days, either party may then request Department of Financial Services to schedule a mediation hearing. The mediation hearing must be requested by contacting the Department of Financial Services using one of the methods indicated below: • By Online Request: hftps://apps.fldfs.com/ESERVICE/mediationlnfo.aspx • By Telephone: Consumer Helpline 1 -877 -MY -FL -CFO (1-877-693-5236) • By TDD line: 1-800-640-0886 • For Out of State Callers: (850) 413-3089 • By Fax: Attn Mediation Section (850) 488-6372 • By Mail: Florida Department of Financial Services Mediation Section Bureau of Education Advocacy and Research 200 East Gaines Street Tallahassee, Florida 32399-0322 P.O. Box 20089 • St. Petersburg, FL 33742 Phone: (866) 274-5677 • Fax: (866) 840-1905 • www.AmericanStrategic.com Page 1 of 6 ASI Insured: Cabrera, Angel Property: 769 WATERLOO CT NAPLES, FL 34120 Home: 769 WATERLOO CT NAPLES, FL 34120 Claim Rep.: Genny Busbice Estimator: Genny Busbice Reference: Catatrophe Team Four Position: ASI ADJUSTER Company: ARK ROYAL INSURANCE Business: 1 ASI WAY ST PETERSBURG, FL 33702 Home: (407) 508-0333 Business: (866) 274-5677 Business: (866) 274-5677 Business: (727) 456-1673 Claim Number: 488091-171011-125040 Policy Number: ARK105460 Type of Loss: Wind Damage Date Contacted: 2/27/2018 Date of Loss: 9/9/2017 1:00 PM Date Received: 9/12/2017 Date Inspected: 3/1/2018 3:00 PM Date Entered: 9/16/2017 6:47 PM Date Est. Completed: 3/14/2018 7:32 PM Price List: FLNA8X_MAR18 Restoration/Service/Remodel Estimate: CABRERA ANGEL1111 Dear ASI Policyholder, The estimate attached reflects the cost to repair the known damages to your property. Please review the estimate and note the Dwelling Summary page, which shows the total damages, including sales tax and your deductible. If you hire a general contractor to make the repairs, you should provide your contractor with a copy of the estimate. Job -Personnel Overhead/Sub contractor overhead and profit expense is included in your estimate under the Labor Overhead portion of each unit price. No supplement or other payments will be issued for any repairs not listed in the estimate without prior authorization. Approval must be given by ASI prior to the replacement or repair of any additional items. ASI must have the opportunity to view the additional damages or proposed changes prior to the initiation of further work. If there is a mortgage holder included on the policy, by law the mortgage holder must be included on the payment. You must contact the mortgagee to secure endorsement of the check. Regards, ASI Claims Department ASI Right Elevation DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 13. General Laborer - per hour 2.00 HR 32.58 0.00 13.69 78.85 (0.00) 78.85 To straighten frame around pool enclosure door 14. General Laborer - per hour 2.00 HR 32.58 0.00 13.69 78.85 (0.00) 78.85 To fix sliding glass door Totals: Right Elevation 0.00 27.38 157.70 0.00 157.70 Rear Elevation DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 15. Tree - removal - 12" to 24" diameter/ 1.00 EA 1,141.52 0.00 239.72 1,381.24 (0.00) 1,381.24 large canopy To remove tree from structure 16. Tree - tear out and disposal - 12" to 24" 1.00 EA 689.25 0.00 144.75 834.00 (0.00) 834.00 diameter For tree disposal Totals: Rear Elevation 0.00 384.47 2,215.24 0.00 2,215.24 Left Elevation DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 17. General Laborer - per hour 2.00 HR 32.58 0.00 13.69 78.85 (0.00) 78.85 To straighten frame around pool enclosure door Totals: Left Elevation 0.00 13.69 78.85 0.00 78.85 Den -12'2" 11'6" t2'2^11'6" i Den F 0pI r 1 SKETCH2 Main Level 296.00 SF Walls 376.50 SF Walls & Ceiling 8.94 SY Flooring 37.00 LF Ceil. Perimeter Height: 8' 80.50 SF Ceiling 80.50 SF Floor 37.00 LF Floor Perimeter DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV CABRERA ANGEL1111 3/14/2018 Page:3 ASI Line Item Totals: CABRERA_ANGEL1111 Grand Total Areas: 296.00 SF Walls 80.50 SF Floor 0.00 SF Long Wall 80.50 Floor Area 357.00 Exterior Wall Area 3,076.67 Surface Area 39.00 Total Ridge Length 271.52 3,607.22 20,783.98 1,183.54 19,600.44 80.50 SF Ceiling 8.94 SY Flooring 0.00 SF Short Wall 93.28 Total Area 39.67 Exterior Perimeter of Walls 30.77 Number of Squares 188.71 Total Hip Length 376.50 SF Walls and Ceiling 37.00 LF Floor Perimeter 37.00 LF Ceil. Perimeter 296.00 Interior Wall Area 238.00 Total Perimeter Length Coverage Item Total % ACV Total % Dwelling 16,619.91 79.97% 15,646.37 79.83% Debris Removal 0.00 0.00% 0.00 0.00% IRC - Dwelling 0.00 0.00% 0.00 0.00% Other Structures 4,164.07 20.03% 3,954.07 20.17% Debris Removal 0.00 0.00% 0.00 0.00% IRC - Other Structures 0.00 0.00% 0.00 0.00% Personal Property 0.00 0.00% 0.00 0.00% Debris Removal 0.00 0.00% 0.00 0.00% Loss of Use 0.00 0.00% 0.00 0.00% Liability 0.00 0.00% 0.00 0.00% Medical Payment 0.00 0.00% 0.00 0.00% Ordinance Or Law 0.00 0.00% 0.00 0.00% Trees and Shrubs 0.00 0.00% 0.00 0.00% Debris Removal 0.00 0.00% 0.00 0.00% Fire Department 0.00 0.00% 0.00 0.00% Loss Assessment 0.00 0.00% 0.00 0.00% Credit Card, EFT Card, and Counterfeit 0.00 0.00% 0.00 0.00% Money Scheduled Property 0.00 0.00% 0.00 0.00% Single PHA Deductible 0.00 0.00% 0.00 0.00% HUR Deductible 0.00 0.00% 0.00 0.00% NHR Deductible 0.00 0.00% 0.00 0.00% Total 20,783.98 100.00% 19,600.44 100.00% CABRERA ANGEL1111 3/14/2018 Page:5 ASI Line Item Total Material Sales Tax Subtotal Overhead Profit Replacement Cost Value Less Depreciation Actual Cash Value Less Deductible Net Claim Total Depreciation Less Residual Deductible Total Recoverable Depreciation Summary for Other Structures [Full Deductible = 4,164.07] Net Claim if Depreciation is Recovered Genny Busbice 3,378.37 63.00 3,441.37 344.14 378.56 $4,164.07 (210.00) $3,954.07 (3,954.07) $0.00 210.00 (210.00) 0.00 $0.00 CABRERA ANGEL1111 3/14/2018 Page:7 ASI Summary for Dwelling Line Item Total 13,526.87 Material Sales Tax 208.52 Subtotal 13,735.39 Overhead 1,373.56 Profit 1,510.96 Replacement Cost Value $16,619.91 Less Depreciation (973.54) Actual Cash Value $15,646.37 Less Deductible (875.93) Less Prior Payment(s) (1,075.17) Net Claim Remaining $13,695.27 Total Recoverable Depreciation 973.54 Net Claim Remaining if Depreciation is Recovered $14,668.81 Genny Busbice CABRERA_ANGEL1111 3/14/2018 Page:6 ASI CONTINUED - Den DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 18. R&R 5/8" drywall - hung, taped, 8.00 SF 2.45 0.25 4.18 24.03 (0.83) 23.20 floated, ready for paint 179.92 (0.00) 179.92 including dump fees 29. Content Manipulation charge - per 4.00 HR 32.58 19. Batt insulation - 6" - R19 - unfaced 8.00 SF 0.75 0.24 1.31 7.55 (0.82) 6.73 batt 2.74 130.00 748.90 7.54 741.36 Total: SKETCH2 2.74 20. Mask and prep for paint - plastic, 37.00 LF 1.36 0.51 10.68 61.51 (1.70) 59.81 paper, tape (per LF) 21. Seal the surface area w/latex based 80.50 SF 0.61 0.34 10.38 59.83 (1.13) 58.70 stain blocker - one coat 22. Paint the ceiling - two coats 80.50 SF 0.94 0.92 16.08 92.67 (3.06) 89.61 23. Haul debris - per pickup truck load - 1.00 EA 148.69 0.00 31.23 179.92 (0.00) 179.92 including dump fees 24. Final cleaning - construction - 80.50 SF 0.23 0.00 3.89 22.41 (0.00) 22.41 Residential 25. Drywall Installer / Finisher - per 1.00 HR 75.41 0.00 15.84 91.25 (0.00) 91.25 hour 26. Floor protection - plastic and tape - 80.50 SF 0.30 0.48 5.18 29.81 (0.00) 29.81 10 mil Totals: Den 2.74 98.77 568.98 7.54 561.44 General DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 27. Haul debris - per pickup truck load - 1.00 EA 148.69 0.00 31.23 179.92 (0.00) 179.92 including dump fees 29. Content Manipulation charge - per 4.00 HR 32.58 0.00 27.37 Totals: General 0.00 31.23 179.92 0.00 179.92 Total: Main Level 2.74 130.00 748.90 7.54 741.36 Total: SKETCH2 2.74 130.00 748.90 7.54 741.36 Other Structures DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 28. R&R Storage shed - Vinyl - Gable type 1.00 EA 1,547.60 63.00 338.23 1,948.83 (210.00) 1,738.83 -10'x8' 29. Content Manipulation charge - per 4.00 HR 32.58 0.00 27.37 157.69 (0.00) 157.69 hour Totals: Other Structures 63.00 365.60 2,106.52 210.00 1,896.52 CABRERA ANGEL1111 3/14/2018 Page:4 ASI Roof CABRERA ANGELIIII SKETCHI Main Level 3076.67 Surface Area 30.77 Number of Squares 238.00 Total Perimeter Length 39.00 Total Ridge Length 188.71 Total Hip Length DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 1. Remove Tile roofing - Concrete - "S" 8.24 EA 12.18 0.00 21.08 121.44 (0.00) 121.44 or flat (per TILE) 14,121.90 849.87 13,272.03 Total: SKETCHI 170.25 2,450.92 14,121.90 2. Tile roofing - Concrete - "S" or flat 9.43 SQ 597.62 89.06 1,202.18 6,926.80 (519.53) 6,407.27 tile Actual number of wind damaged field tiles is 29 and 20 additional cap tiles. This allowance is for replacing the rear slope with 15% added for waste. 18.33 105.55 (11.51) 94.04 11. Additional charge for a retrofit 1.00 EA 187.24 3. R&R Ridge / Hip / Rake cap - the 136.00 LF 16.50 56.63 483.13 2,783.76 (330.34) 2,453.42 roofmg 12. Prime & paint door slab only - 1.00 EA 43.41 4. Bird stop - Eave closure strip for tile 23.00 LF 4.95 3.22 24.58 141.65 (0.00) 141.65 roofing - clay Totals: Front Elevation 5. Hip & ridge nailer board for file 272.00 LF 3.03 18.93 177.05 1,020.14 (0.00) 1,020.14 roofing - wood 3/14/2018 Page:2 6. R&R Drip edge 60.00 LF 2.78 2.41 35.54 204.75 (0.00) 204.75 7. Roofer -per hour 16.00 HR 151.00 0.00 507.36 2,923.36 (0.00) 2,923.36 Allowing for 30 hours of labor to harvest rear slope of 824 sq ft. Totals: Roof 170.25 2,450.92 14,121.90 849.87 13,272.03 Total: Main Level 170.25 2,450.92 14,121.90 849.87 13,272.03 Total: SKETCHI 170.25 2,450.92 14,121.90 849.87 13,272.03 Front Elevation DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 8. R&R Gutter / downspout - aluminum - 24.00 LF 7.63 6.96 39.92 230.00 (23.18) 206.82 6" 9. R&R Exterior door - double - metal - 1.00 EA 586.64 24.43 128.32 739.39 (81.44) 657.95 insul. - flush or panel 10. Door lockset & deadbolt -exterior 1.00 EA 83.77 3.45 18.33 105.55 (11.51) 94.04 11. Additional charge for a retrofit 1.00 EA 187.24 0.00 39.32 226.56 (0.00) 226.56 exterior door 12. Prime & paint door slab only - 1.00 EA 43.41 0.69 9.27 53.37 (0.00) 53.37 exterior (per side) Totals: Front Elevation 35.53 235.16 1,354.87 116.13 1,238.74 CABRERA ANGEL1111 3/14/2018 Page:2 ASK ROYAL` INSURANCE In your request for mediation you should include the following: 1. Your name, address, daytime phone number, and e-mail. Similar contact information for any other named insured. 2. The location of the property that is at issue, if it is different than your address. 3. The claim number we have assigned to your claim, as well as your insurance policy number. 4. A brief description of your claim and the nature of the dispute. 5. Your insurer name, its address, phone number, and person designated by your insurer as the contact for scheduling mediation. For reference this information is: Insurance Company: Ark Royal Insurance Company P.O. Box 20089 St. Petersburg, Florida 33742 Contact person: Genny Busbice E-mail: gbusbice@asicorp.olrg Phone: (866) 274-5677, Extension 1602 6. Information with respect to any other policies of insurance that may provide coverage of the insured property for named perils such as flood or windstorm. If we are unable to settle the claim after 21 days expire from your receipt of this notice, the Department Administrator will select the mediator. Either party may disqualify a mediator for good cause. Good cause consists of conflict of interest between a party and the mediator, that the mediator is unable to handle the conference competently or other reasons which would reasonably be expected to impair the conference. Complaints concerning a mediator shall be in writing and submitted to the Department of Financial Services at the address referenced above. Additionally, Florida Administrative Code, Rule 69J -166.031(8)(c)(1) requires that the insured and insurer attend the mediation conference, have full knowledge of the facts of the dispute, and be fully authorized to make an agreement to completely resolve the claim. You may also bring to the conference persons who may assist you in presenting your claims. Should you chose to do so, you are required to notify the mediator of your intention 14 (fourteen) days prior to the scheduled conference, unless we agree otherwise. Please also note that the mediation proceedings are confidential and inadmissible in any subsequent adversarial proceeding. You will be notified in writing by the mediator of the exact date, time, and location of the mediation conference. Sincerely, P.O. Box 20089 • St. Petersburg, FL 33742 Phone: (866) 274-5677 • Fax: (866) 840-1905 • www.AmericanStrategic.com Page 2 of 6 I N S U €i A N C E Please do not construe this letter or any act or failure to act on the part of Ark Royal Insurance Company, or any agent or representative of Ark Royal Insurance Company, as a waiver of any rights or defenses available to it by contract or at law as all such rights and defenses are hereby specifically reserved. Should you have any questions or additional information regarding this claim, please contact the undersigned at 866- 274-5677 ext. 1602, via email at gbusbice@asicorp.olrg, fax at (866) 840-1905 or U.S. Mail at P 0 Box 20089, St. Petersburg, FL 33742. Sincerely, A / / Genny Busbice CAT Supplement Adjuster Office: (866) 274-5677 ext. 1602 Fax: (866) 840-1905 gbusbice@asicorp.org P.O. Box 20089 - St. Petersburg, FL 33742 Phone: (866) 274-5677 - Fax: (866) 840-1905 - www.AmericanStrategic.com Page 6 of 6 E I N S U R A N C l • The deteriorated condition of the roof covering from result of normal wear and aging. • Workmanship deficiencies associated with the installation or repair of the roof assembly. • The deteriorated roof sheathing above the living room that was determined to be long-term, repetitive, and ongoing. • Roof leaks that were not the result of a storm created opening. • Anything required by the state of Florida due to code or ordinance. • Cracks in roof tiles caused by shrinkage or expansion. Ark Royal Insurance Company provides your property coverage under Policy Number ARK105460 effective from January 4, 2017 to January 4, 2018. Your policy provides all risk coverage for your dwelling and named peril coverage for unscheduled personal property under HO 00 03 04 91 - Homeowners3 Special Form, amended by ASI HO 09 SP 0812 - Special Provisions For Florida, subject to limitations and exclusions, that in part state the following: AGREEMENT In reliance on the information you have given us, we agree to provide the insurance coverages indicated on the Policy Declarations. In return, you must pay the premium when due and comply with the policy terms and conditions and immediately inform us of any change of title, use or occupancy of the "residence premises" PERILS INSURED AGAINST Coverage A — Dwelling and Coverage B — Other Structures: We insure against risk of sudden and accidental direct physical loss to property described in Coverages A and B only if that loss is a physical loss to property; however, we do not insure for loss: 2. Caused by: e. Any of the following: (1) Wear and tear, marring, deterioration; (2) Inherent vice, latent defect, mechanical breakdown; (6) Settling, shrinking, bulging or expansion, including resultant cracking, of pavements, patios, foundations, walls, floors, roofs or ceilings; 3. Excluded under Section I — Exclusions. SECTION I — EXCLUSIONS P.O. Box 20089 • St. Petersburg, FL 33742 Phone: (866) 274-5677 • Fax: (866) 840-1905 • www.AmericanStrategic.com Page 4 of 6 A� L I N S U R A N C E As part of its investigation of your claim, ASI obtained an 1 -tel independent laboratory report for the roof tiles based on your roofer's sample photos of the tile. The Itel Laboratories report identifying the tile on your roof is attached and has also been forwarded by email to you. The report identifies the tile as Boral Saxony Slate an older "Boral Lifetile" concrete roof tile. "Boral Lifetile" is now called Boral. In late 2011 Boral purchased sole control of the company and all tiles are now sold under the Boral name. This product is no longer available. Itel was able to supply us with the two closest products currently being produced based on the physical properties and profile of the available sample. The tiles that are the closest match and are available for purchase are the Eagle Bel Air (Slurry Coated) or Boral Saxony 900 Slate (Oxide thru body). Both of these products are an excellent profile match; however these products are not a suitable for individual tile repair, type product and only original recommended as a total Slope/Elevation repair type product matching the original sample physical specifications and profile appearance. Your policy specifies the criteria for the settlement of your claim. The policy will pay the amount to repair or replace the damaged property with "like construction and use", that does not mean the tile have to be an exact match. As such, ASI will pay to repair or replace the hurricane damaged tile with like kind and quality. SECTION I — CONDITIONS 3. Loss Settlement. Covered property losses are settled as follows: a. Property of the following types: (1) Personal property; (2) Awnings, carpeting, household appliances, outdoor antennas and outdoor equipment, whether or not Attached to buildings; and (3) Structures that are not buildings; at actual cash value at the time of loss but not more than the amount required to repair or replace at the actual cash value at the time of loss but not more than the amount required to repair or replace. b. Buildings under Coverage A or B at replacement cost without deduction for depreciation, subject to the following: (1) If, at the time of loss, the amount of insurance in this policy on the damaged building is 80% or more of the full replacement cost of the building immediately before the loss, we will pay the cost to repair or replace, after application of deductible and without deduction for depreciation, but not more than the least of the following amounts: (a) The limit of liability under this policy that applies to the building; (b) The replacement cost of that part of the building damaged for like construction and use on the same premises; or (c) The necessary amount actually spent to repair or replace the damaged building. 4 We will pay at least the actual cash value of the damage, less any applicable deductible, until actual repair is performed. We will pay any remaining amounts necessary to perform such repairs as the work is performed and the expenses are incurred and according to the provisions of b.(1) and b.(2) above. However, if the cost to repair or replace the damage is both: (a) Less than 5% of the amount of insurance in this policy on the building; and P.O. Box 20089 • St. Petersburg, FL 33742 Phone: (866) 274-5677 • Fax: (866) 840-1905 • www.AmericanStrategic.com Page 2 of 6 GHD 1 11151519Eaken-1-Cabrera Roof Assessment LEGEND: c CRACKED ROOF TILE D DISPLACED ROOF TILE m MISSING ROOF TILE R REPLACED ROOF TILE CRACKED AND DEFLECTED ROOF TILE NOTES: i- ROOF PLAN LAYOUT IS APPROXIMATE, 2- SYMBOLS SHOWN INT HE ROOF PLAN REPRESENT THE APPROXIMATE EXTENT AND LOCATION OF SOME OF THE OBSERVED DAMAGE OR CONDITION(S), THE CABRERA RESIDENCE 1115161g 769 WATERLOO COURT Dee 5. 2017 fy a NAPLES,FL ROOF PLAN FIGURE 1 December 6, 2017 Mr. Tim Eaken American Strategic Insurance Post Office Box 20089 Saint Petersburg, Florida 33742 Dear Mr. Eaken: Re: Roof Assessment The Cabrera Residence 769 Waterloo Court Naples, Florida 34120 Claim Number: 488091-171011 1. Introduction Reference No. 11151519 At your request, GHD conducted a visual, non-destructive assessment at the subject structure. The site visit for this assessment was performed on November 2, 2017, by GHD staff in the presence of Mr. Angel Cabrera, the homeowner. The purpose of this assessment was to observe and comment on reported damage to the roof and interior of the subject structure. This document provides a summary of GHD's opinions and observations of the reported damage. 2. Assessment Summary Based on the information acquired and GHD's assessment of the subject structure, the following summary of opinions is provided: • The overall moderately deteriorated condition of the roof covering above the subject structure was the result of normal wear and weathering for the age of the roof covering (approximately 19 years old), as evidenced by the quantity of replaced and/or repaired roof tiles, the aged appearance of the roof covering, and the presence of leaks through the roof assembly. • There was no visual evidence that indicated any hail struck the roof covering and caused functional damage to the roof covering or other hail sensitive items around the residence. • The the roof covering above the subject structure experienced some damage that could be attributed to wind forces, as evidenced by the observed fragmented, cracked, missing, and/or displaced roof tiles. - The noted wind damage to the roof covering involved approximately 20 cap tiles, and 29 field tiles (approximately 62 square feet), which represented approximately 3 percent of the overall roof area and as such did not exceed the 25 percent threshold required to apply the provisions GHD 5904 Hampton Oaks Parkway Suite F Tampa Florida 33610 USA T 813 971 3882 F 813 971 1862 W www.ghd..com specified in Section 708.1.1 "Reroofing," in the Florida Building Code — Existing Building, 51n Edition (2014). • The wind damage to the roof covering above the subject structure was considered repairable despite the moderately deteriorated condition and anticipated remaining service life. The removal and replacement of the entire roof covering above the subject structure was not necessary at the time of GHD's assessment. • The tile roof covering exhibited some damage that resulted from foot traffic during the installation of tarpaulins following the hurricane event, as evidenced by: - The referenced tiles were predominately located near the perimeters of the tarpaulin coverings; - The cracks were predominately located across the width of the tiles; - The cracked portions of the tiles were deflected downward; - A lack of missing tiles fragments on the downslope roof surfaces; and - A lack of scars and/or abrasions on the tile surfaces. The following repairs were present on the roof surface: - A total of 42 field roof tiles had been previously replaced, as evidenced by the different surface color of the referenced tiles and the report of the homeowner; - Several roof tiles showed repair -like materials had been applied within the cracks; • The following conditions constituted workmanship deficiencies: - Several sheathing fasteners were misplaced along the top chord of a truss; and - Mechanically induced cuts were present on some roof tile surfaces. • The apparent microbial growth and the stained and deteriorated roof sheathing in the vicinity above the living room constituted damage caused by exposure to moisture that originated as leaks through the roof assembly. Based on the observed damage, the referenced roof leaks were long-term, repetitive, and on-going over a cumulative period of approximately 6 months or longer prior to GHD's site visit. The referenced roof leaks were not the result of a storm -created opening. The referenced roof leaks were the result of one or more of the following: - The deteriorated condition of the roof covering as a result of normal wear and weathering; and - Workmanship deficiencies associated with the installation of the roof assembly. 3. Description of the Structure The subject structure can be described as a one-story, single-family residence with a screen -enclosed in -ground swimming pool located to the rear of the residence (Photograph 1). According to Collier County Property Appraiser records, the residence was constructed in 1998. As understood by GHD, Mr. Cabrera had owned the residence since January 2013. For the purposes of this document, the residence was referenced to face east. 11151519Eaken-1-Cabrera Roof Assessment The exterior walls of the structure were constructed of concrete masonry units (CMU) and finished on the outside with cementitious stucco. The floor of the residence consisted of a concrete slab -on -grade. The interior walls appeared to be framed and finished with drywall. The roof of the structure was framed construction and was covered with tiles. Refer to Figure 1 for a roof plan of the structure. 4. Background During GHD's assessment, Mr. Cabrera provided the following information: • The passage of Hurricane Irma damaged the residence on September 10, 2017. • The stains in the ceiling finish above the living room was first observed during the hurricane event. • Following the storm event, the homeowner installed tarpaulins on the roof surface. • The roof covering was installed prior to the homeowner's purchase of the residence. • No repairs have been made to the roof covering during the current ownership. • The repaired and replaced roof tiles predate the homeowner's purchase of the residence. • No additions or structural modifications had been made to the subject structure. 5. Site Observations Observations of the referenced structure's interior and attic space revealed the following: • A stain that exhibited a ring-like pattern was present in the ceiling finish at the above north portion of the living room (Photograph 2). • A stain in the ceiling finish was present along a ceiling board joint above the living room (Photograph 3). • Stained and deteriorated roof sheathing that exhibited some apparent microbial growth was present in the attic space above the referenced stained ceiling finishes (Photograph 4). • Stained roof sheathing was present in the vicinity above the stained finish shown in Photograph 3. Several misplaced sheathing fasteners were exposed along the top chord of a truss, including 1 within the stained area (Photograph 5). Observations of the subject structure's roof covering revealed the following: • The roof covering above the subject structure was covered with flat surface concrete roof tiles with an exposed width approximately 12 inches and an exposure length of approximately 15 inches. The roof tiles were secured to the structure with mechanical fasteners. The slope of the roof surface was approximately 4 inches of vertical rise to 12 inches of horizontal run (4:12). The roof section had a sloped area of approximately 2,800 square feet • Roof tiles had been replaced in the vicinity of the deteriorated roof sheathing shown in Photographs 4 and 5 (Photograph 6). 11151519Eaken-1-Cabrera Roof Assessment • Missing cap tiles were observed along the southeast oriented hip above the main entrance to the residence (Photograph 7). • Missing cap tiles were observed along the southeast oriented hip above the southeast portion of the residence (Photograph 8). • Some roof tiles were cracked or fragmented and deflected downward. These tiles exhibited horizontally oriented cracks with the top portion of the referenced tiles deflected downward. A lack of surface scars and/or abrasions and a lack of missing tile fragments were not observed on the referenced tile surfaces (Photographs 9 and 10). • Several roof tiles exhibited missing tile portions that exposed the roof underlayment material (Photographs 11 and 12). • Replaced roof tiles were sporadically located across the roof covering (Photographs 13 and 14). • Repair -like materials had been applied to the crack in some roof tiles (Photographs 15 and 16). • Mechanically induced cuts were resent in some of the roof tile surfaces (Photograph 17). 6. Information Reviewed As part of GHD's assessment of the subject structure, GHD reviewed the following information: Florida Building Code, Existing Building 5t' Edition (2014) • Section 202, "General Definitions", defines repair as: - The restoration to good or sound condition of any part of an existing building for the purpose of its maintenance. • Section 202, "General Definitions", defines roof section as: - A separating or division of a roof area by existing expansion joints, parapet walls, flashing (excluding valley), difference of elevation (excluding hips and ridges), roof type or legal description; not including the roof area required for a proper tie -off with an existing system. • Section 502, "Repairs", states: - 502.1 Scope. Repairs, as defined in Chapter 2, include the patching or restoration or replacement of damaged materials, elements, equipment, or fixtures for the purpose of maintaining such components in good or sound condition with respect to existing loads or performance requirements. - 502.3 Related Work. Work on nondamaged components that is necessary for the required repair of damaged components shall be considered part of the repair and shall not be subject to the provisions of Chapter 7, 8, 9, 10 or 11. • Section 708, "Reroofing", states: 11151519Eaken-1-Cabrera Roof Assessment 4 708.1.1 Not more than 25 percent of the total roof area or roof section of any existing building or structure shall be repaired, replaced, or recovered in any 12 -month period unless the entire roofing system or roof section conforms to the requirements of this code. Florida Buildina Code, Residential, 51h Edition (2014) • Section R202, "Definitions", defines roof assembly as: A system designed to provide weather protection and resistance to design loads. The system consists of a roof covering and roof deck or a single component serving as both the roof covering and roof deck. A roof assembly includes the roof deck, vapor retarder, substrate or thermal barrier, insulation, vapor retarder, and roof covering. • Section R202, "Definitions", defines roof covering as: - The covering applied to the roof deck for weather resistance, fire classification, or appearance. • Section R202, "Definitions", defines roof covering system as: - See 'Roof assembly." • Section R202, "Definitions", defines roof deck as: - The flat or sloped surface not including its supporting members or vertical supports. Historical Permit Search • A review of public permit records available online from BuildFax, Inc. indicated the roof covering had NOT been replaced subsequent to the original construction of the residence. Historical Weather Information A review of historical weather information provided by The Weather Underground indicated that on September 10, 2017, maximum wind gusts of 82 miles per hour and a total of 3.5 inches of precipitation were recorded at Naples Municipal Airport located approximately 14.8 miles from the subject structure. • Storm reports were reviewed from the National Oceanic and Atmospheric Administration, National Centers for Environmental Information, Storm Events Database for Collier County during the period November 2, 2015 through August 1, 2017 (the latest date available). http://www.ncdc.noaa.gov/stormevents/ • Storm reports were reviewed from the National Oceanic and Atmospheric Administration, National Weather Service, Storm Prediction Center for the period August 2, 2017 through November 2, 2017, based on the date of the site visit. http://www.spc.noaa.gov/climo/online/ - A report of 0.75 inch hail at a location approximately 5.6 miles from the subject structure on July 13, 2016; and - A report of wind gust of 69 knots (approximately 79 miles per hour) at a location approximately 13.2 miles from the subject structure on January 17, 2016. It should be noted that although GHD has reviewed the previously referenced information acquired by others and relied on their content, GHD does not guarantee the accuracy of the referenced information. 11151519Eaken-1-Cabrera Roof Assessment 7. Discussion The following analyses/comments discuss GHD's opinions of the observed and reported damage: • on a systemic level, roof tile de -bonding and/or displacement as a result of wind forces will normally first occur along the edges, corners, and ridges of the roof and can progress inward as wind speeds and uplift increase. This behavior of wind forces is recognized by applicable building codes that require these areas to be designed to resist higher forces for a given wind speed compared to the main field of the roof. To cause the detachment of an individual roof tile secured to the substrate with mechanical fasteners; the wind uplift force must first overcome the dead weight of the tile and must be of sufficient additional magnitude to break the the or fastener used to secure the tile to the underlayment. The force necessary to break the tile or fastener of a properly secured tile is greater than the force necessary to overcome the weight of the tile. Therefore, if wind forces were to affect a tile to the degree necessary to cause detachment, GHD would expect that the tile would be displaced from its installed location and/or blown off the roof. • Damage to tile roofs can be caused by wind-borne debris that strikes the roof. Damage from wind- borne debris typically appears as one or more tiles that are "fragmented," or broken into numerous smaller pieces. 8. Limits of Study This document was prepared for the exclusive use of American Strategic Insurance Company and was not intended for any other purpose. The observations and opinions contained herein are based upon information provided to us at the time of this document's preparation. The evaluation performed on the above date was a visual assessment. Areas hidden from view such as ceiling, wall, and floor cavities or other inaccessible areas were not examined. Please note that GHD reserves the right to revise the observations and opinions above as conditions change or additional information becomes available. This document was prepared for our client's use and GHD disavows any liability for use by others. 11 151519Eaken-1 -Cabrera Roof Assessment GHD appreciates this opportunity to have assisted you with this assessment. Please contact us if you have any questions or need additional information. Sincerely, GHD Florida Engineering Business No.: 9931 Local Address: 5904 Hampton Oaks Parkway, Suite F Tampa, Florida 33610 (813) 971-3882 Vincent D. Wicinski Senior Professional Engineer FL PE #72408 VDW/js/01 Encl. Figure 1 Roof Plan Attachment A Site Photographs 11151519Eaken-1-Cabrera Roof Assessment 5 v bzw 21 it is ArA 60" Jason Melton Project Coordinator GHD 1 11151519Eaken-1-Cabrera Roof Assessment 3 — View of a stain in the ceiling finish along a ceiling board joint above the living room. Site Photographs GHD 1 11151519Eaken-1-Cabrera Roof Assessment I Attachment A .\ FNI 4 — View of stained Or and deteriorated roof sheathing within the vicinity above the stained ceiling finish shown in Photograph 2. Apparent microbial growth was present within the stained area. Site Photographs GHD 1 11151519Eaken-1-Cabrera Roof Assessment I Attachment A 5 — View of stained roof sheathing in the vicinity above the stainea ceinng nnisn snum 1 111 Photograph 3. Several misplaced sheathing fasteners were exposed along a truss chord, including 1 within the stained area (arrows). 6 — View of roof tiles that had been replaced in the vicinity of me aetenurareu iuui sheathing shown in Photographs 4 and 5. Site Photographs GHD 111151519Eaken-1-Cabrera Roof Assessment I Attachment A 11 — View of missing portions of roof tile that exposed the roof underlayment. 12 — View of missing portions of roof tile that exposed the roof underlayment. Site Photographs GHD 1 11151519Eaken-1-Cabrera Roof Assessment I Attachment A 15 — View of repair -like materials that had been applied to a cracked roof tile. 16 — View of repair -like materials that had been applied to a cracked roof tile. Site Photographs GHD 1 11151519Eaken-1-Cabrera Roof Assessment I Attachment A 17 — View of mechanically induced cuts into the surrace OT a root we. Site Photographs GHD 1 11151519Eaken-1-Cabrera Roof Assessment I Attachment A 13 — View of roof tiles that had been replaced. Note the repair like material applied to the cracked roof tile located adjacent to the referenced replaced roof tiles. 14 — View of roof tiles that had been replaced. Site Photographs GHD 111151519Eaken-1-Cabrera Roof Assessment I Attachment A 1012040 MOMM - �� .a«., 7 — View of missing cap tiles along the southeast oriented hip above the main entrance of the residence. 8 — View of missing cap tiles along the southeast oriented hip above the southeast portion of the residence. Site Photographs GHD 1 11151519Eaken-1-Cabrera Roof Assessment I Attachment A 1 — View of the east elevation (front) of the subject structure. 2 — View of stain that exhibited a ring-like pattern in the ceiling finish above the living room. Site Photographs GHD 111151519Eaken-1-Cabrera Roof Assessment I Attachment A INSTR 4796900 OR 4883 PG 3106 RECORDED 2/6/2013 4:18 PN PAGES 5 DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT, COLLIER COUNTY FLORIDA DOC@.35 $70.00 REC $44.00 OBLD $20,000.00 4 r STATE HOUSING INITIATIVES PARTNERSHIP (SHIP) PROGRAM SECOND MORTGAGE THIS SECOND MORTGAGE ("Security Instrument") is given onday of 4 201' The Second Mortgagor is: Angel Viniclo Cabrera and S)Ivania I. Cabrera, aamaffled couple ("Borrower'). This Security Instrument Is given to Collier County SHIP TRUST FUND ("Lender"), which is organized and existing under the laws of the United States of America, and whose address is 3339 E. Tamiami Trail, Naples, Florida 34112. Borrower owes Lender the sum of Twenty Thousand and 00/100 Dollars ($20,000.00). Thisdebtis evidenced by Borrower's Note dated the same date as this Security Instrument ("Second Mortgage"), which does not provide for monthly payments. The full debt, If not paid earlier, is due upon sale of the property within the fifteen year term If sold after the fifteen year term, no repayment is required. As long as the borrower continues to own and occupy the assisted property during the tens of the mortgage, then the loan will not have to be repaid. This Security Instrument secures to Lender. (a) the repayment of the debt evidenced by the Note, with interest, and all renewals, extensions and modifications; (b) the payment of all other sums, with interest advanced under paragraph 7 to protect the security of the Security Instrument; and (c) the performance of Borrower's covenants and agreements under this Security Instrument and the Note. For this purpose. Borrower does hereby second mortgage, grant and convey to Lender the following described property located In Collier County, Florida. As more particularly described as Waterways of Naples Unit Two Lot 47, of the Public Records of Collier County, Florida and which has the address of: ("Property Address"): 7 69 Waterloo Ct Naples FL 34120 (Address) (City) (State) (Zip) TOGETHER WITH all the improvements now or hereafter erected on the property, and all easements, rights, appurtenances, rents, royalties, mineral, oil and gas rights and profits, water rights a ures now or hereafter a part of the property. All replacements and additions shall also be covered by the Security instru t. N i referred to in this Security Instrument as the "Property". BORROWER COVENANTS that Borrower 1 conveyed and has the right to mortgage, grant and convey the Property and that the Property is unen xcept for encumbra cord. Borrower warrants and will defend generally the title to the Property against all claims and de n bject to any encumbrance re THIS SECURITY INSTRUMENT comb' es i ants for national us nd n -uniform covenants with limited variation by jurisdiction to constitute a uniform security lost men co r al pr UNIFORM COVENANTS. Borrower nd nder coven gree a follows: 1. Payment of Principal and Inte st; t r sh 11 promptly pay when due the principal of and interest on the debt evidenced by the Note. 2. Taxes. The Mortgagor wilt pay I tta�x , se is s r s or a r ra Gs p or to the accrual of any penalties or interest thereon. t .y The Mortgagor shall pay or cause to d, as the same respecti be ad (1) all taxes and governmental charges of any kind whatsoever which may at any time be Is sessed or levied against ith as the Property, (2) all utility and other charges, including "service charges", incurred or impose operation, maintenan e o y, upkeep and improvement of the Property, and (3) all assessments or other governmental charg ay lawfully be paid in ns er a period of years, the Mortgagor shall be obligated under the Mortgage to pay or cause to be i such installments as ed to be paid during the term of the Mortgage, and shall, promptly after the payment of any of the forego , . Mortga at f such payment. 3. Application of Payments. Unless applica a s , ayments received by Lender shall be applied; first, to Interest due; and, to principal due; and last, to any late chargi' oder 4. Charges; Liens. Borrower shall pay all taxes, as essmen s, charges, fines and impositions attributable to the Property which may attain priority over this Security Instrument, and leasehold payments or ground rents, if any. Borrower shall promptly fumish to Lender all notices of amounts to be paid under this paragraph, and all receipts evidencing the payments. Borrower shall promptly discharge any lien which has priority over this Security Instrument unless Borrower. (a) agrees in writing to the payment of the obligation secured by the lien in a manner acceptable to Lender, (b) contests In good faith the lien by, or defends against enforcement of the lien in, legal proceedings which in the Lender's opinion operate to prevent the enforcement of the lien; or (c) secures from the holder of the lien an agreement satisfactory to Lender subordinating the lien to this Security Instrument. If Lender determines that any part of the Property is subject to a lien which may attain priority over the Security Instrument, Lender may give Borrower a notice identifying the lien. Borrower shall satisfy the lien or take one or more of the actions set forth above within 10 days of the giving of notice. 6. Hazard or Property Insurance. Borrower shall keep the improvements now existing or hereafter erected on the Property insured against loss by fire, hazards included within the term "extended coverage" and any other hazards, Including floods or flooding, for which Lender requires insurance. This insurance shall be maintained in the amounts and for the periods that Lender requires. The insurance carrier providing the insurance shall be chosen by Borrower subject to Lender's approval which shall not be unreasonably withheld. If Borrower fails to maintain coverage described above, Lender may, at Lender's option, obtain coverage to protect Lender's rights in the Property In accordance with paragraph 7. At all times that the Note is outstanding, the Mortgagor shall maintain Insurance with respect to the Premises against such risks and for such amounts as are customarily insured against and pay, as the same become due and payable, all premiums In respect thereto, including, but not limited to , all-risk Insurance protecting the interests of the Mortgagor and Mortgagee against loss or damage to the Premises by fire, lightning, and other casualties customarily insured against (including boiler explosion, if appropriate), with a uniform standard extended coverage endorsement, including debris removal coverage. Such insurance at all times to be in an amount not less than the full replacement cost of the Premises, exclusive of footings and foundations. All insurance policies and renewals shall be acceptable to Lender and shall include a standard mortgage clause. Lender shall have the right to hold the policies and renewals. If Lender requires, Borrower shall promptly give to Lender all receipts of paid premiums and renewal notices. In the event of loss, Borrower shall give prompt notice to the Insurance carrier and Lender. Lender may make proof of loss if not made promptly by Borrower. Unless Lender and Borrower otherwise agree in writing, insurance proceeds shall be applied to restoration or repair of the Property damaged, if the restoration or repair is economically feasible and Lenders security is not lessened. If the restoration or repair is not economically feasible or Lender's security would be lessened, the insurance proceeds shall be applied to the sums secured by the Security Instrument, whether or not then due, with any excess paid to Borrower. If Borrower abandons the Property, or does not answer within 30 days a notice from Lender that the Insurance carrier has offered to settle a claim, then Lender may collect the insurance proceeds. Lender may use the proceeds to repair or restore the Property or to pay sums secured by this Security Instrument, whether or not then due. The 30 -day period will begin when the notice is mailed. Unless Lender and Borrower otherwise agree in writing, any application of proceeds to principal shall not extend or postpone the due date of the monthly payments referred to in paragraph 1 or change the amount of the payments. if under paragraph 21 the Property is acquired by Lender, Borrower's right to any insurance policies and proceeds resulting from damage to the Property prior to the acquisition shall pass to Lender to the extent of the sums secured by this Security Instrument immediately prior to the acquisition. 6. Occupancy, Preservation, Maintenance and Protection of the Property; Borrowers Loan Application, Leaseholds. Borrower shall occupy, establish, and use the Property as Borrower's principal residence within sixty days after the execution of this Security Instrument and shall continue to occupy the Property as Borrower's principal residence for at least one year after the date of occupancy, unless Lender otherwise agrees in writing, which consent shall not be unreasonably withheld, or unless extenuating circumstances exist which are beyond Borrower's control. Borrower shall not destroy, damage or Impair the Property, allow the Property to deteriorate, or commit waste on the Property. Borrower shall be in default if any forfeiture action or proceeding, whether civil or criminal, is begun that In Lenders good faith U� �j. OR 4883 PG 3107 judgment could result in forfeiture of the Property or otherwise materially impair the lien created by this Security Instrument or Lender's security inlerest. Borrower may cure such a default and reinstate, as provided in paragraph 18, by causing the action or proceeding to be dismissed with a ruling that, in Lender's good faith determination, precludes forfeiture of the Borrower's interest in the Property or other material Impairment of the lien created by this Security Instrument or Lender's security interest. Borrower shall also be in default if Borrower, during the loan application process, gave materially false or inaccurate information or statements to Lender (or failed to provide Lender with any material information) in connection with the loan evidenced by the Note, including, but not limited to, representations concerning Borrower's occupancy of the Property as a principal residence. If this Security Instrument is on a leasehold, Borrower shall comply with all the provision of the lease. If Borrower acquires fee title to the Property, the leasehold and the fee title shall not merge unless Lender agrees to the merger in writing. 7. Protection of Lender's Rights in the Property. If Borrower fails to perform the covenants and agreements contained in this Security Instrument; or there is a legal proceeding that may significantly affect Lender's rights in the Property (such as a proceeding in bankruptcy, probate, for condemnation or forfeiture or to enforce laws or regulations), then Lender may do and pay for whatever is necessary to protect the value of the Property and Lender's rights in the Property. Lenders actions may include paying any sums secured by alien which has priority over this Security Instrument, appearing in court, paying reasonable attorneys' fees and entering on the Property to make repairs. Although Lender may take action under this paragraph 7, Lender does not have to do so. Any amounts disbursed by Lender under this paragraph 7 shall become additional debt of Borrower secured by this Security Instrument. Unless Borrower and Lender agree to other terms of payment, these amounts shall bear interest from the date of disbursement at the Note rate and shall be payable, with Interest, upon notice from Lender to Borrower requesting payment. S. Mortgage insurance. If Lender required mortgage insurance as a condition of making the loan secured by this Security Instrument, Borrower shall pay the premiums required to maintain the mortgage insurance in effect. If, for any reason, the mortgage insurance coverage required by Lender lapses or ceases to be in effect, Borrower shall pay the premiums required to obtain coverage substantially equivalent to the mortgage Insurance previously in effect, at a cost substantially equivalent to the cost to Borrower of the mortgage insurance previously in effect, from an alternate mortgage insurer approved by Lender. If substantially equivalent mortgage insurance coverage is not available, Borrower shall pay to Lender each month a sum equal to one -twelfth of the yearly mortgage insurance premium being paid by Borrower when the Insurance coverage lapsed or ceased to be in effect. Lender will accept, use and retain these payments as a loss reserve in lieu of mortgage insurance. Loss reserve payments may no longer be required, at the option of Lender, if mortgage insurance coverage (in the amount and for the period that Lender requires) provided by an Insurer approved by Lender again becomes available and is obtained. Borrower shall pay the premiums required to maintain mortgage Insurance In effect, or to provide a loss reserve, until the requirement for mortgage insurance ends in accordance with any written agreement between Borrower and Lender or applicable law. 9. Inspection. Lender or its agent may make reasonable entries upon and inspections of the Property. Lender shall give Borrower notice at the time of or prior to an inspection specifying reasonable cause for the inspection. 10. Condemnation. The proceeds of any award or claim for damages, direct or consequential, in connection with any condemnation or other taking of any part of the Property, or for conveyance in lieu of condemnation, are hereby assigned and shall be paid to Lender. in the event of a total taking of the Property, the proceeds shall be applied to the sums secured by this Security Instrument, whether or not then due, with any excess paid to Borrower. In the event of a partial to ' e in which the fair market value of the Property immediately before the taking is equal to or greater than the amount s �J curity Instrument immediately before the taking, unless Borrower and Lender otherwise agree in writing, the y this ryV ant shall be reduced by the amount of the proceeds multiplied by.the following fraction: (a) the total am sums secured imm a fore the taking, divided by (b) the fair market value of the Property immediately before the taking, b ce shall be paid to Borrower. n th vent of a partial taking of the Property in which the fair market value of the Property immediatel be "s less than he amo t of a sums secured immediately for the taking, unless Borrower and Lender otherwise agree 1 writi g o applies a therwis rov es, the proceeds shall be applied to the sums secured by this Security Instrument whether o not e m are d . Unle Lender nd orrower otherwise agree in writing, any application of proceeds to principal shall not en e e o o pay ants referred to in paragraphs 1 or change the amount of such payments. 11. Borrower Not Released, Forbe d r of er. a ion th time for payment or modification of amortization of the sums secured'by this Sec uhty,I t er to s in Interest of Borrower shall not operate to release the liability of the original Borrower or er's successors in inte Len era t be required to commence proceedings against any successor in interest or refuse to a ime for payment or othe a di f ization of the sums secured by this Security Instrument by reason of any demand made by t al Borrower or Barco s n Interest. Any forbearance by Lender In exercising any right or remedy shall not be a wal reclude the exercise of remedy. 12. Successors and Assigns Bound; n everal Liability; C e .The covenants and agreements of this Security Instrument shall bind and benefit the successors and era Jett to the Provisions of paragraph 17. Borrower's covenants and a h several. Any Borrower who co-signs this Security Instrument but does not execute the Note; (a) is co-signing thr nt only to mortgage, grant and convey that Borrower's interest in the Property under the terms of this Security Instrument; (b) is not personally obligated to pay the sums secured by this Security Instrument; and (c) agrees that Lender and any other Borrower may agree to extend, modify, forbear or make any accommodations with regard to the terms of this Security Instrument or the Note without that Borrower's consent. 13. Loan Charges. If the loan secured by this Security Instrument is subject to a law which sets maximum loan charges, and that law is finally interpreted so that the interest or other loan charges collected or to be collected in connection with the loan exceed the permitted limits, then: (a) any such loan charge shall be reduced by the amount necessary to reduce the charge to the permitted limit; and (b) any sums already collected from Borrower which exceeded permitted limits will be refunded to Borrower. Lender may choose to make this refund by reducing the principal owed under the Note or by making a direct payment to Borrower. If a refund reduces principal, the reduction will be treated as a partial prepayment without any prepayment charge under the Note. 14. Notices. Any notice to Borrower provided for in this Security Instrument shall be given by delivering it or by mailing it by first class mail unless applicable law required use of another method. The notice shall be directed to the Property Address or any other address Borrower designates by notice to Lender. Any notice to Lender shall be given to Borrower or Lender when given as provided in this paragraph. 16. Governing Law; Severability. This Security Instrument shall be governed by federal law and the law of the jurisdiction in which the Property is located. In the event that any provision or clause of this Security Instrument or the Note conflicts with applicable law, such conflict shall not affect other provisions of this Security Instrument or the Note which can be given effect without the conflicting provision. To this end the provisions of this Security Instrument and the Note are declared to be severable. 16. Borrower's Copy. Borrower shall be given one conformed copy of the Note and of this Security Instrument. 17. Transfer of the Property or a Beneficial Interest In Borrower. If all or any part of the Property or any interest in it is sold or transferred (or if a beneficial Interest in Borrower is sold or transferred and Borrower is not a natural person) without Lender's prior written consent, Lender may, at, its option, require immediate payment in full of all sums secured by this Security Instrument. However, this option shall not be exercised by Lender if exercise is prohibited by federal law as of the date of this Security. instrument. If Lender exercised this option, Lender shall give Borrower notice of acceleration. The notice shall provide a period of not less than 30 days from the date the notice is delivered or mailed within which Borrower must pay all sums, secured by this Security Instrument. If Borrower fails to pay these sums prior to the expiration of this period, Lender may invoke any remedies permitted by this Security Instrument without further notice or demand on Borrower. 18.. Borrower's Right to Reinstate. If Borrower meets certain conditions, Borrower shall have the right to have enforcement of this Security Instrument discontinued at any time prior to the earlier of; (a) 5 days (or such other period as applicable law may specify for reinstatement) before sale of the Property pursuant to any power of sale contained in this Security Instrument; or (b) entry of a judgment enforcing this Security Instrument. Those conditions are that Borrower. (a) pays Lender all sums which then would be due under this Security Instrurnent and the Note as if no acceleration had occurred; (b) cures and default of any other covenants or agreements; (c) pays all expenses incurred in enforcing this. Security Instrument, including, but not limited to, reasonable attorney's fees; and (d) takes such action as Lender may reasonably require to assure that the lien of this Security Instrument, Lender's rights in the Property and Borrower's obligation to pay the sums secured by this Security Instrument shall continue unchanged. Upon reinstatement by Borrower, this Security Instrument and the obligations secured hereby shall remain fully effective as if no acceleration had occurred. However, this right to reinstate shall not apply in the case of acceleration under paragraph 17. 19. Sale of Note; Change of Loan Servicer. The Note or a partial Interest in the Note (together with this Security Instrument) may be sold one or more times without prior notice to Borrower. A sale may result in a change in the entity (known as the "Loan Servicer') that collects monthly payments due under the Note and this Security Instrument. There also may be one or more changes of the Loan Servicer unrelated to a sale of the Note. If there is a change of the Loan Servicer, Borrower will be given written notice of the change in accordance with OR 4883 PG 3108 paragraph 14 and applicable law. The notice will state the name and address of the new Loan Servicer and the address to which payments sfiould be made. The notice will also contain any other information required by applicable law. 20. Hazardous Substances. Borrower shall not cause or permit the presence, use, disposal, storage, or release of any Hazardous Substances on or in the Property. Borrower shall not do, nor allow anyone else to do, anything affecting the Property that is in violation of any Environmental Law. The preceding two sentences shall not apply to the presence, use, or storage on the Property of small quantities of Hazardous Substances that are generally recognized to be appropriate to normal residential uses and to maintenance of the Property. Borrower shall promptly give Lender written notice for any Investigation, claim, demand, lawsuit or other action by any governmental or regulatory agency or private party involving the Property and any Hazardous Substance or Environmental Law of which Borrower has actual knowledge. If Borrower learns, or is notified by any governmental or regulatory authority, that any removal or other remediation of any Hazardous Substance affecting the Property is necessary, Borrower shall promptly take all necessary remedial actions in accordance with Environmental Law. As used in this paragraph 20, "Hazardous Substances" are those substances defined as toxic or hazardous substances by Environmental Law and the following substances: gasoline, kerosene, other flammable or toxic petroleum products, toxic pesticides and herbicides, volatile solvents, materials containing asbestos or formaldehyde, and radioactive materials. As used in this paragraph 20, "Environmental Law' means federal laws and laws of the jurisdiction where the Property is located that relate to health, safety or environmental protection. 21. Acceleration; Remedies. Lender shall give notice to Borrower prior to acceleration following Borrower's breach of any covenant or agreement in this Security Instrument (but not prior to acceleration under paragraph 17 unless applicable law provides otherwise). The notice shall specify: (a) the default; (b) the action required to cure the default; (c) a date, not less than 30 days from the date the notice is given to Borrower, by which the default must be cured; and (d) that failure to cure the default on or before the date specified in the notice may result in acceleration of the sums secured by this Security Instrument, foreclosure by judicial proceeding and sale of the Property. The notice shall further inform Borrower of the right to reinstate after acceleration and the right to assert in the foreclosure proceeding the non-existence of a default or any other defense of Borrower to acceleration and foreclosure. If the default is not cured on or before the date specified in the notice, Lender, at its option, may require immediate payment in full of all sums secured by this Security Instrument without further demand and may foreclose this Security Instrument byjudicial proceeding. Lender shall be entitled to collect all expenses incurred in pursuing the remedies provided in this paragraph 21, including, but not limited to, reasonable attorney's fees and costs of the title evidence. 22. Release. Upon payment of all sums secured by this Security Instrument, Lender shall release this Security Instrument, without charge, to Borrower. Borrower shall pay any recordation costs. 23. Attorneys' Fees. As used in this Security Instrument and the Note, "attorneys' fees" shall include any attorneys' fees awarded by an appellate court. 24. Riders to this Security Instrument If one or more riders are executed by Borrower and recorded together with this Security Instrument, the covenants and agreements of each such rider shall be incorporated Into and shall amend and supplement the covenants and agreements of this Security Instrument as If the rider(s) were a part of this Security Instrument. (Check Applicable Box) ❑ Adjustable Rate Rider ❑ Rate Imp"econd dominium Rider ❑ Graduated Payment Rider ❑ 1-4 Fami Home Rider Balloon Rider ❑ Biweened Unit Development Rider Other(s) (specify SIGNING BELOW, Borrower accepts and ag as t le a7 in d t is S curity Instrument and in any rider(s) executed by Borrower and recorded with it. Signed, sellled aftd delivered in the presence A Witness#1: d S utu i Witness#2: o- Borrower 3ilvani I . Cabre: Signature: Address: 769 Waterloo Ct Naples, FL 34120 STATE OF FLORIDA COUNTY OF COLLIER I hereby certify that on this day, Angel Vinicio Cabrera and Silvana 1. Cabrera before me, an officer duly authorized in the state aforesaid and In the county aforesaid to take acknowledgements, personally appeared to me known to be the person(s) described in and who executed the foregoing instrument and acknowledged before me that (He/ she/ they) executed the same for the purpose therein expressed. WITNESS my hand and official seal in the County and State aforesaid day of 2012. My Commission Expires: ubli s Signature (Seal) )totary �u'prtc Statee OMM Frances S Legdan da MY Cemmiaaion EE154454 ' i Or M1 Expkes 01119/$016 34 Revised: 10/2012 SHIP File#: 11-067 SHIP Purchase Assistance Program ^ Collier County Housing, Human & Veterans Department �f x- 3339 E. Tamiami Trail, Bldg H, Suite 211, Naples, FL 34112 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. 7'he completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. .All completed routing slips and original documents must he received in the County Attorney Office no later than Mondav preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines # i through #2 as appropriate for additional signatures, dates, and/or information needed. excentinn of the Chairman's signature, draw a line through routing lines # 1 through #2 comp tete the checklist. ; Route to Addressees (List in 1. Elizabeth Hernandez 2. Jennifer Belpedio 3. BCC Office Office CHS County Attorney Office Board of County Commissioners If the document is already complete with the td forward to the Court Attorney Office. Initials Date C 1q 1S q-�-L<K NOTE: Clerk's attestation is not required. Please do not route this item to Clerk's Board Minutes and Records. CAO please scan document after execution by Chairman and email them to Clerk's Minute and Records for its records. PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above ma need to contact staff for additional or missing information. Name of Primary Staff Elizabeth Hernandez, CHS Phone Number 239-252-2338 Contact 1 Department Agenda Date Item was 06/12/2012 Agenda Item Number Approved by the BCC Type of Document Insurance Claim Check Endorsement for Number of Original I Check Attached Pierre A. Bor ela Documents Attached PO number or account number if document is NIA to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark "NIA" in the Not Applicable column, whichever is Yes 1. 1 Does the document require the chairman's original signature? 2. Does the document need to be sent to another agency for additional signatures? If yes, provide the Contact Information(Name-, Agency; Address• Phone on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be signed by the Chairman, with the exception of most letters, must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike -through and revisions have been initialed by the County Attorney's Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the document or the final negotiated contract date whichever is applicable. 6. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's signature and initials are re aired. 7. In most cases (some contracts are an exception), the original document and this routing stip should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! & The document was approved by the BCC on 06/12/2012 and all changes made during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes, if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC, all changes directed by the BCC have been made, and the document is ready for the Chairman's signature. NIA (Not Applicable} 0 �A NIA NIA NIA NIA NIA t'--� t an option.for, this line, I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip W WS Original 9.03.}4, Devised l .26.05, Revised 2.24.05; Revised 11130112 IL co co Ln E- -0 .a ti co O ti l t. ti o- m l l m O O i_oVVV1'1JM S' VILL DI RUBBED OR EXPOSED TO HEAT DO NOT WRITE % SIGN/ 5 iA AP BELOW THIS LINE DEPOSITORY BANK ENDORSE:'',AENT 'FEDERAL RESERVE BOARD OF GOVERNORS REG, C.C. Face o4 document Tis Documeni securitly includes: vc'd pantograph, microprntino, coin reactive simulated .'watermark and bermochromatic ink. Padioek design is a ceridiwtion mark of the Checa Payment systems Asscciatiun. Memorandum To: Kimberly Grant, CHS Director CC: Jennifer Belpedio, Assistant County Attorney From: Elizabeth Hernandez, Grant Support Specialist, Community and Human Services Date: 04/06/2018 Re: Homeowner Insurance claim check endorsement -Pierre A. Borgela 443754 1h Avenue NE, Naples, FL 34116 The Homeowner Insurance Check Endorsement Policy approved by the Board on June 12, 2012 (16.1). 10) authorizes the Board Chairman or Vice Chairman to endorse homeowner insurance claim checks for recipients assisted with Purchase Assistance and/or rehabilitation program funds as Collier County is named as Second Mortgagee on their insurance policies. The attached check in the amount of $4,801.12 is for disbursement of the claim funds requiring endorsement by Board Chairman Solis or Vice Chairman. The check names FIFTH THIRD BANCORP as the first mortgage lender and Collier County SHIP as subordinate lien holder. In order for the check to be properly processed, proper signatures/endorsement for all parties listed on check must be obtained. This is a time -sensitive item and must be endorsed as soon as possible as homeowner is waiting to pay for work to be performed on home. Attachments: Homeowners Insurance Policy -Declaration Page Insurance Claim Check (#344372, $4,801.12) Insurance Claim Report & photos of damage Collier County Second Mortgage Collier County Community and Human Services Division (CHS) Homeowner Insurance Check Endorsement Policy Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage/lien, then the loan will not have to be repaid. On occasion, the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and receive money to make the repairs. If the insurance claim check is made payable to the homeowner and Collier County, then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to CHS at the address below for check endorsement consideration. 1. Copy of Homeowner's current insurance policy -Declaration Page. 2. Copy of insurance company's claim report with worksheet including description of repairs and costs. 3. Copy of photos of claim damage. 4. Copy of Insurance check(s) payable to homeowner, first lien holder and Collier County. Homeowner Name: Pierre A Borgela Homeowner Address: 4437 50 Avenue NE, Naples, FL 34116 Primary Contact Number: 239-245-3555 Homeowner Email: ierre4977 aol.com r 4CHSenior Gxant Coordinator OFFICE USE ONLY 4-4-19 Date Reviewed �__KVL� 11yi It Approved CHS Director Date Denied U PC�-h INSURANCE UNITED PROPERTY & CASUALTY INS CO P.O. Box 51149 Sarasota. FL 34232-0330 RENEWAL DECLARATION PIERRE A BORGELA 4437 54TH AVE NE NAPLES FL 34120 Effective: 0812912017 HOMEOWNERS DECLARATION ..POLICY NUMBER P6.6CY PERIOD To Froa:� UHV 2801254 05 41 0812912017 0812912018 n 12:01 a. rn. at the residence premises. `r a a 0 D - D Date issued: (36 29/2017 BRiGHTWAY INSURANCE, INC. PO Box 5700 Jacksonville FL 32247 Telephone: 239-867-1275 Telephone: 239-676-8199 HO 0350 The residence premises covered by this policy, is looated at the address listed below. (10100) 4437 54TH AVE NE NAPLES OR BEFORE FL 34120 THE POLICY RENEWAL EFFECTIVE DATE, IF PAYMENT IS NOT RECEIVED ON THIS POLICY WILL NOT BE IN FORCE. and limit of liability is shown. Flood coverage is not provided and is not a Coverage is provided where premium part of this policy. PREMIUMS SECTION I COVERAGE LIMIT LIABILITY $1,156.00 A. DWELLING $244 3,006.06 8 64.06 $4,8 INCLUDED B. OTHER STRUCTURES C. PERSONAL PROPERTY $1$4, 60.60 INCLUDED INCLUDED D. LOSS OF USE $48, 00.00 SECTION II COVERAGE E. PERSONAL LIABILITY $300,000-00 $18.00 INCLUDED F. MEDICAL PAYMENTS $1,000.00 OPTIONAL COVERAGES $774.00 Premium charge for Hurricane Exposure: The above coverages are subject to a 2% of Coverage A 1 $4,860 Hurricane Deductible per calendar year. The above coverages are subject to a 10% of Coverage A 1 24,300 Sinkhole Deductible per sinkhole loss. The above coverages are subject to a $2,500 All Other Peril Deductible. $1,aa1.oQ TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES: $92.00 The amount of premium change due to approved rate increase is $41.00 The amount of premium change due to coverage change is COVERAGES HAVE BEEN INCREASED TO HELP KEEP PACE WITH RISING REPLACEMENT COSTS. PLEASE CONTACT YOUR AGENT IF THERE ARE ANY QUESTIONS PERTAINING TO YOUR POLICY. HO 0003 (05/11) HO 0350 (06197) HO 0446 (10100) HO 2370 (05113) MORTGAGEE FTBOO10-0414814699 FIFTH THIRD BANCORP ISAOA ATIMA PO BOX 598 AMELIA OH 45102 rs HO 0334 (05113) COUNTERSIGNED DATE -06129/2017 HO 0355 (05113) HO 0496 (04191)1 �'� HO 2386 (05113) BY SECOND MORTGAGEE HOUSING HUMAN & VETERAN SERVIC 3339 E TAMIAMI TRL BLDG H 211 NAPLES FL 34112 UPC 119 05 16 INSURED COPY Page 1 of 4 March 22, 2018 Pierre A Borgela 443754 1h Ave NE Naples FL 34120 Re: insured: UPC Cheep INSURANCE Promise March 22, 2018 Pierre A Borgela 443754 1h Ave NE Naples FL 34120 Re: insured: Pierre A Borgela Claim Number: 2017FLO44912 Policy Number: UHV 2801254 05 01 Date of Loss: 09/12/2017 Cause of Loss: Wind - Hurricane Loss Location: 443754 th Ave NE, Naples, FL 34120 ESTIMATE AND SETTLEMENT OF DAMAGES Dear Mr, Borgela: Enclosed is a copy of the estimate of covered damage to your insured property. The sums noted in the estimate represent the following Coverage[s]: Payment of your claim is being mailed separately. PO Box 1011 • 5t. Petersburg, FL 33731-1411 • 1-888-CLM -DE PIT 9 Claims@U Kimura nce.com ■ upcinsurance.corn UPC �� heeP INSURANCE- Promise Page 2 of 4 Re: Claim Number: 2017FLO44912 Payment of your claire is being mailed to you separately. The settlement check represents the amount we believe you are owed based on the information we have to date. You are permitted to use this check at this time. This payment does not necessarily constitute a full and final settlement of your claim for damages associated with your claimed loss. You may submit claim{s} for any additional damages discovered in the covered reconstruction of the above-mentioned property. If your mortgage holder has been shown as a payee on your check, please understand we are obligated to do so according to the terms of your policy. Please contact your mortgage holder regarding their procedures for endorsing payments. Your policy may provide replacement cost coverage whereby you are permitted to recover up to the above amount listed as Recoverable Depreciation. In order to claim this additional amount, you must notify us of your intent to complete repairs and/or replacement of the depreciated items, and submit the final repair invoices or receipts within 180 days from the date of loss listed above. Request for replacement cost benefits should be sent to the address or email shown below. Please include your name and claim number on all correspondence related to your claim. In order to receive payment of your Recoverable Depreciation, you will need to provide us at least two of the following items we require in order to verify the cost of repairs and that the repairs were completed. • Final invoice or receipts reflecting the total cost of repairs. ■ Signed Letter of Completion on your contractor's letterhead stating that the job has been completed to your satisfaction, • Photos showing the completed work. • Copies of the cancelled checks. if you should have any additional questions regarding the settlement, or have any other information you would like for us to consider in regards to this claim, please contact the undersigned at the information shown below. Sincerely, Erica Purdy Claims Adjuster United Insurance Management, LC, servicing claims on behalf of UPC Insurance Phone: 727.895.7737, Extension. 5425 E-mail: Claims(SUPCinsurance.corn F.S. 817.234(Z)(b) Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree. Pa Box 1011 • St. Petersburg, FL 33731-1011 • 1-888-CLM-DEPT • Claims@UPCinsurance.com 0 upcinsurance.com Page 3 of 4 Re: Claim Number: 2017FLO44912 Notice of the Right to Mediation C Keep u P the INSURANCE Promise, The Chief Financial officer for the State of Florida has adopted a rule to facilitate the fair and timely handling of residential property insurance claims. The rule gives you the right to attend a mediation conference with your insurer in order to settle any claire you have with your insurer. An independent mediator, who has no connection with your insurer, will be in charge of the mediation conference. You can start the mediation process after receipt of this notice by calling the Department of Financial Services at (877) 693-5236. The parties will have 21 days from the date of the notice to otherwise resolve the dispute before a mediation hearing can be scheduled. Am l eligible? Mediation is available to anyone with a disputed residential property damage claim provided the damage is covered under their insurance policy and the dispute is in excess of $500 (not including the deductible). Who would pay for the mediation? Mediation costs would be paid for by United Property and Casualty Insurance ("UPC") The only exception would be if the insured cancels without good cause and wants to reschedule the mediation. Then the insured must pay the cost of a new conference prior to the conference being scheduled. How do I request mediation? You may request mediation by contacting the Department of Financial Services ("DFS") using any one of the methods listed below: • online Request: htt :llwww.m oridacfo,com/Division/Consumers/Mediation/ • Call (877) 693-5236 • Fax a request to (850) 488-6372 • Write to The Department of Financial Services Mediation Section, Bureau of Education, Advocacy, and Research 200 East Gaines Street, Tallahassee, Florida 32399-4212 Where can l obtain additional information? You may contact UPC for more information on your claim and the mediation process using any one of the methods below: • Call UPC Customer Care Center (888) 256-3378 • Fax a request to (800) 380-5053 • Write to: United Property and Casualty Insurance 800 211d Ave. South St, Petersburg, FL 33701 • Contact the adjuster that handled your claim directly What information do I need to provide? • Insured's name (include all named insureds on the policy) • Insured's email address • Mailing address • Loss location address (if different than mailing address) • Phone number(s) where you can be reached during standard business hours • Claim number and policy number • A brief description of the nature of the dispute Po Box 1011 9 5t. Petersburg, FL 33731-1011 • 1-888-CLM-DEPT • Claims@UPCinsurance.com ■ upcinsurance.com P C Page 4 of 4 Keep U �► the INSURANCE- romise Promise - Page4of4 Re: Claim Number: 2017FLO44912 Citizens' contact information to include email address and phone number of the contact person for scheduling the mediation Information with respect to any other policies of insurance that may provide coverage of the insured property for named perils such as flood or windstorm What will happen next? The DFS Administrator will assign a mediator after 21 days from the date of the request if the parties (the insured and UPC) have not yet settled the claim. The mediation conference will occur within 45 days of the mediation request. Please note that either party has the right to disqualify a mediator for good cause. Good cause consists of the existence of a conflict of interest between either party and the mediator, that the mediator is unable to handle the conference competently, or other reasons which would reasonably be expected to impair the conference. What should I bring? Be sure to bring all supporting documents, including your policy, photographs, estimates, bills, reports, letters, etc. It is important to bring specific dollar estimates or quotes for all items that are in dispute. Can I bring representation to the mediation conference? Yes. You must provide notice to the mediator that you will be bringing representation to the conference 14 days before the scheduled conference, unless UPC has waived its right to the notice. What are the limits of mediation? Mediation is non-binding. Neither the insured nor UPC are legally obligated to accept the outcome. Even if a settlement is reached at the mediation, you have a three-day grace period to change your mind; provided you do not cash the settlement check and you inform UPC that you have decided to reject the mediated outcome. Choosing mediation does not prevent you from participating in other dispute resolution procedures, or even going to court later. Nothing you say in a mediation conference can be used against you in any later proceedings References: F. Florida Statute 627.7915 and Rule 69J-166.031 PO Box 1011 ■ 5t. Petersburg, FL 33731-1011 ■ 1-888-CLM-DEPT • Claims@UPCinsurance.com • upcinsurance.com Statement of Loss UPC � URANCE Insured: Pierre A Borgela Claim Number: 2017FLO44912 Coverage A - Buildin Limit of Liability $243,000 Description UPC Estimate: Coverage A Dwelling Allioullt $ 14,135.13 UPC Estimate: Code Upgrade $ 787.22 Collier County Building Permit $ 194-85 Total A $ 15,117.20 Coverage B - Other Structures LimitofLiabdity $ 4,860.00 Descri tion: Amount $ - Total B $ Coverage C - Contents limit oi-Liability .$121,5_00 Amount $ - n.:scnp[ion; $ Total C $ Coverage D - Loss of Use Limit oI'[,iabiIity $48,600 Description Amount $ - Total D $ - Prior Payments: Issue Date Total A + B + C + D $ 15,117-20 $ 1,913.22 11/1/2017 Plus Special Coverage S - $ 3,542.86 1/25/2018 Total Loss . 5,117.20 $ Less Depreciation - Coy. A $ $ s Paid When incurred - Code Upgrade $ $ _ Less Depreciation - Coy. BS- $ Subtotal $ 15,1 17.20 $ Less Deductible $ 4,860,00 Total prior ayrnents: $ 5,456.08 Total Payable $ 10,257.20 Less Prior Payments} $ 5,456.08 Erica Purdy 312 212 0 1 8 Amount Due Now $ 4,801.12 ,mc - version Loa L ��: �`�'lllll INSTR 4746554 OR 4841 PG 1595 RECORDED 10/2/2012 1:23 PM PAGES 4 DWIGHT E. BROCK, CLERK OF THECIRCUIT COURT, COLLIER COUNTY FLORIDA DOC@.35 5106.05 INT@.002 $60.60 REC $35.50 OBLD $30,300.00 OBLI $30,300.00 NEIGHBORHOOD STABILIZATION PROGRAM Property Address: 4437 54TH AVENUE NE, NAPLES, FL 34120 Folio Number: 39027360008 —4— a Q' `v RECORD AND RETURN TO: COLLIER COUNTY HOUSING, HUMAN S VETERAN SERVICES 3339 TAMIAMI TRAIL EAST, SUITE 212 NAPLES, FL 34112 iC:' PURCHASE MONEY SECOND MORTGAGE o�G�c�il � THIS PURCHASE MONEY SECOND MORTGAGE ("Security Instrument") is given onOLD day of 2012. The Purchase Money Second Mortgagor is PIERRE A. BORGELA and YOLANDE BORGELA, husband and wife, ("Borrowers"). This Security Instrument is given to COLLIER COUNTY, a Political Subdivision of the State of Florida ("Lender"), whose address is 3335 Tamlami Trail East, Suite 101, Naples, Florida 34112-5356. Borrower owes Lender the sum of THIRTY THOUSAND, THREE -HUNDRED AND NO/100 DOLLARS ($30,300.00) in US currency. This debt is evidenced by Borrower's Note dated the same date as this Security Instrument ("Purchase Money Second Mortgage"), which provides for monthly payments, with the full debt, if not paid earlier, due and payable upon sale of property, refinance, or loss of homestead exemption . This Security Instrument secures to Lender: (a) the repayment of the debt evidenced by the Note, with interest, and all renewals, extensions and modifications; (b) the payment of all other sums, with interest advanced under paragraph 7 to protect the security of the Security Instrument; and (c) the performance of Borrower's covenants and agreements under this Security Instrument and the Note. For this purpose, Borrower does hereby mortgage, grant and convey to Lender the following described property located in Collier County, Florida. As more particularly described as The West 75 feet of E� of Golden Gate Estates Unit No. 45, according to the plat thereof as recorded In Plat Book 7, Pa a Pubilc Recor er County, Florida and which has the address of: ("Property Address"): 4437 54th Avenue NE, Nap da 34120. TOGETHER WITH all the improveme royalties, mineral, oil and gas rights and profits and additions shall also be covered by the Sec BORROWER COVENANTS that Bo 1 convey the Property and that the Property is 4n the title to the Property against all claims and e THIS SECURITY INSTRUMENT co jurisdiction to constitute a uniform security instn UNIFORM COVENANTS. Borrower a 1. Payment of Principal and Interes interest on the debt evidenced by the Note. 2. Taxes. The Mortgagor will pay all he prop y, a d all easements, rights, appurtenances, rents, all fi res now rhe eafter a part of the property. All replacements %se I this Security Instrument as the "Property". st yed and has the right to mortgage, grant and r. Borrower warrants and will defend generally i ran'r tin -uniform covenants with limited variation by ring real property. covenant and agre II nent and Late Charg s. J%�/shall promptly pay when due the principal of and sewer re_gta-I r*`?OKrates prior to the accrual of any penalties or interest thereon. f ` t The Mortgagor shall pay or cause to be paid, as t rfrre�pe� ecome due, (a) all taxes and governmental charges of any kind whatsoever which may at any time be lawfully assessed or levee amst or with respect to the Property, (b) all utility and other charges, including "service charges", incurred or imposed for the operation, maintenance, use, occupancy, upkeep and improvement of the Property, and (c) all assessments or other governmental charges that may lawfully be paid in Installments over a period of years, the Mortgagor shall be obligated under the Mortgage to pay or cause to be paid only such installments as are required to be paid during the term of the Mortgage. 3. Application of Payments. Unless applicable law provides otherwise, all payments received by Lender shall be applied; first, to interest due; and, to principal due; and last, to any late charges due under the Note. 4. Charges; Liens. Borrower shall pay all taxes, assessments, charges, fines and impositions attributable to the Property which may attain priority over this Security Instrument, and leasehold payments or ground rents, if any. Borrower shall promptly discharge any lien which has priority over this Security Instrument unless Borrower. (a) agrees in writing to the payment of the obligation secured by the lien in a manner acceptable to Lender, (b) contests in good faith the lien by, or defends against enforcement of the lien in, legal proceedings which in the Lender's opinion operate to prevent the enforcement of the lien; or (c) secures from the holder of the lien an agreement satisfactory to Lender subordinating the lien to this Security Instrument. If Lender determines that any part of the Property is subject to a lien which may attain priority over the Security Instrument, Lender may give Borrower a notice identifying the lien. Borrower shall satisfy the lien or take one or more of the actions set forth above within 10 days of the giving of notice. 6. Hazard or Property Insurance. Borrower shall keep the Improvements now existing or hereafter erected on the Property insured against loss by fire, hazards included within the term "extended coverage" and any other hazards, including floods or flooding, for which Lender requires insurance. This insurance shall be maintained in the amounts and for the periods that Lender requires. The insurance carrier providing the insurance shall be chosen by Borrower subject to Lender's approval which shall not be unreasonably withheld. If Borrower fails to maintain coverage described above, Lender may, at Lender's option, obtain coverage to protect Lender's rights in the Property in accordance with paragraph 7. At all times that the Note is outstanding, the Mortgagor shall maintain insurance with respect to the Premises against such risks and for such amounts as are customarily insured against and pay, as the same become due and payable, all premiums in respect thereto, including, but not limited to , all-risk insurance protecting the interests of the Mortgagor and Mortgagee against loss or damage to the Premises by fire, lightning, and other casualties customarily insured against, with a uniform standard extended coverage endorsement, including debris removal coverage. Such insurance at all times to be in an amount not less than the full replacement cost of the Premises, exclusive of footings and foundations. F E 1.6 OR 4841 PG 1596 All insurance policies and renewals shall be acceptable to Lender. Lender shall have the right to hold the policies and renewals. If Lender requires, Borrower shall promptly give to Lender all receipts of paid premiums and renewal notices. In the event of loss, Borrower shall give prompt notice to the insurance carrier and Lender. Lender may make proof of loss if not made promptly by Borrower. Unless Lender and Borrower otherwise agree in writing, insurance proceeds shall be applied to restoration or repair of the Property damaged, if the restoration or repair is economically feasible and Lender's security is not lessened. If the restoration or repair is not economically feasible or Lender's security would be lessened, the insurance proceeds shall be applied to the sums secured by the Security Instrument, whether or not then due, with any excess paid to Borrower. If Borrower abandons the Property, or does not answer within 30 days a notice from Lender that the insurance carrier has offered to settle a claim, then Lender may collect the insurance proceeds. Lender may use the proceeds to repair or restore the Property or to pay sums secured by this Security Instrument, whether or not then due. The 30 -day period will begin when the notice is mailed. Unless Lender and Borrower otherwise agree in writing, any application of proceeds to principal shall not extend or postpone the due date of the monthly payments referred to in paragraph 1 or change the amount of the payments. If under paragraph 21 the Property is acquired by Lender, Borrower's right to any insurance policies and proceeds resulting from damage to the Property prior to the acquisition shall pass to Lender to the extent of the sums secured by this Security Instrument immediately prior to the acquisition. 6. Occupancy, Preservation, Maintenance and Protection of the Property; Borrower's Loan Application, Leaseholds. Borrower shall occupy, establish, and use the Property as Borrower's principal residence within sixty days after the execution of this Security Instrument and shall continue to occupy the Property as Borrower's principal residence for full term as described in the note, unless Lender otherwise agrees in writing; which consent shall not be unreasonably withheld, or unless extenuating circumstances exist which are beyond Borrower's control. Borrower shall not destroy, damage, or impair the Property, allow the Property to deteriorate, or commit waste on the Property. Borrower shall be in default if any forfeiture action or proceeding, whether civil or criminal, is begun that in Lender's good faith judgment could result in forfeiture of the Property or otherwise materially impair the lien created by this Security Instrument or Lender's security interest. Borrower may cure such a default and reinstate, as provided in paragraph 18, by causing the action or proceeding to be dismissed with a ruling that, in Lender's good faith determination, preclude itureof the Borrower's interest in the Property or other material impairment of the lien created by this Security Instrument or e r st. Borrower shall also be in default if Borrower, during the loan application process, gave materially false or inacc a f, ` e to Lender (or failed to provide Lender with any material information) in connection with the loan evidenced b cluding, but representations concerning Borrower's occupancy of the Property as a principal residence. If this Se i y rument is on a leaseho er shall comply with all the provision of the lease. If Borrower acquires fee title to the Property, the I seR" tl and the fee title shall not me a un ss Lender agrees to the merger in writing. 7. Protection of Lender's Righb i the r Ito pe rm t covenants and agreements contained in this Security Instrument, or there is a legal pro din tha a gni f ntly a�fe Lend e rig is in the Property (such as a proceeding in bankruptcy, probate, for condemnation or forte' _re r r or nd may do and pay for whatever is necessary to protect the value of the Property and Lender`4 righ in h o rt . e s on a incl de paying any sums secured by a lien which has priority over this Security Instrument, app ann in ourt p in re o a s' es nd entering on the Property to make repairs. Although Lender may take action under this p 7 n e d n have o s y amounts disbursed by Lender under this paragraph 7 shall become additional debt of er red s Inst 11 �pl ss Borrower and Lender agree to other terms of payment, these amounts shall bear interest e date of disbursement the o atJ d shall be payable, with interest, upon notice from Lender to Borrower requesting payment. 8. Mortgage Insurance. If Lender mortgage insurancey ' c of making the loan secured by this Security Instrument, Borrower shall pay the premiums requi to intain the mortgage ins ' effect. If, for any reason, the mortgage insurance coverage required by Lender lapses or ceases to ® Borrower shat t remiums required to obtain coverage substantially equivalent to the mortgage insurance previously in elle I I ent to the cost to Borrower of the mortgage insurance previously in effect, from an alternate mortgage insurer ap L nd- stantially equivalent mortgage insurance coverage is not available, Borrower shall pay to Lender each month a sum equ Ifth of the yearly mortgage insurance premium being paid by Borrower when the insurance coverage lapsed or ceased to be in effect. Lender will accept, use and retain these payments as a loss reserve in lieu of mortgage insurance. Loss reserve payments may no longer be required, at the option of Lender, if mortgage insurance coverage (in the amount and for the period that Lender requires) provided by an insurer approved by Lender again becomes available and is obtained. Borrower shall pay the premiums required to maintain mortgage insurance in effect, or to provide a loss reserve, until the requirement for mortgage insurance ends in accordance with any written agreement between Borrower and Lender or applicable law. 9. Inspection. Lender or its agent may make reasonable entries upon and inspections of the Property. Lender shall give Borrower notice at the time of or prior to an inspection specifying reasonable cause for the inspection. 10. Condemnation. The proceeds of any award or claim for damages, director consequential, in connection with any condemnation or other taking of any part of the Property, or for conveyance in lieu of condemnation, are hereby assigned and shall be paid to Lender. In the event of a total taking of the Property, the proceeds shall be applied to the sums secured by this Security Instrument, whether or not then due, with any excess paid to Borrower. In the event of a partial taking of the Property, in which the fair market value of the Property immediately before the taking is equal to or greater than the amount of the sums secured by this Security Instrument immediately before the taking, unless Borrower and Lender otherwise agree in writing, the sums secured by this Security Instrument shall be reduced by the amount of the proceeds multiplied by the following fraction: (a) the total amount of the sums secured immediately before the taking, divided by (b) the fair market value of the Property immediately before the taking. Any balance shall be paid to Borrower. In the event of a partial taking of the Property in which the fair market value of the Property immediately before the taking is less than the amount of the sums secured immediately for the taking, unless Borrower and Lender otherwise agree in writing or unless applicable law otherwise provides, the proceeds shall be applied to the sums secured by this Security Instrument whether or not the sums are then due. Unless Lender and Borrower otherwise agree in writing, any application of proceeds to principal shall not extend or postpone the due date of the monthly payments referred to in paragraphs 1 or change the amount of such payments. 11. Borrower Not Released, Forbearance by Lender Not a Waiver. Extension of the time for payment or modification of amortization of the sums secured by this Security Instrument granted by Lender to any successor in interest of Borrower shall not operate to release the liability of the original Borrower or Borrower's successors in interest. Lender shall not be required to commence proceedings against any successor in interest or refuse to extend time for payment or otherwise modify amortization of the sums secured by this Security Instrument by reason of any demand made by the original Borrower or Borrower's successors in interest. Any forbearance by Lender in exercising any right or remedy shall not be a waiver of or preclude the exercise of any right or remedy. �� 2 y� OR 4841 PG 1597 12. Successors and Assigns Bound; Joint and Several Liability; Co -Signers. The covenants and agreements of this Security Instrument shall bind and benefit the successors and assigns of Lender and Borrower, subject to the Provisions of Paragraph 17. Borrowers covenants and agreements shall be joint and several. Any Borrower who co-signs this Security Instrument but does not execute the Note; (a) is co-signing this Security Instrument only to mortgage, grant and convey that Borrower's interest in the Property under the terms of this Security Instrument; (b) Is not personally obligated to pay the sums secured by this Security Instrument; and (c) agrees that Lender and any other Borrower may agree to extend, modify, forbear or make any accommodations with regard to the terns of this Security Instrument or the Note without that Borrower's consent. 13. Loan Charges. If the loan secured by this Security Instrument is subject to a law which sets maximum loan charges, and that law is finally interpreted so that the interest or other loan charges collected or to be collected in connection with the loan exceed the permitted limits, then: (a) any such loan charge shall be reduced by the amount necessary to reduce the charge to the permitted limit; and (b) any sums already collected from Borrower which exceeded permitted limits will be refunded to Borrower. Lender may choose to make this refund by reducing the principal owed under the Note or by making a direct payment to Borrower. If a refund reduces principal, the reduction will be treated as a partial prepayment without any prepayment charge under the Note. 14. Notices. Any notice to Borrower provided for in this Security Instrument shall be given by delivering it or by mailing it by first class mail unless applicable law required use of another method. The notice shall be directed to the Property Address or any other address Borrower designates by notice to Lender. Any notice to Lender shall be given to Borrower or Lender when given as provided in this paragraph. 15. Governing Law; Severability. This Security Instrument shall be governed by federal law and the law of the jurisdiction in which the Property is located. In the event that any provision or clause of this Security Instrument or the Note conflicts with applicable law, such conflict shall not affect other provisions of this Security Instrument or the Note which can be given effect without the conflicting provision. To this end the provisions of this Security Instrument and the Note are declared to be severable. 16. Borrower's Copy. Borrower shall be given one conformed copy of the Note and of this Security Instrument. 17. Transfer of the Property or a Beneficial Interest I er. If all or any part of the Property or any interest in it is sold or transferred (or if a beneficial interest in Borrower is sold o ,e wer is not a natural person) without Lender's prior written consent, Lender may, at its option, require immediate p i by this Security Instrument. However, this option shall not be exercised by Lender it exercise is prohibited b as of the da t i urity Instrument. If Lender exercised this option, Lender shall give notice of acceleration. too 'ce shall provide a period of not less than 30 days from the date the notice is delivered or mailed wit in Borrower must pay all sum ecu d by this Security Instrument. If Borrower tails to pay these sums prior to the expiration of this rioder ma n medie a 'tied by this Security Instrument without further notice or demand on Borrower. 18. Borrower's Right to Reinstate if B rr e a' i err all have the right to have enforcement of this Security Instrument discontinued at any tim pri to th a er o. ( ) da (o c oth r period as applicable law may specify for reinstatement) before sale of the Property p rsu t t any po er of le ai d th Se urity Instrument; or (b) entry of a judgment enforcing this Security Instrument. Those co a t e . () ays Le de all (ter which then would be due under this Security Instrument and the Note as it no acceleration (b a ult o t enants or agreements; (c) pays all expenses incurred in enforcing this Security Instrument, i g, but not limited to, rea able tto ees; and (d) takes such action as Lender may reasonably require to assure that the lien of thi ity Instrument, Lender' is ' t erty and Borrower's obligation to pay the sums secured by this Security Instrument shall Contin anged. Upon reinstate er, this Security Instrument and the obligations secured hereby shall remain fully effective as if n cce ation had occurred. Hoe , is right to reinstate shall not apply in the case of acceleration under paragraph 17. 0 Y` 19. Sale of Note; Change of Loan Servicer. T e r tecea ' the Note (together with this Security Instrument) may be sold one or more times without prior notice to Barrowe . In change in the entity (known as the "Loan Servicer") that collects monthly payments due under the Note and this Security ere also may be one or more changes of the Loan Servicer unrelated to a sale of the Note. If there is a change of the Loan Servicer, Borrower will be given written notice of the change in accordance with paragraph 14 and applicable law. The notice will state the name and address of the new Loan Servicer and the address to which payments should be made. The notice will also contain any other information required by applicable law. 20. Hazardous Substances. Borrower shall not cause or permit the presence, use, disposal, storage, or release of any Hazardous Substances on or in the Property. Borrower shall not do, nor allow anyone else to do, anything affecting the Property that is in violation of any Environmental Law. The preceding two sentences shall not apply to the presence, use, or storage on the Property of small quantities of Hazardous Substances that are generally recognized to be appropriate to normal residential uses and to maintenance of the Property. Borrower shall promptly give Lender written notice for any investigation, claim, demand, lawsuit or other action by any governmental or regulatory agency or private party involving the Property and any Hazardous Substance or Environmental Law of which Borrower has actual knowledge. It Borrower leams, or is notified by any governmental or regulatory authority, that any removal or other remediation of any Hazardous Substance affecting the Property is necessary, Borrower shall promptly take all necessary remedial actions in accordance with Environmental Law. As used in this paragraph 20, "Hazardous Substances" are those substances defined as toxic or hazardous substances by Environmental Law and the following substances: gasoline, kerosene, other flammable or toxic petroleum products, toxic pesticides and herbicides, volatile solvents, materials containing asbestos or formaldehyde, and radioactive materials. As used in this paragraph 20, "Environmental Law"means federal laws and laws of the jurisdiction where the Property is located that relate to health, safety or environmental protection. 21. Acceleration; Remedies. Lender shall give notice to Borrower prior to acceleration following Borrower's breach of any covenant or agreement in this Security Instrument (but not prior to acceleration under paragraph 17 unless applicable law provides otherwise). The notice shall specify: (a) the default; (b) the action required to cure the default; (c) a date, not less than 30 days from the date the notice is given to Borrower, by which the default must be cured; and (d) that failure to cure the default on or before the date specified in the notice may result in acceleration of the sums secured by this Security Instrument, foreclosure by judicial proceeding and sale of the Property. The notice shall further inform Borrower of the right to reinstate after acceleration and the right to assert in the foreclosure proceeding the non-existence of a default or any other defense of Borrower to acceleration and foreclosure. It the default is not cured on or before the date specified in the notice, Lender, at its option, may require immediate payment in full of all sums secured by this Security Instrument without further demand and may VQ2 *** OR 4841 PG 1598 *** foreclose this Security Instrument by judicial proceeding. Lender shall be entitled to collect all expenses incurred in pursuing the remedies provided in this paragraph 21, including, but not limited to, reasonable attorney's fees and costs of the title evidence. 22. Release. Upon payment of all sums secured by this Security Instrument, Lender shall release this Security Instrument, without charge, to Borrower. Borrower shall pay any recordation costs. 23. Attomeys' Fees. As used in this Security Instrument and the Note, "attorneys' fees" shall include any attomeys' fees awarded by an appellate court. 24. Special Covenants. Subsidy Retention. a. Fair Market Value: Fair Market Value is the market value of the Property as reasonably determined by appraisal. Lender and Homeowner shall mutually select an appraiser whose determination shall be deemed Fair Market Value. if Lender and Homeowner cannot mutually agree on an appraiser, each shall select an appraiser who shall each submit an appraisal. If the two appraisals differ, then the average of the two appraisals shall be deemed the Fair Market Value. All costs of appraisal shall be bome by Homeowner. b. Term: The Subsidy Retention requirement shall commence upon transfer of title to the Property to Homeowner and shall end on the later of (i) the original maturity date of the Note; or (ii) fifteen (15) years. c. Purpose: The subsidy retention amount is the amount necessary to reduce the purchase price to an affordable level for the qualifying Homeowner having an income below one hundred twenty percent (120%) of the Area Median Income ('AMI). d. Index: U.S. Department of Labor Bureau of Labor Statistics consumer Price Index — All Urban Consumers Miami -Fort Lauderdale, Florida Area, effective date of proposed transfer. e. Appreciation Limitation: Should Homeowner desire to transfer the Property prior to maturity date of the Note and Mortgage, appreciation shall be limited to these price plus annual appreciation based upon the Index defined in section (1)(d) of this Mortgage. For �xa's m eowner purchases the home for $175,000 and there is a 3% annual income inflation as dete ecb nd of five years the house will be worth $202,873.00 representing the projected Home y of $27,873. No ng that the Property could be sold for a greater Fair Market Value than $202,873, $ 2(@7 ill be the maximum allow e p hase price the house can be sold for, and only to an income qualified Applicant,/6p r r County Housing a Hu an Services. f. Joint and Several Liability Eac pe xec 'ng tfiis gage a Ho eowner shall be jointly and severally liable for each and every obligation arising ereunder. SIGNING BELOW, Borrower accepts and agr as tth term acid cjw by Borrower and recorded with it. J Signed, sealed and delivered in the presence o� Witness#1: Lim r� IQ • (a_ Signature: Borrower Signature:.�— Witness#2: t 0. Signature: STATE OF FLORIDA COUNTY OF COLLIER Borrower Instrument and in any rider(s) executed w~/ BORGELA Address: 1141 Eisenhower Boulevard, Lehigh Acres, FL 33974 I hereby certify that on this day, before me, an officer duly authorized in the state aforesaid and in the county aforesaid to take acknowledgements, personally appeared PIERRE A. BORGELA and YOLANDE BORGELA to me known to be the persons described in and who executed the foregoing instrument and acknowledged before me that they executed the same for the purpose therein expressed. WITNESS my hand and official seal in the County and State aforesaid this day o X .2012. My Commission Expires: ota s ignat (Seal) f �^ TAMMY J. OR P/F F commission # DD 891857 Expires May 21, 2013 '•'; r��.° r.+-KII Pro Tn ran hrnm3 -PPM 4 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing cines #1 through #2 as appropriate for additional signatures, dates, and/or information needed. if the document is already complete with the exception of the Chairman's sienature. draw a line throueh routine lines # 1 throueh #2. complete the checklist. and forward to the County Attornev Office. Route to Addressees (List in routing order) Office Initials Date 1. Jennifer A. Bel edio, ACA County Attorney Office Initial 1 3 ! 2. BCC Office Board of County Commissioners �] 3. Minutes and Records Clerk of Court's Office NOTE: Clerk's attestation is not required. Please do not route this item to Clerk's Board Minutes and Records. CAO please scan document after execution by Chairman and email them to Clerk's Minute and Records for its records. PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above- may need to contact staff for additional or missine information. Name of Primary Staff Elizabeth Hernandez, CHS Phone Number 239-252-2338 Contact 1 Department ap2ropriate. Initial Applicable) Agenda Date Item was January 3, 2018 Agenda Item Number Approved by the BCC Does the document need to be sent to another agency for additional signatures? If yes, Type of Document Insurance Claim Check Endorsement for Number of Original i Attached Sarah Schafer Documents Attached ` PO number or account signed by the Chairman, with the exception of most letters, must be reviewed and signed number if document is NIA to be recorded All handwritten strike -through and revisions have been initialed by the County Attorney's NIA INSTRUCTIONS & CHECKLIST I: Forms/ County Forms/ BCC Forms/ Original Documents /touting Slip WWS original 9.03-04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12 Initial the Yes column or mark "NIA" in the Not Applicable column, whichever is Yes NIA (Not ap2ropriate. Initial Applicable) 1. Does the document require the chairman's original signature? 2, Does the document need to be sent to another agency for additional signatures? If yes, provide the Contact Information Name; Agency; Address• Phone on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be NIA signed by the Chairman, with the exception of most letters, must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike -through and revisions have been initialed by the County Attorney's NIA Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the NIA document or the final negotiated contract date whichever is applicable. 6. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's C1 r, r1 ��^7 sipnature and initials are required. 7. In most cases (some contracts are an exception), the original document and this routing slip NIA should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 06/12/2012 and all changes made during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes, if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC, all changes directed by the BCC have been made, and the document is ready for the el—I A��_ Chairman's signature, I: Forms/ County Forms/ BCC Forms/ Original Documents /touting Slip WWS original 9.03-04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12 � m N � ILD z _m N � � o N Qy O mCD ❑ ri r N a l k w k 2 Z Y U w X U a ry r w F- U W U x U E!I J 07 ❑ U C "CS C 'T U LI1 vQ o L io<Z: a E �u) oN�n �-j maw LLx �m c z Q E a Q cc U) .].. ❑ LULL a z (n w; w a: 0- a v a r m ;_Fm La oa a Z)� U � 0 N u)Z a L. Z ❑ LAI Z LU d } Lll 1- a ❑ -� U x❑ 2 n g w J a¢ Q — � m N � _m N N N Qy O M L1 Q CG [D tf] Cl) [Y] W � U u Z d j�\� rr nn Qi CL ul C M CL U 1 cts a Q 0 r 7z z Cu LU a m t!] ti a] i ff W D U C Cif Y Z im f >= M LU LL Q U C/) Q Q CI) w d I m m U7 LZ ti 1 ru 1 I ❑ o r. ru .a E �r li. La CD �I z . m Collier County Community and Human Services Division (CHS) Homeowner Insurance Check Endorsement Policy Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage/lien, then the loan will not have to be repaid. On occasion, the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and receive money to make the repairs. If the insurance claim check is made payable to the homeowner and Collier County, then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to CHS at the address below for check endorsement consideration: 1. Copy of Homeowner's current insurance policy -Declaration Page. 2. Copy of insurance company's claim report with worksheet including description of repairs and costs. 3. Copy of photos of claim damage. 4. Copy of Insurance check(s) payable to homeowner, first lien holder and Collier County. Homeowner Name: Sarah Schafer Homeowner Address: 5$$0 Everglades Blvd. Naples, FL 34120 Primary Contact Number: 239-254-9171 Homeowner Email: aarose528@p-mail.com CIN- Grant Coordinator CHS Director OFFICE USE ONLY 1 3 [� Reviewed a //ah - Date Approved Denied Memorandum To: Kimberly Grant, CHS Director CC: Jennifer Belpedio, Assistant County Attorney From: Elizabeth Hernandez, Grant Support Specialist, Community and Human Services Date: 12/19/17 Re: Homeowner Insurance claim check endorsement -Javier and Maria Sendejas 10564 Majestic Circle, Naples, FL 34114 The Homeowner Insurance Check Endorsement Policy approved by the Board on June 12, 2012 (16.D.10) authorizes the Board Chairman or Vice Chairman to endorse homeowner insurance claim checks for recipients assisted with Purchase Assistance and/or rehabilitation program funds as Collier County is named as Second Mortgagee on their insurance policies. The attached check in the amount of $13,098.18 is for disbursement of the claim funds requiring endorsement by Board Chairman Taylor or Vice Chairman. The check names M&T Bank as the first mortgage lender and Collier County SHIP as subordinate lien holder. In order for the check to be properly processed, proper signatures/endorsement for all parties listed on check must be obtained. This is a time -sensitive item and must be endorsed as soon as possible as homeowner is waiting to pay for work to be performed on home. Attachments: Homeowners Insurance Policy -Declaration Page Insurance Claim Check (#288060 $13,098.18) Insurance Claim Report & photos of damage Collier County Second Mortgage I 1 P r. HOMEOWNERS DECLARATION ..... %.r I N s U R A N c E POLICY NUMBER POLICY PERIOD UNITED PROPERTY & CASUALTY INS CO Coverage is provided where premium and From To P.O. Box 51149 UHV 3267228 04 01 12/20/2016 12/20/2017 Sarasota, FL 34232-0330 SECTION I COVERAGE 12:01 a. m. at the residence premises. RENEWAL DECLARATION Effective: 12/20/2016 Date Issued: 10/28/2016 INSURED: AGENT:. 2002741 B. OTHER STRUCTURES SARAH SCHAFER INSURANCE PRODUCTS AND C. PERSONAL PROPERTY 5880 EVERGLADES BLVD N SERVICE INC D. LOSS OF USE NAPLES FL 34120 5620 STRAND BLVD UNIT 2 SECTION II COVERAGE NAPLES FL 34110 E. PERSONAL LIABILITY Telephone: 239-250-9171 Telephone: 239-591-4028 F. MEDICAL PAYMENTS The residence premises covered by this policy is located at the address listed below. INCLUDED OPTIONAL COVERAGES COLLIER COUNTY GOVT CIO HSG ISAOA 5880 EVERGLADES BLVD N NAPLES FL 34120 HUMAN & VETERAN SVC COLLIER IF PAYMENT IS NOT RECEIVED ON OR BEFORE THE POLICY RENEWAL EFFECTIVE DATE, THIS POLICY WILL NOT BE IN FORCE. HO 0003 (05/11) Coverage is provided where premium and limit of liability is shown. Flood coverage is not provided and is not a part of this policy. HO 0355 (05113) SECTION I COVERAGE LIMIT OF LIABILITY PREMIUMS A. DWELLING $250,000.00 $984.00 B. OTHER STRUCTURES $5,000.00 INCLUDED C. PERSONAL PROPERTY $52,500.00 -$156.00 D. LOSS OF USE $50,000.00 INCLUDED SECTION II COVERAGE SECOND MORTGAGEE E. PERSONAL LIABILITY $300,000.00 $18.00 F. MEDICAL PAYMENTS $1,000.00 INCLUDED OPTIONAL COVERAGES COLLIER COUNTY GOVT CIO HSG ISAOA Premium charge for Hurricane Exposure: $558.00 The above coverages are subject to a 2% of Coverage A 1 $5,000 Hurricane Deductible per calendar year. The above coverages are subject to a 10% of Coverage A/ $25,000 Sinkhole Deductible per sinkhole loss. The above coverages are subject to a $2,500 All Other Peril Deductible. TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES: $873.00 The amount of premium change due to approved rate increase is $28.00 The amount of premium change due to coverage change is $32.00 COVERAGES HAVE BEEN INCREASED TO HELP KEEP PACE WITH RISING REPLACEMENT COSTS. PLEASE CONTACT YOUR AGENT IF THERE ARE ANY QUESTIONS PERTAINING TO YOUR POLICY. FORMS AND ENDORSEMENTS HO 0003 (05/11) HO 0334 (05113) COUNTERSIGNED DATE 10/28/2016 HO 0350 (06/97) HO 0355 (05113) ``��"" TG HO 0446 (10100) HO 0496 (04191) i - HO 2370 05113) -HPINSTALL (11114) l BY Continued on Forms Schedule ADDITIONAL INTERESTS MORTGAGEE SECOND MORTGAGEE 91863316 M&T BANK COLLIER COUNTY GOVT CIO HSG ISAOA HUMAN & VETERAN SVC COLLIER P O BOX 5738 3339 E TAMIAMI TRAIL SUITE 211 SPRINGFIELD OH 45501-5738 NAPLES FL 34112 UPC 119 05 16 INSURED COPY Page 1 of 4 I IPC:/ -000* HOMEOWNERS DECLARATION INSURANCE UNITED PROPERTY & CASUALTY INS CO P.D. Box 51149 Sarasota, FL 34232-0330 NIA POLICY NUMBER FromPOLICY PERIOD ra UHV 3267228 04 01 12/20/2016 12/20/2017 72:01 a.m. at the residence premises. FORM TYPE HO -3 RENEWAL DECLARATION Effective: 12/20/2016 Date Issued. -10/28/2016 INSURED: AGENT: 2002741 SARAH SCHAFER 5880 EVERGLADES BLVD N NAPLES FL 34120 Telephone- 239-250-9171 INSURANCE PRODUCTS AND SERVICE INC 5620 STRAND BLVD UNIT 2 NAPLES FL 34110 Telephone. 239-5914028 The residence premises covered by this policy is located at the above insured address unless otherwise stated below: 5880 EVERGLADES BLVD N NAPLES FL 34120 SECTION Ir SECTION II AND OPTIONAL PREMIUMS EMERGENCY MANAGEMENT TRUST FUND SURCHARGE MANAGING GENERAL AGENCY (MGA) POLICY FEE TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES NOTE: The portion of your premium for Hurricane Coverage is: The portion of your premium for All Other Coverages is: Premium: $846.00 $2.00 $25.00 $873.00 $558.00 $288.00 An adjustment of -5.8% is included to reflect the Building Code grade for your area. Adjustments range from 1 surcharge to 46.1 % credit. Your policy includes endorsement Ha 04 46 Inflation Guard- which automatically increases the amount of Dwelling Coverage by the annual percentage amount shown below. FLOOD CARRIER NIA FORM TYPE HO -3 YEAR BUILT 2003 TOWN/ROW HOUSE NIA CONSTRUCT TYPE M CONSTRUCT SUPERIOR N NUMBER OF FAMILIES 00001 AOP TERRITORY 551 PROTECTION CLASS 03 USE CODE P MUNICIPAL CODE 999999 COUNTY CODE 021 PROT DEVICE/BURGLAR N PROT DEVICE/FIRE N PROT DEV/SPRINKLER N PROT DEWSHUTTER N WIND/HAIL EXCLUSION N REPLACEMENT COST N OCCUPANCY CODE OWNER FLOOD CREDIT N SINKHOLE COVERAGE I WIND TERRITORY 551A WATER PREVENTION CR N INFLATION GUARD 4% UPC 119 05 16 INSURED COPY Page 2 of 4 I 1 PIr'_� % HOMEOWNERS DECLARATION INSURANCE UNITED PROPERTY & CASUALTY INS CO POLICY NUMBER POLICY PERIOD From To P.O. Box 51149 UHV 3267228 04 01 12/20/2016 12/20/2017 Sarasota, FL 34232-0330 12:01 a. m. at the res idents premises. RENEWAL DECLARATION Effective: 12/20/2016 Date Issued: 10/28/2016 INSURED: AGENT: 2002741 SARAH SCHAFER INSURANCE PRODUCTS AND 5880 EVERGLADES BLVD N SERVICE INC NAPLES FL 34120 5620 STRAND BLVD UNIT 2 NAPLES FL 34110 Telephone! 239-250-9171 Telephone! 239-591-4028 The residence premises covered by this policy is located at the above insured address unless otherwise stated below: 5880 EVERGLADES BLVD N NAPLES FL 34126 LAW AND ORDINANCE OVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE FROM THE NATIONAL FLOOD INSURANCE PROGRAM. WITHOUT THIS COVERAGE, YOU MAY HAVE UNCOVERED LOSSES. PLEASE DISCUSS THESE COVERAGES WITH YOUR INSURANCE AGENT. (YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM.) A rate adjustment of 81 % of wind premium is included to reflect the windstorm mitigation features of your dwelling. Adjustments range from 0% to 89% credit subject to verification that your home meets the windstorm mitigation characteristics of the 2001 Florida Building Code. THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES, WHICH MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU. IN CASE OF A LOSS TO COVERED PROPERTY, YOU MUST TAKE REASONABLE EMERGENCY MEASURES SOLELY TO PROTECT THE PROPERTY FROM FURTHER DAMAGE IN ACCORDANCE WITH THE POLICY PROVISIONS (MAY NOT EXCEED THE GREATER OF $3000 OR 1% OF YOUR COVERAGE A LIMIT OF LIABILITY UNLESS YOU CALL US FIRST AND RECEIVE APPROVAL). PROMPT NOTICE OF THE LOSS MUST BE GIVEN TO US OR YOUR INSURANCE AGENT. EXCEPT FOR REASONABLE EMERGENCY MEASURES, THERE IS NO COVERAGE FOR REPAIRS THAT BEGIN BEFORE THE EARLIER OF - JA} 72 HOURS AFTER WE ARE NOTIFIED OF THE LOSS, [B] THE TIME OF LOSS INSPECTION BY US, OR (C) THE TIME OF OTHER APPROVAL BY US. TO REPORT A LOSS OR CLAIM CALL 1(888) 256-3378. ************* Additional Information This replaces all previously issued policy declarations, if any. The declarations page together with all policy provisions and any other applicable endorsements completes your policy. UPC 119 05 16 INSURED COPY Page 3 of 4 UPC INSURANCE UNITED PROPERTY & CASUALTY INS CO P.O. Box 51149 Sarasota, FL 34232-0330 01RB11655 (02110) UPC 112 (08199) UPC 176 (10112) UPC 603 (12114) -01RB11670 (01106) " UPC 155 {01106} UPC 191 (04116) UPCNCPT (06115) POLICY NUMBER POLICY PERIOD From TO UHV 3267228 04 01 12/20/2016 12/20/2017 12:01 a.m. at the residence premises. FORMS SCHEDULE (continued from page 1) ' UIM 424 (06101) UPC 105 (07114) -UPC 107 (08199) "UPC 160 (10105) UPC 164 (06106) UPC 174 (09106) UPC 192 (07114) UPC 601 (02114) UPC 602 (02114) UPC 119 05 16 INSURED COPY Page 4 of 4 INSTR 4929021 OR 4996 PG 823 RECORDED 12/30/2013 10:26 AM PAGES 5 DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT, COLLIER COUNTY FLORIDA DOC@.35 $70.00 Ifi $40.00 REC $44.00 OBLD S20,0D0.00 OBLI 520,000.00 Prepared by and Return to: Collier County Housing, Human and Veteran Services Department 3339 E. Tamiami Trail, Building H, Suite 211 Naples, Florida 34112 STATE HOUSING INITIATIVES PARTNERSHIP (SHIP) PROGRAM SECOND MORTGAGE THIS SECOND MORTGAGE ("Security Instrument") Is given on 2 6th day of December, 2013 2813. The Second Mortgagor Is: Sarah Schafer, A single person ("Borrower"). This Security Instrument is given to Collier County— SHIP ("Lender"), which is organized and existing under, the laws of the United States of America, and whose address is 3339 E. Tamiami Trail, Naples, Florida 36112. Borrower owes Lender the sum of Twenty Thousand and 00/100 Dollars ($20,000.2a. This debt is evidenced by Borrower's Note dated the same date as this Security instrument ("Second Mortgage"). which does not provide for monthly payments. The full debt, if not paid earlier, is due upon sale of the property withf0,lhe fifteen year term. If sold after the fifteen year term, no repayment is required. As long as the borrower continues to own and occupy the assisted property during the term o the mortgage, then the loan will not have to be repaid. This Seourdy Instrument secures to Lender. (a) the repayment of the debt evidenced by the Note, with interest, and all renewals, extensions and modifications; (b) the payment of all other sums, with interest advanced under paragraph 7 to protect the security of the Security Instrument; and (c) the performance of Borrower's covenants and agreements under this Security Instrument and the Note. For this purpose, Borrower does hereby second mortgage, grant and convey to Lender the following described property located in Collier County, Florida. As more particularly described as: GOLDEN GATE EBT UNIT 434 180 FT OF TR 4 and which has the address of The Mortgagor shall pay or cause to be paid, as s k v a due, (A)(1) all taxes and governmental charges of any kind whatsoever which may at any time be lawfully assessed o with respect to the Property, (2) all utility and other charges, including "service charges", incurred or imposed for the operation, maintenance, use, occupancy, upkeep and improvement of the Property, and (3) all assessments or other governmental charges that may lawfully be paid in installments over a period of years, the Mortgagor shall be obligated under the Mortgage to pay or cause to be paid only such installments as are required to be paid during the term of the Mortgage, and shall, promptly after the payment of any of the foregoing, forward to Mortgagee evidence of such payment. 3. Appllca0on of Payments. Unless applicable law provides otherwise, all payments received by lender shall be applied; first, to interest due; and, to principal due: and East, to any late charges due under the Note. 4, Charges; Llens. Borrower shall pay all taxes, assessments, charges, fines and impositions attributable to the Property which may attain priority over this Securlty Instrument, and leasehold payments or ground rents, if any. Borrower shall promptly furnish to Lender all notices of amounts to be paid under this paragraph, and all receipts evidencing the payments. Borrower shall promptly discharge any lien which has priority over this Security instrument unless Borrower. (a) agrees in writing to the payment of the obligation secured by the lien In a manner acceptable to Lender, (b) contests in good faith the lien by, or defends against enforcement of the lien in, legal proceedings which in the Lender's opinion operate to prevent the enforcement of the lien; or (c) secures from the holder of the lien an agreement satisfactory to Lender subordinating the lien to this Security Instrument If Lender determines that any part of the Property is subject to alien which may attain priority over the Security Instrument, Lender may give Borrower a notice identifying the lien. Borrower shall satisfy the lien or take one or more of the actions set forth above within 10 days of the giving of notice. S. Hazard or Property Insurance. Borrower shall keep the improvements now existing or hereafler erected on the Property Insured against loss by fire, hazards included within the temp "extended coverage" and any other hazards, including floods or flooding, for which Lender requires insurance. This insurance shall be maintained in the amounts and fw the periods that Lender requires. The Insurance carrier providing the insurance shall be chosen by Borrower subject to Lender's approval which shall not be unreasonably withheld. If Borrower fails to maintain coverage described above, tender may, at Lenders option, obtain coverage to protect Lendees rights in the Property in accordance with paragraph 7. At all times that the Note is outstanding, the Mortgagor shall maintain insurance with respect to the Premises against such risks and for such amounts as are customarity insured against and pay, as the same became due and payable, all premiums In respect thereto, including, but not limited to , all-risk insurance protecting the interests of the Mortgagor and Mortgagee against loss or damage to the Premises by fire, Ilghtri and other CasuaRtes Customarily Insured against (Including boiler explosion. If appropriate), with a uniform standard extended coverage endorsement, including debris removal coverage. Such insurance at all times to be in an amount not less than the full replacement cost of the Premises, exclusive of footings and foundations. Ail insurance policies and renewals shall be acceptable to Lender and shall include a standard rrmarlgage clause. Lender shall have the right to hold the policies and renewals. If Lender requires, Borrower shall promptly give to tender all receipts of paid premiums and renewal notices. In the event of toss, Borrower shall give prompt notice to the insurance carrier and Lender. Lender may make proof of loss if not made promptly by Borrower. Unless Lender and Borrower otherwise agree in writing, insurance proceeds shall be applied to restoration or repair of the Property damaged, if the restoration or repair is economically feasible and Lender's security is not lessened. If the restoration or repair is not economically feasible or Lenders security would be lessened, the insurance proceeds shall be applied to the sums secured by the Security Instrument, whether or not then due, with arty excess paid to Borrower. If Borrower abandons the Property, or does not answer within 30 days a notice from tender that the insurance carrier has offered to settle a claim, then Lender may collect the Insurance proceeds. Lender may use the proceeds to repair or restore the Property or to pay sums secured by this Security Instrument, whether or not then due. The 30 -day period will begin when the notice is matted. Unless Lender and Borrower otherwise agree In writing, any application of proceeds to principal shall not extend or postpone the due date of the monthly payments referred to in paragraph 1 or change the amount of the payments. If under paragraph 21 the Property is acquired by Lender, Borrower's right to any Insurance policies and proceeds resulting from damage to the Property prior to the acquisition shall pass to Lender to the extent of the sums secured by this Security Instrument immediately prior to the acquisition. {"Property Address"): 5913❑ Ever lades 81v Y� FL 3612p (Address) � {City (Slate] (Zip] TOGETHER WITH all the improveme I'll erected o he pro y, a all easements, rights, appurtenances, rents, royalties, mineral, oil and gas rights and profits t rig tock a a res or h ager apart of the property. All replacements and additions shall also be covered by the Be rity st moot th Fore ei Is rete d t in this Security Instrument as the "Property". BORROWER COVENANTS that Bo ow s h nye ed end has the right to mortgage, grant and convey the Property and that the Property is n m x p for h n s re ord. Borrower warrants and will defend generally the title to the Property against all claims and ds su ' ct y bran re THIS SECURITY INSTRUMENT bid tions n �Cr nifomn covenants with limited variation by jurlsdfCtfon to constitute a uniform security lost _ e t covering real property. UNIFORM COVENANTS. Borrower der covenant amid agree�tolldws� ti t. Payment of Principal and Into � yment and Late Chart/ hal] promptly pay when due the principal of and interest on the debt evidenced by the Note. 2. Taxes. The Mangagar will pay all taxa � ants, sewer rents prior to the accrual of any y pena[tias or interest OR 4996 PG 824 6. Occupancy, preservation, Maintenance and Protection of the Proparty; Borrower's Loan Application, Leaseholds. Borrower shall occupy, establish, and use the Property as Borrowers principal residence within sixty days after the execution of this Security Instrument and shall continue to Occupy the Properly as Borrower's principal residence for at least one year after the date of occupancy, unless Lender olherwise agrees inwriting, which consent shall not be unreasonably with held, or unless extenuating circumstances exist whlch are beyond Borrower's control. Borrower shall not destroy, damage or impair the Property, allow the Property to deteriorate, or oommft waste on the Property. Borrower shall be in default if any forfeiture action or proceeding, whether civil or criminal, is begun that in Lender's good faith judgment could result in forfeiture of the Property or otherwise materially impair the lien created by this Security Instrument or Lenders security interest. Borrower may cure such a default and reinstate, as provided in paragraph 18, by causing the action or proceeding to be dismissed with a ruling that, in Lendefs good faith dole rminallon, preludes forfeiture of the Borrowers interest in the Property or other material impairment of the lien created by this Security Instrument or Lender's security interest. Borrower shall also be in default if Borrower, during the loan application process, gave materially false or inaccurate Information or statements to Lender (or failed to provide Lender with any materlal information) in connection with the loan evidenced by the Note. Including, but not limited to, representations concerning Borrower's occupancy of the Property as a principal residence. If this Security Instrument is on a leasehold. Borrower shall comply with all the provision of the lease - If Borrower acquires fee title to the Property, the leasehold and the fee title shall not merge unless Lender agrees to the merger In writing. T. Protection of Lenders Rights to the Property. If Borrower faits to perform the covenants and agreements contained in this Security instrument, or there is a legal proceeding that may significantly affect Lender's rights in the Property (such as a proceeding in bankruptcy, probate, for condemnation Or forfeiture or to enforce laws or regulations), then Lender may do and pay for whatever is necessary to protect the value ofthe Property and Lender's rights in the Property. Lender's actions may Include paying any sums secured by a Ilan which has priority over this Security Instrument, appearing In court, paying reasonable attorneys' fees and entering on the Property 10 make repairs. Although Lender may take action under this paragraph 7. Lender does not have to do so. Any amounts diabursed by Lender under this paragraph 7 shall become additional debt Of Borrower secured by this Security Instrument. Unless Borrower and Lender agree to Other terms of payment, these amounts shall hear interest from the date of disbursement at the Note rate and shall be payable, with interest, upon notice from Lender to Borrower request ng payment. 8. Mortgage Insurance. If Lender required mortgage insurance as a condition of making the loan secured by this Security Instrument, Borrower shall pay the premiums required to maintain the mortgage insurance In effect. If, for any reason, the mortgage insurance coverage required by Lander lapses or ceases to be In effect, Borrower shall pay the premiums required to obtain coverage substantially equivalent to the mortgage Insurance previously in effect, at a cost substantially equivalent to the cost to Borrower of the mortgage insurance previously in effect, from an alternate mortgage insurer approved by Lender. If substantially equivalent mortgage insurance coverage is not available, Borrower shall pay to Lender each month a sum equal to ane -twelfth of the yearly mortgage Insurance premium being paid by Borrower when the insurance coverage lapsed Or ceased to be in aired. Lender will accept, use and retain these payments as a loss reserve in lieu Of mortgage insurance. Loss reserve payments may no ionger be required, at the option of Lender, if mortgage insurance coverage (in the amount and for the period that Lender requires) provided by an insurer approved by lender again becomes available and is obtained. Borrower she[[ pay the premiums required to maintain mortgage in effect, or to provide a loss reserve, until the requirement for mortgage insurance ends In accordance with any written at A - er and Lender or applicable law. 9. Inspection. Lender or its agent may mak s cid eCfions of the Property. Lender shall give Borrower notice at the time of or prior to an inspection specify€ a cause for the' 10. Condemnation. The proceeds or a or claim for damages, di nsequentlaf, In connection with any condemnation or other taking of any part of the Property, or for rive nce In li u of condemnalion, he y assigned and shall be paid to Lender. In the event of a total taking of the Property, the proce ds s al! � ecwed y thi Security Instrument, whether or not then due, with any excess paid to Berrower. In the event f a rtia kin ft roperty, 'a which a fa market value of the Property immediately before the laking is equal to dr greater than Th am c C I rishument immediately before the taking, unless Borrower and Lender otherwise agree in writi , th u s r y i un e t sh Il be reduced by the amount of the proceeds multiplied by the following fractlon: (a) the to am at ft su s ec ed be re t e taking, divided by (b) the fair market value of the Property immediately before the taking, 1 11 d ❑ rrowe I th ive t of a partial taking of the Properly In which the fair market value of theProperty immed[a I or a take es he a un ,$ ums secured immediately For the taking, unless Borrower and Lender otherwise agree i I g or unless applicable la the 'se s, the proceeds shall be applied to the sums secured by this Security Instrument whether or sums are Then due. U d orrower otherwise agree in writing, any application of proceeds to principal shall not exte tpone the due date of yments referred to In paragraphs 1 or change the amount of such payments. 11. Borrower Not Released, Forbearan , Not a Waive of the time for payment or modification of amort nation of" sums secured by this Security Instru nt $Ta b uccessor fn interest of Borrower shall not operate to release the liability of the original Borrower or Borrower's su Jn nder shall not be required to commence proceedings against any successor in interest or refuse to extend time for paym erwise modify amortization of the sums secured by this Security Instrument by reason of any demand made by the original Borrower or Borrowers successors In interest. Any forbearance by Lender in exercising any right or remedy shall not be a waiver of or preclude the exercise of any right or remedy. 12. Successons and Assigns Bound; Joint and Several Liability; Cc -Signer. The covenants and agreements of this Security Instrument shall bind and benefit the successors and assigns of Lender and Borrower, subject to the Provisions of paragraph 17. Borrowers covenants and agreements shall be joint and several. Any Borrower who co-signs this Securily Instrument but does not execute the Note; (a) is co-signing this Security Instrument only to mortgage, grant and convey that Borrower's interest in the Properly under the terms of this Security Instrument; (b) Is not personally obligated to pay the sums secured by this Security Instrument: and (c) agrees that Lender and any other Borrower may agree to extend, modify, forbear or make any accommodations with regard to the terms of this Security Instrument or the Note without that Borrowers consent. 13. Loan Charges. If the loan secured by this Security Instrument Is subject to a law which sets maximum loan charges, and that law is finally interpreted so that the interest or other loan charges collected or to be collected in connection with the loan exceed the permitted Ilmits, then: (a) any such loan charge shall be reduced by the amount necessary to reduce the charge to the permitted limit; and (b) any sums already collected from Borrower which exceeded permitted limits will be refunded to Borrower. Lender may choose to make this refund by reducing the principal owed under the Note or by making a direct payment to Borrower. [fa refund reduces principal, the reduction will be treated as a partial prepayment without any prepayment charge under the Note, 14. Notices. Any notice to Borrower provided for in this Security Instrument shall be given by delivering it or by mailing it by first class mail unless applicable law required use of another method. The notice shall be directed to the Property Address or any other address Borrower designates by notice to Lender. Any notice to Lender shall be given to Borrower or Lender when given as provided in this paragraph. 15. Cove ming Law; Severability. This Security Instrument shall be governed by federal law and the law of the jurisdiction In which the Property is located. In the event that any provision or clause of this Security instrument or the Note conflicts with applicable law, such conflict shall not affect other provisions of this Security Instrument or the Note which can be given effect without the conflicting provision. To this end the provisions of this Security Instrument and the Nate are declared to be severable. 16. Borrower's Copy. Borrower shall be given One conformed copy of the Note and of this Security Instrument. 17. Transfer of the Property or a BeneFclal Interest In Borrower. If all er any part of the Property or any interest in it is sold or transferred (or if a beneficial interest in Borrower is sold or transferred and Borrower is not a natural person) without Lenders prier written consent. Lender may, at its option, requite immediate payment In Full of all sums secured by this Security Instrument. However, this option shall not be exercised by Lender if exercise is prohibited by federal law as of the date of this Security Instrument. If Lender exercised this option, under shall give Borrower notice of acceleration. The notice shall provide a period of not less than 30 days From the date the notice is delivered or mailed within which Borrower must pay all sums secured by this Security Instrument. If Borrower fails to pay these sums prior to the expiration of this period, Lender may invoke any remedies permitted by this Security Instrument without further notice or demand On Borrower. 1B. Borrower's Right to Reinstate. If Borrower meets certain conditions, Borrower shall have the right to have enforcement of this Security Instrument discontinued at any time prior to the earlier of : (a) 5 days (or such other period as applicable law may specify For reinstatement) before sale of the Property pursuant to any power of safe contained in this Sam rfty Instrument; or (b) entry Of a judgment enforcing this Security Instrument. Those conditions are that Borrower: (a) pays Lender all sums which then would be due under this Security Instrument and the Note as if no acceleration had occurred; (b) oures and default of any other covenants Or agreements; (c) pays all expenses incurred in enforcing this Security Instrument, including, but not limited to, reasonable attorneys fees; and (d) takes such action as Lender may reasonably require to assure that the lien of this Security Instrument, Lender's rights in the Property and Borrower's obligation to pay the sums secured by this Security Instrument shall continue unchanged. Upon reinstatement by Borrower, this Security Instrument and the obligations OR 4996 PG 825 secured hereby shall remain fully effective as if no acceleration had occurred. However, this right to reinstate shall not apply in the case of acceleration under paragraph 17. t9. Sale of Note; Change of Loan Servicer. The Note ora partial Interest in the Note (together with this Security Instrument) may be sold one or more times without prior notice to Borrower. A sale may result in a change in the entity (known as the 'Loan Servicer) that collects monthly payments due under the Note and this Security Instrument. There also may be one or more changes of the Loan Servicer unrelated to a sale of the Note. If there is a change of the Loan Servicer, Borrower will be given written notice of the change In accordance wish paragraph 14 and applicable law. The notioe will state the name and address of the new Loan Servicer and the address to which payments should be made. The notice will also contain any other information required by applicable law. 20. Hazardous Substances, Borrower shall not cause or permit the presence, use, disposal, storage, or release of any Hazardous Substances on Orin the Property. Borrower shall not do, nor allow anyone else to do, anything affecting the Property that Is In violation of any Environmental Law. The preceding two sentences shall not apply to the presence, use, or storage on the Property of small quantities of Hazardous Substances that are generally recognized to be appropriate to normal residential uses and to maintenance of the Property, Borrower shall promptly give Lender written notice for any investigation, claim, demand, lawsuit or other action by any governmental or regulatory agency or private party involving the Property and any Hazardous Substance or Environmental Law of which Borrower has actual knowledge. If Borrower learns, or is notified by any governmental or regulatory authority, that any removal or other remediation of any Hazardous Substance affecting the Property is necessary, Borrower shall promptly take ail necessary remedial actions in accordance with Environmental Law. As used in this paragraph 20, "Hazardous Substances" are those substances defined as toxic or hazardous substances by Environmental Law and the following substances: gasoline, kerosene, other flammable or toxic petroleum products, toxic pesticides and herbicides, volatile solvents, materials containing asbestos or formaldehyde, and radioactive materials. As used in this paragraph 20, "Environmental Lav" means federal laws and laws of the jurisdiction where the Property is located that relate to health, safety or environmental protection. 21. Acceleration; Rented les. Lender shall give notice to Borrower prior to acceleration following Borrower's breach of any covenant or agreement in this Security Instrument (hut not prior to acceleratlon under paragraph 17 unless applicable law provides otherwise). The notice shall specify: (a) the default; (b) the action required to cure the default; (c) a date, not less than 30 days from the date the notice Is given to Borrower, by which the default must be cured; and (d) that failure to cure the default on or before the date specified in the notice may result in acceleration of the sums secured by this Security Instrument, foreclosure by judicial procaeding and sale of the Property. The notice shall further inform Borrower of the right to reinstale after acceleration and the right to assert In the foreclosure proceeding the non-existence of a default or any other defense of Borrower to acceleration and foreclosure. If the default is not cured on or before the date specified in the notice, Lender, M its optton, may require Immediate payment in full of al] sums secured by this Security Instrument without further demand and may foreclose this Security Instrument by Judicial proceeding. Lender shall be entllted to collect all expenses Incurred In pursuing the remedies provided in this paragraph 21, including, but not limited to, reasonable attorney's fees and costs of the title evidence, 22. Release. Upon payment of all sums secured by this strument. Lender shalt release this Security Insttrment, without charge, to Borrower. Borrower shall pay any recordation SS 23. Attanneys' Fees. As used In this 5ecuri tfi�rpp eys' fees" shall include any attorneys' fees awarded by an appellate court [� 24. Riders to this Security Instrument. F o 'b" more riders are executrB r and recorded together with this Security Instrument, the covenants and agreements of ea sue rider shall be incorporatedinto no s 4 amend and supplement the covenants and agreements of this Security Instrument as if the der[ apart S�ri{y Instru ent. Cherie Applicable Box) ❑ Adjustable Rate Rider ❑ Rai ❑ Graduated Payment Rider ❑ 1-4 ❑ Balloon Rider ❑ ant ❑ Other(s) (specify SIGNING BELOW, Borrower accepts and by Borrower and recorded with it. Signed, sealed and delivered in the presence of. Sig naturo! Borrower Sarah Schafer STATE OF FLORIDA COUNTY OF COLLIER and covenants cohbfia ii o�HE crRG Signature: _ Co- Borrower Rider Home Rider Unit Development Rider Instrumerd and in any rider(s) executed Address: 5880 Everglades Blvd, N NaPleJ Florida 34120 I hereby certify that, Sarah Schafer , personally appeared to me known to be the person(s) described in and who executed the foregoing instrument and acknowledged before me that (He/ she/ they) executed the same for the purpose therein expressed. WITNESS my hand and official seal in the County and State aforesaid thisZ 6 t'pay of _ December 2073. My Commission Expires: (seal) Notary Publio'S Signature wr y i A, At. PECX p Notary Public - State of Florida �' My Comm. Expires Oeo 8, 2flt4 Notary's Printed Name 'zis Gnmmission / EE 39543 g7ndc8'mriwjn Nati&W NOVI AM- RM SHIP File#: 12-039 SHIP Purchase Assistance Program 11/25/2017 Sarah Schafer 5884 Everglades Blvd. Naples, FL, 34120 Re' Insured: Claim Number. Policy Number: Date of Loss: Cause of Loss: Loss Location: Dear Ms. Schafer: U PC Keep the INSURANCE Promise � d#7 CW_ D�`>la A707 R! !(0L_0lerFDO DEC 2 9 2017 COLL] LR COUNTY CHs GRANTS BY: Sarah Schafer 2017FL044526 UHV3267228O4 09/10/2917 The cause of the loss was due to Hurricane Irma wind and rain damage 5880 Everglades Blvd„ Naples, FL. 34120 ESTIMATE AND SETTLEMENT OF DAMAGES Enclosed is a copy of the estimate of covered damage to your insured property. The sums noted in the estimate represent the following Coverage(s): Payment ofoX ur claim is being mailied_separately. Payment of your claim is being mailed to you separately. The settlement check represents the amount we believe you are owed based on the information we have to date. You are permitted to use this check at this time. This payment does not necessarily constitute a full and final settlement of your claim for damages associated with your claimed loss. You may submit claim(s) for any additional damages discovered in the covered reconstruction of the above-mentioned property. If your mortgage holder has been shown as a payee on your check, please understand we are obligated to do so according to the terms of your policy. Please contact your mortgage holder regarding their procedures for endorsing payments. Your policy may provide replacement cost coverage whereby you are permitted to recover up to the above amount listed as Recoverable Depreciation. In order to claim this additional amount, you must complete repairs and/or replacement of the depreciated items, and submit the final repair invoices or receipts within P❑ Box 1011 • 5t. Petersburg, FL 33731-1011 • 1-888-CLM-DEPT • Claims@UPCinsurance.cam • upcinsurance.cam Page 2 of 4 RE: Claim Number: 2017FLO51387 UP C�� he p INSURANCE Promise - 180 days from the date of loss listed above. Request for replacement cost benefits should be sent to the address or email shown below. Please include your name and claim number on all correspondence related to your claim. In order to receive payment of your Recoverable Depreciation, you will need to provide us with the following items we require in order to verify the cost of repairs and that the repairs were completed. • Final invoice or receipts reflecting the total cost of repairs. • Signed Letter of Completion on your contractor's letterhead stating that the job has been completed to your satisfaction, • Photos showing the completed work. • Copies of the cancelled checks. If you should have any additional questions regarding the settlement, or have any other information you would like for us to consider in regards to this claim, please contact the undersigned at the information shown below. Sincerely, r/�r Tlwm�sol( Tim Thompson Claims Adjuster United Insurance Management LC, Servicing Claims on Behalf of UPC Insurance Phone: 1-800-861-4370 ext. 5311 E-mail: Claims@UPCinsurance.com F.S. 89 7.234(9)(b) Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree. Notice of the Right to Mediation Pa Box 1011 • St. Petersburg, FL 33731-1011 • 1-888-CLM-DEPT • Claims@UKinsurance.com - uponsurance.com Page 3 of 4 RE: Claim Number 2017FLO51387 U PCS Keep the INSURANCE Promise The Chief Financial Officer forthe State of Florida has adopted a rule to facilitate the fair and timely handling of residential property insurance claims. The rule gives you the right to attend a mediation conference with your insurer in order to settle any claim you have with your insurer. An independent mediator, who has no connection with your insurer, will be in charge of the mediation conference. You can start the mediation process after receipt of this notice by calling the Department of Financial Services at (877) 693-5236. The parties will have 21 days from the date of the notice to otherwise resolve the dispute before a mediation hearing can be scheduled. Am I eligible? Mediation is available to anyone with a disputed residential property damage claim provided the damage is covered under their insurance policy and the dispute is in excess of $500 (not including the deductible). Who would pay for the mediation? Mediation costs would be paid for by United Property and Casualty Insurance ("UPC") The only exception would be if the insured cancels without good cause and wants to reschedule the mediation. Then the insured must pay the cost of a new conference prior to the conference being scheduled. How do I request mediation? You may request mediation by contacting the Department of Financial Services ("DFS") using any one of the methods listed below: • Online Request: http://www.myfloridacfo.com/Division/Consumers/Mediation/ • Cal1 (877) 693-523£ Fax a request to (850) 488-6372 • Write to: The Department of Financial Services Mediation Section, Bureau of Education, Advocacy, and Research 200 East Gaines Street, Tallahassee, Florida 32399-4212 Where can I obtain additional information? You may contact UPC for more information on your claim and the mediation process using any one of the methods below: • Call UPC Customer Care Center (888) 256-3378 Fax a request to ($00) 380-5053 • Write to: United Property and Casualty Insurance 800 2"d Ave. South St. Petersburg, FL 33701 Contact the adjuster that handled your claim directly What information do I need to provide? • Insured's name (include all named insureds on the policy) • Insured's email address • Mailing address • Loss location address (if different than mailing address) • Phone number(s) where you can be reached during standard business hours • Claim number and policy number PC Box 1011 • 5t. Petersburg, FL 33731-1011 • 1-888-CLM-DEPT • Claims@UPCinsurance.com • upcinsurance.com Page 4 of 4 RE: Claim Number: 2017FLO51387 UPC Keep the INSURANCE, S Promise A brief description of the nature of the dispute Citizens' contact information to include email address and phone number of the contact person for scheduling the mediation Information with respect to any other policies of insurance that may provide coverage of the insured property for named perils such as flood or windstorm What will happen next? The DFS Administrator will assign a mediator after 21 days from the date of the request if the parties (the insured and UPC) have not yet settled the claim. The mediation conference will occur within 45 days of the mediation request. Please note that either party has the right to disqualify a mediator for good cause, Good cause consists of the existence of a conflict of interest between either party and the mediator, that the mediator is unable to handle the conference competently, or other reasons which would reasonably be expected to impair the conference. What should I bring? Be sure to bring all supporting documents, including your policy, photographs, estimates, bills, reports, letters, etc. It is important to bring specific dollar estimates or quotes for all items that are in dispute. Can I bring representation to the mediation conference? Yes. You must provide notice to the mediator that you will be bringing representation to the conference 14 days before the scheduled conference, unless UPC has waived its right to the notice. What are the limits of mediation? Mediation is non-binding. Neither the insured nor UPC are legally obligated to accept the outcome. Even if a settlement is reached at the mediation, you have a three -lay grace period to change your mind; provided you do not cash the settlement check and you inform UPC that you have decided to reject the mediated outcome. Choosing mediation does not prevent you from participating in other dispute resolution procedures, or even going to court later. Nothing you say in a mediation conference can be used against you in any later proceedings References: G Florida Statute 627,7015 and Rule 69J-166.031 P❑ Box 1011 • 5t. Petersburg, FL 33731-1011 ■ 1-868-CLM -DE PT ■ Claims@UPOnsurance.eom • upcinsurance.com UPC43i :`° UPC Insurance I HS URANCE�r-- 360 Central Avenue, Suite 900 St. Petersburg FL 33701 (888)256-3378 Insured: SARAH SCHAFER Property: 5880 EVERGLADES BLVD N NAPLES, FL 34120 Home: 5884 EVERGLADES BLVD NAPLES, FL 34120 Claim Rep.: Jason Lanagan Estimator: Jason Lanagan Reference: Enrique Cedrei Company: UPC Insurance Business: 360 Central Avenue, Suite 900 St. Petersburg, FL 33741 Claim Number: 2017FLO44526 Policy Number: UHV326722804 Date Contacted: 9/23/2017 Date of Loss: 9/10/2017 Date Inspected: 10/13/2017 Price List: FLNA8X_DCT17 Restoration./Service/Remodel Estimate: 1720925 Home: (239) 642-6020 E-mail: aarose528 cr gmail.com Business: (304) 880-6618 Business: (304) 880-6618 Business: (888) 256-3378 Date Received: 9/19/2017 Date Entered: 9/19/2017 Type of Loss: Wind - Hurricane "This adjuster, the author of this estimate, has no authority to: ( 1 ) approve or deny claims; or, (2) bind UPC as to coverage for your claim or the amount of your loss, if any. A copy of this estimate does not constitute a settlement of this claim or any representation on the part of UPC. The estimate is subject to the review, modification and approval of UPC, including, but not limited to, the application of policy limitations, exclusions and deductible provisions. Any additional repairs to, or replacement of, items not included in this estimate are also subject to UPC prior approval. You are required to keep all records, cancelled checks, inspection reports, etc., as proof of repair/replacement in the event of any future loss and pursuant to your post -loss duties under your insurance policy. This estimate is not an authorization of repair. The hiring of a contractor is strictly the decision of the UPC policyholder." YPC4M: l i{sunANcr P--' 360 Central Avenue, Suite 900 St. Petersburg FL 33701 (888)256-3378 1I7" DESCRIPTION 1720925 Source- EagleView rR. 7•�16 ' tiveffi Ro [ �-- Dwelling Roof 2976.73 Surface Area 279.65 Total Perimeter Length 185.44 Total Hip Length QUANTITY UNIT PRICE TAX 29.77 Number of Squares 75.51 Total Ridge Length RCV DEPREC. ACV 30 year laminated shingles 1 16 years old depreciated based on age and condition 1 1 layer 14112 pitch 1 Estimated for roof replacement 1. Remove Tear off, haul and dispose of comp. shingles - 29.77 SQ 60.21 0.00 1,792.45 (0.00) 1,792.45 Laminated 2. Laminated - comp. shingle rfg. - wl felt 34.00 SQ 244.69 184.19 8,503.65 (4.535.28) 3,968.37 3. Roofing felt - 15 ib. 33.93 SQ 33.23 13.31 1,140.80 (912.64) 228.16 4. Ridge cap - composition shingles 260.96 LF 4.09 13.47 1,080.80 (691.71) 389.09 5. R&R Drip edge 279.65 LF 2.69 11.24 763.50 (305.57) 457.93 6. R&R Flashing - pipe jack - lead 3.00 EA 72.96 5.76 224.64 (92.55) 132.09 7. Roof vent - Detach & reset 2.00 EA 85.46 0.06 170.98 (0.00) 170.98 8. Digital satellite system - Detach & reset 2.00 EA 27.74 0.00 55.48 (0.00) 55.48 9. Digital satellite system - alignment and calibration 2.00 EA 83.23 0.00 166.46 (0.00) 166.46 only 10. Re -nailing of roof sheathing - complete re -nail 2,976.73 SF 0.25 1.79 745.97 (745.97) 0.00 Totals: Dwelling Roof 229.82 14,644.73 7,283.72 7,361.41 Front Elevation DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV Inspection of the front elevation shows no sign of storm related damage Totals. Front Elevation 0.00 0.00 0.00 0.00 Right Elevation DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV Inspection of the right elevation shows no sign of storm related damage Totals: Right Elevation 0.00 4.00 0.00 0.00 1720925 10/15/2017 Page:2 IJFC=� UPC Insurance 360 Central Avenue, Suite 900 St. Petersburg FL 33701 (888)256-3378 Rear Elevation DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 11. R&R Latticework 112.00 SF 4.21 12.10 483.62 (14.47) 469.15 Depreciation applied per age and condition 0.93 3.56 293.72 (78.33) Totals: Rear Elevation 13. Paint baseboard - two coats 12.10 483.62 14.47 469.15 Left Elevation (15.05) 41.37 IC Mask the floor per square foot - plastic and tape - 4 208.72 SF DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV Inspection of the left elevation shows no sign of storm related damage Totals: Left Elevation 0.00 0.00 0.00 0.00 Total: Source - EagleView 0.00 241.92 15,128.35 7,298.19 7,830.16 Interior Kitchen Height: 8' 11'+" 14'2"-r 312.00 SF Walls 208.72 SF Ceiling T 25' G' v - i 524.72 SF Walls & Ceiling 208.72 SF Floor 23.19 SY Flooring 39.09 LF Floor Perimeter 39.00 LF Ceil. Perimeter Missing Wall 25'8" X 8' Opens into LIVING_ROOM Missing Wall 2' 10" X 8' Opens into LIVING -ROOM DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV Depreciation applied per age and condition with the age of paint estimated at 4 years in average condition 12. Paint the walls - two coats 312.00 SF 0.93 3.56 293.72 (78.33) 215.39 13. Paint baseboard - two coats 39.00 LF 1.44 0.26 56.42 (15.05) 41.37 IC Mask the floor per square foot - plastic and tape - 4 208.72 SF 0.25 0.63 52.81 (14.08) 38.73 mil 15. Contents - move out then reset - Small room 1.00 EA 33.28 0.00 33.28 (0.0o) 33.28 Totals: Kitchen 4.45 436.23 107.46 328.77 1720925 10/15/2017 Page:3 UPC UPC Insurance Neunnk k = •+- 360 Central Avenue, Suite 900 St. Petersburg FL 33701 (888)256-3378 Missing Wall Missing Wall DESCRIPTION Living Room 594.67 SF Walls 1150.47 SF Walls & Ceiling 61.76 SY Flooring 74.33 LF Ceil. Perimeter 21 10" X 8' 25'8"X8' Height: 81 555.81 SF Ceiling 555.81 SF Floor 74.33 LF Floor Perimeter Opens into KITCHEN Opens into KITCHEN QUANTITY UNIT PRICE TAX RCV DEPREC. ACV Depreciation applied per age and condition with the age of drywall estimated at 20 years and the age of the paint estimated at 4 years in average condition 16. Drywall patch 1 small repair, ready for paint 1.00 EA 60.62 0.15 60.77 (8.10) 52.67 17. Spot seal wloil based/hybrid stain blocker 2.00 EA 25.79 0.27 51.85 (13.82) 38.03 18. Paint the walls and ceiling - two coats 1,150.47 SF 0.93 13.12 1,083.06 (288.82) 794.24 19. Detach & Reset Baseboard - 3 114" 74.33 LF 2.93 0.09 217.88 (0.00) 217.88 20. Paint baseboard - two coats 74.33 LF 1.44 0.49 107.53 (28.67) 78.86 21. Contents - move out then reset - Large room 1.00 EA 66.52 0.00 66.52 (0.00) 66.52 22. R&R Laminate floor - per specs from independent 555.81 SF 6.60 18.01 3,686.35 1479.54) 3,206.81 analysis 1.00 EA 66.52 0.00 66.52 (0.00) 66.52 23. R&R Underlayment - soundlcrack membrane - up to 555.81 SF 2.91 36.35 1,653.76 (297.23) 1,356.53 40 mil Totals: Living Roam 68.48 6,927.72 1,116.18 5,811.54 Master Bedroom 460.00 SF Walls 664.75 SF Walls & Ceiling 22.75 SY Flooring 57.50 LF Ceil. Perimeter Height: 8' 204.75 SF Ceiling 204.75 SF Floor 57.50 LF Floor Perimeter DESCRIPTION QUANTITY UNIT PRICE TAX, RCV DEPREC. ACV Depreciation applied per age and condition with the age of drywall estimated at 20 years and the age of the paint estimated at 4 years in average condition 24. Drywall patch 1 small repair, ready for paint 1.00 EA 60.62 0.15 60.77 (8.10) 52.67 25. Texture drywall - machine - knockdoArn 57.50 SF 0.44 0.10 25.49 (3.38) 22.02 Drywall texture added for texture pulled aivay from the wall above the baseboard 26. Spot seal wloil based/hybrid stain blocker 2.00 EA 25.79 0.27 51.85 (13.82) 38.03 27. Paint the walls and ceiling - two coats 664.75 SF 0.93 7.58 625.80 (166.88) 458.92 28. Detach & Reset Baseboard - 3 114" 57.50 LF 2.93 0.47 168.55 (0.00) 168.55 29. Paint baseboard - two coats 57.50 LF 1.44 0.38 83.18 (22.18) 61.00 30. Contents - move out then reset - Large room 1.00 EA 66.52 0.00 66.52 (0.00) 66.52 1724925 10/15/2017 Page:4 UL Li qAN CE PC UPC Insurance Pvc.<' 360 Central Avenue, Suite 900 St. Petersburg FL 33701 (888)256-3378 CONTINUED - Master Bedroom DESCRIPTION QIJANTITY UNIT PRICE TAX RCV DEPREC. ACV 31. R&R Laminate floor -per specs from independent 244.75 SF 6.60 6.63 1,357.98 (176.65) 1.181.33 analysis 32. R&R Underlayment - sound/crack membrane - up to 204.75 SF 2.91 13.39 609.22 (109.50) 499.72 40 mil Totals: Master Bedroom 28.57 3,049.27 500.51 2,548.76 Mask r Belh : h or: K• th � I y` 5 6 6"yr^�8 3 F �� e' 9"moi 111 Master Bath Height: 8' 225.89 SF Walls 283.68 SF Walls & Ceiling 6.42 SY Flooring 28.24 LF Ceil. Perimeter Subroom: offset (1) 202.18 SF Walls 249.87 SF Walls & Ceiling 5.30 SY Flooring 25.27 LF Ceil. Perimeter 57.80 SF Ceiling 57.80 SF Floor 28.24 LF Floor Perimeter Height: 8' 47.69 SF Ceiling 47.69 SF Floor 25.27 LF Floor Perimeter Missing Wall 3' 4 11116" X 8' Opens into MASTER BATH DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV Depreciation applied per age and condition with the age of drywall estimated at 20 years and the age of the paint estimated at 4 years in average condition 33. Drywa€€ patch 1 small repair, ready for paint 1.00 EA 60.62 0.15 60.77 (8.10) 52.67 34. Spot seal wloil based/hybrid stain blacker 1.00 EA 25.79 0.14 25.93 (6.92) 19.61 35. Paint the walls and ceiling - tmro coats 533.55 SF 0.93 6.08 502.28 (133.94) 368.34 36. Paint baseboard - one coat 53.51 LF 0.94 0.23 50.53 (13.47) 37.06 37. Contents - move out then reset - Small room 1.00 EA 33.28 0.00 33.28 (0.00) 33.28 Totals: Master Bath 6.60 672.79 162.43 510.36 1720925 10/15/2017 Page:5 UPCCI. . UPC Insurance rvcu nnNcr - .. 360 Central Avenue, Suite 900 St. Petersburg FL 33701 (888)256-3378 2nd Bedroom II 397.33 SF Walls 2ABdmom -'` 550.33 SF Walls & Ceiling 17.00 SY Flooring I 49.67 LF Ceil. Perimeter DESCRIPTION QUANTITY UNIT PRICE Height: 8' 153.00 SF Ceiling 153.00 SF Floor 49.67 LF Floor Perimeter TAI{ RCV DEPREC. ACV Depreciation applied per age and condition with the age of paint estimated at 4 years in average condition 4.85 624.63 120.37 38. Spot sea] wloil based/hybrid stain blocker 1.00 EA 25.79 0.14 25.93 (6.92) 19.01 39. Paint the walls - two coats 397.33 SF 0.93 4.53 374.05 (99.75) 274.30 40. Detach & Reset Baseboard - 2 114" 49.67 LF 2.93 0.06 145.59 (0.00) 145.59 41. Paint baseboard - two coats 49.67 LF 1.44 0.33 71.85 (19.16) 52.69 42. Mask the floor per square foot - plastic and tape - 4 153.00 SF 0.25 0.46 38.71 (10.32) 28.39 mil 0.36 30.36 (8.10) 22.26 mil 43. Contents - move out then reset 1.04 EA 44.35 0.00 44.35 (0.00) 44.35 Totals: 2nd Bedroom 5.52 700.48 136.15 564.33 X12'6"--------- i 3rd Bedroom 352.00 SF Walls 472.00 SF Walls & Ceiling 13.33 SY Flooring 44.00 LF Ceil. Perimeter Height: 8' 120.00 SF Ceiling 120.00 SF Floor 44.00 LF Floor Perimeter DESCRIPTION QUANTITY UNIT PRICE TAI{ RC V DEPREC:. ACV Depreciation applied per age and condition with the age of paint estimated at 4 years in average condition 4.85 624.63 120.37 44. Spot sea] wloil based/hybrid stain blocker 1.00 EA 25.79 0.14 25.93 (6.92) 19.01 45. Paint the walls - two coats 352.00 SF 0.93 4.01 331.37 (88.37) 243.00 46. Detach & Reset Baseboard - 2 1/4" 44.00 LF 2.93 0.05 128.97 (0.00) 128.97 47. Paint baseboard - two coats 44.00 LF 1.44 0.29 63.65 (16.98) 46.67 48. Mask the floor per square foot - plastic and tape - 4 120.00 SF 0.25 0.36 30.36 (8.10) 22.26 mil 49. Contents - move out then reset 1.00 EA 44.35 0.00 44.35 (0.00) 44.35 Totals: 3rd Bedroom 4.85 624.63 120.37 504.26 Total: Interior 118.47 12,411.12 2,143.10 10,268.02 Line Item Totals: 1720925 360.39 27,539.47 9,441.29 18,098.18 1720925 10/15/2017 Page:6 LJPC�I - UPC Insurance ..«�� - 360 Central Avenue, Suite 900 St. Petersburg FL 33701 (888)256-3378 Grand Total Areas: 2,544.06 SF Walls 1,347.77 SF Floor 0.00 SF Long Wall 1,347.77 Floor Area 2,127.12 Exterior Wall Area 2,976.73 Surface Area 75.51 Total Ridge Length 1,347.77 SF Ceiling 149.75 SY Flooring 0.00 SF Short Wall 1,437.13 Total Area 215.51 Exterior Perimeter of Contents Walls 29.77 Number of Squares 185.44 Total Hip Length 3,891.83 SF Walls and Ceiling 318.01 LF Floor Perimeter 318.01 LF Ceil. Perimeter 2,544.46 Interior Wall Area 279.65 Total Perimeter Length Coverage Item Total % ACV Total % Dwelling 26,793.50 97.29% 18,098.18 100.00% Other Structures 4.00 0.00% 0.04 0.00% Contents 0.04 0.00% 0.00 0.00% Ordinance of law 745.97 2.71% 0.00 0.00% Total 27,539.47 100.00% 18,098.18 100.00% 1720925 10/15/2017 Page:7 UPC® INgURANC! hUPC Insurance v..e' 360 Central Avenue, Suite 904 St. Petersburg FL 33701 (888)256-3378 Line Item Total Material Sales Tax Replacement Cost Value Less Depreciation Actual Cash Value Net Claim Total Recoverable Depreciation Net Claim if Depreciation is Recovered Summany kor.Ia+weuwg Jason Lanagan 26,434.90 358.60 $26,793.50 (8,695.32) $18,098.18 $18,098.18 8,695.32 $26,793.50 1720925 10/15/2017 Page:8 UPCUPC Insurance I HSU KANCE °�•v. 360 Central Avenue, Suite 900 St. Petersburg FL 33701 (888)25&-3378 Line Item Total Material Sales Tax Replacement Cost Value Less Depreciation Actual Cash Value Net Claim Total Recoverable Depreciation Net Claim if Depreciation is Recovered Suinmary° for Ordinance of law Jason Lanagan 744.18 1.79 $745.97 (745.97) $0.00 $0.00 745.97 $745.97 1720925 10/15/2017 Page:9 CL L40�9 Parameters Emissivity 0.95 Refl. temp. 68 °F For the purpose of this report: The blue areas in the thermal pictures are cooler in temperature and the yellow areas are warmer. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** 91301201712:29:53 PM The arrows drawn in this report are to be FLIR5628.jpg approximations and are not exact 9/3012017 12i29:53 PM locations. We were called into this home due to the storm and the effect on this home. FUR E5 s1.o 63913351 FLIR5628.jpg FUR E5 63913351 1136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. CijLL Parameters Emissivity 0.95 Refl. temp. fib °F Living Room: Visual signs of damage and buckling noticed upon entry of this home. Floor movement was noticed under foot. There was also a thermal difference noticed here but due to man-made materials moisture could not be confirmed. However, moisture would bode these results. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** 9130/2017 12:37:02 PM FLIR5629.jpg FUR E5 9134/2017 12:37:02 PM eF 77.4 70.0 63913351 FLIR5629.jpg FUR E5 63913351 2136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. CLiia9 Parameters Emissivity Refl. temp. 0.95 68 IF Living Room: Here we can see the edging has loosened and thermal difference is indicated by the white arrow. This report is generated for the property located at - 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma .*. 9130/2017 12:37:05 PM eF FLIR5630.jpg FUR E5 9/30/2017 12:37:05 PM 63913351 FUR5630.jpg FUR E5 63913351 3136 This report is generated far the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and witl not be held liable for any or all content. C&14_0�91 Parameters Emissivity 6.95 Refl. temp. 68 'F Living Room: Behind Entry Door: Here we noticed the baseboard was off in this area potentially due to expansion and contraction. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** 9/30/2017 12:37:24 PM FL1R5631.jpg FUR E5 9/3012017 1237:24 PM 'F 78.2 70.9 63913351 FLIR5631.jpg FUR E5 63913351 4136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. CL LA749 Parameters Emissivity 0.95 Refl. temp. 68 °F Living Room: White and Red arrows: The baseboard here shows elevated signs of separation. The Green arrow in the images point to the separation of this flooring which seem to be a result of this elevated moisture event. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** 91301201712:40:07 PM °F FLIR5633.jpg FUR E5 9/3012017 12:40:07 PM .9 i.5 63913351 6 . 6 A FLIR5633.jpg FUR E5 63913351 5136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or alt content. Parameters Emissivity 0.95 Refl. temp. 68 °F Living Room: A moisture meter reading was 57.0% in this area. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** FLIR5635.jpg 9130/2017 12:40:42 PM FUR E5 °F 84.6 73.4 63913351 6136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. Parameters Emissivity 0.95 Refl. temp. 68 °F Dining Room: Here we have thermal difference extending underneath this window at least four feet off the ground. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith **` Hurricane Irma *** 91301201712:42:18 PM °F FLIR5637.jpg FUR E5 9130/2017 12:42:18 PM 78.1 70.7 63913351 FLIR5637.jpg FUR E5 63913351 7136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. r, C�ivua9 Parameters Emissivity 0.95 Refl, temp. 68 °F Dining Room: A moisture meter test here read wet at 20.3%. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** 9/34/2017 12:39:58 PM °F 91.5 FLIR5632.jpg 9/30/2017 12:39:58 PM 9 63913351 FLIR5632.jpg FUR E5 63913351 8136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. C&oun9 Parameters Emissivity 0.95 Refl. temp. 68 °F Kitchen Bar Island: Here the baseboards were taken out to help dry out occur. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** 9/3012017 12:42:24 PM °F FLIR5838.jpg FUR E5 9/3012017 12:42:24 PM -71.1 63913351 FLIR5638.jpg FUR E5 63913351 9136 This report is generated for the sole use of the entity listed above, Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. CL�ur�►9 Parameters Emissivity 0.95 Refl. temp. 68 °F A moisture meter here read 50.0%. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** 9/30/2017 12:41:00 PM °F FLIR5636.jpg FUR E5 9/30/2017 12:41:00 PM FLIR5636.jpg FUR E5 =73.o 63913351 63913351 10136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. CLauo9 Parameters Emissivity 0.95 Refl. temp. 68 °F Living Room Ceiling: Although little thermal difference remains, this ceiling had multiple stains visible to the eye and noted here. This report is generated for the property located at: 5880 Everglades Blvd North in C/o Sarah Smith *** Hurricane Irma "' 9/30/2017 12:43:10 PM FLIR5640.jpg FUR E5 91301201712:43:10 PM °F 87.3 59,2 63913351 FLIR5640.jpg FUR E5 63913351 11135 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. /901 CL [JLJ�9 Living Room Ceiling: This is a close up of this stain pictured on page 11. (The thermal image did not develop) This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma "' 91301201712:43:19 PM 12136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. CL. i4A 7�9 Parameters Emissivity 0.95 Refl. temp. — 68 °F Living Room Ceiling: Thermal difference here may indicate previous moisture intrusion. Notice that stains are apparent to the naked eye. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma "" 9/30/2017 12:43:27 PM 9/30/2017 12:4327 PM FLIR5642.jpg FUR F5 63913351 °F 85.1 76.3 3351 13136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content - CLtiL as Parameters Emissivity 0,95 Refl. temp. 68 °F Living Room Ceiling: A wide angle view to orient the room: This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith ** Hurricane Irma *** 9/30/2017 12:43:34 PM °F FLIR5641jpg FUR E5 9/30/2017 12:43:34 PM 86,2 75.9 63913351 FLIR5643.jpg FUR E5 63913351 14/36 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any lime and will not be held liable for any or all content. WONVU-4romp Parameters Emissivity 0.95 Refl. temp. -- -- _168 'F�_._.. Living Room Ceiling: Thermal difference here could be the result of insulation that was blown around by this event. Defective or missing insulation should be corrected. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma " 9/30/2017 12:47:34 PM FLIR5647.jpg FUR E5 9/30/2017 12:47:34 PM 'F 88.2 76.2 63913351 FLIR5647.jpg FUR E5 63993351 15136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. CA.auo9 Parameters Emissivity 0.95 Refl. temp. 68 °F Living Room Ceiling: This type of cracking of the ceiling is consistent with a moisture related event. This report is generated for the property located at: 5880 Everglades Blvd North in do Sarah Smith *** Hurricane Irma *** 9/30/2017 12:48:13 PM "F 1.6 9/30/2017 12:48:13 PM FLIR5648.jpg FLIR E5 63913351 4.3 351 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. CLL409) Parameters Emissivity 0.95 Refl. temp. 68 `F Living Room Slider: This is directly over the slider door to the lanai. Here we can see the yellow arrows pointing to the visible stains in this area. The red arrow points to the slider. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** 9130/2017 12:48:34 PM FLIR5651.jpg FUR E5 9/3012017 12:48:34 PM '3.7 63913351 FLIR5651.jpg FUR E5 63913351 17/36 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. C�.oun9 Parameters Emissivity 0.95 Refl. temp. 68 °F This report is generated for the property located at: 5880 Everglades Blvd North in C/o Sarah Smith *** Hurricane Irma **- 9/30/2017 12:48:46 PM f R - i FLIR5652.jpg FUR E5 9130/2017 12:48:46 PM eF 3.1 - 75,1 63913351 FLIR5652.jpg FUR E5 63913351 18136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. Parameters Emissivity 6.95 Refl. temp. 68 °F This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith Hurricane Irma *"* 9/30/2017 12:49:17 PM eF t-LIK5553.jpg FUR E5 913012017 12:49:17 PM 63913351 1-UKbt O.tpg FUR E5 63913351 19136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. CLOlJO9 Parameters Emissivity 0.95 Refl. temp. 68 °F Living Room Floor by Slider: Here we can see heavy buckling and separation of baseboard. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith ** Hurricane Irma * 9130/2017 12:50:05 PM °F FLIR5655.jpg FUR E5 63913351 9130/2017 12:50:06 PM FLIR5655.jpg FUR E5 63913351 20136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Horne Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. 1-40�6� CLO Parameters _ Emissivity 0.95 Refl. temp. - 68 `F - — Owner's Suite: This picture is merely to orient the viewer as to the location of the next inspection: This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma " 9130/2017 12:50:18 PM °F FLIR5657.jpg FUR E5 9/3012017 12:50:18 PM M 72.8 63913351 FLIR5657.jpg FUR ES 63913351 21136 This report is generated for the sole use of the entity listed above- Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. Parameters Emissivity Refl. temp. 6.95 68 °F - Owner's Suite: Elevated thermal difference and visible signs of intrusion are indicated here. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** FLIR5658.jpg FUR E5 9/3012017 12:50:31 PM T 82.2 74,9 63913351 FLIR5658.jpg FUR E5 63913351 22/36 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. CLouo9 Parameters Emissivity 0.95 Refl. temp. 68 °F Owner's Suite: The baseboard has pulled away from the drywall and taken the paint with it. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** 9/30/2017 12:50:38 PM °F FLIR5660.jpg FUR E5 63913351 9/30/2017 12:50:38 PM 23/36 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend. alter or re -inspect any part of this report at any time and will not be held liable for any or all content. C,ff,ciuo9 Parameters Emissivity 0,95 Refl. temp. 68 °F Owner's Suite: This flooring also showed signs of elevated swelling. 24136 This report is generated for the property located at: 5884 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** 9/30/2017 12:52:23 PM FLIR5662.jpg FUR E5 9/30/2017 12:52:23 PM i Fu R5652.jpg °F 79.3 71.9 63913351 FUR E5 63913359 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content, C�auo9 Parameters Emissivity 0.95 Ref!. temp. 68 °F Owner's Suite: The baseboard has pulled away from the drywall and the floor shows elevated damage from this event. MYS1.1i This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** 9/3012017 12:52:31 PM ?PL� Vin, FLIR5663.jpg 9/30/2017 12:52:31 PM °F 79.8 FUR E5 63913351 FLIR5663.jpg FUR E5 63913351 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. CLouD9 Parameters Emissivity 10.95 Refl. temp. - Owner's Suite: This window was suspect of allowing intrusion. 26136 This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** 913012017 12:53:25 PM FLIR5665.jpg FUR E5 9/3012017 12:5125 PM °F 82.6 75.3 63913351 FLIR5665.jpg FUR E5 63913351 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. CL L'Vt+� Parameters Emissivity 0.95 Refl. temp. 68 `F Owner's Suite: A moisture meter test on the left side of this window resulted in wet at 20.3%. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith Hurricane Irma *** 9/30/2017 12:53:17 PM °F FLIR5664.jpg FUR E5 9/30/2017 12:53:17 PM 94.5 76.9 63913351 FLIR5664.jpg FUR E5 63913351 27/36 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. CL�vuo9 Parameters Lmissivity 0.95 Refl. temp. 68 "F The thermal difference in this area needs moisture tested. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** 9/30/2017 12:55:10 PM FLIR5666.jpg FUR E5 9/3012017 12:55:10 PM -F 79.2 71.8 63993351 28136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. C�auo9 Parameters Emissivity 4.95 Refl. temp. --- — j 68 OF - - ..._.. . The moisture meter here reads wet at 99.9%. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** FUR5669.jpg 9134/2017 1:01:25 PM FUR E5 OF 85.4 79.1 63913351 29136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictiy prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. Oel swi CLaL1o� Parameters Emissivity 0.95 Refl. temp. 68 'F Girls Bedroom #1: We noticed the elevated area of thermal difference under this window. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma "' 9130120171:02:19 PM FL1R5670.jpg 9130/2017 1.02:19 PM FUR E5 'F 90.6 63913351 FLIR5670.jpg FUR E5 63913351 30136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content, Parameters Emissivity -- 0.95 - Refl. temp.-._._._..- 68 °F Girls Bedroom #1: Here the moisture meter reads 99.9%. 31136 This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma """ 9130/2017 1:01:10 PM FLIR5668.jpg FUR E5 9130120171:01:10 PM FLI R5668.jpg FUR E5 79.8 63913351 63913351 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. 11 CL o�uO6 This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** Parameters 9130/2017 1:04:25 PM Emissivity 0,95 Reft, temp. i 68 °F Girls Bedroom #2: This room has east facing window that would have taken the brunt of the event. FLIR5672.jpg FUR E5 9/30/2017 1:04:25 PM °F 80.2 72.8 63913351 32136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. CLaLJ,ID�i Parameters Emissivity Refl. temp. 0.95 68 aF .... Girls Bedroom #2: A moisture meter reading here was wet at 99.9%. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma "'F 9130120171:04:20 PM FLIR5671.jpg 9/30120171:04:20 PM FUR E5 63913351 rtiM5611.lpg FUR E5 63913351 33136 This report is generated for the sole use of the entity listed above, Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. Parameters Emissivity 0.95 Refl. temp. 68 `F Dining Room Window: Here we wanted to run one final test of this east facing window. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma "" 9/34/2017 1:09:44 PM FLPR5675.jpg FUR E5 9130120171:09:44 PM °F 87.4 M 73.6 63913351 FLI R5675.jpg FUR E5 63913351 34136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Claud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. Parameters Fmissivity 0.95 Refl. temp. 68 °F Dining Room Window: The moisture meter read wet at 99.9%. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith Hurricane Irma *** 9130120171:09:49 PM °F FtIR5676.jpg FUR E5 63913351 9/3012017 1:09:49 PM 35136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. CL LiV69) Findings: This report is generated for the property located at: 5884 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** All windows we inspected failed a moisture meter test. The east facing windows seemed to be most affected and allowed elevated levels of moisture inside this building envelope. Flooring in Living Room, Dining Room and Owners Suite was cupping and showed heavy signs of intrusion. Baseboards under each failed window were separated completely from the drywall. Ceiling in the living Room showed visible stains almost entirely. This home was reported to have undergone 8 days without air conditioning. Due to power outages, a humidity bloom here was quite probable. According to the Florida Solar Energy Center, there are 4 critical requirements for mold growth — available mold spores, available mold food, appropriate temperatures and considerable moisture, The removal of any one of these items will prohibit mold growth. All these conditions were present at time of inspection. A Florida Certified General Contractor should be contacted for further roof and window investigation. A Florida Certified mold assessor should be called in to further asses and write a protocol for remediation, if needed. We recommend Brenton Mongan, 239-287-2120 36/36 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TQ THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The compieted routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney ice no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines 41 through #2 as appropriate for additional signatures, dates, and/or informatien needed. ]fthe document is already complete with the exce tion of the Chairman's si ature, draw a Zine throw h routin lines #1 throw #2, cam tete the checklist, and forward to the Count Attorne Office. Route to Addressees {List is routing order} Office Iultlal5 Date I. Elizabeth Hernandez CHS 2. Jennifer Belpedio County Attorney office 3. BCC Office l Board of County Commissioners NOTE: Clerk's attestation is not required. Please do not route this item to Clerk s Board Miutes Records, CAO please scan document after execution by Chairman and email them to Clerk's Minuted and Records ,for its records. PRIMARY CONTACT INFORMATION Normally the primary contact is the person who creatediprepared the Executive Summ Prim addressees above, may need tp contact staff for additional or missin information. ary contact information is needed in the event one of the Name of Primary Staff Elizabeth Hernandez, CHS Phone Number Contact 1 Denartment 239-252-233$ Agenda Date Item was 06/12/2012 Agenda Item Number Approved b the BCC Type of Document Insurance Claim Check Endorsement for Number of Original Attached Aleido Martin Cabrera & Osmary Jarrin Documents Attached Camacho PO number or account number if document is NIA to be recorded INSTRUCTIONS & CHECKLIST Initial they Yes column or mark "NIA" in the Not Applicable column, whichever is I. I Does the document require the chairman's original signature? 2. 1 Does the document need to be sent to another agency for additional signatures? If yes, rovide the Contact Information ame; A enc ; Address; Phone on an attached street. 3- Original document has been signed/initialed for legal sufficiency. (All documents to be signed by the Chairman, with the exception of most letters, must be reviewed and signed b the Office of the Coun Attarne . 4. All handwritten strike -through and revisions have been initialed by the County Attorney's Office and all other arties exce t the BCC Chairman and the Clerk to the Board 5. The Chairman's signature fine date has been entered as the date of BCC approval of the document or the final ne otiated contract date whichever is applicable. 6. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's si nature and initials are re wired, 7. In most cases (some contracts are an exception), the original document and this routing slip should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of our deadlines! S. ;Attorne document was approved by the BCC on ()611212412 and all changes made during meeting have been incorporated in the attached document. The County 's Office has reviewed the than es if licable. 9. als of attorney verifying that the attached document is the version approved by the SCC, all changes directed by the BCC have been made, and the document is ready for the Chairman's sienature. t -4t 1(2) 1 check Yes NIA (Not InitiaFN/A An NIA ): Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12 co 0 N LO O W H A . HAB AT R HUMANITY (T F4 OF ::SIGNATURE OF 1NDtVII�IAl. abut noT S_ By. Collier County Community and Human Services Division (CHS) Homeowner Insurance Check Endorsement Policy Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage/lien, then the loan will not have to be repaid. On occasion, the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and receive money to make the repairs. If the insurance claim check is made payable to the homeowner and Collier County, then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to CHS at the address below for check endorsement consideration: 1. Copy of Homeowner's current insurance policy -Declaration Page. 2. Copy of insurance company's claim report with worksheet including description of repairs and costs. 3. Copy of photos of claim damage. 4. Copy of Insurance check(s) payable to homeowner, first lien holder and Collier County. Homeowner Name: Aleido Martin Cabrera & Osmary Jarrin Camacho Homeowner Address: 1830 Frey Court Naples, FL 34120 Primary Contact Number: 239-465-3681 239-245-2203 Homeowner Email: OFFICE USE ONLY -Tl -F E Reviewed Dat 1,/) (T? I Ig Date Approved- Denied pprovedDenied SonntagKristi From: GrantKimberley Sent: Wednesday, June 6, 2018 1:39 PM To: SonntagKristi; LopezMaggie; KemnerCynthia; GiblinCormac; PelletierLouise; HutchinsonBarbetta Cc: CarnellSteve Subject: Delegation I will be out of the office Thursday and Friday 6/7 and 6/8. During this time Kristi Sonntag will be Acting Director and have full authority to sign on my behalf. All items for the 6/26 meeting will be out of my queue, so any changes or additions should be able to wait until Monday. Thank you, Kim Grant, MBA, CPM Director .So W t Community and Human Services Making our Community Stronger: One life, one home, one project at a time. 3339 East Tamiami Trail, Building H, Room 211, Naples, FI 34112 Phone: 239-252-6287 Cell: 239-450-3672 Kimberley.Grant(a@colliercountyfl.gov Under Florida Law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by telephone or in writing. Memorandum To: Kimberly Grant, CHS Director CC: Jennifer Belpedio, Assistant County Attorney From: Elizabeth Hernandez, Grant Support Specialist, Community and Human Services Date: June 6, 2018 Re: Homeowner Insurance claim check endorsement-Aleido Martin Cabrera & Osmary Jarrin Camacho, 1830 Frey Court, Naples, FL 34120 The Homeowner Insurance Check Endorsement Policy approved by the Board on June 12, 2012 (16.D.10) authorizes the Board Chairman or Vice Chairman to endorse homeowner insurance claim checks for recipients assisted with Purchase Assistance and/or rehabilitation program funds as Collier County is named as Second Mortgagee on their insurance policies. The attached check in the amount of $9,500.00 is for disbursement of the claim funds requiring endorsement by Board Chairman Solis or Vice Chairman. The check names _JOBA Adiustiniz, Inc and Collier County SHIP as subordinate lien holder. In order for the check to be properly processed, proper signatures/endorsement for all parties listed on check must be obtained. This is a time -sensitive item and must be endorsed as soon as possible as homeowner is waiting to pay for work to be performed on home. Attachments: Homeowners Insurance Policy -Declaration Page Insurance Claim Check (#75504, $9,500.00) Insurance Claim Report & photos of damage Collier County Second Mortgage 1 AVATAR PROPERTY AND CASUALTY INSURANCE COMPANY 1101 E CUMBERLAND AVE, TAMPA, FL 33602 Policy Number Policy Period FROM 12:01 A M TO 12:01 A M_ VH30033532 HOMEOWNER DECLARATIONS 03/072018 03/072019 NAMED INSURED: ALEIDO A MARTIN CABRERA & OSMARY JARRIN CAMACHO MAILED To: PRODUCER: ALEIDO A MARTIN CABRERA & OSMARY JARRIN BRUCE HENDRY INSURANCE CAMACHO 711 W. MAIN STREET 1830 FREY CT IMMOKALEE FL 34142 NAPLES FL 34120 TELEPHONE: 2396573614 DATE MAILED: 01/182018 Page 1 of 4 PROPERTY LOCATION: 1830 FREY CT NAPLES FL 34120 FIRST MORTGAGEE: SECOND MORTGAGEE: THIRD MORTGAGEE: HABITAT FOR HUMANITY OF COLLIER CO COLLIER COUNTY DEPARTMENT OF INC HOUSING HUMAN AND VETERAN 11145 TAM IAMI TRL E SERVICES NAPLES FLORIDA 34113 3339 TAMIAMI TRAIL EAST BUILDING H Loan No.: 1411 SUITE 211 NAPLES FLORIDA 34112 Loan No.: 1411 LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE FROM THE NATIONAL FLOOD INSURANCE PROGRAM. WITHOUT THIS COVERAGE, YOU MAY HAVE UNCOVERED LOSSES. PLEASE DISCUSS THESE COVERAGES WITH YOUR INSURANCE AGENT. THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES, WHICH MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU. Your Calendar Year Hurricane Deductible Dollar Amount Is: $3,040 YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM A102200707 AVATAR PROPERTY AND CASUALTY INSURANCE COMPANY _ 1101 E CUMBERLAND AVE, Tampa, FL 33602 Policy Number Policy_ Period FROM 12:01 AM TO 12:01 AM VH30033532 HOMEOWNER DECLARATIONS 03/072018 03/07/2019 NAMED INSURED:ALEIDO A MARTIN CABRERA & OSMARY JARRIN CAMACHO PROPERTY LOCATION: 1830 FREY CT NAPLES FL 34120 SECTION 1 HURRICANE DEDUCTIBLE 23 $.3M DEDUCTIBLES NON HURRICANE DEDUCTIBLE $1000 LIMIT OF LIABILITY SECTION 11 COVERAGES LIMIT OF LIABILITY SECTION I COVERAGE: PROPERTY PREMIUMS A: DWELLING $152,000 E. COMP. PERSONAL LIABILITY Non Hurricane B: OTHER STRUCTURES $3,040 EACH OCCURRENCE $100,000 C: UNSCHEDULED PERSONAL PROPERTY $56,000 F: MED PAY EACH PERSON $1,000 D: LOSS OF USE $15,200 Included Ordinance or Law $38,000 IF MORE THAN ONE PROPERTY IS INSURED UNDER THIS POLICY, SECTION I AND SECTION II COVERAGES OF EACH LOCATION MAY NOT BE ADDED TOGETHER IN THE EVENT OF LOSS. SCHEDULED PERSONAL PROPERTY LIMIT PER ARTICLE AGGREGATE PER LOSS PREMIUM PROPERTY PREMIUMS Non Hurricane $253 E -Personal Liability Included F -Medical Payments Included G -Accidental Death $2,000 Included Ordinance or Law $38,000 Included Preferred Contractor Savings Program Included Sink Hole Exclusion Included Water Back up $5,000 $25 Wind and Hail Included Hurricane $432 ADDITIONAL CREDITS SURCHARGES: SUBTOTAL $710 New Home Discount -1.0 Emergency Management Preparedness & Assistance T F Fee $2 Wind Mitigation Credit -78.0° Managing General Agency Fee $25 TOTAL PREMIUM (ENDORSEMENTS ELED_04950317 ELEPCSP_1016 ENCLOSED WITH THIS DECLARATIONS PAGE: IMPORTANT INFORMATION $737 This policy declarations replaces all declarations with the same or prior effective date. Your homeowner insurance expires and coverage ceases at 12:01 AM on 03/072019. Coverage under this policy will become effective provided premium is paid as indicated on the Notice of Premium Due mailed under separate cover. NEWBUSINESS EFFECTIVE 03/072018 12:01 AM AGENT BUSINESS A102200707 AVATAR PROPERTY AND CASUALTY INSURANCE COMPANY 1101 E CUMBERLAND AVE, Tampa, FL 33602 Policy Number Policy Period FROM 12:01 AM TO 12:01 AM VH30033532 HOMEOWNER DECLARATIONS 03/072018F/07/2019 NAMED INSURED:ALEIDO A MARTIN CABRERA & OSMARY JARRIN CAMACHO PROPERTY LOCATION: 1830 FREY CT NAPLES FL 34120 LIST ALL DISCOUNTS New Home Discount, Wind Mitigation Credit ZONE AGE I BCEG PAY PLAN MULTI POLICY STORM SHUTTER WIND MIT PROT CLASS GATED COMM NEW HOME I 55 and RET 1PERSPROPI EXCL SINKHOLE EXCL 0 20161 99 1 FULLPAY N N Y 5 N Y N i N j Y Total Premium for the Policy Period. (Your bill will be mailed separately). Total Premium for Property Insured: $737 Your Policy includes 25 % of Coverage A for Law and Ordinance Coverage. Your Policy Documents. Your homeowners policy consists of this Policy Declarations and the documents listed below. Please keep these together: MAILTOCVRPG EPICRENEWCVLTR NAMECHANGEENDORSEMENT A102200707 VS2 ELEHOJ_1013 ELEDHO_30516 ELEGLB 0114 HO 03520106 ELECGCC_1013 ELED_1071213 ELED_1081213 ELEDO_1013 ELEDH03_1213 ELEOLN 1013 ELE_NCPT ELED_04950317 ELEPCSP_1016 OIR-B1-1655 OIR-81-1670 POLINVOICE A102200707 Mail Cover Page 6 2017 Acq Renewal Cover Letter Name Change Endorsement Declarations Page 10 13 - Homeowners Policy Jacket 05 16 - Homeowners 3 Special Form 01 14 - Privacy Notice 0106 Calendar Year Hurricane Deductible - Florida 10 13 - Catastrophic Ground Cover Collapse Notice 12 13 - Home Day Care Exclusion Endorsement 12 13 - Trampoline Liability Exclusion 10 13 - Deductible Options Notice 12 13 Outline Of Coverage 10 13 - Ordinance Or Law Coverage Notification Form Notice Of Change In Policy Terms 03 17 - Water Back Up And Sump Coverage 1016 - Preferred Contractor Savings Program Endorsement Notice Of Premium Discounts for Hurricane Loss Mitigation Checklist of Coverage Invoice Billing Statement AVATAR PROPERTY AND CASUALTY INSURANCE COMPANY 1101 E CUMBERLAND AVE, Tampa, FL 33602 Policy Number Policy Period FROM 12:01 AM TO 12:01 AM_ VH30033532 HOMEOWNER DECLARATIONS 03/07/2018 03/07/2019 NAMED INSURED:ALEIDO A MARTIN CABRERAA OSMARY JARRIN CAMACHO PROPERTY LOCATION: 1830 FREY CT NAPLES FL 34120 If You Have a Question About Your Insurance. If you wish to present an inquiry or obtain information about your coverage, of if you need assistance in resolving a complaint, please call: Your agent at: 2396573614 or, Avatar Property And Casualty Insurance Company at: (877) 233-3237. Hitesh (John) P. Adhia Pamir Patel A102200707 4 iAVATAR Avatar Property & Casualty rs }r !, F! -j any ,. . 1101 East Cumberland Ave nm: �!_ 33602 PI(OT)-VTOIt 01 YOUR ASSFTS Phone: (813) 514-0333 Toll Free: (877) 233 ; ;57 3) 5 14 -0255 tar nt.com May 10, 2018 ALEIDO CABRERA & OSMARY CAMACHO 1830 FREY CT NAPLES, FL 34120 Property Owners: Claim No.: 20177637 ALEIDO CABRERA & OSMARY CAMACHO Property Information: 1830 FREY CT NAPLES, FL 34120 Dear Insureds: Policy No.: VH30033532 Thank you for trusting Avatar Property & Casualty Insurance Company ("Avatar") to protect your assets under the policy listed above. Avatar is in receipt of the executed general release. Enclosed you will find a draft for $9,500.00 which represents the supplemental settlement amount for the above listed claim. Please contact Avatar with any questions. Sincerely, Avatar Property & Casualty Insurance Company Encl.: Draft 4 1 h' r� Ai JOBA Adjusting, Inc April 6", 2018 JOBA ADJUSTING, INC. All Lines Public Adjusters Residential and Commercial Property RELEASE OF RELEASE OF CLAIM Insured: Aleido Martin Address: 1830 Frey Ct Naples, FL 34120 Claim #: 20177637 DOL: 09/10/2017 Loss Type: Hurricane As you know, your insurance company is requesting that you sign a full release of your insurance claim. First and foremost, please know that we cannot provide any legal opinion as to whether the release should be signed. However, we can inform you that in the event that you do sign the release, your claim will forever be closed and cannot be reopened for any reason. This shall confirm that you will hold JOBA Adjusting, Inc. harmless from any action in the event you choose to sign, or not sign the requested release. In the event you have any questions regarding the release, place contact an attorney of your choice. 1115iueu 5 .3igiiature f�l L c. i d o 4A IZt /:0 Insured's Name Insured's Signature 04,4ani rri Ins ed's Name JOBA ADJUSTING, INC. 4110 CENTER POINTE DR. # 215 FORT MYERS, FL 33916 Office: (239) 207-9981 Direct: (954) 790-8284 1 Fax: (239)215-8709 j obaadj usting(d)gmaiL e om AGREEMENT AND GENERAL RELEASE OF AVATAR PROPERTY & CASUALTY INSURANCE CORPORATION This Agreement and General Release of AVATAR PROPERTY & CASUALTY INSURANCE CORPORATION ("AVATAR") is effective this 6 of April, 2018, by ALEIDO A MARTIN CABRERA & OSMARY JARRIN CAMACHO. AVATAR and the INSUREDS have reached a settlement regarding claim number 20177637 ("the Claim"), with a claimed date of loss of 09-10-2017, relating to the INSURED'S property located at 1830 FREY CT, NAPLES, COLLIER, FL 34120, which claim was submitted under AVATAR policy number VH30033532. AVATAR and the INSUREDS acknowledge that this Agreement and General Release fully resolves now and forever any claim related to the Claim and the damages alleged as part of same identified herein. It is understood that this is a settlement of a disputed claim, and by making payment, AVATAR makes no admission of liability, but intends to resolve the Claim and any pending related lawsuit, avoid further litigation, and settle the matter existing between the INSURED and AVATAR TERMS 1. Payment: AVATAR shall pay the sum of NINE THOUSAND FIVE HUNDRED DOLLARS ($9,500) to ALEIDO A MARTIN CABRERA & OSMARY JARRIN CAMACHO & HABITAT FOR HUMANITY OF COLLIER CO INC & COLLIER COUNTY DEPARTMENT OF HOUSING HUMAN AND VETERAN SERVICES. The draft will be issued within twenty (20) days of receipt of this executed Agreement and General Release in full and final settlement for damages to the subject property relative to the Claim and all claims that have been made or could have been made under the subject Policy, both known and unknown, including additional living expenses, personal property damage, debris removal costs, law and ordinance expenses, cosmetic damages, and all other coverage provided under the policy issued by AVATAR, as well as claims for interest, attorneys' fees, public adjusters' fees, costs, and Florida Statute § 627.70131(5)(a) interest. 2. General Release: The INSURED and their successors, assigns, agents, attorneys, and representatives, hereby release and forever discharge AVATAR, and its agents, employees, officers, directors, attorneys, and representatives, from any claims and causes of action of any kind that have been made or could have been made both known and unknown, including without limitation breach of contract, bad faith, extra -contractual damages, negligence, attorneys' fees, interest, costs, additional living expenses, personal property damage, debris removal costs, law and ordinance costs, and for claims investigation, handling, settlement, and/or all events from beginning of time through the date of this Agreement and General Release. 3. Release and Covenant Not to Sue: In addition to releasing AVATAR, the INSURED agrees that they shall not make any claim whether known or unknown, or file any suit for any other loss to any insured property relative to the Claim that is the subject matter of this Agreement and General Release. 4. Other Provisions: a. The INSURED represents and warrants that no other individual or entity, including the INSURED's attorneys, public adjusters, and their successors or assigns, has an interest in, or claim to, the settlement proceeds described in this Agreement and General Release. b. The INSURED agrees that there are no other mortgage holders, assignees or individuals that have a claim or interest in the insured property, litigation or settlement of any current or potential claims under the policy. The INSURED further agrees that the INSURED did not retain a public adjuster or other third party consultant that has any interest in the insured property, litigation or settlement of the claim. C. The INSURED hereby declares that the terms of this Agreement and General Release have been completely read and are fully understood and voluntarily accepted for the purposes of making a full and final compromise, as described above, in settlement of any and all claims, disputed or otherwise, resulting from the Claim. It is specifically agreed that this Agreement and General Release shall be a complete bar to all claims or suits for damages of whatever nature resulting from the Claim. d. The INSURED agrees that this Agreement and General Release should not be construed more favorably toward one party over the other regardless of the drafter. e. The INSURED represent that she has had the full and fair opportunity to review this Agreement and General Release and understands and acknowledges that this Agreement and General Release is a binding agreement. Enforcement. Nothing in this Agreement and General Release shall be construed to waive the INSURED's or AVATAR'S right to bring an action to enforce its terms. Signed and Sealed this _10_ day of �¢ i , 2018. ALE O A MARTIN CABRERA & OSMARY JARRIN CAMACHO ACKNOWLEDGMENT UNDER OATH STATE OF FLORIDA COUNTY OF C� 9I 1'e r / da / 1 r I 2018, came ALEIDO BEFORE ME, this y of A MARTIN CABRERA & OSMARY JARRIN CAMACHO known to me to be the individual who executed this release, and acknowledged that she fully understands its contents and freely executed same for the sole consideration therein expressed. Personally known Produced Identification FL ►ver L 1 CP��Se Type of Identification Produced R ]arivep- I «m Se `111111111/1 - Ki� Gp AR,q 'I/NOTARY PUB C • My Comm. Expires t t ApHi 04, 2021 Cl •: No. GG 90326 ,A. ',OF F! D -a, AramaEo Typed/Printed Name of Notary &�rO M, 2021 Commission No./Expiration . .Ioba Adjusting, Inc. _ 4110 Center Point Dr JOU #44ed% Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax. (239) 215-8709 Email: jobaadjusting@gmail.com Insured: Aleido Martin I Osmary 7arrin Property: 1830 Frey Court Dr Naples, FL 34120 Claim Number: Policy Number: VH30033532 Type of Loss: Hurricane Date of Loss: 9/10/2017 Date Inspected: Price List: FLNA7X DEC17 Restoration/Service/Remodel Estimate: ALEIDOMARTINHIRMA Date Received: Date Entered: 11/28/2017 4: 10 PM Valued Client, Please find the attached itemized estimate for the lass that occurred at the property located at the address said above . This estimate represents the damage to the covered loss that could be observed at the time of the inspection. If any additional damage is found, please document the findings with photos or video and contact your representative to further evaluate the findings. This estimate was built using the most current Price List(s) available from xactware. contact your representative if you have any questions in regards to this estimate or claim. Pursuant to the Florida Statute 817.234 "Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree." en 56) bAdkmd ny. Im Joba Adjusting, Inc. 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com Office Room ALEIDOMARTINHIRMA Main Level 368.00 SF Walls 500.00 SF Walls & Ceiling 14.67 SY Flooring 46.00 LF Ceil. Perimeter Height: 8' 132.00 SF Ceiling 132.00 SF Floor 46.00 LF Floor Perimeter DESCRIPTION QNTY REMOVE REPLACE TOTAL 35. Floor protection - self-adhesive plastic 132.00 SF 0.45 0.00 59.40 film 36. Mask and prep for paint - paper and tape 46.00 LF 0.00 0.51 23.46 (per LF) 37. Seal/prime the ceiling - one coat 132.00 SF 0.00 0.40 52.80 38. Paint the ceiling - two coats 132.00 SF 0.00 0.64 84.48 40. Contents - move out then reset - Large 1.00 EA 0.00 58.38 58.38 room 41. General clean - up 2.00 HR 0.00 26.73 53.46 42. Texture drywall - smooth / skim coat 132.00 SF 0.00 0.83 109.56 43. R&R Blown -in insulation - 10" depth - 132.00 SF 0.91 0.72 215.16 R26 44. Detach & Reset Ceiling fan & light - 1.00 EA 0.00 0.00 157.84 High grade 45. Heat/AC register - Mechanically 1.00 EA 0.00 12.24 12.24 attached - Detach & reset Totals: Office Room 826.78 DESCRIPTION Roofl 469.53 Surface Area 89.70 Total Perimeter Length QNTY 4.70 Number of Squares 28.19 Total Ridge Length REMOVE REPLACE TOTAL ALEIDOMARTR4EM MA 5/18/2018 Page: 2 JORA ng. inc Joba Adjusting, Inc. 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com CONTINUED - Roon DESCRIPTION QNTY REMOVE REPLACE TOTAL 20. R&R Drip edge 180.41 LF 0.34 2.35 485.30 21. Asphalt starter - universal starter course 180.41 LF 0.00 2.20 396.90 22. R&R Exhaust cap - through roof - up to 1.00 EA 9.44 78.46 87.90 4" 1.00 EA 185.10 0.00 185.10 23. R&R Flashing - pipe jack - lead 2.00 EA 7.39 65.57 145.92 24. Meter mast for overhead power - Detach 1.00 EA 0.00 480.05 480.05 & reset 5.00 EA 23.72 271.64 1,476.80 25. R&R Flashing - pipe jack - split boot 1.00 EA 7.39 69.88 77.27 26. R&R Continuous ridge vent - aluminum 17.71 LF 0.88 8.54 166.82 27. R&R Exhaust cap - through roof 1.00 EA 9.44 84.71 94.15 28. Roofing felt - 15 lb. 17.33 SQ 0.00 33.23 575.88 29. 3 tab - 25 yr. - comp. shingle roofing - 17.33 SQ 0.00 196.09 3,398.24 w/out felt 30. Remove 3 tab - 25 yr. - comp. shingle 17.23 SQ 58.19 0.00 1,002.61 roofing - w/out felt 31. Dumpster load - Approx. 20 yards, 4 1.00 EA 463.00 0.00 463.00 tons of debris 32. R&R Sheathing - plywood - 3/4" CDX 64.00 SF 0.71 1.99 172.80 33. R&R Soffit -metal 360.81 SF 0.32 4.06 1,580.35 34. R&R Gutter guard/screen - High grade 56.00 LF 0.66 8.47 511.28 Totals: Roofl 9,638.47 Total: Main Level 10,465.25 General DESCRIPTION QNTY REMOVE REPLACE TOTAL 1. Job -site storage container - 20' long - per 1.00 MO 0.00 87.83 87.83 month 2. Single axle dump truck - per load - 1.00 EA 185.10 0.00 185.10 including dump fees 3. General Laborer - per hour 8.00 HR 0.00 28.53 228.24 46. R&R Aluminum window, horiz. slider 5.00 EA 23.72 271.64 1,476.80 12-23 sf (2 pane) ALEIDOMARTINHH?MA 5/18/2018 Page:3 CONTINUED - General DESCRIPTION QNTY REMOVE REPLACE TOTAL totals: Cfeneral 1,977.97 Line Item Totals: ALEIDOMARTINHIRMA 12,443.22 Grand Total Areas: 368.00 SF Walls 132.00 SF Floor 0.00 SF Long Wall 132.00 Floor Area 466.74 Exterior Wall Area 469.53 Surface Area 28.19 Total Ridge Length 132.00 SF Ceiling 14.67 SY Flooring 0.00 SF Short Wall 147.78 Total Area 48.67 Exterior Perimeter of Walls 4.70 Number of Squares 0.00 Total Hip Length 500.00 SF Walls and Ceiling 46.00 LF Floor Perimeter 46.00 LF Ceil. Perimeter 368.00 Interior Wall Area 89.70 Total Perimeter Length ALEIDOMARTI HIRMA 5/18/2018 Page:4 Joba Adjusting, Inc. . A 4110 Center Point Dr io" . h� Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com CONTINUED - General DESCRIPTION QNTY REMOVE REPLACE TOTAL totals: Cfeneral 1,977.97 Line Item Totals: ALEIDOMARTINHIRMA 12,443.22 Grand Total Areas: 368.00 SF Walls 132.00 SF Floor 0.00 SF Long Wall 132.00 Floor Area 466.74 Exterior Wall Area 469.53 Surface Area 28.19 Total Ridge Length 132.00 SF Ceiling 14.67 SY Flooring 0.00 SF Short Wall 147.78 Total Area 48.67 Exterior Perimeter of Walls 4.70 Number of Squares 0.00 Total Hip Length 500.00 SF Walls and Ceiling 46.00 LF Floor Perimeter 46.00 LF Ceil. Perimeter 368.00 Interior Wall Area 89.70 Total Perimeter Length ALEIDOMARTI HIRMA 5/18/2018 Page:4 ® Joba Adjusting, Inc. 6.000% 4110 Center Point Dr .In BA nna Inc Suite 215 , Fort Myers FL 33916 Subtotal Phone: (239) 207-9981 Fax: (239) 215-8709 @ Email: jobaadjusting@gmail.com Summary for Dwelling Line Item Total Material Sales Tax @ 6.000% Storage Rental Tax @ 6.000% Subtotal Overhead @ 10.0% Profit @ 10.0% Replacement Cost Value Net Claim ALEIDOMARTINHIRMA 12,443.22 238.70 5.27 12,687.19 1,268.73 1,268.73 $15,224.65 $15,224.65 5/18/2018 Page:5 r. JOELA n& Inr Joba Adjusting, Inc. 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com Recap by Room Estimate: ALEIDOMARTINHIRMA Area: Main Level Office Room Roofl 826.78 6.64% 9,638.47 77.46% Area Subtotal: Main Level General 10,465.25 84.10% 1,977.97 15.90% Subtotal of Areas 12,443.22 100.00% Total 12,443.22 100.00% ALEIDOMARTINHIRMA 5/18/2018 Page:6 Joba Adjusting, Inc. 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com Recap by Category O&P Items Total % CLEANING 53.46 0.35% CONTENT MANIPULATION 146.21 0.96% GENERAL DEMOLITION 2,264.66 14.87% DRYWALL 109.56 0.72% ELECTRICAL 480.05 3.15% FRAMING & ROUGH CARPENTRY 127.36 0.84% HEAT, VENT & AIR CONDITIONING 12.24 0.08% INSULATION 95.04 0.62% LABOR ONLY 228.24 1.50% LIGHT FIXTURES 157.84 1.04% PAINTING 160.74 1.06% ROOFING 5,310.41 34.88% SOFFIT, FASCIA, & GUTTER 1,939.21 12.74% WINDOWS - ALUMINUM 1,358.20 8.92% O&P Items Subtotal 12,443.22 81.73% Material Sales Tax @ 6.000% 238.70 1.57% Storage Rental Tax @ 6.000% 5.27 0.03% Overhead @ 10.0% 1,268.73 8.33% Profit @ 10.0% 1,268.73 8.33% Total 15,224.65 100.00% ALEIDOMARTINHIItMA 5/18/2018 Page:7 ®w C Joba Adjusting, Inc. 4110 Center Point Dr g� jmbM I ` Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 1 IMG -4389 Date Taken: 11/15/2017 Taken By: JOBA 2 IMG_4390 Date Taken: 11/15/2017 Taken By: JOBA f ALEIDOMARTINHIRMA 5/18/2018 Page:8 ® Joba Adjusting, Inc. 4110 Center Point Dr JOHA A WsW4 k� Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 3 IMG_4391 Date Taken: 11/15/2017 Taken By: JOBA 4 IMG -4392 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTINHIRMA 5/18/2018 Page:9 Joba Adjusting, Inc. ®� � 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 5 IMG -4393 Date Taken: 11/15/2017 Taken By: JOBA 6 IMG -4394 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTWEBWA 5/18/2018 Page: 10 Joba Adjusting, Inc. 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 7 IMG -4396 Date Taken: 11/15/2017 Taken By: JOBA 8 IMG -4397 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTINHII2MA 5/18/2018 Page: 11 Joba Adjusting, Inc. PIP 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 9 IMG -4398 Date Taken: 11/15/2017 Taken By: JOBA 10 IMG -4399 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTINHIRMA 5/18/2018 Page: 12 �1 poen Adjustr4 xK Joba Adjusting, Inc. 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone:(239)207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 11 IMG_4400 Date Taken: 11/15/2017 Taken By: JOBA 12 IMG_4401 Date Taken: 11/15/2017 Taken By: JOBA ,•h ALEIDOMARTINHIRMA 5/18/2018 Page: 13 14 IMG_4403 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTWIII 5/18/2018 Page: 14 Joba Adjusting, Inc. PIP 4110 Center Point Dr nelumnna Suite 215 , Fort Myers FL 33916 SORA Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 13 IMG_4402 Date Taken: 11/15/2017 Taken By: JOBA 14 IMG_4403 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTWIII 5/18/2018 Page: 14 15 IMG_4404 Date Taken: 11/15/2017 Taken By: JOBA 16 IMG_4405 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTWHIRMA 5/18/2018 Page: 15 Joba Adjusting, Inc. ® r: 4110 Center Point Dr �� Suite 215 , Fort Myers FL 33916 JOBA stft k- Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 15 IMG_4404 Date Taken: 11/15/2017 Taken By: JOBA 16 IMG_4405 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTWHIRMA 5/18/2018 Page: 15 ® Joba Adjusting, Inc. 4110 Center Point Dr Suite 215, Fort Myers FL 33916 JOBA ABPA" w pec Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 17 IMG -4406 Date Taken: 11/15/2017 Taken By: JOBA 18 IMG -4407 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTINHIRMA 5/18/2018 Page: 16 Joba Adjusting, Inc. 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 19 IMG_4408 Date Taken: 11/15/2017 Taken By: JOBA 20 IMG_4409 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTINHHtMA 5/18/2018 Page: 17 Ioba Adiusting, Inc. 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 21 IMG_4410 Date Taken: 11/15/2017 Taken By: JOBA 22 IMG -4411 Date Taken: 11/15/2017 Taken By: JOBA A ALEIDOMARTR4HIRMA 5/18/2018 Page: 18 ® Joba Adjusting, Inc. 4110 Center Point Dr 215 , Fort Myers FL 33916 A"Suite 5*4 IM Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 23 IMG -4412 Date Taken: 11/15/2017 Taken By: JOBA 24 IMG -4413 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTINHIRMA 5/18/2018 Page: 19 nalucn�o lM Joba Adjusting, Inc. 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 25 IMG -4414 Date Taken: 11/15/2017 Taken By: JOBA 26 IMG -4415 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTINHIRMA 5/18/2018 Page: 20 Joba Adjusting, Inc. 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 27 IMG -4416 Date Taken: 11/15/2017 Taken By: JOBA 28 IMG -4417 Date Taken: 11/15/2017 Taken By: JOBA '4t , ALEIDOMARTINHIRMA 5/18/2018 Page: 21 Joba Adjusting, Inc. 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 29 IMG -4418 Date Taken: 11/15/2017 Taken By: JOBA 30 IMG -4419 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTR4MMA 5/18/2018 Page: 22 Joba Adjusting, Inc. 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 31 IMG_4420 Date Taken: 11/15/2017 Taken By: JOBA 32 IMG -4421 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTINHIRMA 5/18/2018 Page: 23 SMI— Joba Adjusting, Inc. 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 33 IMG -4422 Date Taken: 11/15/2017 Taken By: JOBA 34 MG_4423 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTINHIRMA 5/18/2018 Page: 24 ® Joba Adjusting, Inc. -ter 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 poen nnpsbM Phone: (239)207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 35 IMG -4424 Date Taken: 11/15/2017 Taken By: JOBA 36 IMG_4425 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTINHIRMA 5/18/2018 Page: 25 pp KIP F,771' Joba Adjusting, Inc. 4110 Center Point Dr -T p' "' °" Suite 215 , Fort Myers FL 33916 '� :7n, Inc Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 37 IMG_4426 Date Taken: 11/15/2017 Taken By: JOBA 38 IMG -4427 Date Taken: 11/15/2017 Taken By: JOBA r 1 e As ALEIDOMARTR4BIRMA 5/18/2018 Page: 26 ®•:1 Joba Adjusting, Inc. 4110 Center Point Dr poen�Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 39 IMG -4428 Date Taken: 11/15/2017 Taken By: JOBA 40 IMG -4429 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTINHIRMA 5/18/2018 Page: 27 I + ^ � ♦ r .� � r,sJ 9 M.•'ff Sih / lhp "'"M"i r;R4l rs "`"S'+�,+.f s'��5�`T•s t�`+s"a'*°..�'� 'sZ� r� t i� Y3 <1 �i°iLi Y .. *-�1 ' ti's a.j' � S l♦ 1.� .fie.. ,A i° ry x •'L � -. ': Joba Adjusting, Inc. Y • 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 JOBA Ad*sUn% Inc Pbone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 43 IMG -4432 Date Taken: 11/15/2017 Taken By: JOBA 44 IMG -4433 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTINHIRMA 5/18/2018 Page: 29 Joba Adjusting, Inc. 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 45 IMG -4434 Date Taken: 11/15/2017 Taken By: JOBA 46 IMG_4435 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTWHI A 5/18/2018 Page: 30 poen nap�snno. i�c Joba Adjusting, Inc. 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 47 IMG -4436 Date Taken: 11/15/2017 Taken By: JOBA 48 IMG -4437 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTR4HIRMA 5/18/2018 Page: 31 MM, -own t 33 RX i M&A soil . . . . . . . . . . . . . . . . . . . . . Ask niow A- .......... 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L - S • ; { � s i' 3 "t SE t n,SS� t � :1 �w .+�.�r„ �X ��'4 �L ��'`' r Joba Adjusting, Inc. 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 57 IMG -4446 Date Taken: 11/15/2017 Taken By: JOBA 58 IMG -4447 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTWHMMA 5/18/2018 Page: 36 ® _y, Joba Adjusting, Inc. 4110 Center Point Dr o`�� Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 59 IMG -4448 Date Taken: 11/15/2017 Taken By: JOBA 60 IMG -4449 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTINHU MA 5/18/2018 Page: 37 61 IMG_4450 Joba Adjusting, Inc. 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com Date Taken: 11/15/2017 Taken By: JOBA 62 IMG -4451 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTINHIltMA 5/18/2018 Page: 38 � `'4e"' 't..k K fir• . 1 'ar * gy y d y a ai J rt rMac sj - 'r Lupo . r,.bd-.•fit •,:�+_tr kti,_`n'`ne�. fl :�.:} .. ^. r- �.. " � r '� i� �.� 5 e r 4�• h• ��c� ? 11 a�r�'j�� t=� �� ✓7' p<T' S�rII `wY 3; AiY .i�. �Syk 5..: �{��'. �:it b•��". Joba Adjusting, Inc. 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 65 IMG_4454 Date Taken: 11/15/2017 Taken By: JOBA 66 IMG -4455 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTR4HHUAA 5/18/2018 Page: 40 . -.L,�,S�'�Fya+�.<.r'�'+,.-� «=tet ^*S:�r` , t� >t, o- � ��k�� +r � �`�` ;•, t _ `�v°�J t"' r.^+,S '�,r �� 4 � �i � Y...• i y' �e�r rtE �F.Q> t.$ -"`, f a `,��y®' �,� �` � �` 3'=� `�i ,��i� �Ct r.�•��y,C 4 ,A;.i '7�'w 'f.�s .a.,x �r g. '!r 'e.�„y � ,4 � �Fv...m, „i$•1.�., ,� Joba Adjusting, Inc. 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 69 IMG -4458 Date Taken: 11/15/2017 Taken By: JOBA 70 IMG -4459 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTINHIRMA 5/18/2018 Page: 42 m } ry k J m Joba Adjusting, Inc. 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 73 IMG -4462 Date Taken: 11/15/2017 Taken By: JOBA 74 IMG -4463 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTINHIRMA 5/18/2018 Page: 44 Joba Adjusting, Inc. 4110 Center Point Dr Suite 215 , Fort Myers FL 33916 Phone: (239) 207-9981 Fax: (239) 215-8709 Email: jobaadjusting@gmail.com 75 IMG -4464 Date Taken: 11/15/2017 Taken By: JOBA 76 IMG_4465 Date Taken: 11/15/2017 Taken By: JOBA ALEIDOMARTINHIRMA 5/18/2018 Page: 45 J �s �• . I g tt^it.i fi Ty84i �J�� t� � 4�! y11.lf �i �t I T! • � s 3 r j','a'.a ,+•. � ,. LEi° l�. w4.G . :s^� d4. �<1 _ 1-7 £ A�aefy az i a f` s; l t �� a+r it fkl'3Y>Y:•� yt ...'�?.-xrf'�'Y^ ,a_. a V-4 AL aA 6: ISO. VIP vl` Q o Q� J C � a OA a 00 0 N 00 m i I I m LL Q LL o Q� J C � a OA a 00 0 N 00 m IN5TR 5385247 OR 5377 PG 2005 RECORDED 3/30/2017 1:42 Pat PAGES 5 DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT, COLLIER COUNTY FLORIDA Doc@.35 $105.00 REC 544.00 OBLD $30,000.00 Prepared by and Return to: Eilzabelh Hernandez Collier County Community & Human Services Division 3339 E. Tamlami Trail, Building H, Suite 211 Naples, Florida 34112 STATE HOUSING INITIATIVES PARTNERSHIP (SKIP) PROGRAM SECOND MORTGAGE THIS SECOND MORTGAGE ("Security Instrument") is given on 2q day of 0r&1L_ 2017, The Second Mortgagor is Alcido A. Martin Cahmra and Osmary.larrin Camacho, a married couple This Security Instrument is given to Collier County— SHIP ("Lender'), which is organized and existing under the laws of the United Stales of America, and whose address Is 3339 E. Tamiami Trail Naples, Florida 34112. Barrower owes Lender the sum of Thirty Thousand aund 00/100 Dollars ($30, 000, OD) . This debt Is evidenced by Horrower's Note dated the same date as this Security Instrument ("Second Mortgage"), which does not provide for monthly payments. The full debt, if not paid earlier, is due upon a a ItpJJhLRM2eEU. title tra nsfer refinance ho s no to ngeLp rimary residence. or Is lea aad or rgmted within the fifteen year term. If sold after the Sheen year term, no repayment Is required. As long as the borrower continues to own and occupy the assisted property during the term of the mortgage, then the loan will not have to be repaid. This Security Instrument secures to Lender (a) the repayment of the debt evidenced by the Note, with interest, and all renewals, extensions and modifications; (b) the payment of all other sums, with interest advanced under paragraph 7 to protect the security of the Security Instrument and (c) the performance of Borrower's covenants and agreements under this Security Instrument and the Note. For this purpose, Borrower does hereby second mortgage, grant and convey to Lender the following described property located In Collier County, Florida. As more particularly described as: _Le_qacy Lakes 11 i and which has the address of: ("Properly Address"): 1830 Frey Cour �Q Naples 1 r ,. Florida 34120 TOGETHER WITH a{I the impraveme s no ar er ed oonNh art and 11 easements, rights, appudenanoes, rents, royalties, mineral, oil and gas rights and prof is t n a her after a part of the properly. All replacements and additions shall also be covered by the $e*"' e rity 1 m �t f to i this Security Instrument as the "Property". BORROWER COVENANTS that Bo we s il wfull s ze o t e re ve d and has the right to mortgage, grant and convey the Property and that the Property is u d t or n u bra e r orrower warrants and will defend generally the tale to the Property against all claims and d inn tact a ran Q� THIS SECURITY INSTRUMENT cam iSre funiform covenants for na at us a na�f niform covenants with limited variation by jurisdiction to conslitute a uniform security instru a ng real property. 4 UNIFORM COVENANTS. Bonoweran rcovenan, and agree a' II Q 1. Payment of Principal and Intereat; y ant and Late Charges, shall promptly pay when due the principal of and inle rest on the debt evidenced by the Note. 2. Taxes. The Mortgagor will pay all taxes, a itt1 0l v� rates prior to the accrual of any penalties or interest thereon. 71 [: r'" f'a The Mortgagor shall pay or cause to be paid, as the sa�hr a dtwelyleeoma dua, (A)(1) all taxes and governmental charges of any kind whatsoever which may at any time be lawfully assessed c levied against or with respect to the Property, (2) all utility and other charges. including 'service charges", Incurred or imposed for the operation, maintenance, use, occupancy, upkeep and improvement of the Property, and (3) all assessmenis or other governmental charges that may lawfully be paid in installmenla over a period of years, the Mortgagor she II be obligated under the Mortgage to pay c cause to be paid only such installments as ere required to be paid during the term of the Mortgage, and shall, promptly after the payment of any of the foregoing, forward to Mortgagee evidence of such payment. I Applitation of Payments, Unless applicable law provides otherwise, all payments received by Lender shall be applied; first, to interest due; and, to prlnclpaI due; and last, to any late charges due under the Note. 4. Charges; Liens. Borrower shall pay all taxes, assessments, charges, fines and impositions attributable to the Property which may attain priority over this Security Instrument, and leasehold payments or ground rents, if any. Borrower shall promptly furnish to Lender all notices of amounts to be paid under this paragraph, and all receipts evidencing the payments. Borrower shall promptly discharge any lien which has priority over this Security Instrument unless Borrower: (a) agrees in writing to the payment of the obligation secured by the lien to a manner acceptable to Lender, (b) contests In good faith the lien by, or defends against enforcement of the lien in, legal proceedings which In the Lender's opinion operate to prevent the enforcement of the lien; or (c) secures from the holder of the lien an agreement satisfactory to Lender subordinating the lien to this Security instrument. If Lender determines that any part of the Property is subject to a lien which may attain priority over, the Security Instrument, Lender may give Borrower a notice identifying the lien. Borrower she 11 satisfy the lien or take one or more of the actions set forth above within 10 days of the giving of notice. S. Hazard or Property Insurance. Borrower shall keep the improvements now existing or hereafter erected on the Property insured against Ions by Fre, hazards included within the term "extended coverage" and any other hazards, including floods or flooding, for which Lender requires insurance. This insurance shall be maintained in the amounts and for the periods that Lender requires. The insurance carrier providing the insurance shall be chosen by Borrower subject to Lender's approval which shall not be unreasonably withheld. If Borrower fails to maintain coverage described above, Lender may, at Lender's option, obtain coverage to protect Lender's rights in the Properly in accordance with paragraph 7. At all times that the Note is outstanding, the Mortgagor shall maintain Insurance with respect to the Premises against such risks and for such amounts as are customarily insured against and pay, as the same become due and payable, all premiums in respect thereto, including, but not limited to , all-risk insurance protecting the interests of the Mortgagor and Mortgagee against loss or damage to the Premises by tire, lightning, and other casuallies customarily insured against (including boiler explosion, if appropriate), with a uniform standard axle nded coverage endorsement, including debris removal coverage. Such insurance at all times to be in an amount not less than the full replacement cost of the Premises, exclusive of footings and foundations. All insurance policies and renewals shall be acceptable to Lender and shall include a standard mortgage clause. Lender shall have the right to hold the policies end renewals. If Lender requires, Borrower shall promptly 9" to Lender all receipts of paid premiums and renewal notices. In the event of loss, Borrower shall give prompt notice to the insurance carrier and Lender. Lender may make proof of foss if not made promptly by Borrower. Unless Lender and Borrower otherwise agree in writing, insurance proceeds shall be applied to restoration or repair of the Property damaged, if the restoration or repair is economically feasible and Lender's security Is not lessened. If the restoration or repair is not economically feasible or Lenders security would be lessened, the insurance proceeds shall be applied to the sums secured by the Security Instrument. whether or not then due, with any excess paid to Borrower, If Borrower abandons the Property, or does not answer within 30 days a notice from Lender that the insurance carrier has offered to settle a claim, then Lender may collect the Insurance proceeds. Lender may use the proceeds to repair or restore the Property or to pay sums secured by this Security Instrument, whether or not then due. The 30 -day period will begin when the notice is mailed. Unless Lender and Borrower otherwise agree in writing, any application of proceeds to prindpai shall not extend or postpone the due date of the monthly payments referred to in paragraph 1 or 0ange the amount of tha payments, If under paragraph OR 5377 PG 2007 21 the Property is acquired by Lender, Borrower's right to any Insurance policies and proceeds resulting from damage to the Property prior to the acquisition shall pass to Lender to the extent of the sums secured by this Security Instrument immediately prier to the acquisition. G. Occupancy, Preservation, Mal ntenanee and Prolection of the Property; Borrowers Loan Appllcatlon. Leaseholds. Borrower shall occupy, establish, and use the Property as Borrower's principal residence within sixty days after the execution of this Security Instrument and shall continue to occupy the Property as Borrower's principal residence for all least one year aRer the date of occupancy, unless lender otherwise agrees in writing, which consent shall not be unreasonably withheld, or unless exlenuall ng circumstances exist which are beyond Borrower's control. Borrower shad not destroy, damage, or Impair the property, allow the property to deteriorate, or commit waste on the properly. Borrower shall be In default if any forfellure action or proceeding, whether civil or criminal, is begun that In Lender's good faith judgment could result in forfeiture of the Property or otherwise ma lerialiy impair the lien created by this Securily Instrument of Lender's security interest. Borrower may cure such a default and reinstate, as provided in paragraph 18, by causing the action or proceeding 10 be dismissed with a ruling that, in Lenders good faith determination, precludes forfeiture of the Borrowers interest in the Property or other material impairmentof the lien created by this Security Instrument or Lender's security interest. Borrower shall also be in default if Borrower, during the loan applicatlon process, gave materially false or inaccurate Information o'statements to Lender (or failed to provide Lender with any materia! information) in connection with the loan evidenced by the Note, including, but not limited to, representations concerning Borrowers occupancy of the Property as a principal residence. If this Security Inslrument is on a leasehold, borrower shall comply with al! the provision of the lease. If Borrower acquires fee title to the Property, the leasehold and the fee title shall not merge unless Lender agrees to the merger in writing. 7. Protection of Lender's Rights In the Property, If Borrower fails to perform the covenants and agreements contained in this Security Inslrument, or there is a legal proceeding that may significantly affect Lender's rights in the Property (such as a proceeding in bankruptcy, probate, for condemnation or forfeiture or to enforce laws or regulations), then Lender may do and pay for whatever is necessary to protect the value of the Property and Lenders rights in the Property. Lenders actions may include paying any sums secured by a lien which has priority over this Security Instrument, appearing in court, paying reasonable attorneys' fees and entering on the Properly to make repairs. Although Lender may take action under this paragraph 7, Lender does not have to do se. Any amounts disbursed by Lender under this paragraph 7 shall become additional debt of Borrower secured by this Security Instrument. Unless Borrower and Lender agree to other terms of payment, these amounts shall bear Interest from the date of disbursement at the Note rale and shall be payable, with interest, upon notice from Lender to Borrower requesting payment. 8. Mortgage Insurance. If Lender required mortgage insurance as a condition of making the loan secured by this Security Instrument, Borrower shall pay the premiums required to maintain the mortgage insurance in effect If, for any reason, the mortgage insurance coverage required by Lender lapses or ceases to be in effect. Borrower shalt pay the premiums required to obtain coverage substantially equlvalent to the mortgage insurance previously in effect, at a cost substantially equivalent to the cost to Borrower of the mortgage insurance previously in effect, from an alternate mortgage Insurer approved by Lender. If substantially equivalent mortgage insurance coverage is not available, Borrower shall pay to Lender each month a sum equal to one -twelfth of the yearly mortgage insurance premium being paid by Borrower when the insurance coverage lapsed or ceased to be in effect. Lender will accept, use and retain these payments as a loss reserve in Ileu of mortgage Insurance. Lass reserve payments may no Ion erre• , at the option of Lender, if mortgage insurance coverage (in the amount and for the period that Lender requires) provide �re�� Lender again becomes available and is obtained. Borrower shall pay the premiums required to maintain m a ravide a loss reserve, uncil the requirement for mortgage insurance ends in accordance with any cur[ antbetween Bo Lender or applicable law. 9. Inspection. Lender or its agent may unable entries upon an �$ ns of the Property. Lender shall give Borrower notice at the time of or prior to an inspection sped ing r -son bl cause for the inspe n. ib, Condemnation. The proceeds or ny aayyrraa r taim direct An s�quantial, in connection with any condemnat on or other taking of any part of the Property, ar for nv¢yance in of demnalion, areby ssigntV and shall be paid to Lender. In the event of a luta! taking of the Properly, She pro s p h is ecu, y Instrument, whether or not then due, with any excess paid to Borrower, Ir the event oTatt g T e r y, hfair arket value of the Property immediately before the taking Is equal to or greater than th amu nt f the u s ec r is ty nsI menl Immediately before the taking, unless Borrower and Lender otherwise agree in writin , �lrpi rs S ur ly In l e t[ be reduced by the amount of the proceeds multiplied by the following fraction: (a) the lotai yG t e su cud edi of a taking, divided by (b) the fair market value of the Property immediately before the taking. ante shall be paid to SO wer. n th eve t of a partial taking of the Property in which the fair market value of the Property immediately the taking is less than m un sums secured immediately for the takIv. unless Borrower and Lender otherwise agree in w ' ' unless applicable law i t es, the proceeds shall be applied to the sums secured by this Security Instrument whether or not su are then due. Unless t. Borrower otherwise agree in writing, any application of proceeds to principal shall not extend o e due date of payments referred to in paragraphs i or change I the amount of such payments. r �7 11. Borrower Not Released, Forbearance By ens lon of the time for payment or modification of amortization of the sums secured by this Security Instrument gran r to any Successor in interest of Borrower shall not ape rate 10 release the liability of the original Borrower or Barrowees successors in interesl. Lender shall not be required to commence proceedings against any successor in interest or refuse to extend time for payment or otherwise modify amortization of the sums secured by this Security Instrument by reason of any demand made by the original Borrower or Borrower's successors In interest. Any forbearance by Lender in exercising any right or remedy shall not be a waiver of or preclude the exercise of any right or remedy. 12. Successors and Asslgna Bound; Joint and Several Liability; Cosigners. The covenants and agreements of thls Security Instrument shall bind and benefit the successors and assigns of Lender and Borrower, subject to the provisions of paragraph 17. Borrowers covenants and agreements shall be joint and several. Any Borrower who co-signs this Socudly Instrumenl b does not execute the Note; (a) Is co-signing this Security Instrument only to mortgage, grant and convey that Borrowers Interest in the Properly under the terms of this Security instrument; (b) is not personally obligated to pay the sums secured by this Security Instrument; and (c) agrees that Lender and any other Borrower may agree to exlend, modify, forbear or make any accommodations with regard to the terms of this Security Inslrument or the Note without that Borrower's consent. 13. Loan Charges. If the loan secured by this Security Instrument is subject to a law which sets maximum loan charges, and that law is finally Interpreted so that the interest or other loan charges collected or to be collected In connection with the loan exceed the permitted limits, then: (a) any such loan charge shall be reduced by the amount necessary to reduce the charge to the permitted limit; and (b) any sums already collected from Borrower which exceeded permitted limits will be refunded to Borrower. Lender may choose to make this refund by reducing the principal owed under the Note or by making a direct payment to Borrower. If a refund reduces principal, the reductionwill be treated as a partial prepayment without any prepayment charge under the Note. 14. Notices. Any notice to Borrower provided for in this Security Instrument shall be given by delivering it or by mailing it by first Gass mail unless applicable law required use of another method. The notice shall be directed to the Property Address or any other address Borrower designates by notice to Lender. Any notice to Lender shall be given to Borrower or Lender when given as provided in this paragraph. 15. Governing Law; Severabliity. This Security Instrument shall be governed by federal taw and the law of the Jurisdiction In which tho Property Is located. In the event that any provision or clause of this Security Instrument or the Note conflicts with applicable law, such conflict shall not affect other provisions of this Security Instrument or the Nate which can be given effect withavt the cont icting provision. To this end the provisions of this Security Ins Vument and the Note are declared to be severable. 15. Borrower's Copy. Borrower shall be given one conformed copy of the Nate and of this Security Instrument - 17. Transfer of the Property or a Beneficial Interest In Borrower. If all or any part of the Property or any interest in it is sold or transferred (or if a beneficial interest in Borrower is sold or transferred and Borrower is not a natural person) without Lenders prior written consent, Lender may, at its option, require immediate payment in full of all sums secured by this Security instrument. However, this option shall not be exercised by Lender if exerdse is prohibited by federal law as of the date of this Security Instrument. If Lender exercised this option, Lender shall give Borrower notice of acceleration. The notice shall provide a period of not less than 30 days from the date the notice is delivered or mailed within which Borrower must pay all sums secured by this Security Instrument. If Borrower fails to pay these sums prior to the expiration of this period. Lender may invoke any remedies permitted by this Security Instrument without further notice or demand on Borrower. 16. Borrower's Right to Reinstate. If Borrower meets certain ccnditlans, Borrower shall have the right to have enforcement of this Security Instrument discontinued at any time prior to the earlier of. (a) 5 days (or such other period as applicable law may specify for reinstatement) before sale of the Property pursuant to any power of sale contained in this Security Instrument; or (b) entry of a Judgment enforcing this Security Instrumenl. Those conditions are that Borrower. (a) pays Lender all sums which then would be due under this Security Instrument and the Note as if no acceleration had occurred; (b) cures and default of any other covenants or agreements; (c) pays all expenses incurred in enforcing this Security Instrument. including, but not limited to, reasonable allorney's fees; and (d) takes such action as Lender may reasonably require to assure that the lien of this Security Instrument, Larder's rights In the Property and Borrower's obligation to pay the sums OR 5377 PG 2008 secured by this Security Instrument shall continue unchanged. Upon reinstatement by Borrower, this Security Instrument and the obligations secured hereby shall remain fully effective as it no acceleration had occurred. However, this right to reinstate shall not apply in theme of aoceleratien under paragraph 17. 19. Sale of Note, Change of Loan Servicer. The Note or a partial interest In the Note (together with this Security Instrument) may be sold one or more times without prior notice to Borrower. A sale may result In a change in the entity (known as the "Loan Servicer") that collects monthly payments due under the Note and this Security Instrument, There also may be one or more changes of the Loan Servicer unrelated to a sale of the Note. If there Is a change of the Loan Servicer, Borrower will be given written notice of the change in accordance with paragraph 14 and applicable law. The notice will slate the name and address of the new Loan Servicer and the address to which payments should be made. The notice will also contain any other information required by applicable law. 20, Hazardous Substances. Borrower shall not cause or permit the presence, use, disposal, storage, or release of any Hazardous Substances on or In the Properly. Borrower shall not do, nor allow anyone else to do, anything affecting the Property that is in violation of any Environmental Law. The preceding two $anlencEs shalt not apply to the presence, use, or storage on the Property of small quantities of Hazardous Substances that are generally recognized to be appropriate to normal fesidenliat uses and to maintenance of the Property. Borrower shall promptly give Lender written notice for any investigation, claim, demand, lawsuit or other action by any governmental or regulatory agency or private party invQNing the Property and any Hazardous Substance or Environmental Law of which Borrower has actual knowledge. If Borrower learns, or Is notified by any governmental or regulatory authority, that any removal or other remediation of any Hazardous Substance affecting the Property is necessary, Borrower shall promptly lake all necessary remedial actions in accordance with Environmental Law. As used In this paragraph 20, "Hazardous Substances" are those substances defined as toxic or hazardous substances by Environmental Law and the following substances gasoline, kerosene, other flammable or toxic petroleum products, toxic pesticides and herbicides, volatile solvents, materials containing asbestos or formaldehyde, and radioactive materials. As used In this paragraph 20, "Environmenlal Lary' means federal laws acrd laws of the jurisdiction where the Property is located that relate to health, safety or environmental protection, 21. Acceleration; Remedies, Lender shall give notice to Borrower prior to acceleration following Borrower's breach of any covenant or agreement in this Security Instrvment (but not prior to acceleration under paragraph 17 unless applicable law provides otherwise). The notice shall specify: (a) the default; (b) the action required to cure the default; (c) a date, not less than 30 days from the date the notice is given to Borrower, by which the default must be cured; and (d) that failure to cure the default an or before the dale specified in the notice may result in acceleration of the sums secured by this Security Instrument, foreclosure by judicial proceeding and sale of the Property. The noticeshall further inform Borrower of the right to reinstate after acceleration and the right to assert in the foreclosure preceding the non-existence of a default or any other defense or Borrower to acceleration and foreclosure. If the default is not cured on or before the date "driied in the notice, Lender, at its option, may require immediate payrnenl in full of all sums secured by this Security Instrument without further demand and may foreclose this Security Instrument by judicial proceeding. Lender shall be entitled to tolled all expenses incurred in pursuing the remedies provided in this paragraph 21, including, but not limited to, reasonable attorney's fees and costs of the title evidence. R2. Release. Upon payment of all sums secured by ti �an ment, Lender shall release this Security Instrument, without charge, to Borrower. Borrower shall pay any recordation : K U 23. Attorneys' Fees. As used in this Securit Y. Sees" shall include any attorneys' fees awarded by an appellate court. 24. Riders to this Se curlty instrumenlL f � r more riders are execujInto or and recorded together with this Security instrument, the covenants and agreements of eac sue a incorporateds II amend and supplement the covenants and agreements of this Security Inslrument as if the er( art is�0c�� nt. Check Applicable Box) ❑ Adjustable Rate Rider ❑ Ratellmpr' ndo mium Rider ❑ Graduated Payment Rider ❑ 1.4 amll Ri er 5 ndHome Rider ❑ Balloon Rider ❑ 0 e PI *J1 Unit Development Rider ❑ Other(s) (specify �l'� U SIGNING BELOW, Borrower accepts and agrees f� s and covenants coma r i f ecurity Instrument and in any rider(s) executed by Borrower and recorded with it. Q Signed, sealed and delivered In the presence of Tfir, ,'D C; Signature: Signature: 16 r A e do A. Martin Cabrera Osmaty darrht Ca macho Address, 1830 Fray Court Naples, Florida 34120 STATE OF FLORIDA COUNTY OFCOLLIE Vi11fY7�. �SrNpr+� I hereby certify that, A personally appeared to me knovJn to be the person(s) described in and who executed the foregoing Instrument and acknowledged before me that (Het she/ they) executed the same for the purpose therein expressed. WITNESS my hand and official seal in the County and State aforesaid this 2±_ day of Pc 2017. My Commission Expires: f (Seal) KXIMA LVLBEAIE 7A1'GOh4�e5SION@FFt71215 N a blit ure ' r EXPIRES: Rlgllsl Z9, 2{118 s'f, eeewrm,rrarayw�uwr.w. 0 Q Notary's Printed Name SHIP File#:i5-D45 Purchase Assistance Program ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines #I through #2 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the exception of the Chairman's signature- draw a line rhrnnvh routing sn.,, Al thr.,.. l' 41 ,......I,.. L_ Route to Addressees (List in routing order) -11 „ • 1 ... — .. I ., -o onconusr all Office forward to me Count Initials Attorney Unice. Dat 1. Elizabeth Hernandez CHS Initi 1 18 2. Jennifer Belpedio County Attorney Office Agenda Item Number Approved by the BCC Does the document need to be sent to another agency for additional signatures? If yes, N/A 3. BCC Office Board of County Commissioners AS 1 check ,.Tl1TT Sarah Schafer Documents Attached 1�- 114UPI h. Cierx's attestation is not required. Please do not route this item to Clerk's Board Minutes and Records. CAO please scan document after execution by Chairman and email them to Clerk's Minute and Records for its records. PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above, may need to contact staff for nrlditinnal or —i -;n ;nr rn, t: Name of Primary Staff — - ---- - ---_. _. ... ... ... .... .. ... Elizabeth Hernandez, CHS Phone Number 239-252-2338 Contact / Department appropriate. Initi 1 Applicable) Agenda Date Item was 06/12/2012 Agenda Item Number Approved by the BCC Does the document need to be sent to another agency for additional signatures? If yes, N/A Type of Document Insurance Claim Check Endorsement for Number of Original 1 check Attached I Sarah Schafer Documents Attached N/A PO number or account signed by the Chairman, with the exception of most letters, must be reviewed and signed number if document is N/A to be recorded All handwritten strike -through and revisions have been initialed by the County Attorney's N/A INSTRUCTIONq Rr CAF.CKi .iCT 1: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05, Revised 11/30/12 Initial the Yes column or mark "N/A" in the Not Applicable column, whichever is Yes N/A (Not appropriate. Initi 1 Applicable) 1. Does the document require the chairman's original signature? VAI 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A provide the Contact Information Name; Agency; Address; Phone on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be N/A signed by the Chairman, with the exception of most letters, must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike -through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's signature and initials are required. sp, 7. In most cases (some contracts are an exception), the original document and this routing slip N/A should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 06/12/2012 and all changes made during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the Chan es, if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC, all changes directed by the BCC have been made, and the document is ready for the 1401A Chairman's signature. 1: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05, Revised 11/30/12 i -0c o� Z C W 0 ;,;u D o co 0000 m D c cn -nZ n U) W m W D o 0 TI _ 00 M L Q Z 90GoD Z Q n -a rn O .01 0) 00 A J ENDORSE /CHEC ERE . ............. ... VS VV'ILLDISAPP�P RA�iD—iEJ PIPE�tA#4,"or%,YIEN RUBBED OR EXPOSEP TO HEAI-. DO NOT WRITE' SIGN / S-FAMIP BELOW LINE DEPOSITORY BANK ENDORSEivE.14 I 'FEDERAL RESERVE cOARD OF GOVE 3NORS PEG C.C. —7,,, Inlu Facec�. docume ol is blue, Dowmert sewrk indud void Pantoura,Ph, � ic-roprinfing, coir. reactive 12 r, i I saiu!ateu- watermark arlicl t1hermochromak III,",. Fad cc damp is a certftcaf.Dn —,aof the Check Par; Memorandum To: Kimberly Grant, CHS Director CC: Jennifer Belpedio, Assistant County Attorney From: Elizabeth Hernandez, Grant Support Specialist, Community and Human Services Date: August 9, 2018 Re: Homeowner Insurance claim check endorsement -Sarah Schafer, 5880 Everglades Blvd., Naples, FL 34120 The Homeowner Insurance Check Endorsement Policy approved by the Board on June 12, 2012 (16.1). 10) authorizes the Board Chairman or Vice Chairman to endorse homeowner insurance claim checks for recipients assisted with Purchase Assistance and/or rehabilitation program funds as Collier County is named as Second Mortgagee on their insurance policies. The attached check in the amount of $10,239.15 is for disbursement of the claim funds requiring endorsement by Board Chairman Solis or Vice Chairman. The check names M&T Bank and Collier County SHIP as subordinate lien holder. In order for the check to be properly processed, proper signatures/endorsement for all parties listed on check must be obtained. This is a time -sensitive item and must be endorsed as soon as possible as homeowner is waiting to pay for work to be performed on home. Attachments: Homeowners Insurance Policy -Declaration Page Insurance Claim Check (#401684) Insurance Claim Report & photos of damage Collier County Second Mortgage 1 UPC INSURANCE UNITED PROPERTY & CASUALTY INS CO P.O. Box 51149 Sarasota, FL 34232-0330 RENEWAL DECLARATION SARAH SCHAFER 5880 EVERGLADES BLVD N NAPLES FL 34120 HOMEOWNERS DECLARATION UHV 3267228 05 01 12/20/2017 12/20/2018 12:01 a. m. at the residence premises. Effective: 12/20/2017 Date Issued: 10/20/2017 SEEMAN HOLTZ P AND C, INC. 5620 STRAND BLVD UNIT 2 NAPLES FL 34110 Telephone: 239-250-9171 Telephone: 239-591-4028 The residence premises covered by this policy is located at the address listed below. 5880 EVERGLADES BLVD N NAPLES FL 34120 IF PAYMENT IS NOT RECEIVED ON OR BEFORE THE POLICY RENEWAL EFFECTIVE DATE, THIS POLICY WILL NOT BE IN FORCE. Coverage is provided where premium and limit of liability is shown. Flood coverage is not provided and is not a part of this policy. SECTION I COVERAGE LIMIT OF LIABILITY PREMIUMS A. DWELLING $260,000.00 $1,114.00 B. OTHER STRUCTURES $5,200.00 INCLUDED C. PERSONAL PROPERTY $65,000.00 -$162.00 D. LOSS OF USE $52,000.00 INCLUDED SECTION II COVERAGE E. PERSONAL LIABILITY $300,000.00 $18.00 F. MEDICAL PAYMENTS $1,000.00 INCLUDED OPTIONAL COVERAGES Premium charge for Hurricane Exposure: $640.00 The above coverages are subject to a 2% of Coverage A / $5,200 Hurricane Deductible per calendar year. The above coverages are subject to a 10% of Coverage A/ $26,000 Sinkhole Deductible per sinkhole loss. The above coverages are subject to a $2,500 All Other Peril Deductible. TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES: $997.00 The amount of premium change due to approved rate increase is $89.00 The amount of premium change due to coverage change is $35.00 COVERAGES HAVE BEEN INCREASED TO HELP KEEP PACE WITH RISING REPLACEMENT COSTS. PLEASE CONTACT YOUR AGENT IF THERE ARE ANY QUESTIONS PERTAINING TO YOUR POLICY. HO 0003 (05/11) HO 0334 (05/13) COUNTERSIGNED DATE 10/20/2017 HO 0350 (06/97) HO 0355 (05/13) ��"" "" HO 0446 (10/00) HO 0496 (04/91) " o�w, /, bLns� d HO 2370 05/13) L -HPINSTALL (11/14) BY MORTGAGEE 91863316 M&T BANK I SAOA P O BOX 5738 SPRINGFIELD OH 45501-5738 SECOND MORTGAGEE COLLIER COUNTY GOVT C/O HSG HUMAN & VETERAN SVC COLLIER 3339 E TAMIAMI TRAIL SUITE 211 NAPLES FL 34112 UPC 119 05 16 MORTGAGEE COPY Page 1 of 4 UPC HOMEOWNERS DECLARATION INSURANCE UNITED PROPERTY & CASUALTY INS CO P.O. Box 51149 Sarasota, FL 34232-0330 N/A POLICY NUMBER POLICY PERIOD From To UHV 3267228 05 01 12/20/2017 12/20/2018 12:01 a.m. at the residence premises. FORM TYPE HO -3 RENEWAL DECLARATION Effective: 12/20/2017 Date Issued: 10/20/2017 INSURED: AGENT: 3006928 SARAH SCHAFER 5880 EVERGLADES BLVD N NAPLES FL 34120 Telephone: 239-250-9171 SEEMAN HOLTZ P AND C, INC. 5620 STRAND BLVD UNIT 2 NAPLES FL 34110 Telephone: 239-591-4028 The residence premises covered by this policy is located at the above insured address unless otherwise stated below: 5880 EVERGLADES BLVD N NAPLES FL 34120 SECTION I, SECTION II AND OPTIONAL PREMIUMS EMERGENCY MANAGEMENT TRUST FUND SURCHARGE MANAGING GENERAL AGENCY (MGA) POLICY FEE TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES NOTE: The portion of your premium for Hurricane Coverage is: The portion of your premium for A11 Other Coverages is: Premium: $970.00 $2.00 $25.00 $997.00 $640.00 $330.00 An adjustment of -5.8% is included to reflect the Building Code grade for your area. Adjustments range from 1% surcharge to 46.1% credit. Your policy includes endorsement HO 04 46 Inflation Guard- which automatically increases the amount of Dwelling Coverage by the annual percentage amount shown below. FLOOD CARRIER N/A FORM TYPE HO -3 YEAR BUILT 2003 TOWN/ROW HOUSE N/A CONSTRUCT TYPE M CONSTRUCT SUPERIOR N NUMBER OF FAMILIES 00001 AOP TERRITORY 551 PROTECTION CLASS 03 USE CODE F, MUNICIPAL CODE 050999 COUNTY CODE 021 PROT DEVICE/BURGLAR N PROT DEVICE/FIRE N PROT DEV/SPRINKLER N PROT DEV/SHUTTER N WIND/HAIL EXCLUSION N REPLACEMENT COST N OCCUPANCY CODE OWNER FLOOD CREDIT N SINKHOLE COVERAGE I WIND TERRITORY 551A WATER PREVENTION CR N INFLATION GUARD 4% UPC 119 05 16 MORTGAGEE COPY Page 2 of 4 I 1 P C: HOMEOWNERS DECLARATION INSURANCE UNITED PROPERTY & CASUALTY INS CO P.O. Box 51149 Sarasota, FL 34232-0330 POLICY NUMBER POLICY PERIOD From To UHV 3267228 05 01 12/20/2017 12/20/2018 1 12:01 a.m. at the residence premises. RENEWAL DECLARATION Effective: 12/20/2017 Date Issued: 10/20/2017 INSURED: AGENT: 3006928 SARAH SCHAFER 5880 EVERGLADES BLVD N NAPLES FL 34120 Telephone: 239-250-9171 SEEMAN HOLTZ P AND C, INC. 5620 STRAND BLVD UNIT 2 NAPLES FL 34110 Telephone: 239-591-4028 The residence premises covered by this policy is located at the above insured address unless otherwise stated below: 5880 EVERGLADES BLVD N NAPLES FL 34120 LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE FROM THE NATIONAL FLOOD INSURANCE PROGRAM. WITHOUT THIS COVERAGE, YOU MAY HAVE UNCOVERED LOSSES. PLEASE DISCUSS THESE COVERAGES WITH YOUR INSURANCE AGENT. (YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM.) A rate adjustment of 81 % of wind premium is included to reflect the windstorm mitigation features of your dwelling. Adjustments range from 0% to 89% credit subject to verification that your home meets the windstorm mitigation characteristics of the 2001 Florida Building Code. THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES, WHICH MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU. IN CASE OF A LOSS TO COVERED PROPERTY, YOU MUST TAKE REASONABLE EMERGENCY MEASURES SOLELY TO PROTECT THE PROPERTY FROM FURTHER DAMAGE IN ACCORDANCE WITH THE POLICY PROVISIONS (MAY NOT EXCEED THE GREATER OF $3000 OR 1% OF YOUR COVERAGE A LIMIT OF LIABILITY UNLESS YOU CALL US FIRST AND RECEIVE APPROVAL). PROMPT NOTICE OF THE LOSS MUST BE GIVEN TO US OR YOUR INSURANCE AGENT. EXCEPT FOR REASONABLE EMERGENCY MEASURES, THERE IS NO COVERAGE FOR REPAIRS THAT BEGIN BEFORE THE EARLIER OF - (A) 72 HOURS AFTER WE ARE NOTIFIED OF THE LOSS, (B) THE TIME OF LOSS INSPECTION BY US, OR (C) THE TIME OF OTHER APPROVAL BY US. TO REPORT A LOSS OR CLAIM CALL 1(888) 256-3378. ************* Additional Information ************* This replaces all previously issued policy declarations, if any. The declarations page together with all policy provisions and any other applicable endorsements completes your policy. UPC 119 05 16 MORTGAGEE COPY Page 3 of 4 UPC INSURANCE UNITED PROPERTY & CASUALTY INS CO P.O. Box 51149 Sarasota, FL 34232-0330 OIRB11655 (02/10) UPC 112 (08/99) UPC 176 (10/12) UPC 603 (12/14) * OIR611670 (01/06) `UPC 155 (01/06) UPC 191 (04/16) POLICY NUMBER POLICY PERIOD From To UHV 3267228 05 01 12/20/2017 12/20/2018 -UPC 107 12:01 a.m. at the residence premises. FORMS SCHEDULE (continued from page 1) * UIM 424 (06/01) UPC 105 (07/14) -UPC 107 (08/99) -UPC 160 (10/05) UPC 164 (06/06) UPC 174 (09/06) UPC 192 (07/14) UPC 601 (02/14) UPC 602 (02/14) UPC 119 05 16 MORTGAGEE COPY Page 4 of 4 Collier County Community and Human Services Division (CHS) Homeowner Insurance Check Endorsement Policy Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage/lien, then the loan will not have to be repaid. On occasion, the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and receive money to make the repairs. If the insurance claim check is made payable to the homeowner and Collier County, then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to CHS at the address below for check endorsement consideration: 1. Copy of Homeowner's current insurance policy -Declaration Page. 2. Copy of insurance company's claim report with worksheet including description of repairs and costs. 3. Copy of photos of claim damage. 4. Copy of Insurance check(s) payable to homeowner, first lien holder and Collier County. Homeowner Name: Sarah Schafer Homeowner Address: 5880 Everglades Blvd. N Naples FL 34120 Primary Contact Number: 239-250-9171 Homeowner Email: OFFICE USE ONLY CH -Grant Coordinator Date CHS Director Date Reviewed KApproved Denied U PC � Keep the INSURANCE- Promise July 5, 2018 LAW OFFICES OF WILLIAM G MORRIS, P.A. 247 NORTH COLLIER BLVD, SUITE 202 MARCO ISLAND, FL 34145 Re: Insured: SARAH SCHAFER Claim Number: 2017FLO44526 Policy Number: UHV 3267228 04 Date of Loss: 09/10/2017 Cause of Loss: WIND - HURRICANE Loss Location: 5880 EVERGLADES BLVD N NAPLES FL 34120. ESTIMATE AND SETTLEMENT OF DAMAGES Dear Ms. Schafer Enclosed is our estimate in the amount of $ 37,168.85. The payment represents settlement of damages under the following Coverage(s): Payment of your claim is being mailed separately. This settlement check represents the unrestricted tender of the amount we believe you are owed as a result of your loss. You are permitted to use this check at this time. If your mortgage holder has been shown as a payee on your check, please understand we are obligated to do so according to the terms of your policy. Please contact your mortgage holder regarding their procedures for endorsing payments. We have received the inspection report from AMCAT, an independent adjusting firm. The inspecting adjuster observed water damage to multiple interior rooms and found no evidence of any storm related damage to the windows of the home, only normal wear and tear. At this time, these interior water damages to the walls appear to be as a result of ground water and urban flooding. In addition it was noted that the screen material on several of the panels of the patio enclosure were affected by the wind — hurricane. Your policy provides coverage for the ensuing PO Box 1011 • St. Petersburg, FL 33731-1011 • 1-888-CLM-DEPT • Claims@UPCinsurance.com • upcinsurance.com OtherBuilding Structures Replacement $ 37,168.85 $ 37,168.85 Cost Recoverable $ 8,831.52 $ 8,831.52 Depreciation Prior Payments / $ 13,098.18 $ 13,098.18 Advances Deductible $ 5,000.00 $ 5,000.00 Net Payment $ 10,239.15 $ 10,239.15 Payment of your claim is being mailed separately. This settlement check represents the unrestricted tender of the amount we believe you are owed as a result of your loss. You are permitted to use this check at this time. If your mortgage holder has been shown as a payee on your check, please understand we are obligated to do so according to the terms of your policy. Please contact your mortgage holder regarding their procedures for endorsing payments. We have received the inspection report from AMCAT, an independent adjusting firm. The inspecting adjuster observed water damage to multiple interior rooms and found no evidence of any storm related damage to the windows of the home, only normal wear and tear. At this time, these interior water damages to the walls appear to be as a result of ground water and urban flooding. In addition it was noted that the screen material on several of the panels of the patio enclosure were affected by the wind — hurricane. Your policy provides coverage for the ensuing PO Box 1011 • St. Petersburg, FL 33731-1011 • 1-888-CLM-DEPT • Claims@UPCinsurance.com • upcinsurance.com U P C�� Keep the INSURANCE" Promise, Hurricane wind and rain damage; however, it excludes coverage for water damage caused by flooding, damages from wear and tear to dwelling including windows, and does not include coverage for the screen room fabric of the patio enclosure. In addition, you have made claim for loss of refrigerated products and additional living expenses that occurred during home's loss of power immediately following Hurricane Irma. Loss of power from general power outage, which caused the loss of food, is not a named peril and does not render the home uninhabitable; therefore, we are unable to render payment for your food loss and additional living expenses. Your HO 00 03 05 11 Homeowners 3 Special Form policy, as endorsed by Special Provisions UPC 191 04 16 and UPC 603 12 14, states in part: SECTION I — PERILS INSURED AGAINST A. Coverage A — Dwelling and Coverage B — Other Structures We insure against direct physical loss to property described in Coverages A and B. 2. We do not insure, however, for loss: a. Excluded under Section I — Exclusions; C. Caused by: (6) Any of the following: (a) Wear and tear, marring, deterioration; B. Coverage C — Personal Property We insure for direct physical loss to the property described in Coverage C caused by any of the following perils unless the loss is excluded in Section I — Exclusions. 1. Fire Or Lightning 2. Windstorm Or Hail This peril includes loss to watercraft of all types and their trailers, furnishings, equipment, and outboard engines or motors, only while inside a fully enclosed building. This peril does not include loss to the property contained in a building caused by rain, snow, sleet, sand or dust unless the direct force of wind or hail damages the building causing an opening in a roof or wall and the rain, snow, sleet, sand or dust enters through this opening. PO Box 1011 • St. Petersburg, FL 33731-1011 • 1-888-CLM-DEPT • Claims@UPCinsurance.com • upcinsurance.com Kee UPCted INSURANCE" Promise 3. Explosion 4. Riot Or Civil Commotion 5. Aircraft 6. Vehicles 7. Smoke & Vandalism Or Malicious Mischief 9. Theft 10. Falling Objects 11. Weight Of Ice, Snow Or Sleet 12. Accidental Discharge Or Overflow Of Water Or Steam 13. Sudden And Accidental Tearing Apart, Cracking, Burning Or Bulging 14. Freezing 15. Sudden And Accidental Damage From Artificially Generated Electrical Current 16. Volcanic Eruption SECTION 1— EXCLUSIONS A. We do not insure for loss caused directly or indirectly by any of the following. Such loss is excluded regardless of any other cause or event contributing concurrently or in any sequence to the loss. These exclusions apply whether or not the loss event results in widespread damage or affects a substantial area. 3. Water This means: a. Flood, surface water, waves, including tidal wave and tsunami, tides, tidal water, overflow of any body of water, or spray from any of these, all whether or not driven by wind, including storm surge; b. Water which: (1) Backs up through sewers or drains; or (2) Overflows or is otherwise discharged from a sump, sump pump or related equipment; c. Water below the surface of the ground, including water which exerts pressure on, or seeps, leaks or flows through a building, sidewalk, driveway, patio, foundation, swimming pool or other structure; or d. Waterborne material carried or otherwise moved by any of the water referred to in A.3.a. through A.3.c. of this exclusion. PO Box 1011 • St. Petersburg, FL 33731-1011 • 1-888-CLM-DEPT • Claims@UPCinsurance.com • upcinsurance.com UPC 1I Keep the INSURANCE'" Promise This Exclusion A.3, applies regardless of whether any of the above, in A.3.a. through A.3.d., is caused by an act of nature or is otherwise caused. This Exclusion A.3. applies to, but is not limited to, escape, overflow or discharge, for any reason, of water or waterborne material from a dam, levee, seawall or any other boundary or containment system. However, direct loss by fire, explosion or theft resulting from any of the above, in A.3.a. through A.3.d., is covered. B. We do not insure for loss to property described in Coverages A and B caused by any of the following. However, any ensuing loss to property described in Coverages A and B not precluded by any other provision in this policy is covered. 3. Faulty, inadequate or defective: a. Planning, zoning, development, surveying, siting; b. Design, specifications, workmanship, repair, construction, renovation, remodeling, grading, compaction; C. Materials used in repair, construction, renovation or remodeling; or d. Maintenance; of part or all of any property whether on or off the "residence premises". SCREENED ENCLOSURE AND CARPORT DEFINITIONS "Carport(s) " means an aluminum framed structure designed to offer limited protection for vehicles from the weather, and attached to the main dwelling. "Screen Enclosure(s) or Pool Cage(s)"means an aluminum framed structure attached to the main dwelling, enclosed by screens on more than one side and otherwise open to the weather. SECTION I — PROPERTY COVERAGES Coverage A — Dwelling and Coverage B — Other Structures The following is added. There is no coverage for loss caused by hurricane to `Screen Enclosure(s) or Pool Cage(s)" or "Carport(s) " of any type. PO Box 1011 • St. Petersburg, FL 33731-1011 • 1-888-CLM-DEPT • Claims@UPCinsurance.com • upcinsurance.com U P C�1 Keep the INSURANCE"l Promise, The provisions and the terms of this endorsement apply only for loss caused by hurricane to "Screen Enclosure(s) or Pool Cage(s)" or "Carport(s). If an Additional Premium for Limited Screen Enclosure and Carport is shown on the policy declarations page, then the following provision applies: For an additional premium, we insure for direct physical damage caused by hurricane loss only to those items below: a. Aluminum framed "Screened Enclosure(s) or Pool Cage(s)" attached to the main dwelling; and b. Aluminum framed "Carport(s) " attached to the main dwelling. This endorsement does not provide coverage for screen material or costs associated with removing or replacing screens. This coverage does not increase the limit of liability for Coverage A. In addition, your UPC 191 04 16 Special Provisions endorsement states in part: Paragraph H. Suit Against Us is replaced by the following: H. Suit Against Us: If you and we fail to agree on the settlement regarding the loss, prior to filing suit, you must notify us of your disagreement in writing. No action can be brought against us unless there has been full compliance with all of the terms under Section I of this policy and the action is started within five years after the date of loss. Mediation or Appraisal is required as a prerequisite before an Insured can file suit related to Section I of this policy regarding the amount of loss. Your policy may provide replacement cost coverage whereby you are permitted to recover up to the above amount listed as Recoverable Depreciation. In order to claim this additional amount, you must notify us of your intent to complete repairs and/or replacement of the depreciated items, and submit the final repair invoices or receipts within 180 days from the date of loss listed above. Request for replacement cost benefits should be sent to the address or email shown below. Please include your name and claim number on all correspondence related to your claim. In order to receive payment of your Recoverable Depreciation, you will need to provide us at least two of the following items we require in order to verify the cost of repairs and that the repairs were completed. • Final invoice or receipts reflecting the total cost of repairs. • Signed Letter of Completion on your contractor's letterhead stating that the job has been completed to your satisfaction. • Photos showing the completed work. • Copies of the cancelled checks. PO Box 1011 • St. Petersburg, FL 33731-1011 • 1-888-CLM-DEPT • Claims@UPCinsurance.com • upcinsurance.com UPC^�Keep the INSURANCE- PromiseF UPC reserves all rights and defenses it has under the terms of the insurance contract and all applicable laws. By stating the above, UPC neither waives, nor shall be estopped from raising, any of these or any other grounds it has or may discover in the future in denial of your claims, or as a defense to any claim or suit by you for insurance proceeds. Nothing herein constitutes, nor should be construed to constitute, any waiver or relinquishment of any rights of defenses UPC may have to your claim. Should have any additional questions regarding the settlement, or have any other information you would like for us to consider in regards to this claim, please contact the undersigned at the information shown below. Sincerely, Kristi Berry Claims Adjuster United Property & Casualty Insurance Company Phone: 727-895-7737 ext. 5589 Fax: 800-380-5053 Email: claims@upcinsurance.com Enc: Estimate of Damages Statement of Loss Mediation Brochure F.S. 817.234(1)(b) Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree. If this document contains an excerpt from a UPC Insurance Company Policy ("the Policy') it is provided here for informational purposes only. This excerpt is not the official version of the Policy. The official version of the Policy is the policy issued to the insured on the policy effective date. In the event there is inconsistency between this document and the Policy, the Policy shall serve as the official version. PO Box 1011 • St. Petersburg, FL 33731-1011 • 1-888-CLM-DEPT • Claims@UPCinsurance.com • upcinsurance.com UPC I �1 Keep the INSURANCE Promise° Mediation of Residential Property Insurance Claims The Chief Financial Officer for the State of Florida has adopted a rule to facilitate the fair and timely handling of residential property insurance claims. The rule gives you the right to attend a mediation conference with your insurer in order to settle any claim you have with your insurer. An independent mediator, who has no connection with your insurer, will be in charge of the mediation conference. You can start the mediation process after receipt of this notice by calling the Department of Financial Services at 1 (877) 693- 5236. The parties will have 21 days from the date of the notice to otherwise resolve the dispute before a mediation hearing can be scheduled. 1. You [the insured] may also request mediation by faxing a request to the Department at (850) 488-6372 or by writing to the Department of Financial Services, Mediation Section, Bureau of Education, Advocacy and Research, 200 East Gaines Street, Tallahassee, FL 32399-0319. 2. The parties [Insured and Insurer] will have 21 days from the date of the notice to otherwise resolve the dispute before a mediation hearing can be scheduled. 3. If you desire additional information, please contact us at United Property and Casualty Insurance Company PO Box 1011 St. Petersburg, FL 33731 or call us at (800) 861-4370. 4. The Administrator will select the mediator. 5. At any time a party may move to disqualify a mediator for good cause. Good cause consists of conflict of interest between a party and the mediator, that the mediator is unable to handle the conference competently, or other reasons which would reasonably be expected to impair the conference. Complaints concerning a mediator shall be written and submitted to the Department of Financial Services, Mediation Section, Bureau of Education, Advocacy and Research, 200 East Gaines Street, Tallahassee, Florida 32399-4212. 6. You [the insured] will need to notify the mediator 14 days before the mediation conference if you will bring representation to the conference, unless the insurer waives the right to the notice of representation. Upon receipt of such notice from the insured, the mediator shall provide to the insurer that the insured will be represented at the mediation conference. PO Box 1011 - St. Petersburg, FL 33731-1011 - 1-888-CLM-DEPT - Claims@UPCinsurance.com - upcinsurance.com UPC K,r INSURANCE UPC INSURANCE �''��*'s= PO BOX 1011 St. Petersburg, FL 33701 1-888-CLM-DEPT Insured: SARAH SCHAFER Property: 5880 Everglades Blvd N Naples, FL 34120 Home: 5880 Everglades Blvd N Naples, FL 34120 Claim Rep.: Ben Landrum Position: Independent Adjuster Company: AMCAT Estimator: Ben Landrum Position: Independent Adjuster Company: AMCAT Claim Number: 2017FL044526 Date Contacted: 5/19/2018 7:01 PM Date of Loss: 9/10/2017 Date Inspected: 5/25/2018 7:02 PM Date Est. Completed: 6/14/2018 4:44 PM Policy Number: URV326722804 Price List: FLNABX_JUN 18 Restoration/Service/Remodel Estimate: SARAH SCHAFER Home: (239) 289-0311 Business: (251) 747-2617 Business: (251) 747-2617 Type of Loss: Wind Date Received: 5/18/2018 9:59 AM Date Entered: 5/18/2018 10:29 PM We completed an estimate of repair for covered damages to your property. Please note, depreciation may be applied to your estimate based on the age and/or condition of the damaged property. If your policy provides for replacement cost coverage, refer to your policy for specific time limits to make claim for recoverable depreciation. Your applicable policy deductible will be deducted from any payment. We do not direct or warranty the work of any contractor/repair providers, whether referred by us or not. It is your decision on who to hire and to ensure any repairs are done to your satisfaction. If you believe repairs will exceed this estimate, contact us immediately. No additional payment will be issued without our review and approval. Approval must be provided by us prior to any repair. Should you receive a repair estimate which exceeds this estimate, please forward this information to us at: Address: UPC Insurance, P.O Box 1011, St. Petersburg, FL 33731-1011 Email: claims@upcinsurance.com. Thank you for the opportunity to service your claim. If you have any questions, please contact us. UPC NSURANCE'UPC INSURANCE I �'"-'^'� PO Box 1011 St. Petersburg, FL 33701 1-888-CLM-DEPT SARAH SCHAFER House Roof DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV Figures are based previous adjuster's figures. 7.92 49.87 (23.31) 26.56 sf 13. Material Only Add on for grid (double 8.00 SF 2.35 1.13 3.76 1. Remove Tear off, haul and dispose of 29.77 SQ 60.34 0.00 359.26 2,155.58 (0.00) 2,155.58 comp. shingles - Laminated 2. Laminated - comp. shingle rfg. - w/ felt 34.00 SQ 255.74 190.96 1,739.04 10,625.16 (4,443.06) 6,182.10 3. Roofing felt - 15 lb. 33.93 SQ 34.60 13.40 234.80 1,422.18 (890.54) 531.64 4. Ridge cap - composition shingles 260.96 LF 4.33 14.72 226.00 1,370.68 (686.81) 683.87 5. R&R Drip edge 279.65 LF 2.83 11.91 158.28 961.60 (302.33) 659.27 6. R&R Flashing - pipe jack - lead 3.00 EA 78.73 6.49 47.24 289.92 (94.48) 195.44 7. Roof vent - Detach & reset 2.00 EA 89.71 0.06 35.88 215.36 (0.00) 215.36 8. Digital satellite system - Detach & reset 1.00 EA 27.81 0.00 5.56 33.37 (0.00) 33.37 9. Digital satellite system - alignment and 1.00 EA 83.41 0.00 16.68 100.09 (0.00) 100.09 calibration only 10. Re -nailing of roof sheathing -complete 2,976.73 SF 0.27 3.57 160.74 968.03 (80.73) 887.30 re -nail Allowances from previous adjuster. Totals: House Roof 241.11 2,983.48 18,141.97 6,497.95 11,644.02 Exterior Exterior DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV Following figures were based on previous adjuster's estimate. Total: Exterior 0.00 0.00 0.00 0.00 0.00 Front Elevation DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 11. Window Reglazing/Repair - Labor 1.00 EA 162.51 0.00 32.50 195.01 (0.00) 195.01 Minimum 12. Material Only Reglaze window, 1 - 9 1.00 EA 39.58 2.37 7.92 49.87 (23.31) 26.56 sf 13. Material Only Add on for grid (double 8.00 SF 2.35 1.13 3.76 23.69 (11.07) 12.62 or triple pane windows) 3.50 44.18 268.57 34.38 234.19 Totals: Front Elevation SARAH SCHAFER 6/14/2018 Page:2 U PCS r UPC INSURANCE I N S V R A N C E' ('.cm�ee- PO BOX 1011 St. Petersburg, FL 33701 1-888-CLM-DEPT Right Elevation DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV There was no visible storm damage to the elevation. Totals: Right Elevation 0.00 0.00 0.00 0.00 0.00 Rear Elevation DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV Following figures were based on previous adjuster's estimate. 14. R&R Lattice work 112.00 SF 4.22 12.03 94.52 579.19 (14.47) 564.72 Totals: Rear Elevation 12.03 94.52 579.19 14.47 564.72 Left Elevation DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV There was no visible storm damage to the elevation. Totals: Left Elevation 0.00 0.00 0.00 0.00 0.00 Total: Exterior 15.53 138.70 847.76 48.85 798.91 26-4" i T °O a Kitchen - - L � 1 -25'8" N Interior Kitchen Height: 8' 319.78 SF Walls 533.67 SF Walls & Ceiling 23.77 SY Flooring 42.33 LF Ceil. Perimeter Missing Wall 25'8" X 8' Missing Wall - Goes to Floor 2' 10" X 61899 DESCRIPTION QUANTITY UNIT PRICE 15. Contents - move out then reset - Small 1.00 EA 33.36 room 16. Mask the floor per square foot - plastic 213.89 SF 0.25 and tape - 4 mil SARAH SCHAFER 213.89 SF Ceiling 213.89 SF Floor 39.50 LF Floor Perimeter Opens into Exterior Opens into Exterior TAX O&P RCV DEPREC. ACV 0.00 6.68 40.04 (0.00) 40.04 0.64 10.70 64.81 (0.00) 64.81 6/14/2018 Page:3 UPC °t"" UPC INSURANCE INSURANCE' ("l - DESCRIPTION PO BOX 1011 St. Petersburg, FL 33701 1-888-CLM-DEPT CONTINUED - Kitchen QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 17. Paint the walls - two coats 319.78 SF 0.94 3.65 60.12 364.36 (81.13) 283.23 18. Paint baseboard - two coats 39.50 LF 1.44 0.26 11.38 68.52 (15.24) 53.28 Previous adjuster allowance. Totals: Kitchen 4.55 88.88 537.73 96.37 441.36 15' 10"q 5'6 8' a in RoLAi iL 3 2" ----31' ]0" Missing Wall Missing Wall DESCRIPTION Living Room 662.08 SF Walls 1236.32 SF Walls & Ceiling 62.33 SY Flooring 75.68 LF Ceil. Perimeter 2'10"X8' 25'8" X 8' QUANTITY UNIT PRICE TAX Height: Peaked 574.24 SF Ceiling 561.00 SF Floor 74.50 LF Floor Perimeter Opens into Exterior Opens into Exterior O&P RCV DEPREC. ACV 19. Contents - move out then reset - Large 1.00 EA 66.66 0.00 13.34 80.00 (0.00) 80.00 room 20. Paint the walls and ceiling - two coats 1,236.32 SF 0.94 14.09 232.42 1,408.65 (313.66) 1,094.99 21. Detach & Reset Baseboard - 3 1/4" 74.33 LF 2.94 0.09 43.70 262.32 (0.00) 262.32 22. Paint baseboard - two coats 74.33 LF 1.44 0.49 21.40 128.93 (28.67) 100.26 23. R&R Laminate - simulated wood 561.00 SF 7.61 103.34 853.84 5,226.39 (588.30) 4,638.09 flooring 24. R&R Underlayment - sound/crack 561.00 SF 2.91 36.69 326.50 1,995.70 (300.00) 1,695.70 membrane - up to 40 mil Drywall repair revised from previous adjuster allowance above. 25. 1/2" drywall - hung, taped, floated, 196.00 SF 1.94 5.64 76.04 461.92 (10.29) 451.63 ready for paint 26. R&R Batt insulation - 8" - R25 - 196.00 SF 1.35 8.82 52.92 326.34 (6.82) 319.52 unfaced batt 27. Seal the surface area w/PVA primer - 196.00 SF 0.59 0.59 23.12 139.35 (31.00) 108.35 one coat 28. Texture drywall - light hand texture 196.00 SF 0.52 0.71 20.38 123.01 (3.42) 119.59 29. Ceiling fan - Detach & reset 1.00 EA 157.89 0.00 31.58 189.47 (0.00) 189.47 30. Heat/AC register - Mechanically 2.00 EA 12.25 0.00 4.90 29.40 (0.00) 29.40 attached - Detach & reset Totals: Living Room 170.46 1,700.14 10,371.48 1,282.16 9,089.32 SARAH SCHAFER 6/14/2018 Page:4 U PCSUPC INSURANCE INSURANCE PO Box 1011 St. Petersburg, FL 33701 1-888-CLM-DEPT Maser Bedroom - 1 DESCRIPTION Master Bedroom 460.00 SF Walls 664.75 SF Walls & Ceiling 22.75 SY Flooring 57.50 LF Ceil. Perimeter QUANTITY UNIT PRICE TAX Height: 8' 204.75 SF Ceiling 204.75 SF Floor 57.50 LF Floor Perimeter O&P RCV DEPREC. ACV 31. Contents - move out then reset - Large 1.00 EA 66.66 0.00 13.34 80.00 (0.00) 80.00 room 32. Texture drywall - machine 57.50 SF 0.40 0.14 4.60 27.74 (0.61) 27.13 33. Paint the walls and ceiling - two coats 664.75 SF 0.94 7.58 124.98 757.43 (168.65) 588.78 34. Detach & Reset Baseboard - 3 1/4" 57.50 LF 2.94 0.07 33.82 202.94 (0.00) 202.94 35. Paint baseboard -two coats 57.50 LF 1.44 0.38 16.56 99.74 (22.18) 77.56 36. R&R Laminate - simulated wood 204.75 SF 7.61 37.71 311.64 1,907.50 (214.71) 1,692.79 flooring 37. R&R Underlayment - sound/crack 204.75 SF 2.91 13.39 119.16 728.38 (109.50) 618.88 membrane - up to 40 mil Previous adjuster allowance. 38. R&R 1/2" drywall - hung, taped, 57.50 SF 2.39 1.66 27.50 166.59 (3.78) 162.81 floated, ready for paint 39. Seal the surface area w/PVA primer - 57.50 SF 0.59 0.17 6.78 40.88 (0.00) 40.88 one coat 40. R&R Batt insulation - 4" - RI l- 57.50 SF 0.71 0.97 8.18 49.98 (0.89) 49.09 unfaced batt Totals: Master Bedroom 62.07 666.56 4,061.18 520.32 3,540.86 u• Master Bathroom 1 II -9' 2"�� i Offset (1) - I 1 DESCRIPTION Master Bathroom 264.00 SF Walls 324.50 SF Walls & Ceiling 6.72 SY Flooring 33.00 LF Ceil. Perimeter Subroom: Offset (1) 216.00 SF Walls 258.50 SF Walls & Ceiling 4.72 SY Flooring 27.00 LF Ceil. Perimeter QUANTITY UNIT PRICE Height: 8' 60.50 SF Ceiling 60.50 SF Floor 33.00 LF Floor Perimeter Height: 8' 42.50 SF Ceiling 42.50 SF Floor 27.00 LF Floor Perimeter TAX O&P RCV DEPREC. ACV SARAH SCHAFER 6/14/2018 Page: 5 UPC UPC INSURANCE INSVRANCE PO BOX 1011 St. Petersburg, FL 33701 1-888-CLM-DEPT CONTINUED - Master Bathroom DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 41. Contents - move out then reset - Small 1.00 EA 33.36 0.00 6.68 40.04 (0.00) 40.04 room 42. Mask the floor per square foot - plastic 103.00 SF 0.25 0.31 5.16 31.22 (0.00) 31.22 and tape - 4 mil 43. Drywall patch / small repair, ready for 1.00 EA 61.02 0.16 12.20 73.38 (1.63) 71.75 paint 44. Spot seal w/oil based/hybrid stain 1.00 EA 26.03 0.14 5.20 31.37 (6.98) 24.39 blocker 45. Paint the walls - two coats 480.00 SF 0.94 5.47 90.24 546.91 (121.78) 425.13 46. Paint baseboard - one coat 60.00 LF 0.95 0.25 11.40 68.65 (15.27) 53.38 Previous adjuster allowance. 49.67 LF 1.44 0.33 14.30 86.15 (19.16) 66.99 Previous adjuster allowance. 6.33 130.88 791.57 145.66 645.91 Totals: Master Bathroom 5.52 139.96 845.25 126.95 718.30 Bedroom 2 Height: 8' 397.33 SF Walls 550.33 SF Walls & Ceiling 17.00 SY Flooring 49.67 LF Ceil. Perimeter 153.00 SF Ceiling 153.00 SF Floor 49.67 LF Floor Perimeter DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 47. Contents - move out then reset 1.00 EA 44.45 0.00 8.90 53.35 (0.00) 53.35 48. Mask the floor per square foot - plastic 153.00 SF 0.25 0.46 7.66 46.37 (0.00) 46.37 and tape - 4 mil 49. Spot seal w/oil based/hybrid stain 1.00 EA 26.03 0.14 5.20 31.37 (6.98) 24.39 blocker 50. Paint the walls - two coats 397.33 SF 0.94 4.53 74.70 452.72 (100.81) 351.91 51. Detach & Reset Baseboard - 2 1/4" 49.67 LF 2.94 0.06 29.20 175.29 (0.00) 175.29 52. Paint baseboard - two coats 49.67 LF 1.44 0.33 14.30 86.15 (19.16) 66.99 Previous adjuster allowance. 5.52 139.96 845.25 126.95 718.30 Totals: Bedroom 2 SARAH SCHAFER 6/14/2018 Page:6 UPCL�1 :11'UPC INSURANCE INSURANCE' "_,, PO BOX 1011 St. Petersburg, FL 33701 1-888-CLM-DEPT Bedroom 3 tz� Bedroom 3 °O 1 352.00 SF Walls 472.00 SF Walls & Ceiling 13.33 SY Flooring 44.00 LF Ceil. Perimeter Height: 8' 120.00 SF Ceiling 120.00 SF Floor 44.00 LF Floor Perimeter DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 53. Contents - move out then reset 1.00 EA 44.45 0.00 8.90 53.35 (0.00) 53.35 54. Mask the floor per square foot - plastic 120.00 SF 0.25 0.36 6.00 36.36 (0.00) 36.36 and tape - 4 mil 55. Spot seal w/oil based/hybrid stain 1.00 EA 26.03 0.14 5.20 31.37 (6.98) 24.39 blocker 56. Paint the walls - two coats 352.00 SF 0.94 4.01 66.18 401.07 (89.30) 311.77 57. Detach & Reset Baseboard - 2 1/4" 44.00 LF 2.94 0.05 25.88 155.29 (0.00) 155.29 58. Paint baseboard - two coats 44.00 LF 1.44 0.29 12.68 76.33 (16.98) 59.35 Previous adjuster allowance. 4.85 124.84 753.77 113.26 640.51 Totals: Bedroom 3 253.78 2,851.26 17,360.98 2,284.72 15,076.26 Total: Interior Other Structures (APS) DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV There was no visible storm damage to other structures. Totals: Other Structures (APS) 0.00 0.00 0.00 0.00 0.00 Personal Property DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV Insured reported no storm related damages to personal property and none observed. Totals: Personal Property 0.00 0.00 0.00 0.00 0.00 Debris Removal DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV SARAH SCHAFER 6/14/2018 Page:7 UPC ' "`"' UPC INSURANCE I N S V R A M G E' n.c�,irse PO Box 1011 St. Petersburg, FL 33701 1-888-CLM-DEPT CONTINUED - Debris Removal DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 59. Single axle dump truck - per load - 1.00 EA 251.06 0.00 50.22 301.28 (0.00) 301.28 including dump fees 0.00 0.00% 0.00 0.00% Charge is to haul off non -roofing materials. 0.00 0.00% 0.00 0.00% Totals: Debris Removal 36,651.99 0.00 50.22 301.28 0.00 301.28 Line Item Totals: SARAH SCHAFER 510.42 6,023.66 36,651.99 8,831.52 27,820.47 Grand Total Areas: 2,671.19 SF Walls 1,368.88 SF Ceiling 4,040.07 SF Walls and Ceiling 1,355.64 SF Floor 150.63 SY Flooring 325.17 LF Floor Perimeter 0.00 SF Long Wall 0.00 SF Short Wall 329.18 LF Ceil. Perimeter 1,355.64 Floor Area 1,467.75 Total Area 2,671.19 Interior Wall Area 3,199.99 Exterior Wall Area 398.83 Exterior Perimeter of Walls 0.00 Surface Area 0.00 Number of Squares 0.00 Total Perimeter Length 0.00 Total Ridge Length 0.00 Total Hip Length Coverage Item Total % ACV Total % Dwelling 36,651.99 100.00% 27,820.47 100.00% Other Structures 0.00 0.00% 0.00 0.00% Contents 0.00 0.00% 0.00 0.00% Total 36,651.99 100.00% 27,820.47 100.00% SARAH SCHAFER 6/14/2018 Page:8 t1PCl—n� INSURANCE UPC INSURANCE I'�-"�z� PO Box 1011 St. Petersburg, FL 33701 1-888-CLM-DEPT Line Item Total Overhead Profit Material Sales Tax Replacement Cost Value Less Depreciation Actual Cash Value Net Claim Total Recoverable Depreciation Net Claim if Depreciation is Recovered Summary for Dwelling Ben Landrum Independent Adjuster 30,117.91 3,011.83 3,011.83 510.42 $36,651.99 (8,831.52) $27,820.47 $27,820.47 8,831.52 $36,651.99 SARAH SCHAFER 6/14/2018 Page:9 UPC :,: �''' UPC INSURANCE INSURANCE" P—"', PO BOX 1011 St. Petersburg, FL 33701 1-888-CLM-DEPT Recap of Taxes, Overhead and Profit Overhead (10%) Profit (10%) Material Sales GTax Laundering Tax (2%) Manuf. Home GG Tax Storage Rental ) Line Items 3,011.83 3,011.83 510.42 0.00 0.00 0.00 Tn4ol 3,011.83 3,011.83 SARAH SCHAFER 510.42 0.00 0.00 0.00 6/14/2018 Page: 10 UPC UPC INSURANCE I N 5 V R A N C E' �'°"+5° PO BOX 1011 St. Petersburg, FL 33701 1-888-CLM-DEPT Estimate: SARAH_SCHAFER House Roof Coverage: Dwelling Area: Exterior Front Elevation Coverage: Dwelling Rear Elevation Coverage: Dwelling Recap by Room 100.00% _ 100.00% _ 100.00% _ Area Subtotal: Exterior 2.30% Coverage: Dwelling 100.00% _ Area: Interior 1.48% Kitchen Coverage: Dwelling 100.00% _ Living Room Coverage: Dwelling 100.00% _ Master Bedroom Coverage: Dwelling 100.00% _ Master Bathroom Coverage: Dwelling 100.00% _ Bedroom 2 Coverage: Dwelling 100.00% _ Bedroom 3 Coverage: Dwelling 100.00% _ Area Subtotal: Interior Coverage: Dwelling 100.00% _ Debris Removal Coverage: Dwelling 100.00% _ Subtotal of Areas 100.00% _ Total SARAH SCHAFER 14,917.38 49.53% 14,917.38 220.89 0.73% 220.89 472.64 1.57% 472.64 693.53 2.30% 693.53 444.30 1.48% 444.30 8,500.88 28.23% 8,500.88 3,332.55 11.07% 3,332.55 654.36 2.17% 654.36 699.77 2.32% 699.77 624.08 2.07% 624.08 14,255.94 47.33% 14,255.94 251.06 0.83% 251.06 30,117.91 100.00% 30,117.91 30,117.91 100.00% 6/14/2018 Page: 11 UPC UPC INSURANCE INSURANCEP+or" PO Box 1011 St. Petersburg, FL 33701 1-888-CLM-DEPT O&P Items Recap by Category with Depreciation RCV Deprec. ACV CONTENT MANIPULATION 288.94 288.94 Coverage: Dwelling @ 100.00% = 288.94 GENERAL DEMOLITION 4,019.63 4,019.63 Coverage: Dwelling @ 100.00% = 4,019.63 DRYWALL 677.73 19.50 658.23 Coverage: Dwelling @ 100.00% = 677.73 ELECTRICAL - SPECIAL SYSTEMS 83.41 83.41 Coverage: Dwelling @ 100.00% = 83.41 FLOOR COVERING - WOOD 6,363.39 1,176.60 5,186.79 Coverage: Dwelling @ 100.00% = 6,363.39 FINISH CARPENTRY / TRIMWORK 1,085.21 14.07 1,071.14 Coverage: Dwelling @ 100.00% = 1,085.21 HEAT, VENT & AIR CONDITIONING 24.50 24.50 Coverage: Dwelling @ 100.00% = 24.50 INSULATION 221.88 7.39 214.49 Coverage: Dwelling @ 100.00% = 221.88 LIGHT FIXTURES 157.89 157.89 Coverage: Dwelling @ 100.00% = 157.89 PAINTING 4,056.90 1,033.46 3,023.44 Coverage: Dwelling @ 100.00% = 4,056.90 ROOFING 12,917.54 6,375.35 6,542.19 Coverage: Dwelling @ 100.00% = 12,917.54 WINDOW REGLAZING & REPAIR 220.89 32.43 188.46 Coverage: Dwelling @ 100.00% = 220.89 O&P Items Subtotal 30,117.91 8,658.80 21,459.11 Overhead 3,011.83 3,011.83 Coverage: Dwelling @ 100.00% = 3,011.83 Profit 3,011.83 3,011.83 Coverage: Dwelling @ 100.00% = 3,011.83 Material Sales Tax 510.42 172.72 337.70 Coverage: Dwelling @ 100.00% = 510.42 Total 36,651.99 8,831.52 27,820.47 SARAH SCHAFER 6/14/2018 Page: 12 statement of Loss UPC INSURANCE° Insured: Sarah Schafer Claim Number: 2017FL044526 Coverage A - Building Total A + B + C + D $ Limit of Liability: Desenp-- - UPC-Estimate-RCVDvwellingAmount}$ 3� 61631T99 Cloud 9 Home Watch Invoice #,1386 , $. 468.75 ,Home Depot Receipt dated 9/ 14/.17 - Mailbox Repair = ' $ ,. 48' 11 Less Depreciation - Cov. B $ - Total A $ 37,168.85 Coverage B - Other Structures 28,337.33 Less Deductible $ Limit of Liability.,. $ =,:5,000.00 ' Total Payable $ Amount} $ - Description 13,098.18 n 10,239.15 Total B $'± - Coverage C - Contents Limit of Liability ,$62,500 ..Amount' -DeacnpnbA' 12/09117, $ .13,098.18 $ Total prior payments• $ 13 098.18 Kristi Berry 7/5/2018 sig-ture D.tr UPC - Version 100.1 $ Total C Amount Total D `,$ Total A + B + C + D $ 37,168.85 Plus Special Coverage $ - Total LossINNOW Less Depreciation -Cov. A $ 8,831.52 Less Depreciation - Cov. B $ - Less Depreciation - Cov. C Subtotal $ 28,337.33 Less Deductible $ 5,000.00 Total Payable $ 23,337.33 Less Prior Payment(s) $ 13,098.18 Amount Due Now $ 10,239.15 CrL L1i/lJ �' Parameters Emissivity 0.95 Refl. temp. 68 °F For the purpose of this report: The blue areas in the thermal pictures are cooler in temperature and the yellow areas are warmer. The arrows drawn in this report are to be approximations and are not exact locations. We were called into this home due to the storm and the effect on this home. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** 9/301201712:29:53 PM 'F 101.6 81.0 ,13351 1/36 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. C�.. ourr 4 Parameters ---�_0-95_.... .... _....... Refi. temp. Living Room: Visual signs of damage and buckling noticed upon entry of this home. Floor movement was noticed under foot. There was also a thermal difference noticed here but due to man-made materials moisture could not be confirmed. However, moisture would bode these results. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** 9/301201712:37:02 PM 2136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. Parameters Emissivi F.._....... Living Room: Here we can see the edging has loosened and thermal difference is indicated by the white arrow. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** - °F ........ten.-, A n.11-7.nc DRA .5 '0.1 351 3136 — This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. CL©lJD'�' Parameters Emissivity, _ - °F ................ Living Room: Behind Entry Door: Here we noticed the baseboard was off in this area potentially due to expansion and contraction. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** WI MM7 19.37.94 PM This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. C�vuo9 Parameters _.._ Emissivi 0.95 Refl. temp. ..__..._I 68 F - -- Living Room: White and Red arrows: The baseboard here shows elevated signs of separation. The Green arrow in the images point to the separation of this flooring which seem to be a result of this elevated moisture event. This report is generated for the property located at: 8880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** `F 7.9 r J—mn47 I I -An -M PM 70.5 3351 5136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. Cc.ounaT Parameters Emissivit _ 0.95 Refl. temp,_ ._..___....u.1 68.*F Living Room: A moisture meter reading was 57.0% in this area. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** of 84.6 I 6136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. CL.. DIJiQ t.� Parameters Emissivity-- _ t);95—.-._-_- Refl, Dining Room: Here we have thermal difference extending underneath this window at least four feet off the ground. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** 479.1 nm^lnn47 4Td9.1A PM 7 M 7136 _ This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. Ci rsuas5► Parameters Emissivity _ 0.95 Refl, temp_ -6$.*F--._._.-_._. Dining Room: A moisture meter test here read wet at 20.3%. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** T 91.5 FLIR5632.Jpg 9 i1 3f36 -` This report is generated for the sole use tthe entity listed above, Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & }tome Watch is strictly prohibited, Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any tine and will not be held liable for any or all content. Pararneters .... Emissivity .... — -g5...... Refl. femp. ....... ........ 68_F..___. _._. Kitchen Bar Island: Here the baseboards were taken out to help dry out occur. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** °F 6.4 AAA 71.1 3351 9136 �� This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this repot at any time and will not be held liable for any or all content. 1b C,L. L7LJ'!7'9 Parameters _ f=missivi _ _ _ 0.95 F2etl temp• ................. _.�. 68..�F_...__.._ ._... A moisture meter here read 50.0%. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** 10136 This report Is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any lime and will not be held liable for any or all content. CIlL6- Parameters ........... Emissivity........_..._..__.._. Refl. temp_._.._._._.__._... �$...�F........._ — Living Room Ceiling: Although little thermal difference remains, this ceiling had multiple stains visible to the eye and noted here. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** °F 7.3 413.ASl•4fl PM 59.2 3351 11136 M This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -Inspect any part of this report at any time and will not be held liable for any or all content. �.Mn�nn.ly A' "'L. �: CLOU�7'R Living Room Ceiling: This is a close up of this stain pictured on page 11. (The thermal image did not develop) This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** nlanMn47 49•d3.1Q PM 12136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited, Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. rL/7U'V Parameters Emissivity 0.95 — — Refi temp_—_ 68 "F Living Room Ceiling: Thermal difference here may indicate previous moisture intrusion. Notice that stains are apparent to the naked eye. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** ni4n/'1n47 97•d3.97 PM 13136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. Parameters • 0.95 Living Room Ceiling: A wide angle view to orient the room: This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** r...... ,,.n. -f -A9.9A DRfi Q 1x/36 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. Parameters Emissivi 0.95 Refl--temp•..................... 6$..�F...__.. - Living Room Ceiling: Thermal difference here could be the result of insulation that was blown around by this event. Defective or missing insulation should be corrected. 15/36 This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** °F 88.2 63913351 amn/gn17 19.47'34 PM This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. Parameters Emissivity .— .... 0.95_... Refl. temp.......................68 �F.............. _.. Living Room Ceiling: This type of cracking of the ceiling is consistent with a moisture related event. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** 9/30/201712:48:13 PM 74.3 3351 16136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. Parameters _Emissivity10.95 Refl. temp. Living Room Slider: This is directly over the slider door to the lanai. Here we can see the yellow arrows pointing to the visible stains in this area. The red arrow points to the slider. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** n Inn47 413•AR-QA PRA 73.7 3351 This report Is generated for the sole use of the entity listed above. Any reproduction or 17136 use without the express written consent of Cloud 9 Thermal Imaging & Nome Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. Parameters 0.95 Refl. temp. *F 'F This report is generated for the property located at, 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** °F 3.1 75.1 3351 ----------------- 18136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -Inspect any part of this report at any time and will not be held liable for any or all content. CL QUQ'.5r Parameters Emissivity_ 0.95 -68 *F --__.— This report is generated for the property located at: 5880 Everglades Blvd North in c/o, Sarah Smith *** Hurricane Irma *** nr4Non4 7 41 -AG -17 PM 76.1 3351 19!36 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will nol be held liable for any or all content. Parameters 0.95 - - _-- Refl. temp. _6_'F . ................ Living Room Floor by Slider: Here we can see heavy buckling and separation of baseboard. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** of ............ate An.cn.n= ORA 20136 This report is generated for the sole use of the entity Ilsted above. Any reproduction or use wittiout the express written consent of Cloud 9 Thermal Imaging & Home Watch Is strictly prohibited, Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. iL t71'J'Li 9 Parameters ....._...._............. ... ..................._._....._....... _ Emissivity _ 0.95 Flt...................... 68 o f ... _.._..._._ Owner's Suite: This picture is merely to orient the viewer as to the location of the next inspection: This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** r........ - 4n.cn-40 DRA 72.8 3351 21136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. Parameters Emissivity. ..........................1.0.95_ _._..... __.. - Refl. tempi.. ._ 168 *F.-__ - Owners Suite: Elevated thermal difference and visible signs of intrusion are indicated here. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** nwninn47 49•Fn•31 PM 74.9 3351 22/36 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. Parameters Emissivity ReFl. temp ................... 1.68 T owner's Suite: The baseboard has pulled away from the drywall and taken the paint with it. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** n —Inn47 PM 77.1 3351 23136 _ _-- This report is generated for the sole use of the entity listed above. Any reproduction or use without rtCloud of Thermal lriS strictly prohibited. Cloud 9reserves the right to amend, teroretnspct any part of this report at any time and will not be held liable for any or all content. .$,Wa [Louo9 Parameters. ... _.._.. Emissivity 0.95 Ref... temp ........................ 68 OF... Owner's Suite: This flooring also showed signs of elevated swelling. This report is generated for the property located at: 5884 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** OF 9.3 9/30/201712:52:23 PM 71.9 3351 24/36 u This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. Parameters 0.95 68 °F Owner's Suite: The baseboard has pulled away from the drywall and the floor shows elevated damage from this event. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma "* T 9.s --- an.en•4a mann 72.5 3351 25/36` This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. CL ai/,la' 9 Parameters Emissivity — —_ 0.95 —5 Reft. tem 68 .F . p..._ ......................... Owner's Suite: This window was suspect of allowing intrusion. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** °F 2.6 913012017 12:53.25 PM 75.3 3351 26136 This report is generated for the sole use of the entity listed above. Any reproduction or, use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content, C,LQLJI.�'SI Parameters ..... ................. Emissivity _ __ __ 0,95 Refl, temp:............ _..........6$. �F.....---..._..-- Owner's Suite: A moisture meter test on the left side of this window resulted in wet at 20.3°/x. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** 76.9 3351 27136 �^ This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch Is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content, Parameters Emissivity-- --- - 0.95 _...._....._....... Refl. temp:................._-..� .68 �F.__-_ _._ The thermal difference in this area needs moisture tested. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** ,,.,..,.,n. -i nn.ae•an DKA 28136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any lime and will not be held liable for any or all content. AO AL&bi Parameters Emissivity 0.95 The moisture meter here reads wet at 99.9%. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** Alan/7n47-1-M")A PhA 79.1 3351 29!36 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. Parameters Emissivity, __. 0.95__ Reil. tempi _TMT _-_ 68 "F Girls Bedroom #1: We noticed the elevated area of thermal difference under this window. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** T 90.6 oignj,2n17 1 •x19.19 PM This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. Parameters Emissivity Refl_ temp; 68 _'F___.___._. Girls Bedroom #1: Here the moisture meter reads 99.9%. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** OMI' I71dN•1n PM ;? 31/36 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal linaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to arnend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. L lUA47 Parameters Emisslvity 0,95 68 "F Girls Bedroom #2: This room has east facing window that would have taken the brunt of the event. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** cV3nr9n17 1.04:25 PM °F 10.2 72.8 3351 32/36 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. Parameters Refl. temp. _..._._...__._.F� 68 IF ---- Girls Bedroom #2: A moisture meter reading here was wet at 99.9%. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** 9!3012017 1:04:20 PM 78.4 3351 33136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. CL t7L�119 Parameters Emissivity 0.95 Refl. temper ..F .... Dining Room Window: Here we wanted to run one final test of this east facing window. This report is generated for the property located at: 5880 Everglades Blvd North in c/o Sarah Smith *** Hurricane Irma *** 9/30/2017 1:09:44 PM T 87.4 73.6 3351 34136 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will not be held liable for any or all content. C� otva9 Parameters Emissivity 0.85 --------- ---....-. Refl. temp. ._ — — ..68 �.F ......... ... Dining Room Window: The moisture meter read wet at 99.9%. This report is generated for the property located at: 5880 Everglades Blvd North in C/o Sarah Smith *** Hurricane Irma *** 9/30/2017 1:09:49 PM T 93.8 79.4 3351 35/36 This report is generated for the sole use of the entity listed above. Any reproduction or use without the express written consent of Cloud 9 Thermal Imaging & Home Watch is strictly prohibited. Cloud 9 reserves the right to amend, alter or re -inspect any part of this report at any time and will riot be held liable for any or all content. INSTR 4929021 OR 4996 PG 823 RECORDED 12/30/2013 10:26 AM PAGES DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT, COLLIER COUNTY FLORIDA DOC@.35 $70.00 INT@.002 $40.00 REC $44.00 OBLD $20,000.00 OBLI $20,000.00 Prepared by and Return to: Collier County Housing, Human and Veteran Services Department 3339 E. Tamiam) Trail, Building H, Suite 211 Naples, Florida 34112 STATE HOUSING INITIATIVES PARTNERSHIP (SHIP) PROGRAM SECOND MORTGAGE THIS SECOND MORTGAGE ("Security Instrument") is given on 26th day of December, 2013 2013. The Second Mortgagor is: Sarah Schafer, A single person ("Borrower"). This Security Instrument is given to Collier County— SHIP ("Lender"), which is organized and existing under the laws of the United States of America, and whose address is 3339 E. Tamiami. Trail Naples, Florida 34112. Borrower owes Lender the sum of Twenty Thousand and 00/100 Dollars ($20,000.2a. This debt is evidenced by Borrower's Note dated the same date as this Security Instrument ("Second Mortgage"), which does not provide for monthly payments. The full debt, if not paid earlier, is due upon sale of the Property within the fifteen year term. If sold after the fifteen year term, no repayment is required. As long as the borrower continues to own and occupy the assisted property during the term of the mortgage, then the loan will not have to be repaid. This Security Instrument secures to Lender. (a) the repayment of the debt evidenced by the Note, with interest, and all renewals, extensions and modifications; (b) the payment of all other sums, with interest advanced under paragraph 7 to protect the security of the Security Instrument; and (c) the performance of Borrower's covenants and agreements under this Security Instrument and the Note. For this purpose, Borrower does hereby second mortgage, grant and convey to Lender the following described property located in Collier County, Florida. As more particularly described as: GOLDEN GATE EST UNIT t� �� 180 FT OF TR 4 and which has the address of: ("Property Address"): 5880 Everglades Blv Yl FL 34120 (Address) (City (State) (Zip) TOGETHER WITH all the improveme s n0 erected o he prop y, a all easements, rights, appurtenances, rents, royalties, mineral, oil and gas rights and profits coat rig tock an a r res no or h after a part of the property. All replacements and additions shall also be covered by the Se d y strument. th fore of is refer d t in this Security Instrument as the "Property". BORROWER COVENANTS that Bo row s h e rive ed and has the right to mortgage, grant and convey the Property and that the Property is en m x p for b n re'rjord. Borrower warrants and will defend generally the title to the Property against all claims and e� ds su ct o y ran o rec THIS SECURITY INSTRUMENT co bid. s tiona n niform covenants with limited variation by jurisdiction to constitute a uniform security Inst e t cover ng real property. UNIFORM COVENANTS. Borrower der covenant and agree foil ws• 1. Payment of Principal and Interes f yment and Late Char , or g hall promptly pay when due the principal of and interest on the debt evidenced by the Note. 2. Taxes. The Mortgagor will pay all taxe ents, sewer rents A7 tea prior to the accrual of any penalties or interest thereon. The Mortgagor shall pay or cause to be paid, as s 11.. 1 me due, (A)(1) all taxes and governmental charges of any kind whatsoever which may at any time be lawfully assessed owith respect to the Property, (2) all utility and other charges, including "service charges", incurred or imposed for the operation, maintenance, use, occupancy, upkeep and improvement of the Property, and (3) all assessments or other governmental charges that may lawfully be paid in installments over a period of years, the Mortgagor shall be obligated under the Mortgage to pay or cause to be paid only such installments as are required to be paid during the tern of the Mortgage, and shall, promptly after the payment of any of the foregoing, forward to Mortgagee evidence of such payment. 3. Application of Payments. Unless applicable law provides otherwise, all payments received by Lender shall be applied; first, to interest due; and, to principal due; and last, to any late charges due under the Note. 4. Charges; Liens. Borrower shall pay all taxes, assessments, charges, fines and impositions attributable to the Property which may attain priority over this Security Instrument, and leasehold payments or ground rents, if any. Borrower shall promptly furnish to Lender all notices of amounts to be paid under this paragraph, and all receipts evidencing the payments. Borrower shall promptly discharge any lien which has priority over this Security Instrument unless Borrower. (a) agrees in writing to the payment of the obligation secured by the lien in a manner acceptable to Lender, (b) contests in good faith the lien by, or defends against enforcement of the lien in, legal proceedings which in the Lender's opinion operate to prevent the enforcement of the lien; or (c) secures from the holder of the lien an agreement satisfactory to Lender subordinating the lien to this Security Instrument. If Lender determines that any part of the Property is subject to a lien which may attain priority over the Security Instrument, Lender may give Borrower a notice identifying the lien. Borrower shall satisfy the lien or take one or more of the actions set forth above within 10 days of the giving of notice. 5. Hazard or Property Insurance. Borrower shall keep the improvements now existing or hereafter erected on the Property insured against loss by fire, hazards included within the term "extended coverage" and any other hazards, including floods or flooding, for which Lender requires insurance. This insurance shall be maintained in the amounts and for the periods that Lender requires. The insurance carrier providing the insurance shall be chosen by Borrower subject to Lender's approval which shall not be unreasonably withheld. If Borrower fails to maintain coverage described above, Lender may, at Lenders option, obtain coverage to protect Lenders rights in the Property in accordance with paragraph 7. At all times that the Note is outstanding, the Mortgagor shall maintain insurance with respect to the Premises against such risks and for such amounts as are customarily insured against and pay, as the same become due and payable, all premiums in respect thereto, including, but not limited to , all-risk insurance. protecting the interests of the Mortgagor and Mortgagee against loss or damage to the Premises by fire, lightning, and other casualties customarily insured against (including boiler explosion, if appropriate), with a uniform standard extended coverage endorsement, including debris removal coverage. Such insurance at all times to be in an amount not less than the full replacement cost of the Premises, exclusive of footings and foundations. All insurance policies and renewals shall be acceptable to Lender and shall include a standard mortgage clause. Lender shall have the right to hold the policies and renewals. If Lender requires, Borrower shall promptly give to Lender all receipts of paid premiums and renewal notices. In the event of loss, Borrower shall give prompt notice to the insurance carrier and Lender. Lender may make proof of loss If not made promptly by Borrower. Unless Lender and Borrower otherwise agree in writing, insurance proceeds shall be applied to restoration or repair of the Property damaged, if the restoration or repair is economically feasible and Lenders security is not lessened. If the restoration or repair is not economically feasible or Lenders security would be lessened, the insurance proceeds shall be applied to the sums secured by the Security Instrument, whether or not then due, with any excess paid to Borrower. If Borrower abandons the Property, or does not answer within 30 days a notice from Lender that the insurance carrier has offered to settle a claim, then Lender may collect the insurance proceeds. Lender may use the proceeds to repair or restore the Property or to pay sums secured by this Security Instrument, whether or not then due. The 30 -day period will begin when the notice is mailed. Unless Lender and Borrower otherwise agree in writing, any application of proceeds to principal shall not extend or postpone the due date of the monthly payments referred to in paragraph 1 or change the amount of the payments. If under paragraph 21 the Property is acquired by Lender, Borrowers right to any insurance policies and proceeds resulting from damage to the Property prior to the acquisition shall pass to Lender to the extent of the sums secured by this Security Instrument immediately prior to the acquisition. OR 4996 PG 824 G. Occupancy, Preservation, Maintenance and Protection of the Property; Borrower's Loan Application, Leaseholds. Borrower shall occupy, establish, and use the Property as Borrower's principal residence within sixty days after the execution of this Security Instrument and shall continue to occupy the Property as Borrower's principal residence for at least one year after the date of occupancy, unless Lender otherwise agrees in writing, which consent shall not be unreasonably withheld, or unless extenuating circumstances exist which are beyond Borrower's control. Borrower shall not destroy, damage or impair the Property, allow the Property to deteriorate, or commit waste on the Property. Borrower shall be in default if any forfeiture action or proceeding, whether civil or criminal, is begun that in Lender's good faith judgment could result in forfeiture of the Property or otherwise materially impair the lien created by this Security Instrument or Lender's security interest. Borrower may cure such a default and reinstate, as provided in paragraph 18, by causing the action or proceeding to be dismissed with a ruling that, in Lender's good faith determination, precludes forfeiture of the Borrower's interest in the Property or other material impairment of the lien created by this Security Instrument or Lender's security interest. Borrower shall also be in default if Borrower, during the loan application process, gave materially false or inaccurate information or statements to Lender (or failed to provide Lender with any material information) in connection with the loan evidenced by the Note, including, but not limited to, representations concerning Borrowers occupancy of the Property as a principal residence. If this Security Instrument is on a leasehold, Borrower shall comply with all the provision of the lease. If Borrower acquires fee title to the Property, the leasehold and the fee title shall not merge unless Lender agrees to the merger in writing. 7. Protection of Lender's Rights in the Property. If Borrower fails to perform the covenants and agreements contained in this Security Instrument, or there is a legal proceeding that may significantly affect Lender's rights in the Property (such as a proceeding in bankruptcy, probate, for condemnation or forfeiture or to enforce laws or regulations), then Lender may do and pay for whatever is necessary to protect the value of the Property and Lender's rights in the Property. Lender's actions may include paying any sums secured by a lien which has priority over this Security Instrument, appearing In court, paying reasonable attorneys' fees and entering on the Property to make repairs. Although Lender may take action under this paragraph 7, Lender does not have to do so. Any amounts disbursed by Lender under this paragraph 7 shall become additional debt of Borrower secured by this Security Instrument. Unless Borrower and Lender agree to other terms of payment, these amounts shall bear interest from the date of disbursement at the Note rate and shall be payable, with interest, upon notice from Lender to Borrower requesting payment. 8. Mortgage Insurance. If Lender required mortgage insurance as a condition of making the loan secured by this Security Instrument, Borrower shall pay the premiums required to maintain the mortgage insurance in effect. If, for any reason, the mortgage insurance coverage required by Lender lapses or ceases to be in effect, Borrower shall pay the premiums required to obtain coverage substantially equivalent to the mortgage insurance previously in effect, at a cost substantially equivalent to the cost to Borrower of the mortgage insurance previously in effect, from an alternate mortgage insurer approved by Lender. If substantially equivalent mortgage insurance coverage is not available, Borrower shall pay to Lender each month a sum equal to one -twelfth of the yearly mortgage insurance premium being paid by Borrower when the insurance coverage lapsed or ceased to be in effect. Lender will accept, use and retain these payments as a loss reserve in lieu of mortgage insurance. Loss reserve payments may no longer be required, at the option of Lender, if mortgage insurance coverage (in the amount and for the period that Lender requires) provided by an insurer approved by Lender again becomes available and is obtained. Borrower shall pay the premiums required to maintain mortgage m effect, or to provide a loss reserve, until the requirement for mortgage insurance ends in accordance with any written a t e p ver and Lender or applicable law. 9. Inspection. Lender or its agent may mak s 601 actions of the Property. Lender shall give Borrower notice at the time of or prior to an inspection specifyi a le cause for the 10. Condemnation. The proceeds of e w or claim for damages, di nsequential, In connection with any condemnation or other taking of any part of the Property, or for nve nce in lieu of condemnation, a he y assigned and shall be paid to Lender. In the event of a total taking of the Property, the proce ds s all a plie ecured y thi Security Instrument, whether or not then due, with any excess paid to Borrower. In the event f a artiali akin ft roperty, 'n which a fa market value of the Property immediately before the taking is equal to or greater than th am u 0c ' Inst ment immediately before the taking, unless Borrower and Lender otherwise agree in wrfti , th u s ur d y 1 uri s e t sh II be reduced by the amount of the proceeds multiplied by the following fraction: (a) the tot am nt f th su s an d ed a be re it e taking, divided by (b) the fair market value of the Property immediately before the taking. 1 c II p d o orrowe I th ive t of a partial taking of the Property in which the fair market value of the Property immediat I or a take ass he a un ums secured Immediately for the taking, unless Borrower and Lender otherwise agree i . i g or unless applicable Is the ise . s, the proceeds shall be applied to the sums secured by this Security Instrument whether or t~ sums are then due. U Le d orrower otherwise agree in writing, any application of proceeds to principal shall not axle stpone the due dale of h o yments referred to in paragraphs 1 or change the amount of such payments. 11. Borrower Not Released, For bearanc r Not a Waive of the time for payment or modification of amortization of the sums secured by this Security Instru nt b uccessor in interest of Borrower shall not operate to release the liability of the original Borrower or Borrower's su nQi rider shall not be required to commence proceedings against any successor in interest or refuse to extend time for payme erwise modify amortization of the sums secured by this Security Instrument by reason of any demand made by the original Borrower or Borrower's successors in interest. Any forbearance by Lender in exercising any right or remedy shall not be a waiver of or preclude the exercise of any right or remedy. 12. Successors and Assigns Bound; Joint and Several Liability; Cosigners. The covenants and agreements of this Security Instrument shall bind and benefit the successors and assigns of Lender and Borrower, subject to the Provisions of paragraph 17. Borrower's covenants and agreements shall be joint and several. Any Borrower who co-signs this Security Instrument but does not execute the Note; (a) is co-signing this Security Instrument only to mortgage, grant and convey that Borrower's interest in the Property under the terms of this Security Instrument; (b) is not personally obligated to pay the sums secured by this Security Instrument; and (c) agrees that Lender and any other Borrower may agree to extend, modify, forbear or make any accommodations with regard to the terms of this Security Instrument or the Note without that Borrower's consent 13. Loan Charges. If the loan secured by this Security Instrument is subject to a law which sets maximum loan charges, and that law is finally interpreted so that the interest or other loan charges collected or to be collected in connection with the loan exceed the permitted limits, then: (a) any such loan charge shall be reduced by the amount necessary to reduce the charge to the permitted limit; and (b) any sums already collected from Borrower which exceeded permitted limits will be refunded to Borrower. Lender may choose to make this refund by reducing the principal owed under the Note or by making a direct payment to Borrower. If a refund reduces principal, the reduction will be treated as a partial prepayment without any prepayment charge under the Note. 14. Notices. Any notice to Borrower provided for in this Security Instrument shall be given by delivering it or by mailing it by first class mail unless applicable law required use of another method. The notice shall be directed to the Property Address or any other address Borrower designates by notice to Lender. Any notice to Lender shall be given to Borrower or Lender when given as provided in this paragraph. 15. Governing Law; Severability. This Security Instrument shall be governed by federal law and the law of the jurisdiction In which the Property is located. In the event that any provision or clause of this Security Instrument or the Note conflicts with applicable law, such conflict shall not affect other provisions of this Security Instrument or the Nate which can be given effect without the conflicting provision. To this end the provisions of this Security Instrument and the Note are declared to be severable. 16. Borrower's Copy. Borrower shall be given one conformed copy of the Note and of this Security Instrument. 17. Transfer of the Property or a Beneficial Interest in Borrower. If all or any part of the Property or any interest in it is sold or transferred (or if a beneficial interest in Borrower is sold or transferred and Borrower is not a natural person) without Lender's prior written consent, Lender may, at its option, require immediate payment in full of all sums secured by this Security Instrument. However, this option shall not be exercised by Lender if exercise is prohibited by federal law as of the date of this Security Instrument. If Lender exercised this option, Lender shall give Borrower notice of acceleration. The notice shall provide a period of not less than 30 days from the date the notice is delivered or mailed within which Borrower must pay all sums secured by this Security Instrument If Borrower fails to pay these sums prior to the expiration of this period, Lender may invoke any remedies permitted by this Security Instrument without further notice or demand on Borrower. 18, Borrower's Right to Reinstate. If Borrower meets certain conditions, Borrower shall have the right to have enforcement of this Security Instrument discontinued at any time prior to the earlier of: (a) 5 days (or such other period as applicable law may specify for reinstatement) before sale of the Property pursuant to any power of sale contained in this Security Instrument; or (b) entry of a judgment enforcing this Security Instrument. Those conditions are that Borrower: (a) pays Lender all sums which then would be due under this Security Instrument and the Note as if no acceleration had occurred; (b) cures and default of any other covenants or agreements; (c) pays all expenses incurred in enforcing this Security Instrument, including, but not limited to, reasonable attorney's fees; and (d) takes such action as Lender may reasonably require to assure that the lien of this Security Instrument, Lender's rights in the Property and Borrowers obligation to pay the sums secured by this Security Instrument shall continue unchanged. Upon reinstatement by Borrower, this Security Instrument and the obligations OR 4996 PG 825 secured hereby shall remain fully effective as if no acceleration had occurred. However, this right to reinstate shall not apply in the case of acceleration under paragraph 17. 19. Sale of Note; Change of Loan Servicer. The Note or a partial interest in the Note (together with this Security Instrument) may be sold one or more times without prior notice to Borrower. A sale may result in a change in the entity (known as the "Loan Servicer') that collects monthly payments due under the Note and this Security Instrument. There also may be one or more changes of the Loan Servicer unrelated to a sale of the Note. If there is a change of the Loan Servicer, Borrower will be given written notice of the change in accordance with paragraph 14 and applicable law. The notice will state the name and address of the new Loan Servicer and the address to which payments should be made. The notice will also contain any other information required by applicable law. 20. Hazardous Substances. Borrower shall not cause or permit the presence, use, disposal, storage, or release of any Hazardous Substances on or in the Property. Borrower shall not do, nor allow anyone else to do, anything affecting the Property that is in violation of any Environmental Law. The preceding two sentences shall not apply to the presence, use, or storage on the Property of small quantities of Hazardous Substances that are generally recognized to be appropriate to normal residential uses and to maintenance of the Property. Borrower shall promptly give Lender written notice for any investigation, claim, demand, lawsuit or other action by any governmental or regulatory agency or private party involving the Property and any Hazardous Substance or Environmental Law of which Borrower has actual knowledge. If Borrower leams, or is notified by any governmental or regulatory authority, that any removal or other remediation of any Hazardous Substance affecting the Property is necessary, Borrower shall promptly take all necessary remedial actions in accordance with Environmental Law. As used in this paragraph 20, "Hazardous Substances" are those substances defined as toxic or hazardous substances by Environmental Law and the following substances: gasoline, kerosene, other Flammable or toxic petroleum products, toxic pesticides and herbicides, volatile solvents, materials containing asbestos or formaldehyde, and radioactive materials. As used in this paragraph 20, "Environmental Laud' means federal laws and laws of the jurisdiction where the Property is located that relate to health, safety or environmental protection. 21. Acceleration; Remedies. Lender shall give notice to Borrower prior to acceleration following Borrowers breach of any covenant or agreement in this Security Instrument (but not prior to acceleration under paragraph 17 unless applicable law provides otherwise). The notice shall specify: (a) the default; (b) the action required to cure the default; (c) a date, not less than 30 days from the date the notice is given to Borrower, by which the default must be cured; and (d) that failure to cure the default on or before the date specified in the notice may result in acceleration of the sums secured by this Security Instrument, foreclosure by judicial proceeding and sale of the Property. The notice shall further inform Borrower of the right to reinstate after acceleration and the right to assert in the foreclosure proceeding the non-existence of a default or any other defense of Borrower to acceleration and foreclosure. If the default is not cured on or before the date specified in the notice, Lender, at its option, may require immediate payment in full of all sums secured by this Security Instrument without further demand and may foreclose this Security Instrument by judicial proceeding. Lender shall be entitled to collect all expenses incurred in pursuing the remedies provided in this paragraph 21, including, but not limited to, reasonable attorney's fees and costs of the title evidence. 22. Release. Upon payment of all sums secured by this strument, Lender shall release this Security Instrument, without charge, to Borrower. Borrower shall pay any recordation w 23. Attorneys' Fees. As used In this Securit tPF�gde eys' fees" shall include any attorneys' fees awarded by an appellate court. 24. Riders to this Security Instrument. f o� r more riders are execut rower and recorded together with this Security Instrument, the covenants and agreements of ea suc rder shall be incorporated into nd s all amend and supplement the covenants and agreements of this Security Instrument as if the der(, � a part is Ser . y instru ant. Check Applicable Box) ❑ Adjustable Rate Rider ❑ Rai ❑ Graduated Payment Rider ❑ 1-4 ❑ Balloon Rider ❑ Bim ❑ Other(s) (specify SIGNING BELOW, Borrower accepts and agree; by Borrower and recorded with it. Signed, sealed and delivered in the presence of: Signature: e Borrower Sarah Schafer STATE OF FLORIDA COUNTY OF COLLIER and covenants coht l SNE CIRC I hereby certify that, Sarah Schafer Signature: Co- Borrower inium Rider Home Rider Unit Development Rider Instrument and in any rider(s) executed Address: 5880 Everglades Blvd. N Naples, Florida 34120 personally appeared to me known to be the person(s) described in and who executed the foregoing instrument and acknowledged before me that (He/ she/ they) executed the same for the purpose therein expressed. WITNESS my hand and official seal in the County and State aforesaid this 2 6t'0ay of December 2013 My Commission Expires: (Seal) R.M. PECK Notary Public - State of Florida • = My Comm. Expires Dec 8, 2014 „•.� ,.,•.',; Commission # EE 39543 gond^.d ;hioun^ National Notary Assn. �� V,,, ,-” Notary Public's Signature Notary's Printed Name SHIP File#: 12-039 SHIP Purchase Assistance Program ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 010 TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the exception of the Chairman's signature,draw a line through routing,lines#1 through#2,complete the checklist,and forward to the County Attorney Office. Route to Addressee(s) (List in routing order) Office Initials Date 1. Lisa N. Carr, Sr. Grant Coordinator CHS ( Ci _S'/ 2. Jennifer A. Belpedio,ACA County Attorney Office 3. NOTE: Clerk's attestation is not required.Please do not route this item to Clerk's Board Minutes and Records. CAO please scan document after execution by Chairman and email them to Clerk's Minute and Records for its records. PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above,may need to contact staff for additional or missing information. Name of Primary Staff Lisa N.Can CHS Phone Number 239-252-2339 Contact/ Department Agenda Date Item was June 12,2012 Agenda Item Number 16.D.10 Approved by the BCC Type of Document Insurance Claim Check Endorsement for Number of Original 1 Attached Erin Litvak Documents Attached PO number or account number if document is N/A to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature? LNC 2. Does the document need to be sent to another agency for additional signatures? If yes, provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. N/A 3. Original document has been signed/initialed for legal sufficiency. (All documents to be N/A signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's cu3 signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip N/A should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 06/12/2012 and all changes made during the meeting have been incorporated in the attached document. The County &) Attorney's Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC,all changes directed by the BCC have been made,and the document is ready for th Chairman's signature. I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12 16010 • oho Z7 oyz nz A- o--I D > c Zomw 71 a X m m D m m Z n x m � z❑ mrnr- z 3 • zAcl, m -I �m � i oc >coc�z m � Z ADD r 08 Z r OZ n = Z < T. -n r) rm�Or r' � m cn - c� vc� oo ° o °m SO= -{ RI 3 -� Z (D D) 7' O S S r co m G CD n) m :Z.< (D _. 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E 0 o 0 0 e * 0 o z--cc, "OW.�c'*y... 9n tyFeaw.ezlncluded. oelmaonn,a D V 1. 6 010 • ENDORSE HERE yiej -••�h •u -.--_-• •n -• Isstoners- C,.!CK HEREAFTER MOBILE OR REMOTE DEPOSIT DATE DO NOT WRITE, STAMP OR SIGN BELOW THIS LINE RESERVED FOR FINANCIAL INSTITUTION USE • • • • RS-&3 The security features listed below,as well as those ® not listed,exceed industry guidelines. Security Feature.: Mieroprinted Border •Smaii type in tee border appears as dotted Noe whar:.p1oic_,. Warning Band: •Alerts handler the document contains mcvma/Wives Security Screen Backer. •t Acstes dxerrent c.gtnsiii0 dit/cun le•.pr;Wace Void Background. •Pattern pmtacic against atteratioos;a hidden+rsid beGanm. curie when pholocoplsa or sunned. Chest/tuft Sensitive Pnpec•Stains m spots may appear d cher:kcs;atteraiio:t anentpis era r I i Reef Sensitive Ink: •Responds to warmth.Hon red:maga betwee.t th.,,ntb and forefinger err breathe car'r.The,mage vet,fade end reappear _'au Padlock tlesi n is a cerliticattan mark at the Check Pe meat 5 stems emaciation 16D10 Collier County Community and Human Services Division(CHS) Homeowner Insurance Check Endorsement Policy Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage/lien,then the loan will not have to be repaid. On occasion,the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and receive money to make the repairs.If the insurance claim check is made payable to the homeowner and Collier County,then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to CHS at the address below for check endorsement consideration: 1. Copy of Homeowner's current insurance policy-Declaration Page. 2. Copy of insurance company's claim report with worksheet including description of repairs and costs. 3. Copy of photos of claim damage. 4. Copy of Insurance check(s)payable to homeowner,first lien holder and Collier County. Homeowner Name: Erin L i v ak Homeowner Address: Li D f 0 (o'111 44C. NE7 IV cZ P(Lg� �L 3'412--D Primary Contact Number: Z3'1 `tom - `f 3 4/ Homeowner Email: -' I '€_n -FSct.eat? T y // Reviewed S- rant Coor.inator Date • A 1. IL( x l y Approved HS Director Date Denied 16010 PROGRESSIVE PROPERTY INSURANCE CORP 1 ASI St.Petersburg,Way 33702 PROGRE1l/UE® HOME Homeowners Declaration Page Total Policy Premium: $2,010 Policy Number: ARK103392 Named Insured: ERIN LITVAK Agent: 4048 6TH AVE NE Insurance Solutions of SW Florida NAPLES,FL 34120 1721 San Marco Road,Ste D Marco Island,FL 34145 Agent Code: 411432 For Policy Service,Call: (239)642-0200 Effective Date of This Transaction: 11/25/2018 Activity of This Transaction: Renewal Policy Period: From: 11/25/2018 To: 11/25/2019 (At 12:01 AM Standard Time at the residence premises) Residence Premises: 4048 6TH AVE NE Plan Type: H03 NAPLES,FL 34120 Coverage at the residence premises is provided only where a limit of liability is shown or a premium is stated. Coverages and Limits of Liability Limit Premium SECTION I: A.Dwelling Coverage $149,000 2654.63 B.Other Structures $2,980 Included C.Personal Property $37,250 -214.28 D.Loss of Use $14,900 Included SECTION II: E.Personal Liability-Each Occurrence $300,000 15.00 F.Medical Payments to Others-Each Person $1,000 Included OTHER COVERAGES AND ENDORSEMENTS: (Printed on the following page) Deductibles: HURRICANE: 2%-$2980 ALL OTHER COVERED PERILS: $2500 Mortgagee: 1st Mortgagee: 2nd Mortgagee: REGIONS BANK DBA REGIONS MORTGAGE Collier County SHIP Trust Fund ISAOA 3339 E.Tamiami Trail PO BOX 200401 NAPLES,FL 34112 FLORENCE,SC 29502-0401 Loan#TBD Loan#0899043370 Escrow:Yes Countersigned by Authorized Representative St.Petersburg,FL Date: 09/25/201 ASI HO FL DEC 12 17 The ASI Group is an affiliate of The Progressive Corporation 6 D10 Named Insured(s): ERIN LITVAK Policy Number: ARK103392 Other Coverages And Endorsements: Form Number Limit Premium . Catastrophic Ground Cover Collapse Coverage-Florida ASI HO 09 CG 08 12 Table Of Contents ASI HO 09 COV 01 98 Hurricane Deductible Endorsement ASI HO 09 HD 05 05 Homeowners Policy Outline ASI HO 09 OTL 01 10 Special Provisions For Florida ASI HO 09 SP 08 12 Ordinance or Law Coverage Notification ASI HO FL OLR 08 16 Homeowners3 Special Form HO 00 03 04 91 Home Day Care Explanation HO 04 96 04 91 BCEG -89.25 Tier Factor Premium 557.95 NHR Deductible 2500 -645.63 HUR Deductible 2980 -213.26 PC/Construction Factor 1.79 Limited Fungi,Mold,Wet/Dry Rot ASI HO FL LF 01 18 $10,000 Included Age of Dwelling 40.55 Number of Stories 85.61 Age of Roof -39.39 Fees and Assessments: Managing General Agent Fee 25,00 Emergency Management Preparedness Assistance Fee 2.00 Scheduled Items: Category Description of Property Value Premium The Hurricane Coverage portion of your Total Premium is: $574 The Non-Hurricane Coverage portion of your Total Premium is: $1,436 Additional Insured: Additional Interest: Interest: Rating Information: Construction Type: Masonry Type of Residence: Single Family Total Square Feet: 1,278 Year Built: 1996 ASI Territory: 464C Roof Year: 2008 County: COLLIER Notes: Page 2 of 2 The ASI Group is an affiliate of The Progressive Corporation ASI HO FL DEC 12 17 ~ I 16010 dvanced PA r echnologies 8445 Morningside Drive,Brooksville,FL 34601 Main Office(352)796-3847 • Toll Free(888)440-SINK Fax(352)799-4324 March 10, 2018 APT File Number: 2018-03-05-1204 Subject Property Info: Erin Guthrie 4048 6th Ave NE Naples, Florida 34120 Attorney Info: Mark A. Pecko Morgan and Morgan 12800 University Dr Ste 600 Ft Myers FL 33907 Dear Mr. Pecko: On the above referenced date our company completed an inspection at the subject property in regards to damage the property sustained from Hurricane Irma on September 11,2017. Please find attached an Xactimate Construction Estimate to repair this damage the property suffered as a result of Hurricane Irma. We have also included a corresponding contract between our company and your client to complete these needed repairs as outlined in the Xactimate Construction Estimate. Should you have any questions or need anything further, please do not hesitate to contact our office at your convenience. It has been our pleasure to provide this service for your client. Sincerely, .� �Or(n 1 � .L 4 U /Japhet Robles CBC1259714 Advanced Pace Technologies Expert www.chooseapt.com CGC1521015 • CBC1258589 • CCC1329743 • CGC1520154 • CRC1330456 HI5001 • HI7592 • HI5074 • HI5686 • TN License 00065222 16010 Advanced Claims Concepts,Inc. A 201 Cox Creek Pkwy South Florence,AL 35630 Insured: LITVAK,ERIN Home: (239)450-4341 Property: 4048 6TH AVE NE NAPLES,FL 34120 Home: 4048 6TH AVE NE NAPLES,FL 34120 Claim Rep.: Catastrophe Team Four Estimator: Trey Beecham Business: (903)288-4739 E-mail: treybeecham@gmail.com Reference: Company: Ark Royal Insurance Company Claim Number: 495246-171011-121124 Policy Number: ARK103392 Type of Loss: Wind Damage Date Contacted: 9/24/2017 Date of Loss: 9/11/2017 1:00 PM Date Received: 9/14/2017 Date Inspected: 10/4/2017 Date Entered: 9/17/2017 3:17 PM Date Est.Completed: 11/9/2017 5:03 PM Price List: FLNA8X_NOV 17 Restoration/Service/Remodel Estimate: LITVAK ERIN Dear ASI Policyholder, The estimate attached reflects the cost to repair the known damages to your property. Please review the estimate and note the Dwelling Summary page,which shows the total damages,including sales tax and your deductible. If you hire a general contractor to make the repairs,you should provide your contractor with a copy of the estimate. Job-Personnel Overhead/Sub contractor overhead and profit expense is included in your estimate under the Labor Overhead portion of each unit price._ No supplement or other payments will be issued for any repairs not listed in the estimate without prior authorization.Approval must be given by ASI prior to the replacement or repair of any additional items.ASI must have the opportunity to view the additional damages or proposed changes prior to the initiation of further work. If there is a mortgage holder included on the policy,by law the mortgage holder must be included on the payment.You must contact the mortgagee to secure endorsement of the check. Regards, ASI Claims Department 16010 Advanced Claims Concepts,Inc. A 201 Cox Creek Pkwy South Florence,AL 35630 LITVAK_ERIN Main Roof .--arr--. Roof iINN - 1719.63 Surface Area 17.20 Number of Squares N 1111 168.65 Total Perimeter Length 49.79 Total Ridge Length (a) za DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 1. Digital satellite system-Detach&reset 2.00 EA 27.74 0.00 55.48 (0.00) 55.48 2. Remove Tear off,haul and dispose of comp.shingles- 17.20 SQ 58.19 0.00 1,000.87 (0.00) 1,000.87 3 tab 3. Roofing felt-30 lb. 14.21 SQ 39.98 11.33 579.45 (142.03) 437.42 4. 3 tab-25 yr.-comp.shingle roofing-w/out felt 19.00 SQ 199.33 85.24 3,872.51 (757.45) 3,115.06 5. R&R Drip edge 99.58 LF 2.69 4.00 271.87 (33.43) 238.44 6. Flashing-pipe jack 3.00 EA 42.93 1.68 130.47 (18.40) 112.07 Totals: Roof 102.25 5,910.65 951.31 4,959.34 Total: Main Roof 102.25 5,910.65 951.31 4,959.34 Main Level ioa1,y Bay Height:6' t� .E., 97.50 SF Walls 31.38 SF Ceiling to 128 .88 SF Walls&Ceiling 31.38 SF Floor 3.49 SY Flooring 16.25 LF Floor Perimeter I, i70 28.50 LF Ceil.Perimeter Missing Wall 4'2 9/16"X 6' Opens into LIVING_ROOM Missing Wall 8'3/8"X 6' Opens into DINING_ROOM Window 2' 1/8"X 4' Opens into Exterior Window 8'1"X 3' Opens into Exterior Window 2'5"X 4' Opens into Exterior DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 7. Floor protection-plastic and tape-10 mil 31.38 SF 0.30 0.19 9.60 (0.00) 9.60 8. R&R 5/8"drywall-hung,taped,floated,ready for 31.38 SF 2.42 0.96 76.90 (0.00) 76.90 paint 9. R&R 1/2"drywall-hung,taped,floated,ready for 97.50 SF 2.36 2.81 232.92 (0.00) 232.92 paint LITVAK_ERIN 11/9/2017 Page:2 16010 Advanced Claims Concepts,Inc. A 201 Cox Creek Pkwy South Florence,AL 35630 CONTINUED-Bay DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 10. R&R Batt insulation-6"-R19-paper faced 31.38 SF 1.07 1.04 34.62 (0.00) 34.62 11. R&R Batt insulation-4"-R11-unfaced batt 97.50 SF 0.71 1,64 70.87 (0.00) 70.87 12. Drywall Installer/Finisher-per hour 2.00 HR 75.00 0.00 150.00 (0.00) 150.00 Due to small job 13. Insulation Installer-per hour 2.00 HR 40,63 0.00 81.26 (0.00) 81.26 Due to small job 14. Seal/prime then paint the walls and ceiling(2 coats) 128.88 SF 0.93 1.16 121.02 (39.95) 81.07 15. Clean floor-Heavy 31.38 SF 0,46 0.02 14.45 (0.00) 14.45 Totals: Bay 7.82 791.64 39.95 751.69 '2'j ' '6'-. Bedroom-1 Height:Sloped 674 1-4 ." b Walk. 458.33 SF Walls 139.43 SF Ceiling m Bedroom-1 i J 597.77 SF Walls&Ceiling 131.15 SF Floor I = 1 " Bet 14.57 SY Flooring 45.83 LF Floor Perimeter 47.23 LF Cell.Perimeter P 11'10" s 2 Window 5'X 4' Opens into Exterior Door 2'6"X 6'8" Opens into LIVING_ROOM Door 1'10" X 6'8" Opens into WALKIN_CLOS Window 5'X 4' Opens into Exterior DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 16. Floor protection-plastic and tape-10 mil 131.15 SF 0.30 0.79 40.14 (0.00) 40.14 17. Mask wall-plastic,paper,tape(per LF) 47.23 LF 1,09 0.65 52.13 (0.00) 52.13 18. Content Manipulation charge-per hour 2.00 HR 32.51 0.00 65.02 (0.00) 65.02 19, Drywall Installer/Finisher-per hour 2.00 HR 75.00 0.00 150.00 (0.00) 150.00 Due to small job 20. R&R 5/8"drywall-hung,taped,ready for texture 64.00 SF 2.20 1.92 142.72 (0.00) 142.72 21. R&R Batt insulation-6"-R19-paper faced 64.00 SF 1.07 2.11 70.59 (0.00) 70.59 22. Scrape the surface area&prep for paint 75.43 SF 0.64 0.05 48.33 (0.00) 48.33 23. Acoustic ceiling(popcorn)texture-heavy 139.43 SF 1.00 0.50 139.93 (0.00) 139.93 24. Clean floor-Heavy 131.15 SF 0.46 0.08 60.41 (0.00) 60.41 Totals: Bedroom-1 6.10 769.27 0.00 769.27 LITVAK ERIN 11/9/2017 Page:3 16010 Advanced Claims Concepts,Inc. A 201 Cox Creek Pkwy South Florence,AL 35630 ii,,o, _ Bedroom-2 Height: Sloped T 5"' 578.33 SF Walls 216.49 SF Ceiling t. jBedroom-2 1 794.82 SF Walls&Ceiling 206.92 SF Floor i 22.99 SY Flooring 57.83 LF Floor Perimeter l 59.04 LF Ceil.Perimeter r'!'-. _15'_1' 1 1----16'5" Door 2'6"X 6'8" Opens into LIVING_ROOM Window 5'X 4' Opens into Exterior DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 25. Floor protection-plastic and tape-10 mil 206.92 SF 0.30 1,24 63.32 (0.00) 63.32 26. Mask wall-plastic,paper,tape(per LF) 59.04 LF 1.09 0.81 65.16 (0.00) 65.16 27. Content Manipulation charge-per hour 2.00 HR 32.51 0,00 65.02 (0.00) 65.02 28. Drywall Installer/Finisher-per hour 2.00 HR 75.00 0.00 150.00 (0.00) 150.00 Due to small job 29. R&R 5/8"drywall-hung,taped,floated,ready for 32.00 SF 2.42 0.98 78.42 (0.00) 78.42 paint 30. R&R Batt insulation-6"-R19-paper faced 32.00 SF 1.07 1.06 35.30 (0.00) 35.30 31. Scrape the surface area&prep for paint 184.49 SF 0,64 0.11 118.18 (0.00) 118.18 32. Acoustic ceiling(popcorn)texture-heavy 216.49 SF 1.00 0.78 217.27 (0.00) 217.27 33. Clean floor-Heavy 206.92 SF 0.46 0.12 95.30 (0.00) 95.30 Totals: Bedroom-2 5.10 887.97 0.00 887.97 Total: Main Level 19.02 2,448.88 39.95 2,408.93 Debris Removal DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 34. Haul debris-per pickup truck load-including dump 1.00 EA 148.56 0.00 148.56 (0.00) 148.56 fees Totals: Debris Removal 0.00 148.56 0.00 148.56 Line Item Totals: LITVAK ERIN 121.27 8,508.09 991.26 7,516.83 LITVAK_ERIN 11/9/2017 Page:4 16010 Advanced Claims Concepts,Inc. A. 201 Cox Creek Pkwy South Florence,AL 35630 Grand Total Areas: 3,763.93 SF Walls 1,235.87 SF Ceiling 4,999.79 SF Walls and Ceiling 1,177.88 SF Floor 130.88 SY Flooring 390.54 LF Floor Perimeter 0.00 SF Long Wall 0.00 SF Short Wall 427.00 LF Ceil.Perimeter 1,177.88 Floor Area 1,270.12 Total Area 3,763.93 Interior Wall Area 1,557.10 Exterior Wall Area 152.63 Exterior Perimeter of Walls 1,719.63 Surface Area 17.20 Number of Squares 168.65 Total Perimeter Length 49.79 Total Ridge Length 0.00 Total Hip Length LITVAK ERIN 11/9/2017 Page:5 • 16010 Advanced Claims Concepts,Inc. A 201 Cox Creek Pkwy South Florence,AL 35630 Summary for Dwelling Line Item Total 8,386.82 Material Sales Tax 121.27 Replacement Cost Value $8,508.09 Less Depreciation (991.26) Actual Cash Value $7,516.83 Less Deductible (2,820.00) Net Claim $4,696.83 Total Recoverable Depreciation 991.26 Net Claim if Depreciation is Recovered $5,688.09 Trey Beecham LITVAK_ERIN 11/9/2017 Page:6 16010 Advanced Pace Technologies Advanced Pace Technologies 8445 Morningside Drive Brooksville,Florida,34609 352.796.3847 Recap by Room Estimate:2018-03-05-1204 Area:roof Roofl 13,082.15 33.52% Area Subtotal: roof 13,082.15 33.52% Area:Main Level Bedroom 1 4,543.30 11.64% Bedroom 2 6,205.16 15.90% Area Subtotal: Main Level 10,748.46 27.54% Exterior 10,482.64 26.86% General Conditions 4,445.84 11.39% Labor Minimums Applied 265.37 0.68% Subtotal of Areas 39,024.46 100.00% Total 39,024.46 100.00% 2018-03-05-1204 4/30/2018 Page: 10 16010 a Advanced Pace Technologies Advanced Pace Technologies 8445 Morningside Drive Brooksville,Florida,34609 352.796.3847 Recap by Category O&P Items Total AWNINGS&PATIO COVERS 1,078.56 2.22% CLEANING 540.16 1.11% CONTENT MANIPULATION 130.32 0.27% CONT:PACKING,HANDLNG,STORAGE 551.32 1.13% GENERAL DEMOLITION 5,566.45 11.44% DRYWALL 1,981.63 4.07% FLOOR COVERING-CARPET 1,686.21 3.46% FINISH CARPENTRY/TRIMWORK 447.67 0.92% FRAMING&ROUGH CARPENTRY 1,315.60 2.70% HEAT, VENT&AIR CONDITIONING 222.53 0.46% INSULATION 1,543.88 3.17% LABOR ONLY 1,292.50 2.66% LANDSCAPING 1,500.00 3.08% PAINTING 4,860.14 9.99% SWIMMING POOLS&SPAS 1,239.13 2.55% ROOFING 11,725.36 24.09% SOFFIT,FASCIA,&GUTTER 2,654.20 5.45% TEMPORARY REPAIRS 108.00 0.22% WINDOW TREATMENT 202.02 0.42% WINDOWS-VINYL 202.45 0.42% WINDOWS-WOOD 81.70 0.17% WATER EXTRACTION&REMEDIATION 94.63 0.19% O&P Items Subtotal 39,024.46 80.18% Permits and Fees 950.64 1.95% Material Sales Tax 585.36 1.20% Overhead 4,056.09 8.33% Profit 4,056.09 8.33% Total 48,672.64 100.00% 2018-03-05-1204 4/30/2018 Page: 11 I 1 6010 ,y f lik it y A, 'a : ,.. i it # • ; t t 1fir 16010 .4-o-N g s • .j, .+ • • 16Di0 • • `i. . p 1 t�. 1 16010 S t ;, .,�. `AilVia, t - S'. 16010 CLOSING STATEMENT GEN ATTY: Firm WORK ATTY: AP CLIENT NAME: Erin Litvak MATTER 8112403 ID: RECOVERY FOR FULL AND FINAL SETTLEMENT: ---------- 544,000.00 TOTAL RECOVERY: 544,000.00 LESS ATTORNEY'S FEES: $14,516.50 LESS TOTAL COSTS: $546.47 NET RECOVERY TO $28,937.03 CLIENT: I further acknowledge that the payment of expenses not otherwise mentioned herein,which were incurred as a result of the above-referenced loss or associated with this matter, are our responsibility and they have not been paid from the settlement proceeds. I have been advised that a verdict might have been larger than this settlement. However, I approve of and am satisfied with the above settlement and authorize disbursement in accordance with the above. Client hereby acknowledges and agrees with the disbursement of settlement funds as outlined above. DATED this date of ,2018. Erin Litvak Date (Signature) M. Antoine Pecko, Esquire/Morgan &Morgan, P.A. 1 6010 GENERAL RELEASE That ERIN LITVAK (hereinafter referred to as "First Party") for and in consideration of the sum of FORTY FOUR THOUSAND DOLLARS AND 00/100 CENTS ($44,000) in lawful money of the United States of America, received from PROGRESSIVE PROPERTY INSURANCE COMPANY, F/K/A ARK ROYAL INSURANCE COMPANY (hereinafter referred to as "Second Party"), receipt whereof is hereby acknowledged, does hereby remise, release, acquit and forever discharge the Second Party, its agents, representatives, successors, employees, owners, officers, directors, administrators, insurance adjusters, investigators, attorneys, expert witnesses, affiliates and incorporators, from any and all causes of action, suits, independent tort claims, debts, dues, damages, including compensatory and punitive damages, medical payment benefits, sums of money, accounts, reckonings, attorney fees, bonds, bills, covenants, contracts, controversies, agreements, promises, claims and demands of whatsoever kind or nature, in law or in equity, which First Party ever had, now has or which any legal guardian, attorney-in-fact, personal representative, successor, family member, heir or assign of First Party now has or may hereinafter acquire against Second Party, arising in any way from the water damage claim made by First Party under their policy of insurance with Second Party for the property located at 4048 6th Ave NE, Naples, Florida 34120 that was assigned a date of loss of September 11, 2017 and claim number 495246. The case is titled ERIN LITVAK v. PROGRESSIVE PROPERTY INSURANCE COMPANY, F/K/A ROYAL INSURANCE COMPANY, IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT IN AND FOR COLLIER COUNTY, FLORIDA, Case No. 11-2018-CA-001378-0001-XX. This General Release also is to apply to any and all claims for attorney fees, costs and any claim for bad faith, extra- contractual liability of any kind and/or punitive damages arising out of the lawsuit which is the subject of this General Release. Payment shall be made within 30 days of Second Party's receipt of the executed settlement release. Payment of the settlement proceeds is as follows: • One check to Erin Litvak, Regions Bank d/b/a Regions Mortgage ISAOA, and Collier County SHIP Trust Fund in the amount of $28,937.03.00; and • One check to Morgan & Morgan, P.A. in the amount of $15,062.97.00 First Party fully understands and agrees that this General Release includes any and all claims for any damages, to include compensatory and punitive damages, as well as attorney's fees and costs, and any other causes of actions or any other related claims which could have been raised in the instant action and alleged in or brought under the laws, codes and statutes of any and all state, federal, foreign, local or territorial jurisdictions. Further, this General Release extends and applies to and also covers and includes, all unknown, unforeseen, unanticipated and unsuspected injuries, THIS ISA RELEASE:READ CAREFULLY Page 1 of 4 1 6010 damages, including compensatory and punitive damages, losses and liabilities and the consequences thereof arising in any way from the claims made by First Party under their policy of insurance with Second Party and described in the First Party's Complaint in the above-referenced case. First Party fully understands and agrees that this General Release includes, but is not limited to, a resolution of all claims and potential claims for attorney fees and costs incurred by either Party in this case. First Party understands and agrees that the payment of the afore-described consideration is not to be construed as an admission of liability on the part of any parties and entities hereby released, all of whom expressly deny same. First Party further acknowledges and agrees that the terms, conditions and identity of the parties to this settlement, including any payments made hereunder, shall remain strictly confidential and shall not be disclosed or made known to any third person or party unless such disclosure is required by law. Disclosure of this settlement to First Party's attorneys, tax advisors, lenders, realtors or potential buyers of the subject real property shall not be deemed a violation of this provision. First Party acknowledges that they have had a full opportunity to read the contents of this General Release and has had the benefit of counsel in reviewing General Release. First Party further acknowledges and agrees that no promise or agreement not herein expressed has been made by Second Party, and that this General Release constitutes the entire agreement between the parties hereto, and that the terms of this General Release are contractual and not a mere recital, and that there is no agreement or compromise on the part of the Second Party to do any act or thing not herein mentioned. First Party hereby declares, covenants and warrants that they are over the age of eighteen (18) years, and that they are not suffering from any legal, mental or physical disabilities which would impair or disable them from executing this General Release and that there has been no representations and/or statements made by the Second Party hereto or its agents, insurers, employees, or representatives to influence them in making or executing this General Release. If any section or part of this General Release and Hold Harmless Agreement is held to be invalid by a court of law, the remaining portions of this release shall continue to be in full force and effect. First Party further acknowledges, represents and agrees, on behalf of themselves, their heirs, assigns, subrogees, successors in interest, that they will satisfy, to the extent legally required, all outstanding mortgages and liens against the subject property and/or the proceeds of this settlement. Further, First Party agrees to indemnify THIS ISA RELEASE:READ CAREFULLY Page 2 of 4 16D10 and hold harmless Second Party and their insurers in the event of any claims by the mortgage holders under the terms of the policy, inclusive of costs or liens, or subrogated interests, which do or could represent a lien or claim against these proceeds exist or come to light in the future with respect to the aforementioned policy, and to the extent any such claims or liens are raised, First Party hereby agrees that they shall immediately pay and satisfy same and shall otherwise indemnify and hold the Second Party and its insurers harmless from and against all loss, damage or liability for payment of same, including indemnification incurred in the defense of any claim brought by the mortgagee. Further, if a claim is brought by First Party's mortgagee, First Party also agrees to indemnity Second Party for the attorney's fees and costs associated with said claim(s). First Party hereby declares that the terms of this settlement agreement have been completely read and are fully understood and voluntarily accepted for the purposes of making a full and final compromise, adjustment and settlement of any and all claims, disputes or otherwise, and for the express purpose of precluding forever any further or additional claims, lawsuits or appeals by First Party against Second Party that have or potentially could arisen out of the claims made by First Party under their policy of insurance with Second Party for property located at 4048 6th Ave NE, Naples, Florida 34120 that was assigned a date of loss of September 11, 2017 and claim number 495246, and the policy of insurance issued by Second Party, as well as any other claims or causes of action which could have been brought under his policy of insurance. First Party hereby accepts draft or drafts as final payment of the consideration set forth above. THIS ISA RELEASE:READ CAREFULLY Page 3 of 4 16010 I HAVE READ AND UNDERSTAND THIS FULL AND FINAL RELEASE. ERIN LITVAK: Signed and dated this day of 2018. STATE OF ) COUNTY OF ) The foregoing instrument was acknowledged before me this day of , 2018, by ERIN LITVAK, who is personally known to me or who has produced as identification. Signature of Notary Public - State of Florida Print, Type or Stamp Commissioned Name of Notary Public, Commission Number and Expiration Date of Commission THIS ISA RELEASE.•READ CAREFULLY Page 4 of 4 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 13 1 0 TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed If the document is already complete with the exception of the Chairman's signature,draw a line through routing lines PI through#2,complete the checklist,and forward to the County Attorney Office. Route to Addressee(s)(List in routing order) Office Initials Date 1. Lisa N. Carr CHS 5/141fi1 2. Jennifer A. Belpedio,ACA County Attorney Office • • 5/414/111 3. BCC Office Board of County Commissioners 6t)liZek -‘,V,47 NOTE: Clerk's attestation is not required. Please do not route this item to f erk's Board Minutes and Records. CAO please scan document after execution by Chairman and email them to Clerk's Minute and Records for its records. PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the _addressees above,may need to contact staff for additional or nussira information. Name of Primary Staff Lisa N.Carr,CHS Phone Number 239-252-2339 Contact/ Department Agenda Date Item was June 12,2012 Agenda Item Number 16.D.10 Approved by the BCC Type of Document Insurance Claim Check Endorsement for Number of Original Attached Jorge Valdes Jr. Documents Attached PO number or account number if document is N/A to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1, Does the document require the chairman's original signature'? 2, Does the document need to be sent to another agency for additional signatures? If yes, provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. 3, Original document has been signed/initialed for legal sufficiency, (All documents to be N/A signed by the Chairman, with the exception of most letters,must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here tabs are placed on the appropriate pages indicating where the Chairman's signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip N/A should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 06/12/2012 and all changes made during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC,all changes directed by the BCC have been made,and the document is ready for the C-404A Chairman's signature. I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 126.05,Revised 2.24.05;Revised 11/30/12 CIO i 4remil 5 5k1 1 .c)i 411 N .4•01'4 N 1E ! .,... m . c„ , 2 0 0 -05 c; *It a . U) --5 .c •,:f,,,,‘ r: < ,,, U) « ..7.i.' a) • 01 NI' 4,4 :::Vj ::1:* ce ;A w _a ;.1 i ..i. 0 0 '..!..*: 9 ;r1 u_ co co ti w ,w ...LI .. . . < 0 cc =,,- Nowsi — D a:en 0 NDor SE CHECK IiNHE 1 60 10 CLL DISAPPEAR At` 'QTR WHEN •UPR,r'; st=r$y•/rt�x_HF-, p '(^'Yy J. �aA0 X0.8 146 u.L.{D.TS'i.r?Y 8A K ENDOri r €Mw:.3* sn4*(.3)Guararaszd Pr- By: .i . J Title: Coils lr PP 'FE•DEPA.RESERLE 30A,R OF G IEENC tS REG C C Face o um i is tie Dcu mw,i s rnlp�7t i eon pan S _^,inercvn t,y reactive s rnukeM1 thaF cdomat oSocx Xif.1II table ..,wy7 CF=4 P e t ysaet &s SMn. 1 60 1 0 Collier County Community and Human Services Division (CHS) Homeowner Insurance Check Endorsement Policy Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage/lien,then the loan will not have to be repaid. On occasion,the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and receive money to make the repairs. If the insurance claim check is made payable to the homeowner and Collier County, then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to CHS at the address below for check endorsement consideration: 1. Copy of Homeowner's current insurance policy-Declaration Page. 2. Copy of insurance company's claim report with worksheet including description of repairs and costs. 3. Copy of photos of claim damage. 4. Copy of Insurance check(s)payable to homeowner, first lien holder and Collier County. Homeowner Name: fay-cbt %Aka HomeownerAddress: a RA a. S'T E suJ No4 cks FL .iti Primary Contact Number: 2R8 — 95;3 Homeowner Email: .'yy*.c \to,\ ft( 31 y(Ate,.a • 4 . 310211 I / F ,4eviewed CH'- Giant Coo •inator Da , °7°?1/// 1.--" Approved . • evior Date Denied 0 J' HOMEOWNERS DECLARATIONS INSURANCE POLICY NUMBER POLICY PERIOD o UNITED PROPERTY &CASUALTY INSURANCE CO From P.O.Box 51149 UHV 2064987 10 01 03109/2019 03/09/2020 Sarasota.Ft. 34232-0330 11A'a m.as the•es.4ence ammxs RENEWAL DECLARATION Effective: 03/09%2019 Date Issued.01/18/2019 INSURED: AGENT: 1003040 JORGE VALDES JR G&P INSURANCE INC. 4297 21ST AVE SW 4930 GOLDEN GATE PKWY STE A NAPLES FL 34116 NAPLES FL 34116-5992 Telephone: 239-298-9573 Telephone: 239 353.3500 The residence premises covered by this policy is located at the address listed below. 4297 21S1 AVE SW NAPLES FL 34116 IF PAYMENT IS NOT RECEIVED ON OR BEFORE THE POLICY RENEWAL EFFECTIVE DATE, THIS POLICY WILL NOT BE IN FORCE. Coverage is provided where premium and limit of liability is shown. Flood coverage is not provided and is not a part of this policy. SECTION I COVERAGE LINIfI OF UABIUTY PREMIUMS A. DWELLING $260,000.00 $1,816.00 B. OTHER STRUCTURES $5,200.00 INCLUDED C. PERSONAL PROPERTY $130,000.00 INCLUDED D. LOSS OF USE $52,000,00 INCLUDED SECTION II COVERAGE E. PERSONAL LIABILITY $300,000.00 $30.00 F. MEDICAL PAYMENTS $5,000.00 INCLUDED OPTIONAL COVERAGES Premium charge for Hurricane Exposure: $1,070.00 Hurricane Deductible per calendar year: $5,200 J 2% of Coverage A Sinkhole Deductible per sinkhole loss: $26,000 110%of Coverage A All Other Peril Deductible: $1,000 TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES: $1.873.00 The amount of premium change due to approved rate change is 66.00 The amount of premium change due to coverage change is 103.00 COVERAGES HAVE BEEN INCREASED TO HELP KEEP PACE WITH RISING REPLACEMENT COST. PLEASE CONTACT YOUR AGENT IF THERE ARE ANY QUESTIONS PERTAINING TO YOUR POLICY, FORMS AND ENDORSEMENTS HO 0003 (05/11) HO 0334 (05/13) COUNTERSIGNED DATE 01/18/2019 HO 0350 (06/97) HO 0355 105/13) rv� _ HO 0446 (10/00) HO 0496 (04/911 ,, 1 fi t�E HO 2370 (0513) HO 2386 (05/13) "-t BY Continued on Forms Schedule �..._.� ADDITIONAL INTERESTS MORTGAGEE SECOND MORTGAGEE 1877024155 JPMORGAN CHASE BANK NA COLLIER LLIER COUNTY CES DEPT ISA 3050 N HORSESHOE DR# 110 ATLANTA GGA 30362 O BOX NAPLES FL 34104 A INSURED COPY UPC 101 01 19 Page 1 0l 4 --I- • '7 1 0 I . UPC(" \ HOMEOWNERS DECLARATIONS- - __ '4 INSURANCE I— POLICY NUMBER POLICY PERIOD 6. - UNITED PROPERTY&CASUALTY INS CO , _ ____ , From -- To _ 2 P.O.Box 51149 UHV 2064987 10 01 I 03/09/2019 03109/2020 Sarasota.FL 34232-0330 1,201 on, et th.madam.piami.. ; _- i [RENEWAL DECLARATION Effective 03/0912019 Date Issued:01/18/2019 INSURED: AGENT: 1003040 JORGE VALDES JR G &P INSURANCE INC 4297 21ST AVE SW 4930 GOLDEN GATE PKWY STE A NAPLES FL 34116 NAPLES FL 34116-5992 Telephone:239-298-9573 Telephone:239-353-3500 The residence premises coveted by this policy is located at the above insured address unless otherwise stated below: 4297 21ST AVE SW NAPLES FL 34116________ Premium: SECTION I, SECTION II AND OPTIONAL PREMIUMS $1,846.00 EMERGENCY MANAGEMENT TRUST FUND SURCHARGE $2.00 MANAGING GENERAL AGENCY (MGA) POLICY FEE $25.00 = TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES $1,873.00 NOTE: The portion of your premium for Hurricane Coverage is: $1,070.00 The portion of your premium for All Other Coverages is: $776.00 An adjustment of 0% is included to reflect the Building Code grade for your area. Adjustments range from 1% surcharge to 46.1%credit. Your policy includes endorsement HO 04 46 Inflation Guard.which automatically increases the amount of Dwelling Coverage by the annual percentage amount shown below.Therefore,your hurricane deductible may be higher than indicated on the policy when a hurricane loss occurs due to application of this endorsement. i ) FLOOD CARRIER N/A FLOOD ZONE N/A BFE N/A LFE N/A FORM TYPE HO-3 YEAR BUILT 1968 TOWN/ROW HOUSE N/A CONSTRUCT TYPE M CONSTRUCT SUPERIOR N NUMBER OF FAMILIES 00001 AOP TERRITORY 551 PROTECTION CLASS 03 USE CODE P MUNICIPAL CODE 024999 COUNTY CODE 021 PROT DEVICE/BURGLAR N PROT DEVICE/FIRE N PROT DEV/SPRINKLER N PROT DEV/SHU I leR N WIND/HAIL EXCLUSION N REPLACEMENT COST Y OCCUPANCY CODE OWNER FLOOD CREDIT N SINKHOLE COVERAGE I WIND TERRITORY 551A WATER PREVENTION CR N INFLATION GUARD 4% UPC 101 01 19 INSURED COPY Page 2 of 4 THIS DOCLIMENT HAS A VOID PANTOGRAPH,MICROPRINTING.A COIN REACTIVE ARTIFICIAL WATEPMARk AND THERMOCHROMATIC I 1 60 1NK. UPC iNSURANCE" 2017FL044692 499757 Ribirch 25,2019 J1-24 UPC Insurance 1210 P.O.Box 14568 Saint Petersburg,FL 33733-4568 PAY Fifty Seven Thousand Five Hundred and 00/100 Dollars $****57,590.00 THE JORGE VALDES JR and JPMORGAN CHASE BANK, NA and COLLIER 00* TO ORDER OF COUNTY HOUSING and ADEMAR and Amarilys Rodriguez Authorized Signature Wells Fargo Sank N A san Francisco,CA AuthorizerSt rIttUr641/ Ne 4 • : T.--, z: ' ' -,-- I . -:, ::. 1 , • , 1 613 1 1' 4 f.... , ra.. : .4 a) i' I . . - • ';',:,'';7; ,) :t- ;i• f?'' -1-' 74' '''C C.), 1 ' ' ' P t'''s, ' i g 4.4 E `,F ..... •• i.,`', ' ""M •• •*•••. t ..73" ' ia ' i a'I -4 ','-'•:,''' t••••,. 1 t3-• ,,,, n , .,„ LO -t.i l'-- ,CTZ:r4 ' t, - 53' j• '3 ,- ;. i....,.....,..,,, 1 1•. o ..W .r. .. T,i-,, '......, 4-., ,;•,,, IT , 4. R ',',,,, > ii3' 4 • 1 0 ,... Q. . , s3 ' , 1 1 60 1 0 =MAR Coustnicdos,Inc. CGC461n0 2435 SW 23 Tea. lotfueni,' FL 33135 305-450.9075 losurrdk Jorge Valdez Jr. Property: 4297 21st Ave SW Naples,Ft 34116 Eadootto: MAAR Coe 1n MC-06172D COmparty: HE:1,6MR'no,In Chian reininor: Palley Northers Typo afloat:Hordease Dare of Leto: 9/1W2017 121)0 AM DRrA ari Dale Inspected: Date Sam* Prior List MARX JA1414 20111.011-10-0040 This eadomdebeikold to provide araltato altikeigidith0~101.1111011a111100.01big kW.DAP Wet vetoed airadaRy rattprofesabardly to the best otour kitoroleiga aid ediailithilitistalismilialiis doe*Are is ditposslinity rd'a pairketwies midi,Any=tun *Norm aciathitsamerairogiormallios**Iiiikisy Mottle Wier:Med we became more adorn. Teiy be ordaroceeiMw comphosce cads ihat ortiardodadbartio,irt rihillititalliadihr Code compliroxo.architect plank engine Cioi4or.pourittiog soy nosh kr adoard corOt. There aray be maid sonadedas Oft thot are not itidoiad Wein% VA1trearloiliozightlostadiariadl ar met soy mew iiiimittas iiiliwileatimaappi suable the nary boll4411101.01140, doh& 1 6010 HEMAR Construction,Inc. GCC-11724 2435 SW 23 Ter. Mtaori,FL 33135 305-450-9075 2•18-01-111-11410 Family HaaaaLiWzH 1S g"i 9'4"x l' 400.00 SF Walls 146.22 SF Ceiling 014 i. if546.22 SF Walls&Ctalnts 146.22 SF Floor 16.25 SY Floral* 50.00 LF Floor Perimeter SF Loos Wall 74.67 SF Short Wall 50.00 LF Cell.Perimeter DESCRIP11091 QTY =OW REMOVE 1 X1PLACt TAX O&P TOTAL 34. R&R 112'drywall-bang,taped, 146.22 SF 0.41 1.70 3.86 62.50 374.88 ready ter ter are 36. RAR Bat irolatiera-6"-R19- 14622 SF 0.2.9 094 4.83 36.94 221.62 pew faced 3& RAR 172"drywall-hang,taped, 100.00 SF 0.41 1.70 2.64 42.72 256.36 lady&w tat= 39. R&R Brat lasalatioa-4'-R1S- 100.00 SF 0.24 0.99 3.96 25.40 152.36 paper faced 40. Seal the walls and=Tins wiaati- 546.22 SF 0.00 1.25 23.27 ,141.22 84727 microbial wad e-one oar 41. Tease drywall-heavy Land 546.22 SF 0.00 0.80 4.59 8832 529.89 teoaeae 42. Prat the walls and cal*-two 546.22 SF 0.00 0.88 623 97.38 584.28 coats 43. Rb.R Crown rodding-4 114' 50.00 LF _ 0.66 5.74 5.43 65.08 39051 45. Pains crown melding-two coats 50.00 LF 0.00 1.40 0.33 14.06 8439 46. Oates or switch-1)ctwck&met 8.00 EA 0.00 13.80 0.00 22.01 132.48 47. Light&Owe-Detach&rets 1.00 EA 0.00 38.46 0.00 7.70 46.16 55. Paan door/window trim&jamb-2 1.00 EA 0.00 28.92 0.23 5.82 34.97 oars(par side) 56. Clean basebo d 50.00 I/ 0.00 0.25 0.00 250 15.00 58. Chao Soar the-Harry clean 146.22 SF 0.00 0.61 0.44 17.92 107.55 60. Floor}rosectioa-sidf+dheaQvo 146.22 SF 0.00 059 1.05 17.41 104.80 plastic film 61. Caserta-move art than rare- 1.00 EA 0.00 133.23 0.00 26.66 159.94 Extra large so= Tout: Family Roam 56.86 673.78 4.042.46 2018-08-100040 8/17/2018 Page:2 1 6 0 1 0 HEMAR Coastrecdoa,lac CGC-061720 2435 SW 23 Tarr. • Miami,FL 33135 305-450-9075 Fatty/Dian LzWill 2:r 6^a 11'4"1 r thil‘t4I1 541.33 SF Walla 255.00 SF Ceiling 796.33 SF Walls&Calm 255.00 SF Floor 6 SY 2L33 flowing 180.00 SF Long Wall 7.67 LF Floor Perimeter 90.67 SF Short Wall 67.67 LF CeR.Perimeter &direr 1: 011iat LaWill 13'6"z 71 x V Ad& illr 328.00 SF Walla Wall. il94_50 SF C,eiliog 422.50 SF Wall.&Ceing 94.50 SF Floor 10.50 SY Flooring 41.00 LF Floor Perimeter 102.00 SF Long Wall 56.00 SF Short Wall 41.00 LF Cat Perimeter DESCRIPTION QTY =fart =MOVE EXPLAM TAX O&P TOTAL 63. Detach&Ramo%Mow cover L00 EA 3218 0.00 0.00 0.00 6.58 39.46 66. R&R ur drywall-bog,towed, 34930 SF 0.41 1.70 9.23 14934 896.02 ready lea texture 67. MR Bi inmiotion-6"-R19• 349.50 SF 0.29 0.94 11.53 18.21 529,70 piper focal 68. Twine drywall-heavy bind 349.50 SF 0.00 020 2.94 56.50 339.04 textme 69. Sall the walls Nod coding niard- 1,211.13 SF 0.00 1.25 51.92 315.08 1,89034 microbial amain-ooe eon 70. Point die on&awl caw-two 1,218.113 V 0.00 018 13.19 217.30 1,303.76 coats 71. atordolier-Detach&reset 1.00 EA 0.00 100.00 0.00 20.00 120.00 72. Light forum-Dora&&met 1.00 EA 0.00 38.46 0.00 7.70 46.16 73. R&R IAC, ..Fics - IAD EA 2.45 20.68 0.54 4.74 28.41 Mochanisrly attachod 75. R&R Crown molding-4 1/4" 101.67 LF 0.66 5.74 1120 141.46 148.75 76. Pain atom mokroas-oto coats 10/.67 LF 0.00 1.40 0.72 30.56 113.42 77. Cokl sir return cover-Dotado& 1.00 EA 0.00 1725 0.00 3.51 21.43 met 78, R&R Security system-key pod 1.00 LA 2.77 172.51 5.70 36.20 217.18 '79. Tbeentortat-Detach&resat 1.00 EA 0.00 43.71 0.00 8.74 52.45 BO. TV&Waft-Wall or mai% 1.00 EA 0.00 9431 0.00 18.92 113.50 mooned-Notch&rant 81. Outlet or switch-Detach&reset 10.00 EA 0.00 13.80 0.00 27.40 165.60 83. Clean Soar-tile-Heavy clan 349.50 SF 0.00 0.61 1.05 42.86 257.11 86. RIR Boach000l-4 1/4" 101.6711 0.44 3.59 1147 19.96 539.77 2018-08-10-0040 V17/2018 1'W 3 1 60 1 0 HILMAR Coastractioa,lac. CGC461720 2435 SW23 Tar Mani,FL 33135 305-450-9075 CONTINUED-Entry/Diming DESCRIPTION QTY RESET REMOVE REPLA0i TAX O&P TOTAL 17. Paint bombard-two costs 101.67 LF 0.00 134 0.72 29-26 175.60 84. Floor protection-aelf-wasesive 34930 SF 0.00 039 2.52 41.74 250.47 plaaie film 15. Commas-MOW oat thee reset- 1.00 EA 0.00 133.23 0.00 26.66 159.94 Eats Wee room Tatar EntrytElining 124.43 1,363.06 1,17131 Hallway 1 LtWx11 3'x 3':SI die %.00 SF Wails 105.00 SF Walls&Cain * 24.00 SF Long Wall 9.00 SF Ceibog 9.00 SF Floor 1.00 SY Floor 12.00 LF Floor Perimeter 24.00 SF Short Wall 12.00 LF r...4 Perimeter DESCRIPTION QTY RESET REMOVE REPLACE TAX OM' TOTAL 88. SAX 1/2"&Testi-hang,taped. 9.00 SF 0.41 1.70 0.24 3.84 23.07 newly tor texture 90. Tammy drywall-heavy hind 105.00 SF 0.00 0.80 0.88 1630 101.86 mare 91. Seal the walla and c&iag Wend- 105.00 SF 0.00 1.25 4.47 27.16 162.88 miaobial coming-me coat 92. Paint the wens and cube-two 105.00 SF 0.00 0.111 1.20 11172 112.32 cows 93. Smoke Maser-Detach&maw 240 BA 0.00 37-25 0.00 14.90 89A0 94. Light fame-Death&rem 2.00 EA 0.00 38.46 0.00 15.31 92.30 95. EAR Cram ceddiag-5 1/4" 12.00 LF 0.66 6.35 1.73 17.16 103.01 96. Paint crown moats oversized- 12.00 LF 0.00 1.47 0.09 354 21.27 two cams 97. hilt dote/aim Wm airob- 4.00 EA 0.00 34.02 1.08 27.44 164-60 Large-2 coats(per side) 98. Outlet rs slab*-Dosch&reset 1.00 BA 0.00 13.00 0.00 2.76 16.56 99. Paint bombard-two cots 12.00 LF 0.00 134 0.01 3.24 19.40 100. Wadi&Reed Interior door wait 4.00 EA 70.17 0.00 0.00 0.20 56.11 337.06 101. Psis door deb Judy-2 mete(per 4.00 BA 0.00 3422 1.53 27.68 166.09 side) V. MR Dett iesulation-6'-R19- 9.00 SF 0.29 0.94 0.30 2.21 13.65 papa&cod 103. Clean Door-tie-Heavy clean 9.00 SF 0.00 0.61 0.03 1.10 6.62 104. Floor lactation-sellmbeshm 9.00 SF 0.00 039 0.06 1.08 6.45 plastic fare 2018-08-10-0040 1117/2011 Page:4 16010 • FintAR co..m.cu..,i.e.curb 2135-3W 23 Tau . Meet FL 33135 305-4504075CONTINU1ED-Halhroy 1 DESCR1FT1O 4 QTY RESIST REMOVE REP1AC11 TAX OAP TOTAL 105. Cresco&-atom ad O m resat- 1.00 LA 0.00 133.2E 0.00 26.66 159.94 Extra Wpm= Tasalr BiOwry 1 11.89 266,10 1,596.48 4r0,., 114aeier I•i L:WsU 18'x 4'z 8' 224.00 SF Walls 40.00 SF Coning 264.00 SF Walk A Caking 40.00 SF Roar 4.44 SY Rom* 23.00 LF Floor Perimeter 10.00 SF Lang Wait 32.00 SF Short Wall 21,00 LF Cet1,PmsrtetQ IW$CR1PTION QTY RESET ,1RLiDVE REPLACE TAX 0AP TOTAL 106. R&R lir drywall.k . 1, 264.00 SF 0.41 1.94 6.97 125.48 752.85 floated,ready for paint 107. R*R Batt booboos-6'-R19- 224.00 SF 0.29 0.94 7.39 56.60 339.51 paw Sees! 108. Seal the walla sad aios wind- 264.00 SF 9.00 1.25 11,25 68.26 40951 miarabial coapts-ace coat 109. Palet the walb a 6 mains-two 264.00 SF 0.00 0.8.8 3.01 47.06 2717 39 mats 110. List'Somans-13taa3 R alma 1.00 EA 0.00 31.46 0.00 7.70 46.16 111. Dcrarh A Resat Lisle bar-2 1.00 EA 38.46 0.00 0.00 0.00 7.70 46.16 112. RAR Hort/AC mister- 1.00 EA 2.45 20.68 034 4.74 28.41 Mecbsoicolly ata tbad 113. EtbEst Ens-Detach&reset 1.00 Fit 0.00 138.87 0.00 27.78 166,65 114. RAR Mitran-1/4'plot gree 6.25 SF 0.28 12.66 295 16.78 100.61 117.Duch A Reset Window cow LOD EA 32.88 0.00 0.00 0.00 631 39.46 118. Clew toilet-limy 1.00 EA 0.00 21.91 0.00 4.31 26.29 119. Osla or twitch-Deradt x twat 1.00 LA 0.00 13.10 0.00 2.76 16.56 120. Paiat door/window trim A jamb- 1.00 EA 0.00 28.92 0.23 5.82 34.97 2 coats(pe ride) 121. Pact dear slab cob,-2 coats(per 1.00 EA 0.00 3412 038 6.92 4152. aide) 122. Om floor-Ws-Heavy dew 40.00 SF 0.00 0.61 0,12 4.90 29.42 123. HoarFaaxtioo-,olf- ve 40.00 SF 0.00 039 0.29 4.78 28.67 plastic Elm 124. Ccno®ts-move old than meat- 1.00 EA 0.00 13328 0.00 26.66 159.94 Eon largo room 2018-08-I0-0040 1/17/2018 Page:5 1 6 0 1 0 HEMAR Coastrudloa,Inc. CGC461720 2435 SW 23 Tar. . Miami,FL 33135 1 305-450-9075 CONTIKUKI)-Master Balk DENCIVIION QTY RESET REMOVE REPLACE TAX O&P TOTAL T Mader Badx 33.13 424.90 2349.88 Bedroom LiWili 13'4"i 91 8"x t• 368.00 SF Walk 128.89 SF Ceiling 496.89 SF Walls&Callas 12219 SF Floor 1432 SY Flouting 46.00 LF Floor Perimeter 106.67 SF Long Wall 77.33 SF Short Wall 46.00 LF Ca.Periader Miamian 1: Closet LsWx11 a*x 2'x r 160.00 SF Walls 16.00 SF Ceiling Olif 176.00 SF Walls&Ceiling 16.00 SF 1110 ef0r 1111.78 SY Flooring 64.00 SF Long Wall 20.00 LF Floor Pathoeter 16.00 SE Short Wall 20.00 LF Cal.Pranacter DESCRIPTION QTY RESET REMOVE REPLACE TAX O&P TOTAL 125. RAR 117' drywall-Wig,twat 144.89 SF 0.41 1.94 3.83 6806 413.18 floated,ready ft c paint 126. UR Batt insulation-6"-R19- 14419 SF 0.29 0.94 4.78 36.60 219.60 paper laced 127. Seal the walls and ceding whoa- 67119 SF 0.00 123 21.67 173.96 1,043.74 microbial coating-one coat 128. Paint the walls and ceiling-two 672.89 SF 0.00 OM 7.67 119.96 719 77 costs 129. Detach&Reset Ceiling fan& 1.00 EA 136.98 0.00 0110 0.00 27.40 16438 lied 130. MR Hest/AC regAster- 1.00 EA 2,45 20.1111 0.54 4.74 21.41 Mechanically attached 131. TV 13riclats.Wall or=Bing 1.00 F.A 0.00 9438 0.00 1892 113.50 mounted-Data*&main 132. Paint doolvalow trim&jamb- 2.00 EA 0.00 21.92 0.46 11.66 69.96 2 cows(per side) 133. Detach&React lotilier&tor omit 1.00 EA 70.17 0.00 0.00 0.05 14.06 84.28 134. Paint door slab rely-2 sails(par 1.00 EA 0.00 34.22 038 6.92 4132 side) 135. Outlet or%wail-Detach&reset SAO EA 0.00 13.80 0.00 13.80 82.80 134. Paint baseboard-two coats 66.00 1.7 0.00 1.34 0.44 17.76 106.64 137. Clem floor-ale-Heavy clean 14449 SF 0.00 0,61 0.43 17.76 106_57 2018-08-10-0040 8/17/2018 Page:6 1 60 1 0 . . MAAR Coutrectima,Ise. CGC-041720 _ 2435 SW 23 Tar. . Mani.FL 33135 305-450-9075 CONTINUED-Bathroom DESCRIP11101'4 QTY EMT IMAM REPLACE TAX Oar TOTAL 130 Floorprotectioa-galf-affbeaive 144.89 SF 0.00 039 1.04 17.30 103.13 plastic film 139. Commas-MOW OA that MN- 1.00 EA 0.00 133.28 0.00 26.66 159.94 Extra limp roam Tot Bedroom 48.29 57&36 3,4511.1.2 Maly Roam LxVixEl W r x 51 x 1'249_33 SF Walls 5292 SF Colin dillibli4ie 4 30225 SF Walls&CaTurg 5292 SF Floor 011P 7411 5.41$ SY Flooring $4.67 SF Lass Wall 31.17 LF Floor Perimeter 40.00 SF Short Wall 31.17 LF Cal.Pain/Hetet DESCRIMION QTY WET REMOVE REPLACE TAX O&P TOTAL 140. R&R.Ia.drywall-bay.twat 52-92 SF 0.41 1.70 1.40 22_62 135.68 ready for anwe 141. R&R Bat itradatioa-6.-R19- 249-33 SF 0.29 0.94 6.23 62-98 377.89 paper faced 142. Seal the wens rod ceiling whoti- 302.25 SF 0.00 125 12.21 78.14 46813 miaobral maim-_ant 143. Texture drywall-horsy hood 307 VC SF 0.00 0.10 2-54 48E6 293.20 =Ore 144. Paint tbs walls sod oaks-two 302-23 SF 0.00 0.12 3-45 53.90 32333 eases 145. Light Same-Detach&mime 1.00 EA 0.00 31.46 0.00 7.70 46.16 146. Wallas maishise-Remo,e& 1.00 EA 0.00 2638 0.00 5.36 32.14 resat 147. Wading awebigo water line- 1.00 FA 0.00 79.41 025 16.06 96.32 Disomnas&mama 150. Dryer-Remove&met 1.00 EA 0.00 24.12 0.00 Ca 26.94 151. Air krodkr-Detach&reset 1.00 EA 0.00 745.17 0.00 149.04 194.21 152. RAE Basehosed-4 1/4" 31.17 LF 044 3.59 3.40 25.60 1.54.81 153. Paint baseboard-two mats 31.17 LF 0.00 134 0.21 8.40 50.38 154.Dar*&Resat Cabiastry-upper 2.50 LF 50.12 0.00 0.00 0.00 25.06 150.36 faun)awls 157. Clean floor-tie-Heavy oleic 5292 SF 0.00 0.61 0.16 6-50 30.94 150 Flow protacdas-gatf-adhosiva 52.92 SF 0.00 039 0_38 632 37.92 plastic film 159. Camera-move aut tam=ea- 1.00 EA 0.00 13328 0.00 26.66 159.94 Extra love room 2018-08-104040 8/17/201$ Pa1e:7 16D10 HEMAR construed.",LCCP.0 x61720 2435 SW 23 Tar. . Komi,FL 33133 305-4504075 COMMIE!).MAW ROOM D1184Y11O111 QTY RESir REMOVE WLA(Z TAX O&P TOTAL Tdak: OIilky Road 3330 548.22 3,289.05 Witham LiWill 14'r x Y z r 11,44 37733 SF Wads 13125 SF Ceiling 00, '11114",' 50158 SF Walls A Ca'ling 13123 SF Floor 143E SY Fing W 47.17 LF Floor Perntxta 116.67 SF Lerma Walt 7200 SF Wet Wall 47.17 LF Col.Perimeter IMISC EMON QTY RESET REMOVE 1C LACSE TAX OLP TOTAL 160. RAR Baseboard-4 1/4" 4.00 IF 0.44 339 0.44 3.32 19.88 161, Paint baseboard-too coats 4.00 IF 0.00 1.34 0.03 1.08 6.47 162. RAR Cooesermp-Granite 10.00 SF 529 7629 24.00 167.96 1,007.76 163. Rd:R Cabootr7-lower(base) 5.00 IF 7.59 201.74 50.15 219.38 1.316.18 turas 164. Caip.d er•nab,Trim/Cabinet 3.00 HR 0.00 92.73 0.00 55.64 333.83 -per hoar 165. RAR Cabinet parols-side.mei. 22.00 SF 1.91 17.45 13.60 87.90 527.42 or back 167. Paint the ways sod owlias-two 508.58 SF 0.00 0.88 5.80 90.68 544.03 caws 166. Seat 1-b trails end calms wised- 50858 SF 0.00 1.25 21.67 131.41 788.88 microbial coating-roe coat 168. Clara noir-tela-Heav7 clean 13125 SF 0.00 0.61 0.39 16.10 96.55 169. Floor pnabarlion-self+dbmive 131.25 SF 0.00 039 0.95 15.61 94.07 pIaalo>ihn 170. CoMmts-move oat titan reset- 1.00 EA 0.00 133.21 0.00 26.66 159.94 Extra isaeroom Totals rattan 117.03 $15.88 095.01 Erterier DESCRIPTION QTY RESET REMOVE REPLACE TAX OA? TOTAL 6. RAR Alosslaam furca,5'-8 high 2100 IF 6.13 34.66 36.86 235.80 1,414.78 9. BMR Wood Ewa 5'-6'high- 300.00 IF 6.13 20.09 176.04 1,601.40 9,650.44 1-t w0. 10. Seal A paint-wood imoolgate 1,100.00 SF 0.00 1.11 36.72 406.94 2,441.66 13. RRR Patio Corer-Atta hed- 664.00 SF 2.00 1037 305.57 1.130.42 10,382.47 Ahtmirum 2018-01-10-0040 8117/2018 Nee:8 44 1 60 1 0 HIMAR Construction,Lc, CGC4617211 2435 SW 23 Terr. tvfienit,FL 33135 305-450-9075 CONTINUED-Exterior DESCRIPTION QTY RESET REMOVE REPLACE TAX Oa& TOTAL 16. R&R Cinder/doemepout- 24.00 IF 0.49 4.20 3.02 23.12 138.70 Amin=-up to 5' 19. RikR Oestread door&hentware- 1.00 EA 7357 1,023-1* 43.53 228.06 1,368.34 10'x 7 21. R&R Survaillemee comma system 1.00 EA 0.00 2,300.00 24.00 0.00 2,324.00 24. FAR Sod*-wood 98.00 SF 0.30 3.113 9.29 83.78 502.71 27. R&R Disko'meollite system 1.00 EA 2943 466.55 11.32 101.16 611.16 28. 13A.R Exterior dear-solid alder- 1.00 EA LIS 705.81 36.63 150.12 900.74 poneloi-slab only 30. R&R Door blurs(set of 3) 1.00 EA 14.71 78.33 0.72 18.74 112,50 32. R&R Door lockset-exterior 1.00 EA 12-26 256.74 1.83 54.16 32499 33. RAR Extarior door-jamb& 1.00 EA 21.01 687.41 36.67 149.02 894.11 casing Totals: Exterior 722_20 4,790.42 31,066.60 Roof DESCRIPIION QTY RESET REMOVE RRLM TAX OAP TOTAL I ROOFING 1.00 EA 0.00 29,100.00 0.00 0.00 29,100.00 Home owner provided o roof estimate from Florida Roof Services LLC.Sus elfineto Totals: Roof 0.00 0.00 29,100.00 General DESCRIPT/ON QTY RESET REMOVE REP1LACT. TAX 0.&P TOTAL 2. Dorepotor lord-Aram 20 yeah.4 1.00 EA 424 33 0.00 0.00 84.86 509.19 tow of debris 3. General Laborer-whom $0.00 RR 000 32.05 0.00 51214 3,076,80 Geared Labor for construction nod post coashuorion dsm up. anen 40 hours such-110 hrs. 4. Debris dhposetAssal way 1.00 EA 1,900.00 0.00 0.00 380.00 2,280.00 5. Permits&Foes 103 EA 0.00 1,250.00 0.00 250.00 1,500.00 Totals: General 0.00 1,227.66 7,365.99 Labor Minimums Applied 2018-0840-0040 8/17/2018 Page:9 16010 HEMAR Coastruedaa,Iuc, CGC-061229 . 2435 SW 23 Tea. . FL 33135 305-450.9075 CONTINUED-Labor ltlbitunms Applied DRSCRDTION QTY MET R MOVE =MACE TAX O&P TOTAL 18.Outer tabor minima 1.00 EA 0.00 103.40 0.00 20.68 124.08 57. Cleaning labor mi.imwm 1.00 EA 0.00 46.81 0.00 9.36 56.17 65. Window eretarest repair 1.00 EA 0.00 $4.25 0.00 16.86 101.11 116. lieradibovver door labor 1.00 EA 0.00 118.26 0.00 23.66 141.92 minion' as 149. Phobias Inbar niairaen 1.00 EA 0.00 214.84 0.00 42.96 257.80 Task Labor lien comas Applied 0.00 113.52 681.08 Like Dan Task 3S1$.M-1.NM 1,14733 10,79933 94.222.18 Grad Total Areas: 2,744.00 SF Walls 873.78 SF Ceding 3,617.78 SF Walls rind Ceiling 873•78 SF Floor 97.09 SY Flooring 343.00 LF Floor Perimeter 889.33 SF Long Wall 482.67 SF Short Wall 343.00 LF Cee.Perimeter 0.00 Floor Area 0.00 Total Area 0.00 kit rior Wali Area 0.00 Exterior Wats Area 0.00 Exterior Perimeter of Walls 0.00 Surface Arra 0.00 Number of Squares 0.00 Total Perimeter Length 0.00 Total Ridge Length 0.00 Total flip Length Coverage Item Total % ACV Total % Dwelling 82,715.30 85.96% 82,715.30 85.96% Other Structures 13,506.38 14.04% 13,506.88 14.04% Carnett 0.00 0.00% 0.00 0.00% Total 96,222.18 100.00% 96,222.18 100,00!6 2018-08.10.0040 8/1712018 Page:10 16010 . HE" R C Inc CGC-061720 2435 SW 23 Tar. Mimi,FL 33135 305-450-9075 Summary be Dwelling Line Item Total '73,2641.0 Material' Saks Tax 897.71 Subtotal 74,16634 Ovid 4,27438 Profit 4,27438 Repbeese.t Coat Value 582,71538 Net ado 5ffi,7153Y R13it1AR Coaetr ioo.Inc COC-061720 2018.08-100040 W1712018 Page:11 1 6010 HEMAR Coastnictiea, c cC-416172$ 2433 SW 23 Tea. Miami,FL 33135 303-4349073 Scary br Other Structures Line hem Total 11,006.12 Maiaia1 Sales Tax 249.62 Subtotal 11,253.74 Overhead 1,12537 Profit 1,12357 Repineenent Cod Value S13,51638 Net claim S13,596118 } AR Caartruation.lac, MC-061'720 2018-08-10.0040 8/172018 Page:12 * '' 1 1 \ ' t .. 1: '''..:1 ' Ili. 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I et'f - vett Y i w F` u CI r 160101 G & P INSURANCE INC. 4930 GOLDEN GATE PKWY STE A NAPLES FL 34116-5992 UHV 2064987 01 0000000023 JORGE VALDES JR 4297 21ST AVE SW NAPLES FL 34116 *441V1'.* '14 , re, . f 144iii,144V4V 1040 16010 UPC ♦ ii 3 ;h ro'2 2_"wd $F Y . ,, INSURANCE �C,UNITED PROPERTY&CASUALTY INS CO � P.O.Box 51149 POLICY NUMBER POLICY PERIOD Sarasota, FL 34232-0330 UHV 2064987 10 01 From To -.1y` 03/09/2019 03/09/2020 12:01 am Eastern Standard Time Date Issued:02/08/2019 at the main;address demo Woe. INSURED AGENT JORGE VALDES JR G &P INSURANCE INC. 4297 21ST AVE SW 4930 GOLDEN GATE PKWY STE A NAPLES FL 34116 NAPLES FL 34116-5992 Telephone:239-353-3500 Property Address: 4297 21ST AVE SW NAPLES FL 34116 REMINDER NOTICE Dear: JORGE VALDES JR Policy Number: UHV 2064987 10 01 Please remember your payment is due MARCH 9,2019 Recently we sent you a renewal offer for your homeowners insurance policy. This is just a friendly reminder that if a payment is not received your policy will be cancelled as of 12:01 a-m.on the"payment is due" date above.leaving your home unprotected. If you have already sent us a payment,please disregard this notice as the documents may have crossed in the mail. If not,please detach and mail the payment coupon below along with your payment. If your insurance premium is paid through an escrow account with your mortgage,please contact them and inquire about payment status. Paying Online/Automatic Draft: To pay online or set up automatic draft,go to www.upcinsurance.com and click"Make a Payment." There you will find step-by-step instruction guides for processing payments. If you are an Existing User that is already set up for automatic draft,you do not need to make any changes. Your policy will continue to renew automatically. Thank you for allowing us to serve you. We appreciate your business! Policy Number. UHV 2064987 10 Loan Number: 1877024155 MINIMUM AMOUNT DUE NOW: $1,873.00 Insured: PLEASE SEND PAYMENT TO: JORGE VALDES JR UPC Insurance 4297 21ST AVE SW P.O.Box 31512 NAPLES FL 34116 Tampa,FL 33631-3512 PLEASE CONTACT YOUR AGENT IF YOU HAVE ANY QUESTIONS OR TO CONFIRM RECEIPT OF YOUR PAYMENT ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines #1 through #2 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the exception of the Chairman's sienature- draw a line. through rooting tine Y I thr h 4v) ,.....,,.,«,. «u---i— 11P11-_ _ _ .. ......... Route to Addressee(s) (List in routing order) ........ ., . ..-.-vu . ,,�,, L1W V11L.L.Al1JL, arlU Office 1L/1 Wahl LU ole 1.0LUIl Initials ALtorney vrnce. Date 1- Jennifer A. Bel edio, ACA County Attorney Office Initial) Applicable) 2. BCC Office Board of County Commissioners QCL.8 -)1)0119_ 3. Minutes and Records Clerk of Court's Office N/A tvv i r.: l<erws attestation is not required. Please do not route this item to Clerk's Board Minutes and Records. CAO please scan document after execution by Chairman and email them to Clerk's Minute and Records for its records. PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above. may need to contact staff for additionnl or missing information Name of Primary Staff Lisa N. Carr, Senior Grants Coordinator Phone Number 239-252-2339 Contact / Department CHS Initial) Applicable) Agenda Date Item was June 12, 2012 Agenda Item Number 16D 10 Approved by the BCC Does the document need to be sent to another agency for additional signatures? If yes, N/A Type of Document Insurance Claim Check Endorsement for Number of Original Attached XXXXXXXXX Documents Attached j I C htCk- PO number or account signed by the Chairman, with the exception of most letters, must be reviewed and signed number if document is by the Office of the County Attorney. to be recorded All handwritten strike -through and revisions have been initialed by the County Attorney's N/A INSTRUCTIONS &CHECKLIST I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12 Initial the Yes column or mark "N/A" in the Not Applicable column, whichever is Yes N/A (Not aDnrODriate. Initial) Applicable) 1. Does the document require the chairman's original signature? X 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A rovide the Contact Information(Name; Agency; Address; Phone) on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be NLA signed by the Chairman, with the exception of most letters, must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike -through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's N/A signature and initials are required. 7. In most cases (some contracts are an exception), the original document and this routing slip N/A should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 06/12/2012 and all changes made during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes, if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the 1P BCC, all changes directed by the BCC have been made, and the document is ready for the Chairman's signature. I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12 a Q Q Q O Q co a. LL O U Z Q m S S LL LL ❑ U o QUv m0M Lu LL U Q � W J >+ a)rn W a¢r(°z 0 0 rn o 0 0 0 o(D c) N "t (0 N Lo M � `O a)0 H} 0) o Y o 00 co .. 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S. r -O a rm In [.0 a L� O O a IL Ln Ir a LPI a O "IMP"NY xwgMS ;URWAud 113143 941 M YAW U011RIHIP0 e P L&Sap volped p Ave aped ,J!m asm! a a -p bull.,O, p- 4-41-40q &CO., Pas P10H . :NUI &AJ�JSUOS W014 aP " v4dw ll' `—dd- 4— "W' - ;1"1048)(OWS PIOA 71axo8s Ueol3; Avjn6s ql,41p.N sp., :DUES ftlulefiA P-rOO�WO ca4- -utl PMIOP V. ..adde lap--aq q; i vrdj IZPJOS P*juudon!V4 s""'lua,q Allmn ,s&Wj,aptnb(jjsnpui pwoxe palSli �OU assoig seller sv 'mol aq pr*jsy saj nice; Atar aq.L WO LIGOd3q4-LOPV-9H H0.97190M F --j / H3lJV3Y3H)103140 " v =18i3H 3S8O',IN3 Collier County Community and Human Services Division (CHS) Homeowner Insurance Check Endorsement Policy Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage/lien, then the loan will not have to be repaid. On occasion, the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and receive money to make the repairs. If the insurance claim check is made payable to the homeowner and Collier County, then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to CHS at the address below for check endorsement consideration: Ay of Homeowner's current insurance policy -Declaration Page. V^. py of insurance company's claim report with worksheet including description of re irs and costs. Copy of photos of claim damage. �opy of Insurance check(s) payable to homeowner, first lien holder and Collier County. Homeowner Name: Homeowner Address: j 6qLp kGt Ole -.fit FL �`41 Primary Contact Number: -7 Ap -( j'7 Homeowner Email: r `tel CHSGrant Coordinator 6A_/Z-,sc Dat Date Reviewed Approved Denied VYACHESLAV BORSHCHMOV, P.A. 514 SE 116 Court Fort Lauderdale, Florida 33316 T: 305-503-5985 F, 305-503-5986 E: Sla%&a VII.Legill PUBLIC ADJUSTER FEE DISBURSEMENT SjTATEMENT Re: Insured./Our Client: Angel Cabrera and Silvana Dattari Claim No. 488091-171011 Date of Loss: 9-9-2017 ( +) Gross Recovery of Insurance Proceeds S 45,000.00 (-) Attorneys Fees to Vvacheslav Rorshchukov, P.A. $ 0.00 Public Adjuster Fee $ 9'0W'00 20% pursuant to Public Adjuster Retainer Agreement Net Proceeds To Client S' 36.000.00 Payable as follows: $36,000.00 to Angel Cabrera and Silvana Dattari C= $9,000.00 to Claims Elements Consultants, Inc. Read, Approved and Accepted on this 3 0 day of ....... .... 2019 Angel Cabreud LIMITED POWER OF ATTORNEY TO ENDORSE CHECK(S) KNOW ALL MEN BY THESE PRESENTS: That Angel Cabrera and Silvana Dattari, (the "undersigned") has appointed, andbythese presents, appoints, VYACHESLAV BORSHCHUKOV, ESQ., (the "Attorney"), as the undersigned's true and lawful attorney for the undersigned and in the undersigned's name, place and stead to endorse settlement check(s) to pay attorney fees in reference to the following described insurance claim: Insured: Angel Cabrera and Silvana Dattari Insurance Company: Progressive Property Insurance Company Policy No.: ARK105460 Claim No. 488091-171011 Date of Loss: 9-9-2017 The Attorney shall have full power and authority to do and perform all and every act and thing whatsoever requisite and necessary to be done in and about the premises as fully, to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution and revocation, including without limitation: 1. Execution of Attorneys Fees Settlement Checks: The Attorney shall have the power to sign, indorse, execute, acknowledge, and deliver for the undersigned and in the undersigned's name any and all checks or drafts issued by the Insurance Company for the above referenced claim in which the undersigned is named as a payee. 2. Disbursements of Attorneys Fees The Attorney shall have the power to disburse from the proceeds of any the checks referred to in paragraph 1 of this limited power of attorney full payment of attorneys fees and expenses due to Vyacheslav Borshchukov, P.A. associated with the above - referenced insurance claim. 3. Ratification of Acts of Attorney in Fact The undersigned ratifies and confirms all that the Attorney shall lawfully do or cause to be done by virtue of this limited power of attorney and the rights and powers granted herein. All acts done by the Attorney at any time, pursuant to the power conferred hereunder, including without limitation, during any period of the undersigned's disability or incompetence shall have the same effect and inure to the benefit of and bind the undersigned and the undersigned's heirs, devisees, and personal representatives, as if the undersigned was competent and not disabled. 4. Third Party Reliance No person, insurance company, bank or other entity, who may hereafter deal with our attorney, need require any further documentation from the undersigned, to authorize the Attorney to do or perform any and all of the powers conferred hereunder upon the Attorney. 5. Photocopy of this Limited Power of Attorney A fully executed photocopy, emailed copy or or fax transmitted copy of this Power of Attorney shall be deemed ar► original of this Limited Power of Attorney form. Angel Cabrera STATE OF FLORIDA COUNTY OF M 1 �A: ik administer oaths and take acknowledgm acknowledged before me that he/she/t known to me, or-) ❑ produced W N _ in hand a 201 f/ Dattari �I hereby certify that before me, an officer duly authorized to s, personally appeared Angel Cabrera and Silvana Dattari, who y executed the foregoing instrument and M41io are personally as date and in the County and State on this Lf4k day oft JOSE MARIA VALENTIN * * MY COMMISSION # FF 951062 N9 \oma EXPIRES: April 2, 2020 r17 F�6�" Bonded Thru Budget Notary SeW" I HAVE READ AND UNDERSTAND THIS FULL AND FINAL RELEASE. ANGEL CABRERA: Signed and dated this "-r` "` day of SILVANA DATTARI: i/ z Signed and dated thisT; - day of, STATE OF lOrly'a COUNTY OF aw+l�-' The foregoing in 3a" e tea ss,,Asknowl M� 2019, by- a -lura;' wh produc (d as idegA o��Rr PUB�a JOSE MARIA VALENTIN _ . * MY COMMISSION 9 FF 951062 N,°� EXPIRES: APrit 2, 2020 �JFOF F�°¢ �'id r Budget Notary SecNoes S 2019. 2019. )d befor me -this day of pe sonly known who has to . f Notary Pubf ate of Florida Print, Type or Stamp Commissioned Name of Notary Public, Commission Number and Expiration Date of Com GENERAL RELEASE That ANGEL CABERA and SILVANA DATTARI (hereinafter referred to as "First Party") for and in consideration of the sum of FIFTY-TWO THOUSAND FIVE HUNDRED DOLLARS AND 00/100 CENTS ($52,500) in lawful money of the United States of America, received from PROGRESSIVE PROPERTY INSURANCE COMPANY f/k/a ARK ROYAL INSURANCE COMPANY. (hereinafter referred to as "Second Party"), receipt whereof is hereby acknowledged, does hereby remise, release, acquit and forever discharge the Second Party, its agents, representatives, successors, employees, owners, officers, directors, administrators, insurance adjusters, investigators, attorneys, expert witnesses, affiliates and incorporators, from any and all causes of action, suits, independent tort claims, debts, dues, damages, including compensatory and punitive damages, medical payment benefits, sums of money, accounts, reckonings, attorney fees, bonds, bills, covenants, contracts, controversies, agreements, promises, claims and demands of whatsoever kind or nature, in law or in equity, which First Party ever had, now has or which any legal guardian, attorney-in-fact, personal representative, successor, family member, heir or assign of First Party now has or may hereinafter acquire against Second Party, arising in any way from the water damage claim made by First Party under their policy of insurance with Second Party for the property located at 769 Waterloo Ct Naples, Florida, 34120, that was assigned a date of loss of September 9, 2017 and claim number 488091-171011. The case is titled ANGEL CABRERA AND SILVANA DATTARI v. PROGRESSIVE PROPERTY INSURANCE COMPANY f/k/a ARK ROYAL INSURNACE COMPANY IN THE CIRCUIT COURT OF THE TWENTIETH JUDICIAL CIRCUIT IN AND FOR COLLIER COUNTY, FLORIDA, CIVIL DIVISION, Case No. 2019 -CA -001115. This General Release also is to apply to any and all claims for attorney fees, costs and any claim for bad faith, extra -contractual liability of any kind and/or punitive damages arising out of the lawsuit which is the subject of this General Release. This General Release also is to apply to any and all Assignment of Benefits known and unknown. Payment shall be made within 30 days of Second Party's receipt of the executed settlement release. Payment of the settlement proceeds is as follows: One check to Angel Cabrera, Silvana Dattari, Fifth Third Bancorp ISAOA/ATIMA, and Collier County — Ship Housing Human and Veteran Services in the amount of $36,000.00; and One check to Claims Elements Consultants, Inc., and Vyacheslav Borshchukov, P.A., and Angel Cabrera, Silvana Dattari in the amount of $16,500.00 for fees and costs. First Party fully understands and agrees that this General Release includes any and all claims for any damages, to include compensatory and punitive damages, as well as attorney's fees and costs, and any other causes of actions or any other related claims which could have been raised in the instant action and alleged in or brought under the laws, codes and statutes of any and all state, federal, foreign, local or territorial jurisdictions. Further, this General Release extends and applies to and also covers and includes, all unknown, unforeseen, unanticipated and unsuspected injuries, damages, including compensatory and punitive damages, losses and liabilities and the consequences thereof arising in any way from the claims made by First Party under their policy of insurance with Second Party and described in the First Party's Complaint in the above -referenced case. First Party fully understands and agrees that this General Release includes, but is not limited to, a resolution of all claims and potential claims for attorney fees and costs incurred by either Party in this case. First Party understands and agrees that the payment of the afore -described consideration is not to be construed as an admission of liability on the part of any parties and entities hereby released, all of whom expressly deny same. First Party further acknowledges and agrees that the terms, conditions and identity of the parties to this settlement, including any payments made hereunder, shall remain strictly confidential and shall not be disclosed or made known to any third person or party unless such disclosure is required by law. Disclosure of this settlement to First Party's attorneys, tax advisors, lenders, realtors or potential buyers of the subject real property shall not be deemed a violation of this provision. First Party acknowledges that they have had a full opportunity to read the contents of this General Release and has had the benefit of counsel in reviewing General Release. First Party further acknowledges and agrees that no promise or agreement not herein expressed has been made by Second Party, and that this General Release constitutes the entire agreement between the parties hereto, and that the terms of this General Release are contractual and not a mere recital, and that there is no agreement or compromise on the part of the Second Party to do any act or thing not herein mentioned. First Party hereby declares, covenants and warrants that they are over the age of eighteen (18) years, and that they are not suffering from any legal, mental or physical disabilities which would impair or disable them from executing this General Release and that there has been no representations and/or statements made by the Second Party hereto or its agents, insurers, employees, or representatives to influence them in making or executing this General Release. If any section or part of this General Release and Hold Harmless Agreement is held to be invalid by a court of law, the remaining portions of this release shall continue to be in full force and effect. Further, First Party further agree to indemnify and hold harmless Second Party and its heirs, executors, administrators, successors, insurers, assigns, employees, and representatives from and against any and all claims, causes of action, demands, obligations, damages, costs and expenses, liens and damages or demands of whatever name and nature brought by any third party, more specifically, any liens, mechanic liens, attorney's liens, public adjuster liens, and claims by mortgage holders, co-owners, co- insureds or lien holders arising out of events or Proceedings referenced herein, whether known or unknown, or benefits paid as a result of the events or Proceedings referenced herein. First Party further acknowledges, represents and agrees, on behalf of themselves, their heirs, assigns, subrogees, successors in interest, that they will satisfy, to the extent legally required, all outstanding mortgages and liens against the subject property and/or the proceeds of this settlement. First Party further agrees to indemnify and hold harmless Second Party and their insurers in the event of any claims by the mortgage holders under the terms of the policy, inclusive of costs or liens, or subrogated interests, which do or could represent a lien or claim against these proceeds exist or come to light in the future with respect to the aforementioned policy, and to the extent any such claims or liens are raised, First Party hereby agrees that they shall immediately pay and satisfy same and shall otherwise indemnify and hold the Second Party and its insurers harmless from and against all loss, damage or liability for payment of same, including indemnification incurred in the defense of any claim brought by the mortgagee. Further, if a claim is brought by First Party's mortgagee, First Party also agrees to indemnity Second Party for the attorney's fees and costs associated with said claim(s). First Party hereby declares that the terms of this settlement agreement have been completely read and are fully understood and voluntarily accepted for the purposes of making a full and final compromise, adjustment and settlement of any and all claims, disputes or otherwise, and for the express purpose of precluding forever any further or additional claims, lawsuits or appeals by First Party against Second Party that have or potentially could arise out of the claims made by First Party under their policy of insurance with Second Party for property located at 769 Waterloo Ct Naples, Florida, 34120, that was assigned a date of loss of September 9, 2017 and claim number488091-171011, and the policy of insurance issued by Second Party, as well as any other claims or causes of action which could have been brought under his policy of insurance. First Party hereby accepts draft or drafts as final payment of the consideration set forth above. PROGRESSIVE PROPERTY INSURANCE CORP 0 Homeowners Declaration Page Named Insured: ANGEL CABRERA 769 WATERLOO CT NAPLES, FL 34120 1 ASI Way St. Petersburg, FL 33702 Effective Date of This Transaction: 1/4/2019 Activity of This Transaction: Renewal Residence Premises: 769 WATERLOO CT NAPLES, FL 34120 PR99RE11111F HOME Total Policy Premium: $1,582 Policy Number: ARK105460 Agent: Brightway Insurance P.O. Box 5700 Jacksonville, FL 32247 Agent Code: 418771 For Policy Service, Call: (888)254-5014 Policy Period: From: 01/04/2019 To: 01/04/2020 (At 12:01 AM Standard Time at the residence premises) Plan Type: H03 Coverage at the residence premises is provided only where a limit of liability is shown or a premium is stated. Coverages and Limits of Liability Limit SECTION I: A. Dwelling Coverage $258,000 B. Other Structures $2,580 C. Personal Property $64,500 D. Loss of Use $25,800 SECTION H: E. Personal Liability - Each Occurrence $300,000 F. Medical Payments to Others - Each Person $5,000 OTHER COVERAGES AND ENDORSEMENTS: (Printed on the following page) Deductibles: HURRICANE: 2%-$5160 ALL OTHER COVERED PERILS: $2500 Mortgagee: 1st Mortea¢ee• FIFTH THIRD BANCORP ISAOA/ATIMA PO BOX 598 Amelia, OH 45102 Loan #0416568988 Escrow: Yes 2nd Mortzaaee• COLLIER COUNTY- SHIP HOUSING HUMAN AND VETERAN SERVICES 3339 E TAMIAMI TRAIL BLDG H. RM 211 NAPLES, FL 34112 Loan #TBD Countersigned by Authorized Representative St. Petersburg, FL Date: 11/05/2018 ASI HO FL DEC 1217 The ASI Group is an affiliate of The Progressive Corporation Premium 4595.84 -13.48 -132.96 Included 15.00 10.00 Page 1 of 2 Named Insured(s): ANGEL CABRERA Policy Number: ARK105460 Other Coverages And Endorsements: Form Number Limit Premium Catastrophic Ground Cover Collapse Coverage - Florida ASI HO 09 CG 08 12 Table Of Contents ASI HO 09 COV 0198 Hurricane Deductible Endorsement ASI HO 09 HD 05 05 Homeowners Policy Outline ASI HO 09 OTL 0110 Special Provisions For Florida ASI HO 09 SP 0812 Ordinance or Law Coverage Notification ASI HO FL OLR 0816 Homeowners3 Special Form HO 00 03 04 91 Home Day Care Explanation HO 04 96 04 91 BCEG -135.43 Tier Factor Premium -373.50 Burglar Protection ASI HO 09 PA 06 07 -70.25 Windstorm Loss Reduction -1004.32 NHR Deductible 2500 -388.03 HUR Deductible 5160 -147.55 Ordinance or Law ASI HO FL OL 08 16 25800 178.13 Limited Screen Enclosure/Carport Coverage ASI HO 09 WSE 12 07 10000 150.10 PC / Construction Factor -655.66 Limited Fungi,Mold,Wet/Dry Rot ASI HO FL LF 0118 $10,000 Included Age of Dwelling -377.50 Number of Stories -95.52 Fees and Assessments: Managing General Agent Fee 25.00 Emergency Management Preparedness Assistance Fee 2.00 Scheduled Items: Category Description of Property Value Premium The Hurricane Coverage portion of your Total Premium is: $605 The Non -Hurricane Coverage portion of your Total Premium is: $977 Additional Insured: Additional Interest: Interest: Rating Information: Construction Type: Masonry Type of Residence: Single Family Total Square Feet: 1,950 Year Built: 1998 ASI Territory: 464C Roof Year: 1998 County: COLLIER Notes: Page 2 of 2 The ASI Group is an affiliate of The Progressive Corporation ASI HO FL DEC 1217 I IHN page IN i►uciuIIJuauy IOIL UldUl . PROGRESSIVE PROPERTY INSURANCE CORP 1 ASI Way St. Petersburg, FL 33702 Homeowners Declaration Page Named Insured: ANGEL CABRERA PRIAGRE111YE HOME IMPORTANT NOTICES Policy Number: ARK105460 LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE FROM THE NATIONAL FLOOD INSURANCE PROGRAM. WITHOUT THIS COVERAGE, YOU MAY HAVE UNCOVERED LOSSES. PLEASE DISCUSS THESE COVERAGES WITH YOUR INSURANCE AGENT. THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES, WHICH MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU. YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM. I N S U R A N C E March 14, 2018 ANGEL CABRERA 769 WATERLOO CT NAPLES FL 34120 Re: Claim Number: 488091-171011 Policy Number: ARK105460 Date of Loss: September 9, 2017 Date Reported: September 12, 2017 Underwriting Co: Ark Royal Insurance Company Insured Location: 769 Waterloo CT Naples, FL 34120 Dear Angel Cabrera: The Chief Financial Officer for the State of Florida has adopted a rule to facilitate the fair and timely handling of residential property insurance claims. The rule gives you the right to attend a mediation conference with your insurer in order to settle any claim you have with your insurer. An independent mediator, who has no connection with your insurer, will be in charge of the mediation conference. You can start the mediation process after receipt of this notice by calling the Department of Financial Services at (877) 693-5236. The parties will have 21 days from the date of the notice to otherwise resolve the dispute before a mediation hearing can be scheduled. If after you start the mediation process as explained above, and the claim is not settled within 21 days, either party may then request Department of Financial Services to schedule a mediation hearing. The mediation hearing must be requested by contacting the Department of Financial Services using one of the methods indicated below: • By Online Request: httosJ/apps.fldfs.com/ESERVICE/mediationlnfo.aspx • By Telephone: Consumer Helpline 1 -877 -MY -FL -CFO (1-877-693-5236) • By TDD line: 1-800-640-0886 • For Out of State Callers: (850) 413-3089 • By Fax: Attn Mediation Section (850) 488-6372 • By Mail: Florida Department of Financial Services Mediation Section Bureau of Education Advocacy and Research 200 East Gaines Street Tallahassee, Florida 32399-0322 P.O. Box 20089 • St. Petersburg, FL 33742 Phone: (866) 274-5677 • Fax: (866) 840-1905 • www.AmericanStrategic.com Page 1 of 6 ASI Insured: Cabrera, Angel Property: 769 WATERLOO CT NAPLES, FL 34120 Home: 769 WATERLOO CT NAPLES, FL 34120 Claim Rep.: Genny Busbice Estimator: Genny Busbice Reference: Catatrophe Team Four Position: ASI ADJUSTER Company: ARK ROYAL INSURANCE Business: 1 ASI WAY ST PETERSBURG, FL 33702 Home: (407) 508-0333 Business: (866) 274-5677 Business: (866) 274-5677 Business: (727) 456-1673 Claim Number: 488091-171011-125040 Policy Number: ARK105460 Type of Loss: Wind Damage Date Contacted: 2/27/2018 Date of Loss: 9/9/2017 1:00 PM Date Received: 9/12/2017 Date Inspected: 3/1/2018 3:00 PM Date Entered: 9/16/2017 6:47 PM Date Est. Completed: 3/14/2018 7:32 PM Price List: FLNA8X_MAR18 Restoration/Service/Remodel Estimate: CABRERA ANGEL1111 Dear ASI Policyholder, The estimate attached reflects the cost to repair the known damages to your property. Please review the estimate and note the Dwelling Summary page, which shows the total damages, including sales tax and your deductible. If you hire a general contractor to make the repairs, you should provide your contractor with a copy of the estimate. Job -Personnel Overhead/Sub contractor overhead and profit expense is included in your estimate under the Labor Overhead portion of each unit price. No supplement or other payments will be issued for any repairs not listed in the estimate without prior authorization . Approval must be given by ASI prior to the replacement or repair of any additional items. ASI must have the opportunity to view the additional damages or proposed changes prior to the initiation of further work. If there is a mortgage holder included on the policy, by law the mortgage holder must be included on the payment. You must contact the mortgagee to secure endorsement of the check. Regards, ASI Claims Department ASI DESCRIPTION Right Elevation QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 13. General Laborer - per hour 2.00 HR 32.58 0.00 13.69 78.85 (0.00) 78.85 To straighten frame around pool enclosure door 14. General Laborer - per hour 2.00 HR 32.58 0.00 13.69 78.85 (0.00) 78.85 To fix sliding glass door Totals: Right Elevation 0.00 27.38 157.70 0.00 157.70 Rear Elevation DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 15. Tree - removal - 12" to 24" diameter / 1.00 EA 1,141.52 0.00 239.72 1,381.24 (0.00) 1,381.24 large canopy To remove tree from structure 16. Tree - tear out and disposal - 12" to 24" 1.00 EA 689.25 0.00 144.75 834.00 (0.00) 834.00 diameter For tree disposal Totals: Rear Elevation 0.00 384.47 2,215.24 0.00 2,215.24 Left Elevation DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 17. General Laborer - per hour 2.00 HR 32.58 0.00 13.69 78.85 (0.00) 78.85 To straighten frame around pool enclosure door Totals: Left Elevation 0.00 13.69 78.85 0.00 78.85 Den - 11' 6• j Dm F F 1 SKETCH2 Main Level 296.00 SF Walls 376.50 SF Walls & Ceiling 8.94 SY Flooring 37.00 LF Ceil. Perimeter Height: 8' 80.50 SF Ceiling 80.50 SF Floor 37.00 LF Floor Perimeter DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV CABRERA ANGELllll 3/14/2018 Page:3 ASI Line Item Totals: CABRERA ANGEL1111 Grand Total Areas: 296.00 SF Walls 80.50 SF Floor 0.00 SF Long Wall 80.50 Floor Area 357.00 Exterior Wall Area 3,076.67 Surface Area 39.00 Total Ridge Length 271.52 3,607.22 20,783.98 1,183.54 19,600.44 80.50 SF Ceiling 8.94 SY Flooring 0.00 SF Short Wall 93.28 Total Area 39.67 Exterior Perimeter of IRC - Dwelling Walls 30.77 Number of Squares 188.71 Total Hip Length 376.50 SF Walls and Ceiling 37.00 LF Floor Perimeter 37.00 LF Ceil. Perimeter 296.00 Interior Wall Area 238.00 Total Perimeter Length Coverage Item Total % ACV Total % Dwelling 16,619.91 79.97% 15,646.37 79.83% Debris Removal 0.00 0.00% 0.00 0.00% IRC - Dwelling 0.00 0.00% 0.00 0.00% Other Structures 4,164.07 20.03% 3,954.07 20.17% Debris Removal 0.00 0.00% 0.00 0.00% IRC - Other Structures 0.00 0.00% 0.00 0.00% Personal Property 0.00 0.00% 0.00 0.00% Debris Removal 0.00 0.00% 0.00 0.00% Loss of Use 0.00 0.00% 0.00 0.000/0 Liability 0.00 0.00% 0.00 0.00% Medical Payment 0.00 0.00% 0.00 0.00% Ordinance Or Law 0.00 0.00% 0.00 0.00% Trees and Shrubs 0.00 0.00% 0.00 0.00% Debris Removal 0.00 0.00% 0.00 0.00% Fire Department 0.00 0.00% 0.00 0.000/0 Loss Assessment 0.00 0.00% 0.00 0.000/0 Credit Card, EFT Card, and Counterfeit 0.00 0.00% 0.00 0.00% Money Scheduled Property 0.00 0.00% 0.00 0.00% Single PHA Deductible 0.00 0.00% 0.00 0.00% HUR Deductible 0.00 0.00% 0.00 0.00% NHR Deductible 0.00 0.00% 0.00 0.00% Total 20,783.98 100.00% 19,600.44 100.000/0 CABRERA ANGEL1111 3/14/2018 Page:5 ASI Summary for Other Structures Line Item Total 3,378.37 Material Sales Tax 63.00 Subtotal 3,441.37 Overhead 344.14 Profit 378.56 Replacement Cost Value $4,164.07 Less Depreciation (210.00) Actual Cash Value $3,954.07 Less Deductible [Full Deductible = 4,164.07] (3,954.07) Net Claim $0.00 Total Depreciation 210.00 Less Residual Deductible (210.00) Total Recoverable Depreciation 0.00 Net Claim if Depreciation is Recovered $0.00 Germy Busbice CABRERA ANGEL1111 3/14/2018 Page:7 ASI Summary for Dwelling Line Item Total Material Sales Tax Subtotal Overhead Profit Replacement Cost Value Less Depreciation Actual Cash Value Less Deductible Less Prior Payment(s) Net Claim Remaining Total Recoverable Depreciation Net Claim Remaining if Depreciation is Recovered Genny Busbice 13,526.87 208.52 13,735.39 1,373.56 1,510.96 $16,619.91 (973.54) $15,646.37 (875.93) (1,075.17) $13,695.27 973.54 $14,668.81 CABRERA_ANGEL1111 3/14/2018 Page:6 ASI CONTINUED - Den DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 18. R&R 5/8" drywall - hung, taped, 8.00 SF 2.45 0.25 4.18 24.03 (0.83) 23.20 floated, ready for paint Totals: General 0.00 31.23 179.92 19. Batt insulation - 6" - R19 - unfaced 8.00 SF 0.75 0.24 1.31 7.55 (0.82) 6.73 batt 2.74 130.00 748.90 7.54 741.36 20. Mask and prep for paint - plastic, 37.00 LF 1.36 0.51 10.68 61.51 (1.70) 59.81 paper, tape (per LF) 21. Seal the surface area w/latex based 80.50 SF 0.61 0.34 10.38 59.83 (1.13) 58.70 stain blocker - one coat 22. Paint the ceiling - two coats 80.50 SF 0.94 0.92 16.08 92.67 (3.06) 89.61 23. Haul debris - per pickup truck load - 1.00 EA 148.69 0.00 31.23 179.92 (0.00) 179.92 including dump fees 24. Final cleaning - construction - 80.50 SF 0.23 0.00 3.89 22.41 (0.00) 22.41 Residential 25. Drywall Installer / Finisher - per 1.00 HR 75.41 0.00 15.84 91.25 (0.00) 91.25 hour 26. Floor protection - plastic and tape - 80.50 SF 0.30 0.48 5.18 29.81 (0.00) 29.81 10 mil Totals: Den 2.74 98.77 568.98 7.54 561.44 General DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 27. Haul debris - per pickup truck load - 1.00 EA 148.69 0.00 31.23 179.92 (0.00) 179.92 including dump fees Totals: General 0.00 31.23 179.92 0.00 179.92 Total: Main Level 2.74 130.00 748.90 7.54 74136 Total: SKETCH2 2.74 130.00 748.90 7.54 741.36 Other Structures DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 28. R&R Storage shed - Vinyl - Gable type 1.00 EA 1,547.60 63.00 338.23 1,948.83 (210.00) 1,738.83 -10'x8' 29. Content Manipulation charge - per 4.00 HR 32.58 0.00 27.37 157.69 (0.00) 157.69 hour Totals: Other Structures 63.00 365.60 2,106.52 210.00 1,896.52 CABRERA ANGEL1111 3/14/2018 Page; 4 ASI Roof CABRERA ANGELIIII SKETCHI Main Level 3076.67 Surface Area 30.77 Number of Squares 238.00 Total Perimeter Length 39.00 Total Ridge Length 188.71 Total Hip Length DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 1. Remove Tile roofing - Concrete - "S" 8.24 EA 12.18 0.00 21.08 121.44 (0.00) 121.44 or flat (per TILE) 14,121.90 849.87 13,272.03 Total: SKETCH1 170.25 2,450.92 14,121.90 2. Tile roofing - Concrete - "S" or flat 9.43 SQ 597.62 89.06 1,202.18 6,926.80 (519.53) 6,407.27 tile Actual number of wind damaged field tiles is 29 and 20 additional cap tiles. This allowance is for replacing the rear slope with 15% added for waste. 18.33 105.55 (11.51) 94.04 11. Additional charge for a retrofit 1.00 EA 187.24 3. R&R Ridge / Hip / Rake cap - the 136.00 LF 16.50 56.63 483.13 2,783.76 (330.34) 2,453.42 roofing 12. Prime & paint door slab only - 1.00 EA 43.41 4. Bird stop - Eave closure strip for tile 23.00 LF 4.95 3.22 24.58 141.65 (0.00) 141.65 roofing - clay Totals: Front Elevation 5. Hip & ridge nailer board for tile 272.00 LF 3.03 18.93 177.05 1,020.14 (0.00) 1,020.14 roofing - wood 3/14/2018 Page:2 6. R&R Drip edge 60.00 LF 2.78 2.41 35.54 204.75 (0.00) 204.75 7. Roofer -per hour 16.00 HR 151.00 0.00 507.36 2,923.36 (0.00) 2,92336 Allowing for 30 hours of labor to harvest rear slope of 824 sq ft. Totals: Roof 170.25 2,450.92 14,121.90 849.87 13,272.03 Total: Main Level 170.25 2,450.92 14,121.90 849.87 13,272.03 Total: SKETCH1 170.25 2,450.92 14,121.90 849.87 13,272.03 Front Elevation DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 8. R&R Gutter / downspout - aluminum - 24.00 LF 7.63 6.96 39.92 230.00 (23.18) 206.82 6" 9. R&R Exterior door - double - metal - 1.00 EA 586.64 24.43 128.32 739.39 (81.44) 657.95 insul. - flush or panel 10. Door lockset & deadbolt -exterior 1.00 EA 83.77 3.45 18.33 105.55 (11.51) 94.04 11. Additional charge for a retrofit 1.00 EA 187.24 0.00 3932 226.56 (0.00) 226.56 exterior door 12. Prime & paint door slab only - 1.00 EA 43.41 0.69 9.27 53.37 (0.00) 53.37 exterior (per side) Totals: Front Elevation 35.53 235.16 1,354.87 116.13 1,238.74 CABRERA ANGEL1I11 3/14/2018 Page:2 L _IIIr�' `` YY �D E E: I N 5 U R A N C E In your request for mediation you should include the following: 1. Your name, address, daytime phone number, and e-mail. Similar contact information for any other named insured. 2. The location of the property that is at issue, if it is different than your address. 3. The claim number we have assigned to your claim, as well as your insurance policy number. 4. A brief description of your claim and the nature of the dispute. 5. Your insurer name, its address, phone number, and person designated by your insurer as the contact for scheduling mediation. For reference this information is: Insurance Company: Ark Royal Insurance Company P.O. Box 20089 St. Petersburg, Florida 33742 Contact person: Genny Busbice E-mail: gbusbice@asicorp.olrg Phone: (866) 274-5677, Extension 1602 6. Information with respect to any other policies of insurance that may provide coverage of the insured property for named perils such as flood or windstorm. If we are unable to settle the claim after 21 days expire from your receipt of this notice, the Department Administrator will select the mediator. Either party may disqualify a mediator for good cause. Good cause consists of conflict of interest between a party and the mediator, that the mediator is unable to handle the conference competently or other reasons which would reasonably be expected to impair the conference. Complaints concerning a mediator shall be in writing and submitted to the Department of Financial Services at the address referenced above. Additionally, Florida Administrative Code, Rule 69J -166.031(8)(c)(1) requires that the insured and insurer attend the mediation conference, have full knowledge of the facts of the dispute, and be fully authorized to make an agreement to completely resolve the claim. You may also bring to the conference persons who may assist you in presenting your claims. Should you chose to do so, you are required to notify the mediator of your intention 14 (fourteen) days prior to the scheduled conference, unless we agree otherwise. Please also note that the mediation proceedings are confidential and inadmissible in any subsequent adversarial proceeding. You will be notified in writing by the mediator of the exact date, time, and location of the mediation conference. Sincerely, P.O. Box 20089 • St. Petersburg, FL 33742 Phone: (866) 274-5677 • Fax: (866) 840-1905 • www.AmericanStrategic.com Page 2 of 6 I N S U R A N C E Please do not construe this letter or any act or failure to act on the part of Ark Royal Insurance Company, or any agent or representative of Ark Royal Insurance Company, as a waiver of any rights or defenses available to it by contract or at law as all such rights and defenses are hereby specifically reserved. Should you have any questions or additional information regarding this claim, please contact the undersigned at 866- 274-5677 ext. 1602, via email at gbusbice@asicorp.olrg, fax at (866) 840-1905 or U.S. Mail at P 0 Box 20089, St. Petersburg, FL 33742. Sincerely, Genny Busbice CAT Supplement Adjuster Office: (866) 274-5677 ext. 1602 Fax: (866) 840-1905 gbusbice@asicorp.org P.O. Box 20089 • St. Petersburg, FL 33742 Phone: (866) 274-5677 • Fax: (866) 840-1905 • www.AmericanStrategic.com Page 6 of 6 .\ m _RK ROYAL 1 N 5 U R A N C E • The deteriorated condition of the roof covering from result of normal wear and aging. + Workmanship deficiencies associated with the installation or repair of the roof assembly. • The deteriorated roof sheathing above the living room that was determined to be long-term, repetitive, and ongoing. • Roof leaks that were not the result of a storm created opening. • Anything required by the state of Florida due to code or ordinance. • Cracks in roof tiles caused by shrinkage or expansion. Ark Royal Insurance Company provides your property coverage under Policy Number ARK105460 effective from January 4, 2017 to January 4, 2018. Your policy provides all risk coverage for your dwelling and named peril coverage for unscheduled personal property under HO 00 03 04 91 - Homeowners3 Special Form, amended by ASI HO 09 SP 0812 - Special Provisions For Florida, subject to limitations and exclusions, that in part state the following: AGREEMENT In reliance on the information you have given us, we agree to provide the insurance coverages indicated on the Policy Declarations. In return, you must pay the premium when due and comply with the policy terms and conditions and immediately inform us of any change of title, use or occupancy of the 'residence premises" PERILS INSURED AGAINST Coverage A — Dwelling and Coverage B — Other Structures: We insure against risk of sudden and accidental direct physical loss to property described in Coverages A and B only if that loss is a physical loss to property; however, we do not insure for loss: 2. Caused by: e. Any of the following: (1) Wear and tear, marring, deterioration; (2) Inherent vice, latent defect, mechanical breakdown; (6) Settling, shrinking, bulging or expansion, including resultant cracking, of pavements, patios, foundations, walls, floors, roofs or ceilings; 3. Excluded under Section I — Exclusions. SECTION I — EXCLUSIONS P.O. Box 20089 • St. Petersburg, FL 33742 Phone: (866) 274-5677 • Fax: (866) 840-1905 • www.AmericanStrategic.com Page 4 of 6 ARK ROYAL ? N 5 U R A N C E As part of its investigation of your claim, ASI obtained an 1 -tel independent laboratory report for the roof tiles based on your roofer's sample photos of the tile. The Itel Laboratories report identifying the tile on your roof is attached and has also been forwarded by email to you. The report identifies the tile as Boral Saxony Slate an older "Bora) Lifetile" concrete roof tile. "Boral Lifetile" is now called Boral. In late 2011 Boral purchased sole control of the company and all tiles are now sold under the Boral name. This product is no longer available. Itel was able to supply us with the two closest products currently being produced based on the physical properties and profile of the available sample. The tiles that are the closest match and are available for purchase are the Eagle Bel Air (Slurry Coated) or Boral Saxony 900 Slate (Oxide thru body). Both of these products are an excellent profile match; however these products are not a suitable for individual file repair, type product and only original recommended as a total Slope/Elevation repair type product matching the original sample physical specifications and profile appearance. Your policy specifies the criteria for the settlement of your claim. The policy will pay the amount to repair or replace the damaged property with "like construction and use", that does not mean the the have to be an exact match. As such, ASI will pay to repair or replace the hurricane damaged tile with like Idnd and quality. SECTION I — CONDITIONS 3. Loss Settlement. Covered property losses are settled as follows: a. Property of the following types: (1) Personal property; (2) Awnings, carpeting, household appliances, outdoor antennas and outdoor equipment, whether or not Attached to buildings; and (3) Structures that are not buildings; at actual cash value at the time of loss but not more than the amount required to repair or replace at the actual cash value at the time of loss but not more than the amount required to repair or replace. b. Buildings under Coverage A or B at replacement cost without deduction for depreciation, subject to the following: (1) If, at the time of loss, the amount of insurance in this policy on the damaged building is 80% or more of the full replacement cost of the building immediately before the loss, we will pay the cost to repair or replace, after application of deductible and without deduction for depreciation, but not more than the least of the following amounts: (a) The limit of liability under this policy that applies to the building; (b) The replacement cost of that part of the building damaged for like construction and use on the same premises; or (c) The necessary amount actually spent to repair or replace the damaged building. 4 We will pay at least the actual cash value of the damage, less any applicable deductible, until actual repair is performed. We will pay any remaining amounts necessary to perform such repairs as the work is performed and the expenses are incurred and according to the provisions of b.(1) and b.(2) above. However, if the cost to repair or replace the damage is both: (a) Less than 5% of the amount of insurance in this policy on the building; and P.O. Box 20089 - St. Petersburg, FL 33742 Phone: (866) 274-5677 - Fax: (866) 840-1905 - www.AmericanStrategic.com Page 2 of 6 GHD 1 11151519Eaken-l-Cabrera Roof Assessment LEGEND: D CRACKED ROOF TILE D DISPLACED ROOF FILE m MISSING ROOF TILE R REPLACED ROOF TILE �C CRACKED AND DEFLECTED ROOF TILE NOTES: i. ROOF PLAN LAYOUT IS APPROXIMATE, 2. SYMBOLS SHOWN IN THE ROOF PLAN REPRESENT THE APPROXIMATE EXTENT AND LOCATION OF SOME OF THE OBSERVED DAMAGE OR CONDITION(S), THE CABRERA RESIDENCE 1111516119 769 WATERLOO COURT � Dee 5.2017 1¢nz NAPLES 24 ,FL ROOF PLAN FIGURE 1 ,,n �� <.'i�:L'�Gu'iiiJ*iGf'I`.:1•:IlP�a<<:.P:a,� i ire � � c:r�r�.n i _ i =ic..�u:�..,,� um� December 6, 2017 Mr. Tim Eaken American Strategic Insurance Post Office Box 20089 Saint Petersburg, Florida 33742 Dear Mr. Eaken: Re: Roof Assessment The Cabrera Residence 769 Waterloo Court Naples, Florida 34120 Claim Number: 488091-171011 1. Introduction Reference No. 11151519 At your request, GHD conducted a visual, non-destructive assessment at the subject structure. The site visit for this assessment was performed on November 2, 2017, by GHD staff in the presence of Mr. Angel Cabrera, the homeowner. The purpose of this assessment was to observe and comment on reported damage to the roof and interior of the subject structure. This document provides a summary of GHD's opinions and observations of the reported damage. 2. Assessment Summary Based on the information acquired and GHD's assessment of the subject structure, the following summary of opinions is provided: • The overall moderately deteriorated condition of the roof covering above the subject structure was the result of normal wear and weathering for the age of the roof covering (approximately 19 years old), as evidenced by the quantity of replaced and/or repaired roof tiles, the aged appearance of the roof covering, and the presence of leaks through the roof assembly. There was no visual evidence that indicated any hail struck the roof covering and caused functional damage to the roof covering or other hail sensitive items around the residence. • The tile roof covering above the subject structure experienced some damage that could be attributed to wind forces, as evidenced by the observed fragmented, cracked, missing, and/or displaced roof files. - The noted wind damage to the roof covering involved approximately 20 cap tiles, and 29 field tiles (approximately 62 square feet), which represented approximately 3 percent of the overall roof area and as such did not exceed the 25 percent threshold required to apply the provisions GHD 5904 Hampton Oaks Parkway Suite F Tampa Florida 33610 USA T 813 9713882 F 813 971 1862 w www.ghd..com specified in Section 708.1.1 "Reroofing," in the Florida Building Code — Existing Building, 5th Edition (2014). The wind damage to the roof covering above the subject structure was considered repairable despite the moderately deteriorated condition and anticipated remaining service life. The removal and replacement of the entire roof covering above the subject structure was not necessary at the time of GHD's assessment. • The tile roof covering exhibited some damage that resulted from foot traffic during the installation of tarpaulins following the hurricane event, as evidenced by: - The referenced tiles were predominately located near the perimeters of the tarpaulin coverings; - The cracks were predominately located across the width of the tiles; - The cracked portions of the tiles were deflected downward; - A lack of missing tiles fragments on the downslope roof surfaces; and - A lack of scars and/or abrasions on the the surfaces. The following repairs were present on the roof surface: - A total of 42 field roof tiles had been previously replaced, as evidenced by the different surface color of the referenced tiles and the report of the homeowner; - Several roof tiles showed repair -like materials had been applied within the cracks; • The following conditions constituted workmanship deficiencies: - Several sheathing fasteners were misplaced along the top chord of a truss; and - Mechanically induced cuts were present on some roof tile surfaces. The apparent microbial growth and the stained and deteriorated roof sheathing in the vicinity above the living room constituted damage caused by exposure to moisture that originated as leaks through the roof assembly. Based on the observed damage, the referenced roof leaks were long-term, repetitive, and on-going over a cumulative period of approximately 6 months or longer prior to GHD's site visit. The referenced roof leaks were not the result of a storm -created opening. The referenced roof leaks were the result of one or more of the following: - The deteriorated condition of the roof covering as a result of normal wear and weathering; and - Workmanship deficiencies associated with the installation of the roof assembly. 3. Description of the Structure The subject structure can be described as a one-story, single-family residence with a screen -enclosed in -ground swimming pool located to the rear of the residence (Photograph 1). According to Collier County Property Appraiser records, the residence was constructed in 1998. As understood by GHD, Mr. Cabrera had owned the residence since January 2013. For the purposes of this document, the residence was referenced to face east. 11151519Eaken-l-Cabrera Roof Assessment The exterior walls of the structure were constructed of concrete masonry units (CMU) and finished on the outside with cementitious stucco. The floor of the residence consisted of a concrete slab -on -grade. The interior walls appeared to be framed and finished with drywall. The roof of the structure was framed construction and was covered with tiles. Refer to Figure 1 for a roof plan of the structure. 4. Background During GHD's assessment, Mr. Cabrera provided the following information: • The passage of Hurricane Irma damaged the residence on September 10, 2017. • The stains in the ceiling finish above the living room was first observed during the hurricane event. • Following the storm event, the homeowner installed tarpaulins on the roof surface. • The roof covering was installed prior to the homeowner's purchase of the residence. • No repairs have been made to the roof covering during the current ownership. • The repaired and replaced roof tiles predate the homeowner's purchase of the residence. • No additions or structural modifications had been made to the subject structure. 5. Site Observations Observations of the referenced structure's interior and attic space revealed the following: • A stain that exhibited a ring-like pattern was present in the ceiling finish at the above north portion of the living room (Photograph 2). • A stain in the ceiling finish was present along a ceiling board joint above the living room (Photograph 3). • Stained and deteriorated roof sheathing that exhibited some apparent microbial growth was present in the attic space above the referenced stained ceiling finishes (Photograph 4). • Stained roof sheathing was present in the vicinity above the stained finish shown in Photograph 3. Several misplaced sheathing fasteners were exposed along the top chord of a truss, including 1 within the stained area (Photograph 5). Observations of the subject structure's roof covering revealed the following: • The roof covering above the subject structure was covered with flat surface concrete roof tiles with an exposed width approximately 12 inches and an exposure length of approximately 15 inches. The roof tiles were secured to the structure with mechanical fasteners. The slope of the roof surface was approximately 4 Inches of vertical rise to 12 inches of horizontal run (4:12). The roof section had a sloped area of approximately 2,800 square feet • Roof tiles had been replaced in the vicinity of the deteriorated roof sheathing shown in Photographs 4 and 5 (Photograph 6). 11151519Eaken-1 -Cabrera Roof Assessment M i • Missing cap tiles were observed along the southeast oriented hip above the main entrance to the residence (Photograph 7). • Missing cap tiles were observed along the southeast oriented hip above the southeast portion of the residence (Photograph 8). • Some roof tiles were cracked or fragmented and deflected downward. These tiles exhibited horizontally oriented cracks with the top portion of the referenced tiles deflected downward. A lack of surface scars and/or abrasions and a lack of missing tile fragments were not observed on the referenced the surfaces (Photographs 9 and 10). • Several roof tiles exhibited missing tile portions that exposed the roof underlayment material (Photographs 11 and 12). • Replaced roof tiles were sporadically located across the roof covering (Photographs 13 and 14). • Repair -like materials had been applied to the crack in some roof tiles (Photographs 15 and 16). • Mechanically induced cuts were resent in some of the roof tile surfaces (Photograph 17). 6. Information Reviewed As part of GHUs assessment of the subject structure, GHD reviewed the following Information: Florida Building Code, Existing Building, V Edition (2014) • Section 202, "General Definitions", defines repair as: - The restoration to good or sound condition of any part of an existing building for the purpose of its maintenance. • Section 202, "General Definitions", defines roof section as: - A separating or division of a roof area by existing expansion joints, parapet walls, flashing (excluding valley), difference of elevation (excluding hips and ridges), roof type or legal description; not including the roof area required for a proper tie -off with an existing system. • Section 502, "Repairs", states: - 502.1 Scope. Repairs, as defined in Chapter 2, include the patching or restoration or replacement of damaged materials, elements, equipment, or fixtures for the purpose of maintaining such components in good or sound condition with respect to existing loads or performance requirements. - 502.3 Related Work. Work on nondamaged components that is necessary for the required repair of damaged components shall be considered part of the repair and shall not be subject to the provisions of Chapter 7, 8, 9, 10 or 11. • Section 708, "Reroofing", states: 11151519Eaken-l-Cabrera Roof Assessment 4 708.1.1 Not more than 25 percent of the total roof area or roof section of any existing building or structure shall be repaired, replaced, or recovered in any 12 -month period unless the entire roofing system or roof section conforms to the requirements of this code. Florida Building Code, Residential, 5t' Edition (2014) • Section R202, "Definitions", defines roof assembly as: - A system designed to provide weather protection and resistance to design loads. The system consists of a roof covering and roof deck or a single component serving as both the roof covering and roof deck. A roof assembly includes the roof deck, vapor retarder, substrate or thermal barrier, insulation, vapor retarder, and roof covering. • Section R202, "Definitions", defines roof covering as: - The covering applied to the roof deck for weather resistance, fire classification, or appearance. • Section 8202, "Definitions", defines roof covering system as: - See "Roof assembly." • Section R202, "Definitions", defines roof deck as: - The flat or sloped surface not including its supporting members or vertical supports. Historical Permit Search A review of public permit records available online from BuildFax, Inc. indicated the roof covering had NOT been replaced subsequent to the original construction of the residence. Historical Weather Information • A review of historical weather information provided by The Weather Underground indicated that on September 10, 2017, maximum wind gusts of 82 miles per hour and a total of 3.5 inches of precipitation were recorded at Naples Municipal Airport located approximately 14.8 miles from the subject structure. • Storm reports were reviewed from the National Oceanic and Atmospheric Administration, National Centers for Environmental Information, Storm Events Database for Collier County during the period November 2, 2015 through August 1, 2017 (the latest date available). hftp://www.ncdc.noaa.gov/stormevents/ • Storm reports were reviewed from the National Oceanic and Atmospheric Administration, National Weather Service, Storm Prediction Center for the period August 2, 2017 through November 2, 2017, based on the date of the site visit. http://www.spc.noaa.gov/climo/online/ A report of 0.75 inch hail at a location approximately 5.6 miles from the subject structure on July 13, 2016; and A report of wind gust of 69 knots (approximately 79 miles per hour) at a location approximately 13.2 miles from the subject structure on January 17, 2016. It should be noted that although GHD has reviewed the previously referenced information acquired by others and relied on their content, GHD does not guarantee the accuracy of the referenced information. 11151519Eaken-l-Cabrera Roof Assessment 7. Discussion The following analyses/comments discuss GHD's opinions of the observed and reported damage: • On a systemic level, roof tile de -bonding and/or displacement as a result of wind forces will normally first occur along the edges, comers, and ridges of the roof and can progress inward as wind speeds and uplift increase. This behavior of wind forces is recognized by applicable building codes that require these areas to be designed to resist higher forces for a given wind speed compared to the main field of the roof. • To cause the detachment of an individual roof tile secured to the substrate with mechanical fasteners; the wind uplift force must first overcome the dead weight of the tile and must be of sufficient additional magnitude to break the tile or fastener used to secure the tile to the underlayment. The force necessary to break the the or fastener of a properly secured tile is greater than the force necessary to overcome the weight of the tile. Therefore, if wind forces were to affect a tile to the degree necessary to cause detachment, GHD would expect that the the would be displaced from its installed location and/or blown off the roof. • Damage to tile roofs can be caused by wind-borne debris that strikes the roof. Damage from wind- bome debris typically appears as one or more files that are "fragmented," or broken into numerous smaller pieces. S. Limits of Study This document was prepared for the exclusive use of American Strategic Insurance Company and was not intended for any other purpose. The observations and opinions contained herein are based upon information provided to us at the time of this document's preparation. The evaluation performed on the above date was a visual assessment. Areas hidden from view such as ceiling, wall, and floor cavities or other inaccessible areas were not examined. Please note that GHD reserves the right to revise the observations and opinions above as conditions change or additional information becomes available. This document was prepared for our client's use and GHD disavows any liability for use by others. 11151519Eaken-1-Cabrera Roof Assessment GHD appreciates this opportunity to have assisted you with this assessment. Please contact us if you have any questions or need additional information. Sincerely, GHD Florida Engineering Business No.: 9931 Local Address: 5904 Hampton Oaks Parkway, Suite F Tampa, Florida 33610 (813) 971-3882 Vincent D. Wicinski Senior Professional Engineer FL PE #72408 VDWrs/01 Encl. Figure 1 Roof Plan Attachment A Site Photographs 11151519Eaken-1-Cabrera Roof Assessment _43-vmawI" n MW is avoid 6WY Jason Melton Project Coordinator GHD 1 11151519Eaken-1-Cabrera Root Assessment 3 — View of a stain in the ceiling finish along a ceiling board joint above the living room. W -f P ds # # 4 — View of stained and deteriorated roof sheathing within the vicinity above the stained ceiling finish shown in Photograph 2. Apparent microbial growth was present within the stained area. Site Photographs GHD 1 1115151gEaken-1-Cabrera Roof Assessment I Attachment A 5 — View of stained roof sheathing in the viclnny aoove ine bummu uumliv ..• Photograph 3. Several misplaced sheathing fasteners were exposed along a truss chord, Including 1 within the stained area (arrows). 6 — View of roof tiles that had been replaceo in the vicinity or um umul lu,a«u 1 sheathing shown in Photographs 4 and 5. Site Photographs GHD 111151519Eaken-l-Cabrera Roof Assessment I Attachment A � 1 a Ig MOM F� �NLZ , ir 15 — View of repair -like materials that had been applied to a cracked roof tile. 16 — View of repair -like materials that had been applied to a cracked roof tile. Site Photographs GHD 111151519Eaken-l-Cabrera Roof Assessment I Attachment A 17 — View of mechanically Induced cuts Into the surface of a MOT 1118. Site Photographs GHD 111151519Eaken-1-Cabrera Roof Assessment I Attachment A 13 — View of roof tiles that had been replaced. Note the repair iiKe matenai appnea w me cracked roof tile located adjacent to the referenced replaced roof tiles. 14 — View of roof tiles that had been replaced. Site Photographs GHD 1 11151519Eaken-1-Cabrera Roof Assessment I Attachment A O - �•\� �� \ Com\ � - \ C AMRF •ate,: 'LY�a�� - \� F 1 10 \\ I � 4 m 7& 7 — View of missing cap tiles along the southeast oriented hip above the main entrance or the residence. 6 —View of missing cap flies along the southeast oriented hip above the soutneast portion of the residence. Site Photographs GHD 111151519Eaken-1-Cabrera Roof Assessment I Attachment A 1 — View of the east elevation (front) of the subject structure. 2 — View of stain that exhibited a ring-like pattem in the ceiling finish above the uwng room. Site Photographs GHD 1 1115151gEaken-1-Cabrera Roof Assessment I Attachment INSTR 4796900 OR 4883 PG 3106 RECORDED 2/6/2013 4:18 PM PAGES 5 DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT, COLLIER COUNTY FLORIDA DOC@.35 $70.00 REC $44.00 OBLD $20,000.00 STATE HOUSING INITIATIVES PARTNERSHIP (SHIP) PROGRAM SECOND MORTGAGE THIS SECOND MORTGAGE (Security Instrument") is given onday of 4L 20$ The Second Mortgagor is: Angel Vinlcio Cabrera and Silvanta I. Cabrera, a married couple ("Borrower"). This Security Instrument Is given to Collier County SHIP TRUST FUND ("Lender'), which is organized and existing under the laws of the United States of America, and whose address is 3339 E. Tamiami Trail, Naples Florida 36112. Borrower owes Lender the sum of Twenty Thousand and 00/100 go -liars ($20,000.00), Thisdebtis evidenced by Borrowers Note dated the same date as this Security Instrument ("Second Mortgage"), which does not provide for monthly payments. The full debt, If not paid earlier, is due upon sale of the property within the fifteen Year term if sold after the fifteen year term, no repayment is required. As long as the borrower continues to own and occupy the assisted property during the tern of the mortgage, then the loan will not have to be repaid. This Security Instrument secures to Lender. (4) the repayment of the debt evidenced by the Note, with interest, and all renewals, extensions and modifications; (b) the payment of all other sums, with interest advanced under paragraph 7 to protect the security of the Security Instrument and (c) the performance of Borrowers covenants and agreements under this Security Instrument and the Note. For this purpose, Borrower does hereby second mortgage, grant and convey to Lender the following described property located In Collier County, Florida. As more particularly described as Waterways of Naples Unit Two Lot 47, of the Public Records of Colger County, Florida and which has the address of: ("Property Address"): 7 69 Waterloo Ct Naples FL 34120 (Address) (City) (State) (Zip) TOGETHER WiTH all the Improvements now or hereafter erected on the property, and aft easements, rights, appurtenances, rents, royalties, mineral, oil and gas rights and profits, water rights a a urea now or thereafter a part of the property. All replacements and additions shall also be covered by the Security Instru t. h referred to in this Security Instrument as the "Property". BORROWER COVENANTS that Borrower I elf conveyed and has the right to mortgage, grant and convey the Property and that the Property is unen xcept for enambra cord. Borrower warrants and will defend generally the title to the Property against all claims and de n b)ect to any anambrence THIS SECURITY INSTRUMENT comb es ants for national us nd n -uniform covenants with limited variation by Jurisdiction to constitute a uniform security inst men co r al UNIFORM COVENANTS. Borrower nd rider coven ree a foil, wa: 1. Payment of Principal and Ints t; sh II promptly pay when due the principal of and interest on the debt evidenced by the Note. 2. Taxes. The Mortgagor will pay I isis or r ra ep p or to the accrual of any penalties or interest ,� thereon. t'+ The Mortgagor shall pay or cause to d, as the same respecti t>ece d , (1) all taxes and governmental charges of any kind whatsoever which may at any time be I sessed or levied against a the Property, (2) all utility and other charges, including "service charges", incurred or impos operation, maintenan , upkeep and Improvement of the Property, and (3) all assessments or other governmental charg ay lawfully be paid In ns r a period of years, the Mortgagor shall be obligated under the Mortgage to pay or cause to be such Installments as ed to be paid during the term of the Mortgage, and shall, promptly after the payment of any of the forego , �w Mortga f such payment. 3. Application of Payments. Unless apprica a aymerds received by Lender shall be applied; first, to Interest due; and, to principal due; and Iasi, to any late cha 4. Charges; Liens. Borrower shall pay all taxes, assessment , charges, fines and Impositions attributable to the Property which may attain priority over this Security Instrument, and leasehold payments or ground rents, if any. Borrower shall promptly furnish to Lender all notices of amounts to be paid under this paragraph, and all receipts evidencing the payments. Borrower shall promptly discharge any lien which has priority over this Security Instrument unless Borrower. (a) agrees in writing to the payment of the obligation secured by the lien in a manner acceptable to Lender, (b) contests in good faith the lien by, or defends against enforcement of the lien In, legal proceedings which in the Lenders opinion operate to prevent the enforcement of the Yen; or (c) secures from the holder of the Yen an agreement satisfactory to Lender subordinating the lien to this Security Instrument. If Lender determines that any part of the Property is subject to a lien which may attain priority over the Security Instrument, Lender may give Borrower a notice identifying the lien. Borrower shall satisfy the Yen or take one or more of the actions set forth above within 10 days of the giving of notice. 6. Hazard or Property Insurance. Borrower shall keep the Improvements now existing or hereafter erected on the Property insured against loss by fire, hazards included within the term "extended coverage" and any other hazards. Including floods or flooding, for which Lender requires insurance. This Insurance shall be maintained In the amounts and for the periods that Lender requires. The insurance carrier providing the insurance shall be chosen by Borrower subject to Lenders approval which shall not be unreasonably withheld. If Borrower falls to maintain coverage described above, Lender may, at Lenders option, obtain coverage to protect Landers rights in the Property In accordance with paragraph 7. At all times that the Note Is outstanding, the Mortgagor shall maintain insurance with respect to the Premises against such risks and for such amounts as are customarily insured against and pay, as the same become due and payable, all premiums In respect thereto, including, but not limited to , all-risk Insurance protecting the Interests of the Mortgagor and Mortgagee against loss or damage to the Premises by fire, lightning, and other casualties customarily insured against (including boiler explosion, If appropriate), with a uniform standard extended coverage endorsement, Including debris removal coverage. Such Insurance at all times to be In an amount not less than the full replacement cost of the Premises, exclusive of footings and foundations. All Insurance policies and renewals shall be acceptable to Lender and shall Include a standard mortgage clause. Lender shall have the right to hold the policies and renewals. If Lender requires, Borrower shall promptly give to Lender all receipts of pad premiums and renewal notices. In the event of loss, Borrower shall give prompt notice to the Insurance Cartier and Lender. Lender may make proof of loss If not made promptly by Borrower. Unless Lender and Borrower otherwise agree In writing, insurance proceeds shall be applied to restoration or repair of the Property damaged, If the restoration or repair Is economically feasible and Lenders security is not lessened. If the restoration or repair is not economically feasible or Lenders security would be lessened, the insurance proceeds shag be applied to the sums seared by the Security Instrument, whether or not then due, with any excess paid to Borrower. If Borrower abandons the Property, or does not answer within 30 days a notice from Lender that the Insurance carrier has offered to settle a claim, then Lender may collect the insurance proceeds. Lender may use the proceeds to repair or restore the Property orto pay sums secured by this Security Instrument, whether or not then due. The 30 -day period will begin when the notice is mailed. Unless Lander and Borrower otherwise agree In writing, any application of proceeds to principal shall not extend or postpone the due date of the monthly payments referred to in paragraph 1 or change the amount of the payments. If under paragraph 21 the Property is acquired by Lender, Borrowers right to any Insurance policies and proceeds resulting from damage to the Property prior to the acquisition shall pass to Lender to the extent of the stars seared by this Security Instrument immediately prior to the acquisition. 6. Occupancy, Preservation, Maintenance and Protection of the Property; Borrower's Loan Application, Leaseholds. Borrower shall occupy, establish, and use the Property as Borrowers principal residence within sixty days after the execution of this Security Instrument and shall continue to occupy the Property as Borrowers principal residence for at least one year after the date of occupancy, unless Lender otherwise agrees in writing, which consent shall not be unreasonably withheld, or unless extenuating circumstances exist which are beyond Bomowsee control. Borrower shall not destroy, damage or Impair the Property, allow the Property to deteriorate, or commit waste on the Property. Borrower shall be in default if any forfeiture action or proceeding, whether c*ivilt or criminal, is begun that In Lenders good faith OR 4883 PG 3107 judgment could result in forfeiture of the Property or otherwise materially impair the lien created by this Security instrument or Lender's security inleres't 8lomower may cure such a default and reinstate, as provided in paragraph 18, by causing the action or proceeding to be dismissed with a ruling that, In Lender's good faith determination, precludes forfeiture of the Borrowers Interest In the Property or other material Impairment of the lien created by this Security Instrument or Lenders security interest. Borrower shall also be In default if Borrower, during the loan application process, gave materially false or inaccurate information or statements to Lender (or failed to provide Lender with any material Information) In connection with the loan evidenced by the Note, Including, but not limited to, representations concerning Borrowers occupancy of the Property as a principal residence. If this Security Instrument is on a leasehold, Borrower shag comply with all the provision of the lease. If Borrower acquires fee title to file Property, the leasehold and the fee gtie shall not merge unless Lender agrees to the merger In writing. 7. Protection of Lender's Rights In the Property. If Borrower fails to perform the covenants and agreements contained In this Security Instrument; or there is a legal proceeding that may significantly affect Lenders rights in the Property (such as a proceeding in bankruptcy, probate, for condemnation or forfeiture or to enforce taws or regulations), then Lender may do and pay for whatever is necessary to protect the value of the Property and Lenders rights in the Property. Lenders actions may include paying any sums secured by a lien which has priority over this Security Instrument, appearing in court, paying reasonable attomeys' fees and entering on the Property to make repairs. Although Lender may take action under this paragraph 7, Lender does not have to de so. Any amounts disbursed by Lender under this paragraph 7 shall become additional debt of Borrower secured by this Security Instrument Unless Borrower and Lender agree to other terms of payment, these amounts shall bear interest from the date of disbursement at the Note rate and shall be payable, with Interest, upon notice from Lender to Borrower requesting payment 8. Mortgage insurance. If Lender required mortgage insurance as a condition of making the loan secured by this Security Instrument, Borrower shall pay the premiums required to maintain the mortgage insurance in effect. If, for any reason, the mortgage insurance coverage required by Lender lapses or ceases to be In effect, Borrower shall pay the premiums required to obtain coverage substantially equivalent to the mortgage Insurance previously in effect at a cost substantially equivalent to the cost to Borrower of the mortgage insurance previously in effect, from an alternate mortgage insurer approved by Lender. If substantially equivalent mortgage insurance coverage Is not available, Borrower shall pay to Lender each month a sum equal to one -twelfth of the yearly mortgage insurance premium being paid by Borrower when the Insurance coverage lapsed or ceased to be in effect Lender will accept, use and retain these payments as a loss reserve in lieu of mortgage insurance. Loss reserve payments may no longer be required, at the option of Lender, if mortgage insurance coverage (n the amount and for the period that Lender requires) provided by an Insurer approved by Lender again becomes available and is obtained. Borrower shalt pay the premiums required to maintain mortgage Insurance in effect, or to provide a loss reserve, until the requirement for mortgage Insurance ends in accordance with any written agreement between Borrower and Lender or applicable law. 9. Inspection. Lender or its agent may make reasonable entries upon and inspections of the Property. Lender shall give BonDmr notice at the time of or prior to an inspection specifying reasonable cause for the inspection. 10, Condemnation. The proceeds of any award or claim for damages, direct or consequential, In connection with any condemnation or other taking of any part of the Property, or for conveyance in lieu of condemnation, are hereby assigned and shall be paid to Lender. :In the event of a total taking of the Property, the proceeds shalt be applied to the sums secured by this Security instrument, whether or not then due, with any excess paid to Borrower. In the event of a partial to ' 02tf e0 n which the fair market value of the Property Immediately before the taking is equal to or greater than the amount s enrity Instrument Immediately before the taking, unless Borrower and Lender otherwise agree In writing, the y a ant shall be reduced by the amount of the proceeds multiplied by.the following fraction: (a) the total am sums secured imm ' e tore the taking, divided by (b) the fair market value. of the Property immediately before the taking. ce shall be pail to Borrower. n th vent of a partial taking of the Property In which the fair market value of the Property immediate[ be pr In th he aro t of a sums secured immediately for the taking. unless Borrower and Lender otherwise agree I writ" lea app[ ce e therwis rov as, the proceeds shall be applied to the sums secured by this Security Instrument whether o not e m are Un le Lender nd mower otherwise agree in writing, any application of proceeds to principal shall not en e o pa ants referred to in paragraphs 1 or change the amount of such payments. ' 11. Borrower Not Released, Forb a of r of r. ion 1 time for payment or modification of amortization of the sums secured by this S ty l t r to s in Interest of Borrower shall not operate to release the liability of the original Borrower or es successors in Inte Len era be required to commence proceedings against any successor in interest or refuse to a ime for payment or othes i tion of the sums secured by this Security Instrument by reason of any demand made by at Borrower or Burr s n interest Any forbearance by Lender In exercising any right or remedy shad not be a wa eclude the exercise of remedy. 12. Successors and Assigns Bound; n everal Liability; C o . The covenants and agreements of this Security Instrument shall bind and benefit the successors and era Jett to the Provisions of paragraph 17. Borrowers covenants and a several. Any Borrower who co-signs this Security Instrument but does not execute the Note; (e) is co-signing the t only to mortgage, grant and convey that Borrowers Interest In the Property under the terms of this Security Instrument; (b) is not personally obligated to pay the sums secured by this Security Instrument; and (c) agrees that Lender and any other Borrower may agree to extend, modify, forbear or make any accommodations with regard to the terms of this Security Instrument or the Note without that Borrowers consent. 13. Loan Charges. If the loan secured by this Security Instrument is subject to a law which sets maximum ban charges, and that law is finally interpreted so that the Interest or other loan charges collected or to be collected in connection with the ban exceed the permitted limits, then: (a) any such loan charge shall be reduced by the amount necessary to reduce the charge to the permitted i"unit; and (b) any sums already collected from Borrower which exceeded permitted limits will be refunded to Borrower. Lender may choose to make this refund by reducing the principal owed under the Note or by making a direct payment to Borrower. If a refund reduces principal, the reduction will be treated as a partial prepayment without any prepayment charge under the Note. 14. Notices. Any notice to Borrower provided for in this Security Instrument shall be given by delivering it or by mailing it by first class mail unless applicable law required use of another method. The notice shall be directed to the Property Address or any other address Borrower designates by notice to Lender. Any notice to Lender shall be given to Borrower or Lender when given as provided in this paragraph. 15. Governing Law; Severability. This Security Instrument shall be governed by federal law and the law of the jurisdiction in which the Property is located. In the event that any provision or cause of this Security Instrument or the Note conflicts with applicable law, such conflict shall not affect other provisions of this Security Instrument or the Note which can be given effect without the conflicting provislon. To this end the provisions of this Security Instrument and the Note we declared to be severable. 16. Borrower's Copy. Borrower shall be given one conformed copy of the Note and of this Security Instrument. 17. Transfer of the Property ora Beneficial Interest in Borrower. If all or any part of the Property or any Interest in it Is sold or transferred (or if a beneficial Interest in Borrower Is sold or transferred and Borrower is not a natural person) without Lenders prior written consent, Lender may, at its option, require Immediate payment in full of all sums secured by this Security Instrument. However, this option shall not be exercised by Lender if exercise Is prohibited by federal law as of the date of this Security. Instrument. If Lender exercised this option, Lender shall give Borrower notice of acceleration. The notice shall provide a period of not less than 30 days from the date the notice is delivered or mated within which Borrower must pay all sums secured by this Security Instrument If Borrower fails to pay these sums prior to the expiration of this period, Lender may Invoke any remedies permitted by this Security Instrument without further notice or demand on Borrower. 18.. Borrowers Right to Reinstate. If Borrower meets certain conditions, Borrower shall have the right to have enforcement of this Security Instrument discontinued at any time prior to the earlier of : (a) 5 days (or such other period as applicable law may specify for reinstatement) before sale of the Property pursuant to any power of sale contained in this Security Instrument; or (b) entry of a judgment enforcing this Security instrument. Those conditions are that Borrower. (a) pays Lender all sums which then would be due under this Security Instrument and the Note as if no acceleration had occurred; (b) cures and default of any other covenants or agreements; (c) pays all expenses Incurred in enforcing this.Security Instrument, including, but not limited to, reasonable attomeys fees; and (d) takes such action as Lender may reasonably require to assure that the lien of this Security Instrument, Lenders rights In the Property and Borrowers obligation to pay the sums secured by this Security Instrument shall continue unchanged. Upon reinstatement by Borrower, this Security Instrument and the obligations secured hereby shall remain fully effective as If no acceleration had occurred. However, this right to reinstate shall not apply in the case of acceleration under paragraph 17. 19. Sale of Nota; Change of Loan Servicer. The Note or a partial Interest in the Note (together with this Security Instrument) may be sold one or more times without prior notice to Borrower. A sale may result in a change In the entity (known as the 'Loan Servicer") that collects monthly payments due under the Note and this Security Instrument There also may be one or more charges of the Loan Servicer unrelated to a sale of the Note. If there is a change of the Loan Servicer, Borrower will be given written notice of the change In accordance with OR 4883 PG 3108 paragraph 14 and applicable law. The notice will state the name and address of the new Loan Servicer and the address to which payments shout be made. The notice will also contain any other information required by applicable law. 20. Hazardous Substances. Borrower shall not cause or permit the presence, use, disposal, storage, or release of any Hazardous Substances on or in the Property. Borrower shag not do, nor allow anyone else to do, anything affecting the Property that is in violation of any Environmental Law. The preceding two sentences shall not apply to the presence, use, or storage on the Property of small quantities of Hazardous Substances that are generally recognized to be appropriate to normal residential uses and to maintenance of the Property. Borrower shall promptly give Lender written notice for any Investigation, claim, demand, lawsuit or other action by any governmental or regulatory agency or private party involving the Property and any Hazardous Substance or Environmental Law of which Borrower has actual knowledge. If Borrower teams, or Is notified by any governmental or regulatory authority, that any removal or other remediation of any Hazardous Substance affecting the Property is necessary, Borrower shall promptly take all necessary remedial actions In accordance with Environmental Law. As used in this paragraph 20, "Hazardous Substances" are those substances defined as toxic or hazardous substances by Environmental Law and the following substances: gasoline, kerosene, other flammable or toxic petroleum products, toxic pesticides and herbicides, volatile solvents, materials containing asbestos or formaldehyde, and radioactive materials. As used In this paragraph 20, "Environmental Lava' means federal laws and laws of the jurisdiction where the Property is located that relate to health, safety or environmental protection. 21. Acceleration; Remedies. Lender shall give notice to Borrower prior to acceleration following Borrower's breach of any covenant or agreement in this Security Instrument (but not prior to acceleration under paragraph 17 unless applicable law provides otherwise). The notice shall specify: (a) the default; (b) the action required to cure the default; (c) a date, not less than 30 days from the date the notice is given to Borrower, by which the default must be cured; and (d) that failure to cure the default on or before the date specified In the notice may result In acceleration of the sums secured by this Security Instrument, foreclosure by judicial proceeding and sale of the Property. The notice shall further inform Borrower of the right to reinstate after acceleration and the right to assert in the foreclosure proceeding the nonexistence of a default or any other defense of Borrower to acceleration and foreclosure. If the default is not cured on or before the date specified in the notice, Lender, at its option, may require immediate payment in full of all sums secured by this Security Instrument without further demand and may foreclose this Security Instrument by judicial proceeding. Lender shall be entitled to collect all expenses incurred In pursuing the remedies provided In this paragraph 21, including, but not limited to, reasonable attorneys fees and costs of the title evidence. 22. Release. Upon payment of all sums secured by this Security Instrument. Lender shall release this Security Instrument, without charge, to Borrower. Borrower shall pay any recordation costs. 23. Attorneys' Fees. As used In this Security Instrument and the Note, "attorneys' fees" shall include any attomeys' fees awarded by an appellate court. 24. Riders to this Security Instrument If one or more riders are executed by Borrower and recorded together with this Security Instrument, the covenants and agreements of each such rider shall be incorporated Into and shall amend and supplement the covenants and agreements of this Security Instrument as If the rlder(s) were a part of this Security Instrument. (Check Applicable Box) ❑ Adjustable Rate Rider [—]Rate Rate Improv ern Utjt , Condominium Rider ❑ Graduated Payment Rider Ll1-4 Fami V1 econd Home Rider F1Balloon Rider ❑ Biwee ant Rider need Unk Development Rider ❑ Other(s) (specify SIGNING BELOW, Borrower accepts and a s to a co in is S curity Instrument and in any riders) executed by Borrower and recorded with IL U Signed, seped attd delivered In the presence C Witnessfll: d to t `l TIE CI v Witness82: cLC �+—► h re: o -Borrower Silvan I. Cabre: Signature: Address: 769 Waterloo Ct Naples, FL 34120 STATE OFLF ORIDA COUNTY OF COLLIE I hereby certify that on this day, Angel Vinicio Cabrera and Silvana I. Cabrera before me, an officer duly authorized In the state aforesaid and in the county aforesaid to take acknowledgements, personally appeared to me known to be the person(s) described In and who executed the foregoing instrument and acknowledged before me that (He/ she/ they) executed the same for the purpose therein expressed. WITNESS my hand and official seal In the County and State aforesaid day of �71Ai , 2012. My Commission Expires: (�J/ bli s Signature (Seal) ?w 6 S d " ° h u47iaiite( Fmnar ces 5 Lepdan a. a My Ca rftlr°n EE 154454 E'1*1101/16!2016 54 Revised:10/2012 SHIP File#: 11-067 SHIP Purchase Assistance Program Collier County. Housing, Human & Veterans Department 3339 E. Tamiami Trail, Bldg H, Suite 211, Naples, FL 34112 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines #I through #2 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the exception of the Chairman's signature, draw a line through routing lines # I through #2. commlete the checklist_ and forward to the County Attomev Office. Route to Addressees (List in routing order) Office Initials Date 1. Lisa N. Carr CHS (Initial) Applicable) 2. Jennifer A. Belpedio, ACA County Attorney Office Agenda Item Number 16D10 2. BCC Office Board of County Commissioners N/A NOTE: Clerk's attestation is not required. Please do not route this item to Clerk's Board Minutes and Records. CAO please scan document after execution by Chairman and email them to Clerk's Minute and Records for its records. PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above, may need to contact staff for additional or missing information. Name of Primary Staff Lisa N. Carr, Senior Grants Coordinator Phone Number 239-252-2339 Contact / Department CHS (Initial) Applicable) Agenda Date Item was June 12, 2012 Agenda Item Number 16D10 Approved by the BCC Does the document need to be sent to another agency for additional signatures? If yes, N/A Type of Document Insurance Claim Check Endorsement for Number of Original 1 Attached XXXXXXXXX Documents Attached N/A PO number or account n/a n/a n/a number if document is by the Office of the County Attorney. to be recorded All handwritten strike -through and revisions have been initialed by the County Attorney's N/A INSTRUCTIONS & CHECKLIST I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12 Initial the Yes column or mark "N/A" in the Not Applicable column, whichever is Yes N/A (Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature? X 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A provide the Contact Information(Name; Agency; Address; Phone on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be N/A signed by the Chairman, with the exception of most letters, must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike -through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's N/A signature and initials are required. 7. In most cases (some contracts are an exception), the original document and this routing slip N/A should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 06/12/2012 and all changes made during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes, if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the IP BCC, all changes directed by the BCC have been made, and the document is ready for the Chairman's signature. I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12 D c 0 a O --q <co b C7 �o �p 0 r i m I D c 0 C,/)v c v - <co b C7 Z C 0 CD cnx co �.. C:. 0.0 >. �I cc z a „ r n "� w w J m O w Co CTI v rn 00Q Q O O O O O_ J n �1 O d to Z 'N q.,. rn 'FEDERAL RESERVE BOARD OF GOVERNORS REG. G.G. Face of. document is blue. Document security includes: void pantograph, microprinting, coin reactive simulated watermark and thernochromatic ink. _ ... �Pallock design is a cenifiosi�an mark of is Cneck Payment "systems hsweiation. ""' Collier County Community and Human Services Division (CHS) on g_1 Homeowner Insurance Check Endorsement Policy Collier 6unty has provided purchase assistance and/or rehabilitation assistance to income qualifiebecipients. As long as the recipient continues to own and occupy the assisted property during tffe term of the mortgage/lien, then the loan will not have to be repaid. On occasion, the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and receive money to make the repairs. If the insurance claim check is made payable to the homeowner and Collier County, then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to CHS at the address below for check endorsement consideration: VCopy of Homeowner's current insurance policy -Declaration Page. v/ . Copy of insurance company's claim report with worksheet including description of �epairs and costs. 3. Copy of photos of claim damage. �,4. Copy of Insurance check(s�payable to homeowner, first lien holder and Collier County. Homeowner Name: Homeowner Address: Primary Contact Num] Homeowner Email: \115 .Mft ��i Reviewed Approved Ej Denied bitat of Collier County r Humani Our vision is a world where eve.gone hay a simple, decent place to live. Date: -! �? Loan Number: 9161 Borrower/Mortgagor Name: Daniel Reyes and Odaimy Pino Property Address: 2897 47th Street SW Naples, FL 34116 I, the undersigned Borrower/Mortgagor, understand that Habitat for Humanity of Collier County Inc. (the "Bank"), as my mortgage lender, is named as the mortgagee on the insurance claim check I have received. I also understand that the terms of my Deed of Trust or Mortgage require me to apply any insurance proceeds to the restoration or repair of the Property. I understand and agree that Habitat for Humanity of Collier County Inc., will endorse and release insurance claim proceeds in the amount of $ ( 22,000 ) with the check made out the mortgagor as well as to me. I agree to use the insurance claim proceeds for the sole purpose of completing repairs to my Property and to provide the adjuster's claim report. When repairs are complete, I will contact Habitat for Humanity of Collier County Inc., (239) 775-0036 and provide proof of repairs. Borrower Signature e -1///V_ Date Borrower Signatures Date STATE OF FLORIDA COUNTY OF COLLIER ) worn t subscribed, nd acknowledged before me this day of �•� Q , by c� e iii who is eithe personally known by myself or has produced as id tiiic ti n. (SEAL) o ry Public Signature 01 V" MISHAEL GONZALEZMCellZ- '�" `* Pnnted Name '_ MY COMMISSION # GG001647 �c/, !s;f;,;, , EXPIRES June 13, 2020 _ (407) 398-0153 FlorldallotaryService..com My commission expires: HOMEOWNERS DELI ARATION Coverage is provided where premium and limit of liability is shown. Flood coverage is not provided by Cypress Property & Casualty Insurance Company and is not a part of this policy. SECTION I COVERAGE LIMIT OF LIABILITY POLICY PERIOD .....PC.tI.... A MSER ,:•: . 6007202 00 84 12/03/2018 12/03/2019 112:01 PR( f R rt & CAS1 Ai,])'CFH ... INSURAN(.,L (..OM I'ANY $ 933 .45 A.M. Standard Time at the described location ...::....:..:............................. ...... .......... ............................................................................. P_O::BO.X44229:�1ACKS4M .tL E'F�:>3 3T=4221;:>:::;>:::':1=877=564S:Z24:>f60R:ActLiNQUtRfESF:>. < >`:: '> NEW DECLARATION Effective: 12/03/2018 Date Issued: 12/03/2018 Uft D�;::.:.:: >•:':•,:::: ;>: •:•;....... •.•. >:•::>:.....'.:::...... .......... ::...... :1i46t1Q;3 ::.: :::mGgNT ....:. . DANIEL REYES MONZON K & L INSURANCE SERVICES INC ODAIMY GONZALEZ PINO 5251 GOLDEN GATE PKWY STE A 2897 47TH ST SW NAPLES FL 34116-6018 NAPLES FL 34116 INCLUDED Telephone: 239-692-5373 Telephone: 239-234-6553 The residence premises covered by this policy is located at the above insured address unless otherwise stated below: 2897 47TH ST SW NAPLES FL 34116 Coverage is provided where premium and limit of liability is shown. Flood coverage is not provided by Cypress Property & Casualty Insurance Company and is not a part of this policy. SECTION I COVERAGE LIMIT OF LIABILITY PREMIUMS A. DWELLING $ 175, 000.00 $ 933 .45 B. OTHER STRUCTURES $ 3, 500.00 INCLUDED C. PERSONAL PROPERTY $ 43,750.00 INCLUDED D. LOSS OF USE $ 17,500.00 INCLUDED SECTION II COVERAGE By - - — E. PERSONAL LIABILITY $ 300,000.00 INCLUDED F. MEDICAL PAYMENTS $ 5,000.00 INCLUDED OPTIONAL COVERAGES Wind Loss Mit Credit INCLUDED Sub -Limit - Fungi, Rot, Bacteria $10,000/$20,000 INCLUDED ORDINANCE OR LAW INCREASE 25% INCLUDED 8 0 TOTAL POLICY PREMIUM, ASSESSMENTS, FEES, AND ALL SURCHARGES: $ 1,001.00 PLEASE CONTACT YOUR AGENT IF THERE ARE ANY QUESTIONS PERTAINING TO YOUR POLICY. CPC 106 07104 MORTGAGEE'S COPY PAGE 1 OF 4 Njt ' CPC HO 405(12/12) ' CPC NBWL (07/15) COUNTERSIGNED DATE 12/03/2018 CPC 412 (01/17) " CPC 413 (01/17) 'CPC -103 (09/09) 'CPC -107 (12/12) "CPC -127 (09/09) 'CPC-159NP (01/18) Continued on Forms Schedule By - - — .. MORTGAGEE SECOND MORTGAGEE 9161 HABITAT FOR HUMANITY COLLIER COUNTY SHIP 11145 TAMIAMI TRAIL E BLDG H ROOM 211 NAPLES FL 34113 3339 E TAMIAMI TRAIL NAPLES FL 34112 CPC 106 07104 MORTGAGEE'S COPY PAGE 1 OF 4 w(wrowIUFRC nrpi; AOATinni All other perils deductible: $ 1,000.00 Hurricane deductible: $ 3,S00.00 Sinkhole deductible: N/A SECTION I, SECTION II AND OPTIONAL PREMIUMS $ 973.88 EMERGENCY MANAGEMENT TRUST FUND SURCHARGE $ 2.00 MGA POLICY FEE $ 2S.00 Note: The portion of your premium for Hurricane Coverage is $516.00 CFH 6007202 00 84 12/03/2018 12/03/2019 12:01 A . Standard Time at the described location ::PtD:�:H{}JC �44:223>:�i4Git�O�IVIitE> fL:�3�23'1 ��29::�:�:: ;'}=8:�3=:580�52�4: �•Ftk ::. , Li:: �F�.C11�21�5 :::�:�>;�::: :': `: >::: NEW DECLARATION Effective: 12/03/2018 Date Issued: 12/03/2018 :::.. .................. . ......... :.:.:.:.:.:.:.:::................................... I ..,......................... . . 1.......: . ........:...:: < : 8Q5f1ik33 ............................... DANIEL REYES MONZON ODAIMY GONZALEZ PINO 2897 47TH ST SW NAPLES FL 34116 Telephone: 239-692-5373 K & L INSURANCE SERVICES INC 5251 GOLDEN GATE PKWY STE A NAPLES FL 34116-6018 Telephone: 239-234-6553 The residence premises covered by this policy is located at the above insured address unless otherwise stated below: 2897 47TH ST SW NAPLES FL 34116 All other perils deductible: $ 1,000.00 Hurricane deductible: $ 3,S00.00 Sinkhole deductible: N/A SECTION I, SECTION II AND OPTIONAL PREMIUMS $ 973.88 EMERGENCY MANAGEMENT TRUST FUND SURCHARGE $ 2.00 MGA POLICY FEE $ 2S.00 Note: The portion of your premium for Hurricane Coverage is $516.00 TOTAL POLICY PREMIUM, ASSESSMENTS, FEES, AND ALL SURCHARGES $ 11001.00 AN ADJUSTMENT OF 0% IS INCLUDED TO REFLECT BUILDING GRADE FOR YOUR AREA. ADJUSTMENTS RANGE FROM + 1 eta SURCHARGE TO -12% CREDIT. FORM TYPE HO -3 YEAR BUILT 1989 TOWN/ROW HOUSE N CONSTRUCT TYPE M SENIOR/RETIREE N NUMBER OF FAMILIES 1 USE CODE P PROTECTION CLASS 03 MUNICIPAL CODE 999 COUNTY CODE 11 ACCRED BUILDER N PROT DEVICE/FIRE N PROT DEWSPRINKLER N PROT DEVICE/BURGLAR N WIND/HAIL EXCLUSION N ROOF DECK X PROT DEV/SEC COM N ROOF COVER F ROOF SHAPE H OCCUPANCY CODE OWNER OPENING PROTECT X SWR N ROOF/WALL CONNECT S PD CLAIM SURCHARGE N TERRITORY CENSUS BLOCK IBHS N 08/02/05/551/08/01/064/064 120210104111005 BUILDERS RISK CONY N PRIOR INSURANCE Y THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES, WHICH MAY RESULT IN HIGH OUT OF POCKET EXPENSES TO YOU. THIS POLICY CONTAINS A CO -PAY PROVISION THAT MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU. CPC 106 07/44 MORTGAGEE'S COPY PAGE 2 OF 4 m 8 a HOMEOWNERS DECLARATION LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE FROM THE NATIONAL FLOOD INSURANCE PROGRAM. WITHOUT THIS COVERAGE, YOU MAY HAVE UNCOVERED LOSSES. PLEASE DISCUSS THESE COVERAGES WITH YOUR INSURANCE AGENT. COINSURANCE CONTRACT: THE RATE CHARGED IN THIS POLICY IS BASED UPON THE USE OF THE COINSURANCE CLAUSE ATTACHED TO THIS POLICY, WITH THE CONSENT OF THE INSURED. CPC 106 07104 MORTGAGEE'S COPY PAGE 3 OF 4 nt-CC WP) rac>Pe.Riti ticAa,�. rY I COMPANY POitCY PERIOfl PQtICY NUMSER.:::. CFH 6007202 00 84 12103/2018 12/03/2019 12Dt A.M. Standard f ime at the described location ......... P_©: BU�C 44229: JAQI�SOaVVtL� E `:Fi:: 32Z3=4Z1:::::: ;: i:=f77=56£S:Z24::{FfR:ActL i11fQUiR1E8}:< NEW DECLARATION Effective: 12/03/2018 Date Issued: 12/03/2018 ,...,............... ........ .. .... ....................... . .... ... _ .....•..::.:.:.:.:::::.:.:.:.::.::,::»:.:...:..:.:.:.::.;:.::.;:,:.:.:.:.:.. , .....:::::: AGENT-::....-' ... ... ... ........ ..... _....... ?c.t....... . DANIEL REYES MONZON ODAIMY GONZALEZ PINO 2897 47TH ST SW NAPLES FL 34116 Telephone: 239-692-5373 K & L INSURANCE SERVICES INC 5251 GOLDEN GATE PKWY STE A NAPLES FL 34116-6018 Telephone: 239-234-6553 The residence premises covered by this policy is located at the above insured address unless otherwise stated below: 2897 47TH ST SW NAPLES FL 34116 LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE FROM THE NATIONAL FLOOD INSURANCE PROGRAM. WITHOUT THIS COVERAGE, YOU MAY HAVE UNCOVERED LOSSES. PLEASE DISCUSS THESE COVERAGES WITH YOUR INSURANCE AGENT. COINSURANCE CONTRACT: THE RATE CHARGED IN THIS POLICY IS BASED UPON THE USE OF THE COINSURANCE CLAUSE ATTACHED TO THIS POLICY, WITH THE CONSENT OF THE INSURED. CPC 106 07104 MORTGAGEE'S COPY PAGE 3 OF 4 • CPC -302 (01/17) • CPC -345 (12112) • CPC -400 (01/12) • HO -0648 (10/15) .................... .............. ............. CFH 6007202 00 84 —f,12/03/2018 12/03/2019 12:01,A.M. Standard Time at the described location FORMS SCHEDULE (continued from page 1) • CPC -305 (12/12) • CPC -358 (01/17) • CPC -404 (12/13) • OIRB1 1655 (02/10) • CPC -309 (07/15) • CPC -361 (04/12) • CPC360 (01/18) • TOC H03 (09109) • CPC -320 (06/16) • CPC -366 (02/16) • HO -0003 (10/00) CPC -325 (09/09) CPC -392 (02112) HO -0496 (10/00) CPC 106 07/04 MORTGAGEE'S COPY PAGE 4 OF 4 THE LAW OFFICE OF RAMON J. DIEGO, PA THE PRESTO BUILDING 5001 SOUTHWEST 74TH COURT, SUITE 103 M RAMON J. DIEGO, ESQ. IAMI, FLORIDA 33155 ALEXIS A. FERRO, ESQ. ALEXANDRA CASALS, ESQ. Habitat for Humanity of Collier County Att: Ernesto 11145 Tamiami Trail East Naples, Florida 34113 Re: Borrower: Loan No.: Address: August 19, 2019 Via U.S. Mail TELEPHONE 305-350-3102 FACSIMILE 305-350-3103 RAMON@RJDIEGOLAW.COM Daniel Reyes Monzon and Odaimy Gonzalez Pino Date of Loss: 09/10/2017 Dear Loss Draft Disbursement Department: Pursuant to your request, the enclosed check has been endorsed by all parties. Please note the Law Office of Ramon J. Diego, PA has a vested and pecuniary interest in said proceeds. Please in�clude the Law Office of Ramon J. Diego, PA on all disb9'rsements to the mortgagor or the agreed upon fees of $4,400.00 will be made payable to the Law Office of Ramon J. Diego, P.A. in a separate check and mailed to our office at the above mentioned address. Please be advised that if your institution chooses to not provide new checks reflecting the insured's and the Law Office of Ramon J. Diego, P.A., or pay the agreed upon fees directly to my office, we will hold your institution accountable and liable for our fees an d cost. Once again, please be advised that we are requesting that you endorse and return the enclosed check to our office promptly. Please note if your institution chooses to not return the endorsed check, as stated above, we will hold your company accountable and liable for our fees and costs. Thank you in advance for your prompt attention to this matter. If we can be of any furt her assistance please do not hesitate to contact us. Enclosures SETTLEMENT STATEMENT DANIEL REYES MONZON United Property & Casualty Ins. Co. Claim No. 2017FLO59228 DATE: Tuesday, April 9, 2019 AMOUNT A. AMOUNT OF SETTLEMENT: Check #: 502380 $ 22,000.00 TOTAL $ 22,000.00 B. DEDUCTIONS: Law Office of Ramon J. Diego, PA (10%) $ 2,200.00 National Claims Consultants and Estimation Services, LLC (10%) $ 2,200.00 C. COSTS: General Office Expense N/A Filing Fee N/A Service Process Fee N/A D. GRAND TOTAL DEDUCTIONS: $ 4,400.00 E. NET SETTLEMENT PROCEEDS... $ 17,600.00 ** WAIVED AT THIS TIME DESCRIPTION OF COSTS DESCRIPTION DATE CHECK # AMOUNT Filing Fees: N/A N/A WAIVED Service of Process: N/A N/A WAIVED Consultation, Records & Copies: N/A N/A WAIVED Court Reporting -Transcript, etc.: N/A N/A WAIVED Miscellaneous: N/A N/A WAIVED Opening File: N/A N/A WAIVED Appraisal Fee: N/A N/A WAIVED Photocopies: N/A N/A WAIVED Umpire Fee N/A N/A WAIVED Long Distance Telephone Calls: N/A N/A WAIVED Postage & Deliveries: N/A N/A WAIVED Traveling (gas, tolls, etc.) Expenses N/A N/A WAIVED TOTAL EXPENSES: $ - The Closing jStatent was revised, accepted and approved by the undersigned on day of DANIEL REYES MONZON RELEASE OF ALL CLAIMS This Release of All Claims is being made this day of March 13, 2019, by the Claimants/Plaintiffs in this action, Daniel Reyes Monzon and Odaimy Gonzalez Pino, their agents, representatives, heirs, successors, and assigns (hereinafter referred to as "INSURED'). WHEREAS, the INSURED asserts a dispute as to a loss or damages which was/were reported to have occurred on or about September 10, 2017, to property located at 2897 47th ST SW Naples, FL 34116, and which serves as the subject of claim number: 2017FLOS9228 and associated with policy number UHV2842951 04 01. AND WHEREAS, the parties are desirous of resolving this controversy and settling all claims or demands presently pending or hereafter contemplated arising out of this matter; AND WHEREAS, the parties have negotiated and reached an agreement to resolve the dispute, rather than face the expense and uncertainty of litigation; AND WHEREAS, it is understood that this is a settlement of a disputed claim, and by making payment, UNITED PROPERTY & CASUALTY INSURANCE CGMvIFANY ("UNITED") makes no admission of liability, but intends merely to resolve the issues in controversy, avoid further Iitigation, and settle all matters existing between the parties; NOW THEREFORE, the parties agree: I • A complete and total resolution of the Subject Claim for the total amount of ($32.169.55) (Thirty Two Thousand One Hundred Sixty Nine Dollars and 55/100) (the "Settlement Amount"). The Settlement Amount contemplates issuance of payment in new monies in the total amount of $22,000.00 (Twenty Two Thousand Dollars and 00/100) payable in the following manner: Page 1 of 5 Insured(s) Initials Z>-/?— / 0 . & (1) One check made payable to tDANIEL REYES MONZON AND ODIAMY GONZALEZ PINO AND HABITAT FOR HUMANITY AND COLLIER COUNTY -SHIP AND THE LAW OFFICE OF RAMON J. DIEGO, PA), in the amount of $22,000.00 (Twenty Two Thousand Dollars and 00/100) The Settlement Amount also contemplates the prior payments of $6,669.55 (Six Thousand six Hundred Sixty Nine Dollars and 55/100) and application of the policy's deductible of $3,500.00 (Three Thousand Five Hundred Dollars and 00/100). INSURED accepts these payments in accordance with this agreement. This payment represents full and final payment for damages to the insured dwelling, dwelling extension, personal property, additional living expenses, debris removal, law and ordinance coverage, and all other coverages provided under the Homeowner's Policy issued by UNITED, including pre judgment interest thereon. This payment is inclusive of a settlement of INSURED's attorneys' fees and costs, and any other damages they have claimed, are claiming, or may claim in the future against UNITED, including any claim for bad faith. 2. Upon full execution and delivery of this document, plus other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, INSURED, and their successors, assigns, agents, attorneys, and representatives, hereby release and forever discharge UNITED, its predecessors, subsidiaries, parent corporation and affiliates, officers, directors, and/or employees from any and all claims, including but not limited to every claim for breach of contract, damage to the dwelling and dwelling extension, law and ordinance coverage, personal property damage, loss of use/additional living expenses/loss of rents, debris removal, attorneys Page 2 of 5 Insured(s) Initials fees, costs, and any and all bad faith claims, against UNITED arising from or related in any way to the pending litigation or insurance claim number 2017FL059228, made under UNITED's homeowner's policy number UHV2842951 04 01 issued to INSURED, and/or UNITED's investigation, handling, settlement, nonrenewal of the policy, and/or all events from the beginning of time to the end of time arising out of the claim(s). This release is inclusive of any and all claims for wind, water or any other damage, known or unknown to the property located at 2897 47th ST SW Naples, FL 34116. 3. INSURED agrees, as a further consideration and inducement for this compromise settlement, to satisfy any and all liens, including but not limited to attorney liens and/or claims for benefits paid by collateral sources arising out of the above described proceeds, and furthermore, INSURED promises to hold harmless and indemnify UNITED for all claims whereby any third party (including but not limited to mortgagees, unsecured creditors, and secured creditors) alleges that all or part of the sums paid by UNITED should have been paid to said third party. Additionally, INSURED promises to indemnify UNITED for any costs and attorneys' fees incurred in defending any such allegation made by any such third party. 4. INSURED agrees that this Release of All Claims contains the entire agreement between the parties regarding the matters set forth in this document and that this document shall be binding upon INSURED 5. INSURED agrees to fully cooperate and execute any and all supplementary documents and to take all additional actions that may be necessary or appropriate to give full effect to the terms and intent of this document. Page 3 of 5 Insured(s) Initials �,> /Z / 0 & G 6. INSURED declares and represents that no promise, inducement, or agreement not herein expressed has been made to them. 7. INSURED represents and warrants that no other individual or entity other than their attorneys and public adjuster have an interest in, or claim to, any of the settlement proceeds described in this Release of All Claims. 8. INSURED hereby declares that the terms of this Release of All Claims have been completely read and are fully understood (including a translation from English to his/her/their primary language, if requested), and voluntarily accepted for the purpose of making a full and final compromise, as described above, in settlement of any and all claims, disputed or otherwise, resulting from the claim. It is specifically agreed that this Release of All Claims shall be a complete bar to all claims or suits for damages described above of whatever nature, including attorneys' fees, costs, interest, and extra -contractual damages. 9. Through the execution of the release, INSURED represents that they have been represented by counsel in this action, have had a full and fair opportunity to review this Release and secure the advice of counsel before execution, and understand and acknowledge that this Release is a binding agreement. Page 4 of 5 Insured(s) Initials ;�, /2.. / Signed and Seated this '--UY day of 019. 21 % Insured Signatu B Gh A!! C' "04-00iJ Print 7G Innssuu�re,d, fSignatu Print �- ACKNOWLEDGMENT UNDER OATH STATE OF COUNTY OF BEFORE ME, t is day of�..,�......� 2019, came' ,. Spy -%--.M '%` ,' wn to me to be the individual who executed this release, and acknowled ed that he/she fully understands its contents and freely executed same for the sole consideration therein expressed. Personally known Type of Identification Produced Produced Identification .�v. VtMy CJ;�'sion Expires Page 5 of 5 Insured(s) Initials D A / ,e2 6 4 C, ki VIM r � � � k `r� . r, `'. '��,. . _\�. �> � r i�, F "it"� I � ��' 4� '4 - i. ��` �r Ik f. �� K, � — { � �, �� e1� , �� "..,,,ti, �� r� i r ,<' .. e' y rU' r / � i PAY Twenty Two Thousand and 00/900 Dollars TO THE DANIEL REYES MONZON and ODAIMY GONZALEZ PINO and COLLIER ORDER OF COUNTY -SHIP and HABITAT FOR HUMANITY and RAMON J DIEGO, PA Wells Fargo Bank, N.A. San Francisco, GA $ ....22,000.00 Authorized Signature f Authorized Signature ENDO E OtiEGK E yl�' WILL DISAPPEAR AND RE=APPEAR WHEN RUBBED OR EXPOSED TO HEAT. DO NOT WRITE r SIGN 1 STAIVIIP BELOW THIS LINE j DEPOSITORY BANK ENDORSEMENT LOW Z t� t� J. Die�o� p,q.- Esq. "FEDERAL RESERVE COARD OF G4 VERNORS RE-, G.G. Face o` document is blue. Document security includes: # void pantograph, micropri ;ting coin reactitfe simulated watermark and thermochromatic ink .:Padlocs design is a wrtnication mark of tine c�,C6 Payment systems ASaeGIalion. ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines #I through #2 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the excention of the Chairman's shmamre. draw a line through routine lines #1 through #2cmmnlete the checklistand fnrwnrd to the Ctmnty Annmev office Route to Addressees (List in routing order) Office I ' 'a Date 1. Lisa N. Can CHS CHS 2. Jennifer A. Belpedio, ACA County Attorney Office - Q 2. BCC Office 1 Board of County Commissioners " 11 -ac NOTE: Clerk's attestation is not required. Please do not route this item to Clerk's Board Minutes and Records. CAO please scan document after execution by Chairman and email them to Clerk's Minute and Records for its records. PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above. may need to contact staff for additional or missing information. Name of Primary Staff Lisa N. Carr, Senior Grants Coordinator Phone Number 239-252-2339 Contact / Department CHS itia Applicable) Agenda Date Item was June 12, 2012 Agenda Item Number 16D10 Approved by the BCC Does the document need to be sent to another agency for additional signatures? If yes, N/A Type of Document Insurance Claim Check Endo ment for: Number of Original 1 Attached Alvaro Zulua a Documents Attached N/A PO number or account n/a n/a n/a number if document is by the Office of the County Attorney. to be recorded All handwritten strike -through and revisions have been initialed by the County Attorney's N/A INSTRUCTIONS & CHECKLIST V I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip W WS Original 9.03.04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12 Initial the Yes column or mark "N/A" in the Not Applicable column, whichever is N/A (Not appropriate. itia Applicable) 1. Does the document require the chairman's original signature? X 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A provide the Contact Information(Name; Agency; Addr•ess; Phone on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be N/A signed by the Chairman, with the exception of most letters, must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike -through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's N/A signature and initials are required. 7. In most cases (some contracts are an exception), the original document and this routing slip N/A should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by,the BCC on 06/12/2012 and all changes made duringIA is no the meeting have been incorporated in the attached document. The County n option fo� Attorney's Office has reviewed the changes, if applicable. his line 9. Initials of attorney verifying that the attached document is the version approved by the is no BCC, all changes directed by the BCC have been made, and the document is ready for the d tion foi Chairman's signature. V I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip W WS Original 9.03.04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12 Collier County Community and Human Services Division (CHS) Homeowner Insurance Check Endorsement Policy Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage/lien, then the loan will not have to be repaid. On occasion, the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and.receive money to make the repairs. If the insurance claim check is made payable to the homeowner and Collier County, then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to CHS at the address below for check endorsement consideration: ;. Copy of Homeowner's current insurance policy -Declaration Page. ,,2! Copy of insurance company's claim report with worksheet including description of repairs and costs. , . Copy of photos of claim damage. Copy of Insurance check(s) payable to homeowner, first lien holder and Collier County. Homeowner Name: /%mn Homeowner Address: Primary Contact Number:HomeownerEmail: �V LU �C�IV �✓�� ° C M OFFICE USE ONLY Ekr Reviewed CHS- Grant Coordinator Dafe Approved or Nzwk�.. D. .d REORDER 605 - U.S. WENT NO 55M260. 5575506, 5W1 183, EM5353. 591u3H. 6000000 CLAIM NO. 1902FL24002188 POLICY NO. UiCP0000004544 LOSS DATE 12/23/2019 CHECK NO. 34015 DATE 01 /10 /2020 INSURED ALVARO ZULUAGA AMOUNT *****$13,063.20 )0AAI Ak.x(005'0) Universal Insurance Co. of North America P.O. Box 50907 Sarasota, FL 34232 Thirteen Thousand Sixty—Three And 20/100 Dollars *****$13,063.20 PAYEE ALVARO ZULUAGA & FIRSTBANK OF PUERTO RICO & COLLIER COUNTY BOARD OF CNTY COMMISSIONERS 5385 WHITTEN DR Naples FL 34104 REMARKS Dwelling,LO,Cov A HF CLAIMS 1902FL24002188/20011011192600 'fH15 CHECK IS VOID WITHOUT A COLORED BORDER AND BACKGROUND PLUS A KNIGHT A, FINGERPRINT WATERMARK ON THE BACK • HOLD AT ANGLE TO VIEW Universal Insurance Co. of North America 32-2/1110 ! P.O. Box 50907 Sarasota, FL 34232 DATE 01 /10/2020 Regions Bank Tampa, rL POLICY NO. CLAIM NO. REMARKS Dwelling,LO,Cov A HF INSURED ALVARO ZULUAGA Thirteen Thousand Sixty—Three And 20100 Dollars PAY TO THE ORDER OF ALVARO ZULUAGA & FIRSTBANK OF PUERTO RICO & COLLIER COUNTY BOARD OF CNTY COMMISSIONERS 5385 WHITTEN DR Naples FL 34104 Checks over $20,000 require two signatures. *****113,063.20 -< s.M-112 Issmd:.o9ra4v2ats Universal Insurance Company of North America PREMIUM SUMMARY P.O. Box 901036 Fort Worth, TX 76101-2036 Homeowners Policy Service: 1-866-458-4262 Amended Declarations Page Attached Endorsements Premium DECLARATION EFFECTIVE: 09/24/2019 Claims Service: 1-866-999-0898 DIRECT BILL www.universalnorthamedca.com $4,058.00 Reason: Add second Mortgagee -$2,726.00 Policy Number From Policy Period TO. Agent Code UICP0000004544 5. 08J21119 08/23/20 12:01 AM STANDARD TIME 80632 NAMED INSURED AND ADDRESS: AGENT: (305) 383.4464 ALVARO ZULUAGA 5385 WBrrrF.N DR NAPLES FL 34104-5300 SUPRA INSURANCE AT WEST KENDALL INC 9835 SW 72ND ST STE 102 MIAMI FL 33173 Coverage is provided wnere premium and omit or uaomry is shown. Flood coverage is not provided by the Company and is not part of this policy. COVERAGES - SECTION I Coverage A. Dwelling Liability Coverage B. Other Structures Coverage C. Personal Property Coverage D. Loss of Use LIMITS PREMIUM SUMMARY $196,000 $4,121 Basic Coverages Premium —$63 Attached Endorsements Premium Scheduled Property Premium Policy Fee . and Surcharges INCL TOTAL Policy Premium $4,058.00 -$2,726.00 $.00 $27.00 $1,359.00 LOCATION FORM CONST YEAR USE NUM FAM OCCUP PROT CLASS TERRITORY BCEG HO -3 M 1998 Primary 1 Owner 03 551 04 COUNTY FIRE CODE POLICE CODE PERSONAL PROPERTY REPLACEMENT COST PROOF OF PRIOR INSURANCE Collier Y N Y Coverage is provided wnere premium and omit or uaomry is shown. Flood coverage is not provided by the Company and is not part of this policy. COVERAGES - SECTION I Coverage A. Dwelling Liability Coverage B. Other Structures Coverage C. Personal Property Coverage D. Loss of Use LIMITS PREMIUMS $196,000 $4,121 $3,900 —$63 $98,000 INCL $39,200 INCL Premium Charged For Non -Hurricane Exposure: $ 229 Premium Charged For Hurricane Exposure: $1103 SECTION I COVERAGES ARE SUBJECT TO A $2500 NON -HURRICANE DEDUCTIBLE PER LOSS, AND A2% _ $3920 HURRICANE DEDUCTIBLE. COVERAGES - SECTION H Coverage E. Personal Liability Coverage F. Medical Payments LOCATION(S) OF PROPERTY INSURED 5385 WHITTEN DR, NAPLES FL 34104 Comteret®mture UIC AMD 0119 ('nntinnad nn Nrvt poop. LIMITS $100,000 $1,000 INCL INCL Issued: 0912412019 Policy Number From Policy Period To Agertt Code UICP00000045445 08/23/19 08/23/20 12:01 AM STANDARD TIME I 80632 ADDITIONAL INTERESTS MORTGAGEE(S) FIRST MORTGAGEE FIRSTBANK OF PUERTO RICO ISAOA ATIMA PO BOX 9146 SAN JUAN, PR 00908-0146. LOAN NUMBER: 136237R SECOND MORTGAGEE COLLIER COUNTY BROAD OF COUNTY COMMISSIONERS CHS DIVISION 3339 TAMIAMIA TRIAL EAST SUITE 211 NAPLES, FL34112 LOAN NUMBER: TBD POLICY FORMS AND ENDORSEMENTS APPLICABLE TO THIS POLICY NUMBER EDITION DESCRIPTION OIR.911670 10-06 CheeklistofCoverage HO 00 03 10-00 Homeowners 3 Special OIR B 11655 02=10. Hurricane Loss Mitigation Discounts U103 34 01-18 Limited Fungi, Wet/Dry Rot Set 11 Liability UI' 100 01-18 Special Provision -Florida UI 101 02-13 Animal Liability Exclusion UI 102 04-04 Existing Damage Exclusion UI 107 04-04 Home Day Care Exclusion UI 108 06-05 Trampoline Liability Exclusion UI DO 01-06. Deductible Options Notice UI GLB 03-15 GLB Privacy Notice Ill HOJ 07-11 Homeowners Policy Jacket. UI OC 02-16 Outline of Coverage UICNA OL NOTICE 10-05 Important Notice Regarding Ordinance or Law UI HO CGCC `. 01-12 Catastroplile Ground Covei"Collapse OIR B1 1802, 01-12 Mitigation Affidavit UI COVB 09-06 Coverage B -Other Structures Decreased Limits . UICNA 03 51 o -m Calendar Year Hurricane Deductible BCEG Credit Home Age Adj. - Wind Customer Matrix Adjustment Deductible Adjustment Home Age Adj. - AOP Mature Homeowner Discount Wind Mitigation Credit Policy Fees Emergency Mgmt & Preparedness Assist. Trust Fund ORDINANCE" OR LAW COVERAGE = 25% PREMIUMS INCL INCL INCL INCL INCL INCL INCL INCL INCL INCL INCL INCL INCL INCL. INCL INCL . INCL INCL $ -149 $ -381 $ —112 $ -601 $ 109' $ —54 $-1,538 $ 25 $ 2 A rate adjustment of -5.8% has been applied to the base class portion of your wind premium to reflect the Building Code Grade in your area. Adjustments range from a 4 % surcharge to a 46% credit. Property coverage limit may be increased at renewal by an inflation factor measured by the 360Value index. _ UIC AMD 0119 DA(W 9 Issued: 09(2412019 Poliic Number From Policy Period To A ent Code UICP0000004544-5 1 08123119 08 23 20 12:01 AM STANDARD TIME 80632 This replaces all previously issued policy declarations, if any. This policy applies only to accidents, occurrences, or losses which happen during the policy period shown above, unless otherwise noted in the policy. In case of loss under Section I, only that part of loss over the stated deductible applies, unless otherwise noted in the policy. This declarations page together with all policy provisions and any other applicable endorsements completes your policy. This insurance product is not affiliated with the National Flood Insurance Program. THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES, WHICH MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU. LAW AND ORDINANCE: LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. PLEASE DISCUSS WITH YOUR INSURANCE AGENT. X0 YOUR POLICY PROVIDES COLLAPSE THAT R.ESU17 UNINHABITABLE. OTHER FOR SINKHOLE LOSSES. 7 SINKHOLE LOSSES FOR A NEED TO PURCHASE OF AGE FOR A CATASTROPHIC GROUND COVER E PROPERTY BEING CONDEMNED AND 'OUR POLICY DOES NOT PROVIDE COVERAGE Y.PURCHASE ADDITIONAL -COVERAGE FOR Please contact your agent N there are any questions pertaining to your policy. If you are unable to contact your agent, you may reach us at: 866-458-4262 for Customer Service and 866-999-0898 for Claims. . UIC AMID 0119 Universal North America nnivereol rc�mami;: Universal North America Insurance Company �••�M M•• ••�+•^• P.O. Box 50908 Sarasota, FL 34232 888-877-0770 Insured: ALVARO ZULUAGA Property: 5385 WHITTEN DR Naples, FL 34104-5300 Home: 5385 WHITTEN DR Naples, FL 34104-5300 Claim Rep.: Heather Fellows Estimator: Darrel Anderson Claim Number: 1902FL24002188 Date Contacted: 12/31/2019 Date of Loss: 12/23/2019 4:00 PM Date Inspected: 1/2/2020 Date Est. Completed: 1/3/2020 12:56 PM Home: (239) 692-5565 Business: (239) 692-5565 Business: (512) 228-0190 E-mail: danderson@compassadjusting .com Policy Number: UICP0000004544 Type of Loss: Water Damage Date Received: 12/30/2019 2:00 AM Date Entered: 1/2/2020 4:22 PM Price List: FLNA8X_DEC19 Restoration/S ervice/Remo del Estimate: ALVARO ZULUAGA UNIVERSAL NORTH AMERICA OPENING STATEMENT This is a repair estimate. The insurance policy may contain provisions that will reduce any payment that might be made. Receipt of a cop y of this estimate is not to be interpreted as an acceptance of liability. All estimate figures are subject to company review and approval; this is not an authorization to rep air. Authorization to repair or guarantee of payment must come from the owner of the property. No field adjuster or appraiser has the authority to authorize or guarantee payment. The insurer assumes no responsibility for the quality of repairs that might b e made. A copy of this document does not constitute a settlement of this claim. The estimate figures are subject to the insurance company approval. In accordance with the Mortgage Clause provision of y our policy, the Mortgage Company or L en holder may be included as a payee. Since each company has different procedures for endorsing the payment, we suggest you to contact the mortgage company or lien holder directly to determine their procedures for hand ling insurance payments. If your contractor can p erform the work for the covered damages as outlined in the estimate for the gross dollar amount of the estimate, then proceed with the repairs. If the contractors estimate is greater or there are additional damages found, prior to signing any ontracts or proceeding with the work, we ask you to present the contractors item zed estimate to us for review. Universal North America Insurance Company must have the opportunity to evaluate the supplemental request prior to work being done, for any supplemental consideration to be given. You can fax t he paperwork to: 1-866-465-1759 Or you can email it to: claims@uihna.com Or you can mail it to us at: Universal North America Insurance Company P.O. Box 50908 Sarasota, FL 34232 Please make sure to include your name and claim number on any paperwork submitted (Claim number and name needs to be on every sheet). If you incur costs related to permits and fees with the building department for the repair of cov ered damages, please submit the invoice to Universal for consideration. In addition, if t he building department requires code upgrades for the repair of covered damages, and if your policy provides coverage for Ordinance and Law, please forward the documentation from the building department to Universal for consideration. EMM Wy.mnl N"rtL Americo° mrv.�o+�nnoKu..�mim.. Universal North America Universal North America Insurance Company P.O. Box 50908 Sarasota, FL 34232 888-877-0770 Roofl F1 (A) t 00 0 6' ALVARO_ZULUAGA Roof Main Level 2386.98 Surface Area 256.87 Total Perimeter Length 29.49 Total Hip. Length 23.87 Number of Squares 50.50 Total Ridge Length DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 1. Tear off, haul and dispose of comp. shingles - 23.87 SQ 62.07 0.00 1,481.61 (0.00) 1,481.61 Laminated Includes: Dump fees, hauling, disposal, and labor to remove 30-40 year composition shingles and felt. 2. Re -nailing of roof sheathing - complete re -nail 2,386.98 SF 0.31 3.34 743.30 (0.00) 743.30 3. Roofing felt - 30 lb. 23.87 SQ 45.71 22.49 1,113.59 (171.90) 941.69 4. Laminated - High grd - comp. shingle rfg. - w/out felt 27.67 SQ 287.19 243.06 8,189.61 (1,857.68) 6,331.93 15% waste included for a partial hip roof. 5. R&R Ridge cap - High profile - composition shingles 60.00 LF 10.34 13.15 633.55 (100.48) 533.07 6. R&R Gutter / downspout - aluminum - 6" - 75.00 LF 8.66 30.71 680.21 (234.74) 445.47 Gutters are pinned to metal drip edge. 7. R&R Drip edge 196.87 LF 3.20 11.30 641.28 (86.37) 554.91 8. R&R Valley metal 41.10 LF 6.92 5.15 289.56 (39.35) 250.21 9. R&R Continuous ridge vent - aluminum 20.00 LF 10.60 4.14 216.14 (31.67) 184.47 10. R&R Exhaust cap - through roof - 6" to 8" 1.00 EA 107.39 2.31 109.70 (17.66) 92.04 11. R&R Flashing - pipe jack - lead 2.00 EA 86.22 5.35 177.79 (40.90) 136.89 12. Roofing - General Laborer - per hour 0.50 HR 32.52 0.00 16.26 (0.00) 16.26 Labor cost to remove and re -install irrigation rain sensor that is attached to metal drip edge. - 13. Digital satellite system - Detach & reset 1.00 EA 27.76 0.00 27.76 (0.00) 27.76 14. Digital satellite system - alignment and calibration 1.00 EA 83.26 0.00 83.26 (0.00) 83.26 only 15; Taxes, insurance, permits & fees (Bid Item) 1.00 EA 0.00 0.00 0.00 (0.00) 0.00 Per invoice after cost incurred. Totals: Roofl 341.00 14,403.62 2,580.75 11,822.87 Total: Main Level 341.00 14,403.62 2,580.75 11,822.87 Total: Roof 341.00 14,403.62 2,580.75 11,822.87 Interior Main Level ALVARO ZULUAGA 1/3/2020 Page:2 Universal North America Univeianl Nnrtli.Americu° Universal North America Insurance Company P.O. Box 50908 Sarasota, FL 34232 888-877-0770 Master Bath Missing Wall - Goes to Ceiling Door Missing Wall - Goes to Ceiling Missing Wall - Goes to Ceiling Window Door Door Missing Wall - Goes to Ceiling DESCRIPTION 305.15 SF Walls 357.44 SF Walls & Ceiling 4.83 SY Flooring 32.84 LF Coil. Perimeter Height: Sloped 52.29 SF Ceiling 43.47 SF Floor 19.94 LF Floor Perimeter 6" X 217" Opens into MASTER_SHOWE 1' 10" X 6'81' Opens into MASTER SHOWE 9" X 2171' Opens into MASTER_SHOWE 2' X 2'7" Opens into MASTER_SHOWE 4' X 1' 6" Opens into Exterior 2' 6" X 618" Opens into Exterior 216" X 618" Opens into Exterior 2' 4" X 2'7" Opens into MASTER SHOWE QUANTITY UNIT PRICE TAX RCV DEPREC. ACV ' 16. Drywall tapejoint/repair - per LF 2.001,17 6.80 0.04 13.64 (0.10) 13.54 17. Texture drywall - heavy hand texture 4.00 SF 0.86 0.04 3.48 (0.10) 3.38 18. Mask the floor per square foot - plastic and tape - 4 43.47 SF 0.25 0.15 11.02 (0.00) 11.02 mil 19. Mask and prep for paint - plastic, paper, tape (per LF) 32.84 LF 1.39 0.60 46.25 (0.00) 46.25 20. Seal the surface area w/PVA primer - one coat 4.00 SF 0.59 0.01 2.37 (0.11) 2.26 For area of damaged ceiling drywall tape seam. 21. Paint the ceiling -one coat 52.29 SF 0.65 0.40 34.39 (3.08) 31.31 22. Final cleaning - construction - Residential 43.47 SF 0.23 0.00 10.00 (0.00) 10.00 Totals: Master Bath 1.24 121.15 3.39 117.76 ALVARO ZULUAGA 1/3/2020 Page:3 Unk..1 Nordi Ambdce Universal North America Universal North America Insurance Company P.O. Box 50908 Sarasota, FL 34232 888-877-0770 matt Yea Master Shower Height: Sloped f, 3 ZN 40.17 SF Walls 17.11 SF Ceiling 4 a 57.27 SF Walls & Ceiling 0.09 SF Floor w 1 0.01 SY Flooring 0.07 LF Floor Perimeter 14.01 LF Ceil. Perimeter Missing Wall - Goes to Ceiling 6" X 2'71' Opens into MASTER_RATH Door It 10" X 6'8" Opens into MASTER—BATH Missing Wall - Goes to Ceiling 9" X 217" Opens into MASTER—BATH Missing Wall - Goes to Ceiling 2'X 2'7" Opens into MASTER—BATH Window 2'X 2' Opens into Exterior Missing Wall - Goes to Ceiling 214" X 2'7" Opens into MASTER BATH DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 23. Mask the floor per square foot - plastic and tape - 4 0.09 SF 0.25 0.00 0.02 (0.00) 0.02 Mil 24. Mask and prep for paint - plastic, paper, tape (per LF) 14.01 LF 1.39 0.25 19.72 (0.00) 19.72 25. Paint the ceiling - one coat 17.11 SF 0.65 0.13 11.25 (1.00) 10.25 Totals: Master Shower 0.38 30.99 1.00 29.99 ALVARO ZULUAGA 1/3/2020 Page: 4 Universal North America w.e�"tx"m.nmea<"° Universal North America Insurance Company w".��u^. " �,P^••r P:O. Box 50908 Sarasota, FL 34232 - 888-877-0770 Y 9'�q'9 8'• Great Room Height: Peaked 1367.73 SF Walls 695.07 SF Ceiling i 4,° r 2062.80 SF Walls & Ceiling 641.72 SF Floor oc 3 71.30 SY Flooring 115.07 LF Floor Perimeter dI a^ 163.77 LF Ceil. Perimeter pLpn 2'911 X 6'8" Opens into BEDROOM Door -2 Door 2' 8" X 6'81' Opens into BEDROOM -2 Door 2' 4" X 618" Opens into GUEST -BATH Door 2' 8" X 61811 Opens into LAUNDRY Window 4' 4" X 4' 10", Opens into Exterior Door 2'61' X 6'8" Opens into PANTRY Missing Wall - Goes to Ceiling 5' 11" X 416" Opens into GREAT -ROOM Door 9'X 7' 10" Opens into Exterior Door 2'8" X 618" Opens into Exterior 5' X 618" Opens into BEDROOM Door -1 Door Y X 6' 8" Opens into Exterior Window - Goes to Floor 1' X 6'8" Opens into Exterior DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 26. Contents - move out then reset - Extra large room 1.00 EA 133.07 0.00 133.07 - (0.00) 133.07 27. Window blind - horizontal or vertical - Detach & 1.00 EA 33.70 0.00 33.70 (0.00) 33.70 reset 28. Refrigerator - Remove & reset - 1.00 EA 32.10 0.00 32.10 (0.00) 32.10 29. Range - electric - Remove & reset 1.00 EA 32.94 0.00 32.94 (0.00) 32.94 30. Drywall tape joint/repair -per LF 20.00 LF 6.80 0.43 136.43 (0.97) 135.46 For ceiling & wall drywall tape seam in living/dining area. 31. Texture drywall - heavy hand texture 20.00 SF 0.86 0.22 17.42 (0.50) 16.92 For ceiling & wall drywall tape seam in living/dining area. 32. R&R 5/8" drywall - hung, taped, heavy texture, 10.00 SF. 3.02 0.50 30.70 (1.11) 29.59 ready for paint For ceiling drywall above kitchen window. 33. R&R Batt insulation - 10" - R30 - unfaced batt 10.00 SF 1.50 0.57 15.57 (1.28) 14.29 34, R&R 1/2" drywall - hung, taped, heavy texture, 10.00 SF 2.90 0.46 29.46 (1.04) 28.42 ready for paint For wall drywall below kitchen window. 35. R&R Baseboard - 3 1/4" 8.00 LF 3.80 0.68 31.08 (1.53) 29.55 36. Mask the floor per square foot - plastic and tape - 4 641.72 SF 0.25 2:25 162.68 (0.00) 162.68 mil 37. Mask and prep for paint - plastic, paper, tape (per LF) 163.77 LF 1.39 2.98 230.62 (0.00) 230.62 38. Seal the surface area w/PVA primer - one coat 40.00 SF 0.59 0.14 23.74 -(1.07) 22.67 For area of damaged ceiling & wall drywall & tape seams. 39. Paint the walls and ceiling - one coat 2,062.80 SF 0.65 15.88 1,356.70 (121.39) 1,235.31 ALVARO ZULUAGA 1/3/2020 Page:5 Wivnmol Nngh Americo° ln�wanM nM1MNN��u@I/wl 11F4r'PTPTY"N Universal North America Universal North America Insurance Company P.O. Box 50908 Sarasota, FL 34232 888-877-0770 CONTINUED - Great Room QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 40. Paint baseboard - one coat 110.90 LF 0.95 0.54 105.90 (4.15) 101.75 41. Paint baseboard - two coats 8.00 LF 1.45 0.06 11.66 (0.47) 11.19 42. Paint casing - one coat 108.00 LF 0.96 0.60 104.28 (4.62) 99.66 43. Final cleaning - construction - Residential 641.72 SF 0.23 0.00 147.60 (0.00) 147.60 47. R&R Baseboard - 3 1/4" 25.31 2,635.65 138.13 2,497.52 Totals: Great Room 48. Mask the floor per square foot - plastic and tape - 4 117.71 SF 0.25 0.41 29.84 (0.00) Door Window Bedroom I 473.23 SF Walls 592.62 SF Walls 8c Ceiling 13.08 SY Flooring 42.83 LF Cell. Perimeter 5'X6'8" 4' 4" X 4' Height: Peaked 119.39 SF Ceiling 117.71 SF Floor 37.54 LF Floor Perimeter Opens into GREAT_ROOM Opens into Exterior DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 44. Contents - move out then reset 1.00 EA 44.36 0.00 44.36 (0.00) 44.30 45. Window blind - horizontal or vertical - Detach & 1.00 EA 33.70 0.00 33.70 (0.00) 33.70 reset 46. R&R 1/2" drywall - hung, taped, heavy texture, 10.00 SF 2,90 0.46 29.46 (1.04) 28.42 ready for paint For wall drywall below window. 47. R&R Baseboard - 3 1/4" 11.00 LF 3.80 0.94 42.74 (2.11) 40.63 48. Mask the floor per square foot - plastic and tape - 4 117.71 SF 0.25 0.41 29.84 (0.00) 29.84 mil 49. Seal the surface area w/PVA primer - one coat 10.00 SF 0.59 0.04 5.94 (0.27) 5.67 For area of damaged wall drywall. 50. Paint the walls - one coat 473.23 SF 0.65 3.64 311.24 (27.85) 283.39 51. Paint baseboard - one coat 26.54 LF 0.95 0.13 25.34 (1.00) 24.34 52. Paint baseboard - two coats 11.00 LF 1.45 0.08 16.03 (0.65) 15.38 53. Paint casing - one coat 40.00 LF 0.96 0.22 38.62 (1.71) 36.91 54. Final cleaning - construction - Residential 117.71 SF 0.23 0.00 27.07 (0.00) 27.07 5.92 604.34 34.63 569.71 Totals: Bedroom 1 ALVARO ZULUAGA 1/3/2020 _ Page:6 am=„ Universal North America Universal North A.ed.W Universal North America Insurance Company ln�o"".•w„� x P.O. Box 50908 Sarasota, FL 34232 888-877-0770 Door Door Door Door Window Bedroom 2 400.58 SF Walls 563.95 SF Walls & Ceiling 17.86 SY Flooring 54.10 LF Ceil. Perimeter Height: Sloped 163.37 SF Ceiling 160.75 SF Floor 42.75 LF Floor Perimeter 2'8" X 6'8" Opens into GUEST -BATH 2' 8" X 6' 8" Opens into GREAT -ROOM 21911 X 618" Opens into GREAT -ROOM 2' 10" X 6'8" Opens into Exterior 404" X 4' Opens into Exterior DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 55. Contents - move out then reset 1.00 EA 44.36 0.00 44.36 (0.00) 44.36 56. Window blind - horizontal or vertical - Detach & 1.00 EA 33.70 0.00 33.70 (0.00) 33.70 reset 57. R&R 5/8" drywall - hung, taped, heavy texture, 20.00 SF 3.02 0.99 61.39 (2.23) 59.16 ready for paint ' 58. R&RBatt insulation - 10" - R30 - unfaced batt 20.00 SF 1.50 1.15 31.15 (2.58) 28.57 59. Mask the floor per square foot - plastic and tape - 4 160.75 SF - 0.25 0.56 40.75 (0.00) 40.75 mil 60. Mask and prep for paint - plastic,; paper, tape (per LF) 54.10 LF 1.39 0.98 76.18 (0.00) 76.18 61. Seal the surface area w/PVA primer - one coat 20.00 SF 0.59 0.07 11.87 (0.54) 11.33 For area of damaged ceiling drywall. 62. Paint the walls and ceiling - one coat 563.95 SF 0.65 4.34 370.91 (33.19) 337.72 63. Final cleaning - constmetion - Residential 160.75 SF 0.23 0.00 36.97 (0.00) 36.97 Totals: Bedroom 2 8.09 707.28 38.54 668.74 Door Door DESCRIPTION Garage 64. Contents - move out then reset - Large room 65. Shelving - Detach & reset ALVARO_zULUAGA 514.81 SF Walls 888.75 SF Walls & Ceiling 41.55 SY Flooring 77.35 LF Cell. Perimeter 16'X 7' 2'8"X6'8" Height: 8'4" 373.94 SF Ceiling 373.94 SF Floor 58.68 LF Floor Perimeter Opens into Exterior Opens into LAUNDRY QUANTITY UNIT PRICE TAX, RCV DEPREC. ACV 1.00 EA 66.54 0.00 66.54 (0.00) 66.54 15.00 LF 8.80 0.02 132.02 (0.00) 132.02 1/3/2020 Page:7 MEM Univereel N96 Americo° ,vwarc�wMeNNi,uryTs,i DESCRIPTION Universal North America Universal North America Insurance Company P.O. Box 50908 Sarasota, FL 34232 888-877-0770 CONTINUED - Garage QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 66. Drywall tape joint/repair -per LF 12.00 LF 6.80 0.26 81.86 (0.59) 81.27 For damaged ceiling & wall tape seam, Totals: Debris Removal 0.00 157.86 0.00 67. Texture drywall - heavy hand texture 12.00 SF 0.86 0.13 10.45 (0.30) 10.15 For area of damaged drywall tape seam. 5,429.53 269.20 5,160.33 Total: Interior 68. Mask the floor per square foot - plastic and tape - 4. 373.94 SF 0.25 1.31 94.80 (0.00) 94.80 mil 69. Mask and prep for paint -plastic, paper, tape (per LF) 77.35 LF 1.39 1.41 108.93 (0.00) 108.93 70. Seal the surface area w/PVA primer - one coat 12.00 SF 0.59 0,04 7.12 (0.32) 6.80 For area of damaged drywall tape seam. 71. Paint the walls and ceiling - one coat 888.75 SF 0.65 6.84 584.53 (52.30) 532.23 72. Final cleaning - construction - Residential 373.94 SF 0.23 0.00 86.01 (0.00) 86.01 Concrete floor has a painted surface. Totals: Garage 10.01 1,172.26 53.51 1,118.75 Debris Removal DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 73. Haul debris - per pickup truck load - including dump 1.00 EA 157.86 0.00 157.86 (0.00) 157.86 fees Totals: Debris Removal 0.00 157.86 0.00 157.86 Total: Main Level 50.95 5,429.53 269.20 5,160.33 50.95 5,429.53 269.20 5,160.33 Total: Interior Line Item Totals: ALVARO ZULUAGA 391.95 19,833.15 2,849.95 16,983.20 ALVARO ZULUAGA 1/3/2020 Page: 8 T U.1womal NonL Americo mw�p.�+neuu...mnu. Universal North America Universal North America Insurance Company P.O. Box 50908 Sarasota, FL 34232 888-877-0770 Grand Total Areas: 3,477.45 SF Walls 1,404.97 SF Floor 0.00 SF Long Wall 1,404.97 Floor Area 2,787.66 Exterior Wall Area 2,386.98 Surface Area 50.50 Total Ridge Length ALVARO ZULUAGA 1,497.88 SF Ceiling 156.11 SY Flooring 0.00 SF Short Wall 1,576.57 Total Area 218.07 Exterior Perimeter of. Walls 23.87 Number of Squares 29.49 Total Hip Length 4,975.33 SF Walls and Ceiling 317.05 LF Floor Perimeter 451.01 LF Ceil. Perimeter 3,687.80 Interior Wall Area 0.00 Total Perimeter Length 1/3/2020 Page:9 MEM Univomd N.M. Americo° Universal North America Universal North America Insurance Company P.O. Box 50908 Sarasota, FL 34232 888-877-0770 Line Item Total Material Sales Tax Replacement Cost Value Less Depreciation Actual Cash Value Less Deductible Net Claim Total Recoverable Depreciation Net Claim if Depreciation is Recovered Summary for Coverage A - Dwelling Darrel Anderson 19,441.20 391.95 $19,833.15 (2,849.95) $16,983.20 (3,920.00) $13,063.20 2,849.95 $15,913.15 ALVARO ZULUAGA 1/3/2020 Page: 10 Universal North America Univored Noah Americo Universal North America Insurance Company m •^ m •••mow^ P.O. Box 50908 Sarasota, FL 34232 888-877-0770 Recap of Taxes Material Sales Tax (7%) Laundering Tax (2%) Manu£ Home Tax (6%) Storage Rental Tax (7%) Line Items 391.95 0.00 0.00 0.00 Total 391.95 0.00 0.00 0.00 ALVARO ZULUAGA 1/3/2020 Page: 11 Universal North America Univcrenl NonL Americo° Universal North America Insurance Company W� •^� P.O. Box 50908 Sarasota, FL 34232 888-877-0770 Recap by Room Estimate: ALVARO ZULUAGA Area: Roof Area: Main Level Boon Area Subtotal: Main Level Area Subtotal: Roof Area: Interior Area: Main Level Master Bath Master Shower Great Room Bedroom 1 Bedroom 2 Garage Debris Removal Area Subtotal: Main Level Area Subtotal: Interior Subtotal of Areas Total 14,062.62 72.33% 14,062.62 72.33% 14,062.62 72.33% 119.91 0.62% 30.61 0.16% 2,610.34 13.43% 598.42 3.08% 699.19 3.60% 1,162.25 5.98% 157.86 0.81% 5,378.58 27.67% 5,378.58 27.67% 19,441.20 100.00% 19,441.20, 100.00% ALVARO ZULUAGA 1/3/2020 Page: 12 Universal North America W, mal &;6 A¢j.dcd, Universal North America Insurance Company w^ ^=��w9 �• P.O. Box 50908 Sarasota, FL 34232 888-877-0770 Items APPLIANCES CLEANING CONTENT MANIPULATION GENERAL DEMOLITION DRYWALL ELECTRICAL -SPECIAL SYSTEMS FINISH CARPENTRY / TRIMWORK INSULATION PAINTING ROOFING SOFFIT, FASCIA, & GUTTER WINDOW TREATMENT Subtotal Material Sales Tax Total Recap by Category with Depreciation RCV Depree. 65.04 307.65 288.33 2,066.57 388.66 7.45 111.02 195.08 3.40 33.60 3.61 3,798.64 237.13 11,475.76 2,192.52 609.75 219.38 101.10 19,441.20 391.95 19,833.15 2,663.49 186.46 2,849.95 GCOiL 65.04 307.65 288.33 2,066.57 381.21 111.02 191.68 29.99 3,561.51 9,283.24 390.37 101.10 16,777.71 205.49 16,983.20 ALVARO ZULUAGA 1/3/2020 Page: 13 '�.� �,��--.aC�•� k?„�' It ��. ��SA r �R g it k §'q:. ti,l. �4 £ VII f y�� .. _. _. .. af;d.;K.,v. .�~LA `¢T 'C.L ��#Q°d�•i s��i IF coo p a s YS`Av_.'rt v R h p •r% 5� i y C d N= � I 9 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines #I through #2 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the excention of the Chairman's signature. draw a line throueh routine lines #1 throueh #2. comolete the checklist. and forward to the Countv Attomev Office. Route to Addressees (List in muting order) Office Initials Date 1. Lisa N. Carr Community and Human Services INC 3/12/2020 2. Jennifer Belpedio County Attorney Office Agenda Item Number 3 / 131 db 3. BCC Office Board of County Commissioners LNC 4. Insurance Claim Check Number of Original 1 G ra PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above, may need to contact staff for additional or missing, information. Name of Primary Staff Lisa N. Carr, Senior Grants Coordinator, Phone Number 239-252-2339 Contact / Department Community and Human Services Initial Applicable Agenda Date Item was June 12, 2012 Agenda Item Number 16D 10 Approved by the BCC Does the document need to be sent to another agency for additional signatures? If yes, LNC Type of Document Insurance Claim Check Number of Original 1 Attached Endorsement: Reidel Serrano Documents Attached LNC signed by the Chairman, with the exception of most letters, must be reviewed and signed Check PO number or account by the Office of the County Attorney. number if document is N/A LNC to be recorded Office and all other parties except the BCC Chairman and the Clerk to the Board INSTRUCTIONS & CHECKLIST I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip W WS Original 9.03.04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12 Initial the Yes column or mark "N/A" in the Not Applicable column, whichever is Yes N/A (Not appropriate. Initial Applicable 1. Does the document require the chairman's original signature? LNC 2. Does the document need to be sent to another agency for additional signatures? If yes, LNC provide the Contact Information (Name; Agency; Address; Phone) on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be LNC signed by the Chairman, with the exception of most letters, must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike -through and revisions have been initialed by the County Attorney's LNC Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the LNC document or the final negotiated contract date whichever is applicable. 6. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's LNC si nature and initials are required 7. In most cases (some contracts are an exception), the original document and this routing slip LNC should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 6/12/2012 and all changes made during �/A is not the meeting have been incorporated in the attached document. The County an option foi Attorney's Office has reviewed the changes, if applicable. this line) 9. Initials of attorney verifying that the attached document is the version approved by theN/A is not BCC, all changes directed by the BCC have been made, and the document is ready for the option to Chairman's signature. thi line, I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip W WS Original 9.03.04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12 Instructions 1) Please return two Chairman signed originals (stamped) of each to: Lisa N. Car Sr. Grants, Coordinator Collier County Government I Community and Human Services 3339 E. Tamiami Trail, Bldg. H, Suite 211 Naples, FL 34112 1: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip W WS Original 9.03.04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12 I/ & I§ .i\ ca065 \ « ƒ \ � � / 3 2 © /e / ? / §} < / Gw o « U) § « \� § § \ , m ¥� \ S 42 »z \ §\ ƒ/ § \ w\ ƒ§ 16 �\ \ ( . .$) T. M \ — , m_. . .a . CoINer County -.Board of 1:'nYkxiTFiroURu6 MARQUISBANK aKA ®i W®MRRA CIRCLE. STE.125 70 Collier County Community and Human Services Division (CHS) Homeowner Insurance Check Endorsement Policy Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage/lien, then the loan will not have to be repaid. On occasion, the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and receive money to make the repairs. If the insurance claim check is made payable to the homeowner and Collier County, then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to CHS at the address below for check endorsement consideration: 1. Copy of Homeowner's current insurance policy -Declaration Page. �2. Copy of insurance company's claim report with worksheet including description of repairs and costs. �3. Copy of photos of claim damage. 4. Copy of Insurance check(s) payable to homeowner, first lien holder and Collier County. Homeowner Name: �rmo Homeowner Address: 53 fL D -Ter `�3 W WM1 Aes Gl - -3A\16 Primary Contact Number: 239 5 6 q g 3 9 o Homeowner Email: OFFICE USE ONLY C4jVl-- �eviewed 4CH -CH -e—antoordi or Date i xApproved CH ireetor Date Denied ,P'<-^kka PeoptelsT rust. t U -t Innerance Company SlmpfY a fief to Wey 18 People's Trust Way Deerfield Beach, FL 33441-6270 Policy Number: PFL367221-02 Important Phone Numbers Customer Service: 800.500-1818 To Report a Claim: 677-333.1230 Mortgagee Fax: 561.282-0627 Main Fax: 561-807-0811 www PTI Insure People's Trust Insurance Company Homeowners Declarations Page Insured's Name and Mailing Address: REIDEL SERRANO 2715 53RD TER SW NAPLES, FL 34116-7655 Insured Location (Residence Premises): 2715 53RD TER SW NAPLES, FL 34116-7655 County: COLLIER All Other Perils Deductible: $2,500 Hurricane Deductible: $12,625 (5% of Coverage A) Effective Date: 06/26/2019 Expiration Date: 06/26/2020 12:01 a.m. Eastern Time at the location of the Residence Premises Your Agency: GLV INSURANCE AGENCY INC DBA INSURANCE EXPRESS.COM (0035/00-00) 2005 VISTA PARKWAY SUITE 200 WEST PALM BEACH, FL 33411 (561)471-9813 Deductibles Sinkhole Deductible: No Coverage Coverage is only provided where a limit of liability and a premium is shown. Property and Liability Coverage Coverage A. Dwelling Coverage B. Other Structures Coverage C. Personal Property Coverage D. Loss of Use Coverage E. Personal Liability Coverage F. Medical Payments to Others Limit of Liability $252,494 EXCL EXCL $25,249 $100,000 $2,000 Total Base Premium Optional coverages andAdjustments- HOFL E008 (02116) Request to Exclude Contents Coverage A009 (11/07) Ordinance or Law Coverage Selection Form Fungi, Wel or Dry Rot, or Bacteria Coverage E023 (01119) Preferred Contractor Endorsement HOFL WTRBCKUP (01/19) Water Back -Up and Sump Overflow Coverage 25 $10,000 $5,000 Total Optional Coverages and Adjustments Mandatory Additional Charges Emergency Management Preparedness & Assistance Trust Fund Managing General Agency Fee Total Mandatory Additional Charges Annual Premium $2,301.00 EXCL -$66.00 INCL $15.00 INCL $2,250.00 INCL INCL INCL $(61.00) $25.00 $(36.00) $2.00 $25.00 $27.00 PTIC D001 (01119) Page 1 of 4 Policy Number: PFL367221-02 Total Annual Policy Premium: (Including Assessments and All Surcharges) The portion of your premium for Hurricane Coverage is: $1,291.00 $733.00 The portion of your premium for All Other Coverage is: $425.00 Policy Forms and Endorsements NOCPT (01/19) A002 (11/07) A007 (10/16) A009 (11/07) E023 (01/19) DO (01/19) H03 OC (01/19) E005 (11/07) HOFL E008 (02/16) HOFL E016 (01/19) HOFL WTRBCKUP (01/19) OIR-B1-1670 (01-01-06) P003 (01/19) PTIC INSCR 1117 Roof Decking Age of Home Surcharge Hurricane Year of Construction Surcharge Deductible Adjustment Building Code Effectiveness Grading Surcharge Wind Mitigation Credit Senior Discount Rating Credits and Surcharges Rating Information - Form Type HO -3 Wind/Hail Excluded Year Built 1989 Terrain Construction Type Frame Roof Covering County COLLIER Roof Decking Territory 551 Roof Deck Attachment Census Block Group 120210104191 Roof to Wali Connection Protection Class 3 Roof Shape BCEGS X99 Secondary Water Resistance Burglar Alarm NO Opening Protection Fire Alarm NO FBC Wind Speed Automatic Fire Sprinkler None Wind Speed Design Debris Region $156.00 $34.00 $(369.00) $13.00 $(716.00) $(48.00) NO B FBC Equivalent Dimensional Lumber (Wood) A - 6d @ 6in / 12in Clip Other NO None N/A N/A NO PTIC D001 (01/19) Page 2 of 4 UP Cn� I Keep Policy Number: 10969822,01 the FLOOD POLICY DECLARATIONS INSURANCE' Promise' United Property & Casualty Insurance Co. Standard Policy Type: New Business Reference Number: 87062241592019 Policy Period: 11/15/2019 To 11/15/2020 For payment status, call: (888) 245-7274 Original New Business Effective Date: 11/15/2019 These Declarations are effective Reinstatement Date: as of: 11/15/2019 at 12:01 AM Form: Dwelling NFIP Policy Number: 8706224159 Agent/Agency #: 8005074 Reference#:09430-01233-000 Phone#: (239)205-1500 Property Location: 2715 53RD TER SW NAPLES, FL 34116-7655 Primary Residence: Y Premium Payor: 1st Mortgagee Flood Risk/Rated Zone: AHB Current Zone: Community Number: 12 0067 0412 H Community Name: COLLIER COUNTY Grandfathered: No Post -Firm Construction Program Type: Regular Insured Name and Mailing Address: SERRANO, REIDEL 2715 53RD TER SW NAPLES, FL 34116-7655 NAIC Number: 1o969 Processed by: Flood Insurance Processing Center P.O. Box 2057 Kalispell MT 59903-2057 Building Description: Single Family One Floor slab On Grade Main House N/A Newly Mapped into SFHA: Elev Diff: 2 Elevated Building: N No Addition(s)and Extension(s) Replacement Cost: $250,000 Number of Units: 1 $uiIdirig ,. 250,000 .280 / .080 1,250 6- 319.00 i�inntflIltS: I'. 60,000 .380 / .130 1,250 3- 138.00 G'ontorits ! Lowest Floor Only Above D5 dtioffi Ground Level Coverage Limitations May Apply. See Your Policy Form for Details. First Mortgage: Loss Payee: PENNY MAC LOAN SERVICES LLC PO BOX 514387 LOS ANGELES, CA 90051-4387 Loan#: 8012947059 Second Mortgage: Disaster Agency: To www.fema.gov/cost-of-flood for more ;�Pri� Secretary cost 452.00 115.00 51.00 25.00 50.00 .00 .00 469.00 Producer Name and Mailing Address: FLB ENTERPRISES LLC FLB INSURANCE AGENCY 1716 CAPE CORAL PKWY E I,-11 CAPE CORAL, FL 33904-9620 NFIP Policy Number: 8706224159 Agent/Agency #: 8005074 Reference#:09430-01233-000 Phone#: (239)205-1500 Property Location: 2715 53RD TER SW NAPLES, FL 34116-7655 Primary Residence: Y Premium Payor: 1st Mortgagee Flood Risk/Rated Zone: AHB Current Zone: Community Number: 12 0067 0412 H Community Name: COLLIER COUNTY Grandfathered: No Post -Firm Construction Program Type: Regular Insured Name and Mailing Address: SERRANO, REIDEL 2715 53RD TER SW NAPLES, FL 34116-7655 NAIC Number: 1o969 Processed by: Flood Insurance Processing Center P.O. Box 2057 Kalispell MT 59903-2057 Building Description: Single Family One Floor slab On Grade Main House N/A Newly Mapped into SFHA: Elev Diff: 2 Elevated Building: N No Addition(s)and Extension(s) Replacement Cost: $250,000 Number of Units: 1 $uiIdirig ,. 250,000 .280 / .080 1,250 6- 319.00 i�inntflIltS: I'. 60,000 .380 / .130 1,250 3- 138.00 G'ontorits ! Lowest Floor Only Above D5 dtioffi Ground Level Coverage Limitations May Apply. See Your Policy Form for Details. First Mortgage: Loss Payee: PENNY MAC LOAN SERVICES LLC PO BOX 514387 LOS ANGELES, CA 90051-4387 Loan#: 8012947059 Second Mortgage: Disaster Agency: To www.fema.gov/cost-of-flood for more ;�Pri� Secretary cost 452.00 115.00 51.00 25.00 50.00 .00 .00 469.00 PRIVACY NOTICE Protecting the privacy and confidentiality of information about out customers is very important to us. While information is the cornerstone of our ability to provide superior insurance products, our most important asset is our customers' trust. Accordingly, we limit the collection and use of customer information to the minimum we require in delivering superior products and services. This privacy policy includes examples of the types of nonpublic personal information we collect and the kinds of companies with whom we may share such information. You do not need to do anything in response to this notice. This notice is merely to inform you about how we safeguard your information. Information We Collect We know that you expect us to conduct and process your business in a manner that is both accurate and efficient. To do so, we gather information about you that is pertinent to the underwriting process, such as: Your name, address, telephone number, social security number, age, and employer; Prior insurance coverage, claims history, premiums and payment history; Information from consumer reporting agencies, public records, and data collection agencies. Information We May Disclose We do not disclose any nonpublic personal information about our customers or former customers to anyone, except for information that we may be required by law to disclose. We also may disclose information in order to provide customer service or administer your account. For example, we may use another party to perform services for us, such as providing customer assistance, handling claims, protecting against fraud, and maintaining or developing software for us. We also may disclose information in response to requests from law enforcement agencies or state insurance authorities. Securi To safeguard your nonpublic personal information, we limit access to our customers' nonpublic personal information to only those employees who need access to the information to perform their job functions. Additionally, we insist that the distributors and other companies that perform services for us limit access to your personal information to authorized employees and agents, and maintain appropriate administrative, physical, electronic and procedural safeguards. Ademar The Public Adjusting Firm Inc. EtA41naf Ademar The Public Adjusting Firm Inc. 13055 SW 42nd Street Suite 204 Miami, FL 33175 Insured: Reidel Serrano Property: 2715 53rd Terrace SW Naples, FL 34116 Claim Number: CFL17534731 Policy Number: PFL17534731 Date of Loss: 9/10/2017 12:00 AM Date Received: Date Inspected: Date Entered: Price List: FLM18X_FEB18 Restoration/Service/Remodel Estimate: REIDEL-SERRANO Type of Loss: Wind Damage 4/5/2018 6:15 PM Ademar The Public Adjusting Firm Inc. .jl�clemar Ademar The Public Adjusting Firm Inc. 13055 SW 42nd Street Suite 204 Miami, FL 33175 Main Roof REIDEL-SERRANO Main Roof 2421.48 Surface Area 222.31 Total Perimeter Length 24.21 Number of Squares 83.27 Total Ridge Length DESCRIPTION 250. R&R Drip edge* 251. R&R Fascia - 1" x 8" - #2 pine 252. R&R Valley metal 253. R&R Sheathing -plywood - 5/8" QUANTITY 222.31 LF 222.31 LF 33.26 LF 2,421,48 SF UNIT PRICE 13.02 4.16 6.60 2.14 TAX 155.31 16.81 3.73 138.99 O&P 609.96 188.32 44.64 1,064.20 RCV 3,659.75 1,129.94 267.89 6,385.16 DEPREC. (0.00) (0.00) (0.00) (0.00) ACV 3,659.75 1,129.94 267.89 6,385.16 CDX6,386.89 254. Ice & water shield 255. R&R Flashing - pipe jack - lead 256. R&R Flashing - pipe jack 257. Remove Laminated - Premium grd - 2,421.48 SF 3.00 EA 3.00 EA 24.21 SQ 2.17 75.36 52.72 57.49 67.80 6.72 1.97 0.00 1,064.48 46.56 32.04 278.36 6,386.89 279.36 192.17 1,670.19 (0.00) (0.00) (0.00) (0.00) 279.36 192.17 1,670.19 comp. shingle rfg. - w/ felt 258. Laminated - Premium grd - comp. 28.00 SQ 395.69 275.03 2,270.86 13,625.21 (0.00) 13,625.21 shingle rfg. - w/ felt 259. Roofing felt- 3016. 260. R&R Roof vent - turbine type 261. Ridge cap -synthetic composite 24.21 SQ 3.00 EA 83.27 LF 44.84 124.55 9.34 22.59 12.08 28.97 221.64 77.16 161.34 1,329.81 462.89 968.05 (0.00) (0.00) (0.00) 1,329.81 462.89 968.05 shingles 400.00 SF 2.43 10.92 147.56 973.52 5,841.08 0.00 Totals: Main Roof Totals: Terrace 730.00 6,059.56 36,357.31 0.00 36,357.31 Terrnee Te. F5 400.14 Surface Area 80.01 Total Perimeter Length 4.00 Number of Squares 2/21/2020 Page:2 REIDEL-SERRANO QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV DESCRIPTION 7.22 134.96 604.60 3,627.56 (0.00) 3,627.56 264. R&R Soffit - wood - tongue & groove 400.00 SF 172.34 1,034.02 (0.00) 1,034.02 265. Sand wood - exterior 400.00 SF 2.15 1.68 196.58 1,179.50 (0.00) 1,179.50 266. Stain &finish wood soffit* 400.00 SF 2.43 10.92 147.56 973.52 5,841.08 0.00 5,841.08 Totals: Terrace 2/21/2020 Page:2 REIDEL-SERRANO Ademar The Public Adjusting Firm Inc. ltde01-f Ademar The Public Adjusting Firm Inc. 13055 SW 42nd Street Suite 204 Miami, FL 33175 Total: Main Roof `moi DESCRIPTION Exterior 877.56 7,033.08 42,198.39 0.00 42,198.39 1026.00 SF Walls 1026.00 SF Long Wall 114.00 LF Ceil. Perimeter Subroom 1: Right 333.00 SF Walls 333.00 SF Long Wall 37.00 LF Ceil. Perimeter Subroom 2: Front 495.00 SF Walls 495.00 SF Long Wall 55.00 LF Ceil. Perimeter Subroom 3: Left 288.00 SF Walls 288.00 SF Long Wall 32.00 LF Ceil. Perimeter QUANTITY UNIT PRICE TAX O&P Formula Elevation 114'x 9'x 0" 114.00 LF Floor Perimeter 1026.00 SF Short Wall Formula Elevation 37' x 9' x 0" 37.00 LF Floor Perimeter 333.00 SF Short Wall Formula Elevation 55' x 9' x 0" 55.00 LF Floor Perimeter 495.00 SF Short Wall Formula Elevation 32'x 9'x 0" 32.00 LF Floor Perimeter 288.00 SF Short Wall RCV DEPREC. ACV 267. Mask wall - plastic, paper, tape (per 238.00 LF 1.07 3.67 51.68 310.01 (0.00) 310.01 LF) 268. Mask or cover per square foot 476.00 SF 0.24 2.00 23.24 139.48 (0.00) 139.48 269. Floor protection - self-adhesive 716.00 SF 0.49 6.01 71.36 428.21 (0.00) 428.21 plastic film 270. Exterior - seal or prime then paint 2,142.00 SF 1.21 53.98 529.16 3,174.96 (0.00) 3,174.96 with two finish coats 271. R&R Stucco -natural gray -troweled 1,071.00 SF 6.52 88.46 1,414.28 8,485.66 (0.00) 8,485.66 272. Stucco Plasterer - per lour 16.00 HR 44.66 0.00 142.92 857.48 (0.00) 857.48 273. R&R Water System* 1.00 EA 6,024.54 0.00 0.00 6,024,54 (0.00) 6,024.54 REIDEL-SERRANO 2/21/2020 Page:3 Ademar The Public Adjusting Firm Inc. . NI tffiar Ademar The Public Adjusting Firm Inc. 13055 SW 42nd Street Suite 204 Miami, FL 33175 CONTINUED - Exterior DESCRIPTION QUANTITY UNIT PRICE TAX Totals: Exterior General O&P RCV DEPREC. ACV 154.12 2,232.64 19,420.34 0.00 19,42U.J4 DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 274. Final cleaning - construction - 5,000.00 SF 0.19 0.00 190.00 1,140.00 (0.00) 1,140.00 Residential 138.20 (0.00) 138.20 298. Plumbing labor minimum* 1.00 EA 183.79 0.00 36.76 220.55 275. Dumpster load - Approx. 40 yards, 7- 2.00 EA 836.00 0.00 334.40 2,006.40 (0.00) 2,006.40 8 tons of debris 1,031.72 10,596.24 69,601.87 0.00 69,601.87 276. General clean - up 60.00 HR 32.49 0.04 389.88 2,339.32 (0.00) 2,339.32 277. Electrical - Labor Minimum 8.00 EA 195.28 0.00 312.44 1,874.68 (0.00) 1,874.68 Totals: General 0.04 1,226.72 7,360.40 0.00 7,360.40 Labor Minimums Applied DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 284. Drywall labor minimum* 1.00 EA 219.99 0.00 44.00 263.99 (0.00) 263.99 280. Wood floor covering labor minimum* 1.00 EA 115.16 0.00 23.04 138.20 (0.00) 138.20 298. Plumbing labor minimum* 1.00 EA 183.79 0.00 36.76 220.55 (0.00) 220.55 Totals: Labor Minimums Applied 0.00 103.80 622.74 0.00 622.74 Line Item Totals: REIDEL-SERRANO 1,031.72 10,596.24 69,601.87 0.00 69,601.87 Additional Charges Charge Permit 1,200.00 Taxes 1,000.00 Loss of use 10,000.00 Additional Charges Total $12,200.00 REIDEL-SERRANO 2/21/2020 Page:4 Ademar The Public Adjusting Firm Inc. }l�emar Ademar The Public Adjusting Firm Inc. 13055 SW 42nd Street Suite 204 Miami, FL 33175 Grand Total Areas: 2,142.00 SF Walls 0.00 SF Floor 2,142.00 SF Long Wall 0.00 Floor Area 337.49 Exterior Wall Area 2,821.62 Surface Area 83.27 Total Ridge Length 0.00 SF Ceiling 0.00 SY Flooring 2,142.00 SFShortWall 0.00 Total Area 0.00 Exterior Perimeter of Walls 28.22 Number of Squares 0.00 Total Hip Length 2,142.00 SF Walls and Ceiling 238.00 LF Floor Perimeter 238.00 LF Ceil. Perimeter 0.00 Interior Wall Area 604.65 Total Perimeter Length REIDEL-SERRANO 2/21/2020 Page:5 Ademar The Public Adjusting Firm Inc. .jt�'xl U ar Ademar The Public Adjusting Firm Inc. 13055 SW 42nd Street Suite 204 Miami, FL 33175 Summary for Dwelling Line Item Total 57,973.91 1,200.00 Permit Loss of use 10,000.00 Material Sales Tax 1,031.72 Subtotal 70,205.63 Overhead 6,418.12 Profit 6,418.12 Replacement Cost Value $83,041.87 $83,041.87 Net Claim REIDEL-SERRANO 2/21/2020 Page:6 Ademar The Public Adjusting Firm Inc. jty 9demar Ademar The Public Adjusting Firm Inc. 13055 SW 42nd Street Suite 204 Miami, FL 33175 Recap of Taxes, Overhead and Profit Overhead (10%) Profit (10%) Material Sales Tax Laundering Tax (2%) Manu£ Home Tax Storage Rental Tax (7%) (6%) _. (7%) Line Items 5,298.12 5,298.12 1,031.72 0.00 0.00 0.00 Additional Charges 1,220.00 1,220.00 0.00 0.00 0.00 0.00 Total 6,518.12 6,518.12 1,031.72 0.00 0.00 0.00 REIDEL-SERRANO 2/21/2020 Page:7 Ademar The Public Adjusting Firm Inc. l% 9dem-8T Ademar The Public Adjusting Firm Inc. 13055 SW 42nd Street Suite 204 Miami, FL 33175 Recap by Room Estimate: REIDEL-SERRANO Area: Main Roof Main Roof 29,567.75 51.00% Terrace 4,720.00 8.14% Area Subtotal: Main Roof 34,287.75 59.14% Exterior 17,033.58 29.38% General 6,133.64 10.58% Labor Minimums Applied 518.94 0.90% Subtotal of Areas 57,973.91 100.00% Total 57,973.91 100.00% REIDEL-SERRANO 2/21/2020 Page:8 jlNgmar Ademar The Public Adjusting Firm Inc. Ademar The Public Adjusting Firm Inc. 13055 SW 42nd Street Suite 204 Miami, FL 33175 Recap by Category O&P Items Total % CLEANING 2,899.40 3.44% GENERAL DEMOLITION 5,778.05 6.86% DRYWALL 474.65 0.56% ELECTRICAL 1,562.24 1.85% FLOOR COVERING - WOOD 229.40 0.27% FRAMING & ROUGH CARPENTRY 3,777.51 4.48% PLUMBING 183.79 0.22% PAINTING 4,774.66 5.67% ROOFING 21,858.79 25.95% SOFFIT, FASCIA, & GUTTER 3,548.78 4.21% STUCCO & EXTERIOR PLASTER 6,862.10 8.15% O&P Items Subtotal 51,949.37 61.67% Non -O&P Items Total % GENERAL DEMOLITION 24.54 0.03% PLUMBING 6,000.00 7.12% Non -O&P Items Subtotal 6,024.54 7.15% O&P Items Subtotal 51,949.37 61.67% Permits and Fees 12,200.00 14.48% Material Sales Tax 1,031.72 1.22% Overhead 6,518.12 7.74% Profit 6,518.12 7.74% Total 84,241.87 100.00% REIDEL-SERRANO 2/21/2020 Page:9 t� g 1 r 1 T i P 1 1 ryl, �r�Il� -'/; C �-- '-;, ` _ - r r� • :.� ' y l � : �, .s'i _Tr ��. Y I. I �}cLt / � T� L.. � ��: a .. `> /�/ M/� �' /. k � �. �- ,.IR � _ �, / _ � . �iii� a• f ,._ �f 9 J b i t .. ��y)� l•'' % � , •., � , ., „,; � w I � 1 jr' •�.�� • .,i._ �� ,1�1 'd'd t � .% 1�;1: �;�; „�, ,� ..f, �./i4 �, �•�'�`�l,'�. �>: r, � Ali , % , ' i ' � ti: ' ', 1 ��. �, � ,r�� I �� , � �, •t ,;� � .I .,.i+ , � �� - / : i .1. l i 'I ��'� - 1 � � 'l 1 � �.- ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP," LL TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO U 0 1 C THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the Item Is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed If the document is already complete with the exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office. Route to Addressee(s) (List in routing order) Office Initials Date 1. Lisa N. Carr CHS al rs itt 2. Jennifer A. Belpedio,ACA County Attorney Office z/t G 1a 3. BCC Office Board of County "rdcf Commissioners j S /:9/,/ NOTE: Clerk's attestation is not required. Please do not route this item to Clerk's/Board Minutes and Records. CAO please scan document after execution by Chairman and email them to Clerk's Minute and Records for its records. PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above,may need to contact staff for additional or missing information. Name of Primary Staff Lisa N. Carr,CHS Phone Number 239-252-2339 Contact/ Department Agenda Date Item was June 12,2012 Agenda Item Number 16.D.10 Approved by the BCC Type of Document Insurance Claim Check Endorsement for Number of Original Attached Beatriz Cano. Documents Attached PO number or account number if document is N/A to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature? [nrr 1; Q sn Lit 2. Does the document need to be sent to another agency for additional signa res? If yes, provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. N/A 3. Original document has been signed/initialed for legal sufficiency. (All documents to be N/A signed by the Chairman,with the exception of most letters,must be reviewed and signed r3 by the Office of the County Attorney. It 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's X signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip N/A should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 06/12/2012 and all changes made during the meeting have been incorporated in the attached document. The County Ca0.I� Attorney's Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC,all changes directed by the BCC have been made,and the document is ready for the Chairman's signature. b+ NO REQUIRE-0 I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12 1 6 D 1 Collier County Community and Human Services (CHS) Homeowner Insurance Check Endorsement Policy Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage/lien,then the loan will not have to be repaid. On occasion, the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and receive money to make the repairs. If the insurance claim check is made payable to the homeowner and Collier County, then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to CHS at the address below for check endorsement consideration: )(Copy of Homeowner's current insurance policy-Declaration Page. Z' Copy of insurance company's claim report with worksheet including description of repairs and costs. Let r Copy of photos of claim damage dtsttiver. . ,. va.4e cl)do«iAter Copy of Insurance check(s)payable to homeowner, first lien holder and Collier County. Community and Human Services, 3339 Tamiami Trail E, Room 211. If approved, the CHS staff will contact you to schedule an appointment to endorse the insurance claim check. OFFICE USE ONLY File Name: -ect..4Y►L C a-n 0 File# 1 5_ O53 Vfleview CHS to Date /0 A 5/27D Approved CH Director Date ❑ Denied ii7fieview A SSi County Attorney Date 16010 • Darrell Yeager Cims Examiner • 1:1) HERITAGE' Heritage Property&Casualty Insurance Company P.O.Box 6417 INSURANCE Clearwater,FL 33758 Telephone: 727-362-7200 Ext.7321 Pillars of Strength and Character. Facsimile: 866-728-0583 Email: dveager@heritaaepci.com December 6, 2021 Beatriz E. Cano 4318 27th Ct. SW Apt 201, Naples, FL 34116 Re: Policyholder: Beatriz E. Cano Policy Number: H00007072 Claim Number: H74931 Date of Loss: 12/01/2021 Loss Type: Water Property 4318 27th Ct. SW Apt 201, Address: Naples, FL 34116 Dear Beatriz E. Cano: This is to follow our conversation on 12/06, 2021, regarding your claim submitted with a date of loss of 12/01/202 i. We have completed our investigation of your claim for water damage. An estimate of repair for the amount of$7,859.92 has been enclosed with this letter. Payments have been issued for the amount of$6,415.35. The amount of your claim payment is calculated as follows: Coverage A—Dwelling $ 7,859.92 Coverage B—Other Structures $ 0.00 Coverage C—Personal Property $ 0.00 Coverage D—Loss of Use $ 0.00 Gross Loss $ 7,859.92 Less Recoverable Depreciation $ 0.00 • Lesspeductible $ 500.00 Net Am tiht Cov A $ 6,415.35 Please provide your contractor with a copy of this estimate before the repairs begin. If your contractor believes there is additional damage attributed to this loss that is not included in the estimate, please have them contact us to discuss those differences. Before we can consider any 1 i b D 1 0 additional damage and/or payment(s), we must agree the damage is related to this loss. Further, both we and the contractor must agree on the scope and cost of the additional damage. If this procedure is not followed, it may jeopardize your ability to recover any additional cost you may incur. Heritage Property & Casualty Insurance reserves the right to reinspect the property and/or require additional information prior to the release of any additional funds. Our investigation revealed that the damage to your home was from a leaky Faucet. The repair to the plumbing system is not covered. The damages to the plumbing system are due to wear and tear, not a sudden and accidental loss. We direct your attention to the terms of the HOMEOWNERS 3 SPECIAL FORM, HO 03 09 SPO9 20, policy of insurance that you have with us, as amended by SPECIAL PROVISIONS FOR FLORIDA, HPCHO3 09 SP 09 20, under SECTION I—PERILS INSURED AGAINST,which states in part: Under COVERAGE A—Dwelling and COVERAGE B —Other Structures, the last paragraph under 2., after e.(1) through (8), is deleted and replaced by the following: If any of these cause water damage not otherwise excluded or limited elsewhere in the Policy,from a plumbing, heating, air conditioning or automatic fire protective sprinkler system or household appliance, we cover loss caused by the water, including the cost to tear out or other and repair only that part ther portion"esidencefp premises", toructure covered access the system or er COVERAGE A or B, onor appliance. (1) The cost that we will pay for the tear out and repair of the part or portion of the building or other structure covered under COVERAGE A or B as specified above is limited to only that part or portion of the covered structure or other structure which is necessary to provide access to the part or portion 1of he system any partrorppo'ance that caused rtion of the systemhe covered or appliance,lis whether the system orappliance, or repairable or not. (2) In no event we pay for the repair or the replacement of the system or appliance that caused the covered loss. Under COVERAGE A— Dwelling and COVERAGE B Other Structures, Paragraph 2.f. is added as follows: f. Loss that occurs or develops over a period of time and is caused by or resulting from: (1) Condensation or the presence of humidity, moisture, or vapor, or (2) Seepage or leakage of water, steam, or sewage that is: a. continuous; b. repeating; c. gradual; d. intermittent; e. Slow; or f . trickling. 1611in Under COVERAGE A— Dwelling and COVERAGE B —Other Structures, Paragraph 2.g. is added as follows. g. Falling or dropped objects to the interior of a building unless the roof or an outside wall of the building is first damaged by a falling or dropped object. Damage to the falling or dropped object itself is not covered. Under COVERAGE A— Dwelling and COVERAGE B — Other Structures, Paragraph 2.h. is added as follows: h. To a plumbing system, whether above or below the ground, caused by: (1)Age, collapse, obsolescence, wear, tear; (2) Fading, oxidation,weathering; (3) Deterioration, decay, marring, delamination, crumbling, settling, cracking; (4) Shifting, bulging, racking, sagging, bowing, bending, leaning; (5) Shrinkage, expansion, contraction, bellying, corrosion; (6)The unavailability or discontinuation of a part or component of the system; or (7)Any other age or maintenance related issue; Under COVERAGE A— Dwelling and COVERAGE B — Other Structures, Paragraph 2.i. is added as follows: i. To the plumbing system, whether above or below the ground, caused by the impairment, state or condition ofthe system, which prohibits repair or replacement including access, necessary to connect the adjoining parts of appliances, pipes entertainment units or other types of electronic apparatus. In view of the above policy terms, and without waiving any other policy conditions or defenses available to us, we must necessarily take the position that the plumbing repairs do not come within the terms of your policy. When a dispute exists regarding your claim, or when we have denied payment of your claim, Florida Law requires we notify you of your right to participate in the Property Insurance Mediation Program established by the Department of Financial Services. The Chief Financial Officer for the State of Florida has adopted a rule to facilitate the fair and timely handling of residential property insurance claims. The rule gives you the right to attend a mediation conference with your insurer in order to settle any claim you have with your insurer.An independent mediator, who has no connection with your insurer, will be in charge of the mediation conference. You can start the mediation process after receipt of this notice by calling the Department of Financial Services at 1 (877) 693-5236. The parties will have 21 days from the date of the notice to otherwise resolve the dispute before a mediation hearing can be scheduled. Nothing herein constitutes, nor should it be construed by you as a waiver of any of the rights of Heritage Property and Casualty Insurance Company under its policy of insurance, nor is it the purpose of this letter to waive any of the policy terms and/or conditions. Enclosed is an insert with detailed instructions on how you may request mediation. 16Di0 Sincerely, Darrell Yeager Claims Examiner d ea er herita a ci.com Enclosed: Estimate/Mediation Brochure If this document contains an excerpt from a Heritage Insurance Company Policy ("the Policy") it is proved cial version of the here thefor informationalis the purposes only.to the insu insured on the policy effhis excerpt is not the ective date. In the event there Is inconsistency official stency of the policy is the policy issued to between this document and the Policy,the Policy shall serve as the official version F.S.817.234(1)(b) Any person who knowingly and with intent to injure,defraud,or deceive any insurer files a statement of claim or an application containing any false,incomplete,or misleading information Is guilty of a felony of the third degree. 16Q10 ®NERrrAGE HERITAGE INSURANCE Mom eiStrength and Mande Heritage Insurance P.O.Box 6417 Clearwater,Florida 33758 Insured: CANO BEATRIZ E Home: (239)465-8508 Property: 4318 27Th Ct Sw Apt 201 E-mail: NONE@CANO.COM Naples,FL 34116 Home: 4318 27Th Ct Sw Apt 201 Naples,FL 34116 Claim Rep.: Robert Schwiesow Business: (727)362-7200 Business: PO BOX 6417 Clearwater,FL 33758 Estimator: Robert Schwiesow Business: (727)362-7200 Business: PO BOX 6417 Clearwater,FL 33758 Reference: Business: (727)362-7200 Company: Heritage Insurance E-mail: Claims@heritagepci.com Business: P.O.Box 6417 Clearwater,FL 33758 Claim Number: H74931 Policy Number: H00007072 Type of Loss: Other Date Contacted: 12/2/2021 3:07 PM Date of Loss: 12/1/2021 2:00 AM Date Received: 12/1/2021 12:30 PM Date Inspected: 12/3/2021 9:14 AM Date Entered: 12/1/2021 12:56 PM Date Est.Completed: 12/3/2021 3:32 PM Price List: FLNA8X_DEC21 Restoration/Service/Remodel Estimate: CANO BEATRIZ E 16 10 V INSURANCE HERITAGE Oars y9,e'ph.dC w, Heritage Insurance P.O.Box 6417 Clearwater,Florida 33758 This is an estimate of repair for the damages to your property covered by your insurance policy with Heritage Property& Casualty Insurance Company. The prices used are the prevailing rates for your geographic location. The represented values within this estimate do not constitute a settlement of your claim. Authorization to repair or guarantee of payment must come from the owner of the property.No adjuster or appraiser has the authority to authorize or guarantee payment. Heritage assumes no responsibility for the quality of repairs made to the property. No supplemental payment will be considered without the prior approval of Heritage. If your contractors estimate is greater or additional damages are found,please contact us prior to signing any contracts or proceeding with the work. You can fax the paperwork to: 866-929-4530 Or you can mail it to us at: Heritage Claims PO Box 6417 Clearwater, Fl. 33758 Please make sure to include your name and claim number on any paperwork submitted(Please list the claim number and your name on every page). In accordance with the Mortgage Clause provision of your policy,your Mortgage Company or Lien holder may be included as a payee. If you incur costs related to permits or fees from building officials for the repair of covered damages, and this amount is not already provided for in our estimate,please submit the invoice to Heritage. Additionally,if the building department requires code upgrades for the repair of covered damages,please forward the documentation from the building department to Heritage for consideration. Payments for Ordinance and Law items are based on an incurred basis. CANO_BEATRIZ_E 12/3/2021 Page:2 16010 eg mum. HERITAGE darenrhw(borate: Heritage Insurance P.O.Box 6417 Clearwater,Florida 33758 CANO_BEATRIZ_E Main Level I--10'6"--IT Kitchen Height:8' !•■lm-iii�7.., 257.33 SF Walls 78.67 SF Ceiling i" E. Kitchen t N 336.00 SF Walls&Ceiling 45.81 SF Floor 1'° IyI t 5.09 SY Flooring 32.67 LF Floor Perimeter 35.67 LF Ceil.Perimeter L�3'�5'9'r_.)- 1'5" 1-6'1"-I Missing Wall-Goes to Floor 3'X 6'8" Opens into Exterior Window 2'X 4' Opens into Exterior DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 1. Contents-move out then reset 1.00 EA 59.66 0.00 11.94 71.60 (0.00) 71.60 2. Dishwasher-Detach&reset 1.00 EA 227.85 0.00 45.58 273.43 (0.00) 273.43 3. Detach&Reset Garbage disposer 1.00 EA 156.19 0.00 31.24 187.43 (0.00) 187.43 4. Range-electric-Remove&reset 1.00 EA 32.71 0.00 6.54 39.25 (0.00) 39.25 5. Refrigerator-Remove&reset 1.00 EA 43.60 0.00 8.72 52.32 (0.00) 52.32 6. R&R Cabinetry-lower(base)units 8.08 LF 249.00 108.35 402.40 2,522.67 (286.46) 2,236.21 7. R&R Cabinetry-upper(wall)units 12.83 LF 177.20 107.57 454.70 2,835.75 (316.86) 2,518.89 8. Detach&Reset Kitchen Sink-single 1.00 EA 146.25 0.03 29.26 175.54 (0.00) 175.54 basin j 9. R&R P-trap assembly-ABS(plastic) 1.00 EA 69.03 0.48 I3.82 83.33 (16.89) 66.44 10. R&R Angle stop valve 2.00 EA 39.78 1.01 15.90 96.47 (4.78) 91.69 11. Paint the walls-one coat 257.33 SF 0.71 2.70 36.54 221.94 (86.52) 135.42 12. R&R Countertop-flat laid plastic 10.08 LF 49.61 19.55 100.02 619.64 (217.70) 401.94 laminate 13. Detach&Reset Baseboard-2 1/4" 2.00 LF 3.36 0.00 1.34 8.06 (0.00) 8.06 14. Paint baseboard-one coat 32.67 LF 1.00 0.23 6.54 39.44 (15.36) 24.08 Totals: Kitchen 239.92 1,164.54 7,226.87 944.57 6,282.30 Total: Main Level 239.92 1,164.54 7,226.87 944.57 6,282.30 Debris DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 15. Tandem axle dump trailer-per load- 1.00 EA 266.28 0.00 53.26 319.54 (0.00) 319.54 including dump fees Totals: Debris 0.00 53.26 319.54 0.00 319.54 CANO_BEATRIZ_E 12/3/2021 Page:3 . 16D1p • ®HERS mum E- HERITAGE erd Strong n and awschn Heritage Insurance P.O.Box 6417 Clearwater,Florida 33758 Labor Minimums Applied DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 16. Painting labor minimum 1.00 EA 41.78 0.00 8.36 50.14 (0,00) 50.14 17. Finish carpentry labor minimum 1.00 EA 219.47 0.00 43.90 263.37 (0.00) 263.37 Totals: Labor Minimums Applied 0.00 52.26 313.51 0.00 313.51 Line Item Totals: CANO_BEATRIZ_E 239.92 1,270.06 7,859.92 944.57 6,915.35 Grand Total Areas: 257.33 SF Walls 78.67 SF Ceiling 336.00 SF Walls and Ceiling 45.81 SF Floor 5.09 SY FIooring 32.67 LF Floor Perimeter 0.00 SF Long Wall 0.00 SF Short Wall 35.67 LF Ceil.Perimeter 45.81 Floor Area 91.00 Total Area 257.33 Interior Wall Area 317.00 Exterior Wall Area 38.33 Exterior Perimeter of Walls 0.00 Surface Area 0.00 Number of Squares 0.00 Total Perimeter Length 0.00 Total Ridge Length 0.00 Total Hip Length CANO_BEATRIZ_E 12/3/2021 Page:4 1 61310 ®HERITAGE HERITAGE INSURANCE wra:dwavenawn.<xra. Heritage Insurance P.O.Box 6417 Clearwater,Florida 33758 Summary for--Coverage-A-Dwelling Line Item Total 6,349.94 Overhead 635.03 Profit 635.03 Material Sales Tax 239.92 Replacement Cost Value $7,859.92 Less Depreciation (944.57) Actual Cash Value $6,915.35 Less Deductible (500.00) Net Claim $6,415.35 Total Recoverable Depreciation 944.57 Net Claim if Depreciation is Recovered $7,359.92 Robert Schwiesow • CANO_BEATRIZ_E 12/3/2021 Page:5 16010 IowERITAGE HERITAGE oao-aw.,wrt.w�van Heritage Insurance P.O.Box 6417 Clearwater,Florida 33758 Recap of Taxes,Overhead and Profit Overhead 10% Profit(10%) M °( ) Material Sales Tax Laundering Tax(2/°) Manuf.Home Tax Storage Rental Tax (7%) (6%) (7%) Line Items 635.03 635.03 239.92 0.00 0.00 0.00 Total 635.03 635.03 239.92 0.00 0.00 0.00 CANO_BEATRIZ_E 12/3/2021 Page:6 16010 ®HERITAGE' HERITAGE INSURANCE ~raswom.ieU,xr... Heritage Insurance P.O.Box 6417 Clearwater,Florida 33758 Recap by Room Estimate:CANO_BEATRIZ_E Area:Main Level Kitchen 5,822.41 91.69% Area Subtotal: Main Level 5,822.41 91.69% Debris 266.28 4.19% Labor Minimums Applied 261.25 4.11% Subtotal of Areas 6,349.94 100.00% Total 6,349.94 100.00% CANO_BEATRIZ_E 12/3/2021 Page:7 16810 ®HERRAANGE HERITAGE Mena'5 vow crd Lbw.: Heritage Insurance P.O.Box 6417 Clearwater,Florida 33758 Recap by Category with Depreciation O&P Items RCV Deprec. ACV APPLIANCES 460.35 460.35 CABINETRY 4,540.40 781.67 3,758.73 CONTENT MANIPULATION 59.66 59.66 GENERAL DEMOLITION 532.75 532.75 FINISH CARPENTRY/TRIMWORK 226.19 226.19 PLUMBING 273.44 21.47 251.97 PAINTING 257.15 100.51 156.64 O&P Items Subtotal 6,349.94 903.65 5,446.29 Overhead 635.03 635.03 Profit 635.03 635.03 Material Sales Tax 239.92 40.92 199.00 Total 7,859.92 944.57 6,915.35 Thank you for insuring your property with Heritage Property&Casualty Insurance Company. "Pursuant to s. 817.234, Florida Statutes,any person who,with the intent to injure,defraud, or deceive any insurer or insured, prepares,presents, or causes to be presented a proof of loss or estimate of cost or repair of damaged property in support of a claim under an insurance policy knowing that the proof of loss or estimate of claim or repairs contains any false,incomplete, or misleading information concerning any fact or thing material to the claim commits a felony of the third degree,punishable as provided in s. 775.082,s. 775.083, or s. 775.084,Florida Statutes." Robert Schwiesow CANO_BEATRIZ_E 12/3/2021 Page:8 16 D1i� ■ Heritage Property&Casualty Heritage Property&Casualty Insurance Company Insurance Company Homeowners2600 McCormick Dr.,Suite 300 Declarations Page Clearwater,FL 33759 1-855-536-2744 Agent dre Name: Epperson InsurancercesInc& HERITAGE Address: Financial Services I . 1924 Santa Barbara Insurance Blvd Unit 3 If you have any questions regarding this policy Naples,FL 34116 which your agent is unable to answer,please Agent Phone#: (239)331-7141 contact us at 1-855-536-2744. Agency Code:H4964 Policy Number: H00007072 Insuring Company:Heritage Property&Casualty Insurance Company Named Insured: BEATRIZ E CANO 2600 McCormick Dr.,Suite 300 Mailing Address: 4318 27Th Ct Sw Apt 201 Clearwater,FL 33759 Naples,FL 34116 Phone Number: (239)465-8508 Effective Dates: From:05/09/2021 12:01 am To:05/09/2022 12:01 am Effective date of this transaction:05/09/2021 12:01 am Activity: Renewal Co-Applicant: Insured Location: 4318 27Th Ct Sw Apt 201 Naples,FL 34116 Collier County Coverage at the residence premises is provided only where a limit of liability is shown or a premium is stated. Coverages and Coverage Section Limits Non-Hurricane Hurricane Total Premiums: Coverage-A-Dwelling $50,000 $227.00 $508.00 $735.00 Coverage-C-Personal Property $15,000 $68.00 $152.00 $220.00 Coverage-D-Loss Of Use $6,000 Included Coverage-E-Personal Liability $300,000 $15.00 $15.00 Coverage-F-Medical Payments To Others $2,500 $6.00 $6.00 Total of Premium Adjustments $102.00 ($508.00) ($406.00) SEE PAGE 3 FOR DETAILED DESCRIPTION OF PREMIUM ADJUSTMENTS Total Policy Premium $570 Hurricane Premium=$152.00 Non-Hurricane Premium=$418.00 Deductible: All OtherPerils:$500 Hurricane Deductible: $500 Law and Ordinance: Law and Ordinance: $0 If your policy contains replacement cost on dwelling,the amount of coverage will not exceed the stated policy value. 03/09/2021 --- Ernie Garateix Authorized Signature • Page 1 of 4 HPCH06 DEC2 01 19 16D1Q - Coverage Section Limits Non-Hurricane Hurricane Total Coverage C Increased Special Limits Of Liability-Jewelry, $1,000 Included Watches and Furs Coverage C Increased Special Limits Of Liability-Silverware, $2,500 Included Goldware and Pewterware Limited Fungi,Wet Or Dry Rot,Or Bacteria Coverage $10,000 Included Loss Assessment Coverage $2,000 Included Unit-Owners Coverage A Special Coverage $50,000 $51.00 $51.00 Water Back Up And Sump Discharge Or Overflow $5,000 $25.00 $25.00 Construction Type ($132.00) ($132.00) Age of Home $113.00 ($21.00) $92.00 Protection Class Factor $15.00 $15.00 Senior/Retiree ($34.00) ($34.00) Financial Responsibility Credit ($84.00) ($84.00) Windstorm Loss Mitigation Credit ($11.00) ($355.00) ($366.00) Policy Fee $25.00 $25.00 Emergency Management Preparedness and Assistance Trust $2.00 $2.00 Fund Fee Policy Interest: NAME ADDRESS INTEREST TYPE BILL TO REFERENCE# NATIONSTAR MORTGAGE LLC-Its PO BOX 7729 MORTGAGEE Yes 0653398149 Successors and or Assigns SPRINGFIELD,OH 45501 COLLIER COUNTY BOARD OF COUNTY3339 TAMIAMI TRAIL E STE 211 MORTGAGEE No TBD COMMISSIONERS NAPLES,FL 34112-5361 • • Page 3 of 4 1-1PCHO6 DEC2 01 19 • i .u_1 Special Message: THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES, WHICH MAY RESULT IN HIGH OUT-OF- POCKET EXPENSES TO YOU. LAW AND ORDINANCE: LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. PLEASE DISCUSS WITH YOUR INSURANCE AGENT. FLOOD COVERAGE IS NOT PROVIDED BY THIS POLICY. FLOOD INSURANCE: YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE. YOUR HOMEOWNER'S •INSURANCE POLICY DOES NOT INCLUDE COVERAGE FOR DAMAGE RESULTING FROM FLOOD EVEN IF HURRICANE WINDS AND RAIN CAUSED THE FLOOD TO OCCUR. WITHOUT SEPARATE FLOOD INSURANCE COVERAGE, YOU MAY HAVE UNCOVERED LOSSES CAUSED BY FLOOD. PLEASE DISCUSS THE NEED TO PURCHASE SEPARATE FLOOD INSURANCE COVERAGE WITH YOUR INSURANCE AGENT. • amount of premium change due to an approved rate Increase Is($584.00). e amount of premium change due to a coverage change is$543.00. Page 4 of 4 HPCHO6 DEC2 01 19 t6Q1r+ Any person who knowingly and with Intent to injure,defraud or deceive any insurer files a statement of claim or an application containing any false,incomplete or misleading information Is guilty of a felony in the third degree. Forms and HPC NCPT 02 14 V17C1 H PC WLV 07 13 HC NCPT 02 14 v20B Endorsements: OIR B1 1670 01 06 HPCHO6 WBU 06 17 OIR B1 1655 02 10 HPC HOJ 02 14 HPCH06 1DX 0712 H0 00 06 04 91 HPCH06 09 SP 0816 HPCIC PrefH06 OC 0912 HPCH06 DN 07 12 HPCHO 09 CLP 07 12 HPC CGCC 07 12 HPCHO 09 ED 07 12 HPCHO 09 ELE 05 13 H0 04 96 04 91 HPCHO 09 FCE 07 12 H0 04 21 10 94 HPC PRI 02 14 H0 03 52 01 06 HPCHO REJ OLR 12 12 HPCH06 17 32 05 13 HPC HDR 01 13 HPCH06 PPS 12 13P HPC WE 07 12 Pay Plan: Number of Payments: 1 Bill to: MORTGAGEE Rating Program: HO-6 Construction Type: Masonry Information: Territory: 464F08 Year Constructed: 1983 Scheduled Description: Property: Messages: In the event of a claim,please call toll free 1-855-415-7120. We are available 24 hours a day,7 days a week. This replaces all previously issued policy declarations,if any.In case of property loss,only that part of loss over stated deductibles applies,unless otherwise stated in the policy.This declaration page together with all policy provisions and any other applicable endorsements completes your policy. A rate adjustment of 0%is included to reflect the Building Code Enforcement Grade in your area.Adjustments range from 5%surcharge to 46%credit. A rate adjustment of 70%credit is included to reflect the Windstorm Mitigation Device Credit.This credit applies only to the wind portion of your premium.Adjustments range from 0%to 90%. Property Coverage limit may increase at renewal due to an inflation factor of 8%,as determined by a national Index of construction costs to maintain insurance to the approximate replacement cost of your home. I I�i Page 2 of 4 HPCH06 DEC2 01 19 1 6D 1 0 Heritage P&C Insurance Company CHECK NUMBER 0000327354 BEATRIZ E CANO CHECK DATE 12/07/21 COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS PAYEE CODE BEATRIZ E CANO NATIONSTAR MORTGAGE LLC 4318 27Th Ct Sw Apt 201 Naples,FL 34116 INVOICE DATE REF ID / INVOICE # AMOUNT PAID CHECK NOTES 12/06/21 00237927H74931 6,415.35 H74931 Cano Undisputed Payment BEATRIZ E CANO Claim Number H74931 NET CHECK AMOUNT $ 6,415.35 CHECK NUMBER: 0000327354 Heritage P&C Insurance Company CHECK NUMBER 0000327354 BEATRIZ E CANO CHECK DATE 12/07/21 COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS PAYEE CODE BEATRIZ E CANO NATIONSTAR MORTGAGE LLC 4318 27Th Ct Sw Apt 201 Naples,FL 34116 INVOICE DATE REF ID / INVOICE # AMOUNT PAID CHECK NOTES 12/06/21 00237927H74931 6,415.35 H74931 Cano Undisputed Payment BEATRIZ E CANO Claim Number H74931 NET CHECK AMOUNT $ 6,415.35 CHECK NUMBER: 0000327354 TO VERIFY AUTHENTICITY.SEE REVERSE SIDE FOR DESCRIPTION OF THE 11 SECURITY FEATURES !UER'TAGE' Heritage P&C Insurance Company Regions Bank CHECK NUMBER I n s u r a n t e 2600 McCormick Dr., suite 300 0000327354 'MD*IMtllsl.n„ Clearwater,FL 33759 63-465 631 CHECK DATE 12107/21 PAY: SIX THOUSAND FOUR HUNDRED FIFTEEN DOLLARS &35/100 $******6,415.35 TO THE ORDER OF: BEATRIZ E CANO P72 COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS L ItiAn 'r NATIONSTAR MORTGAGE LLC 000072 4318 27Th Ct Sw Apt 201 AUTHORIZED SIGNATURE Naples,FL 34116 1 di D1 {+ • • • • • F ix m agi I Xi 11111111 11 1 DLL zz „ �o \ a L t1 F r*i L? m -11 -D- 10_ • • • • • • • ' I � II X m 33 Z 0N III li ▪ m m rn 1111111 -nw = 111111 • • m 11 zZ IIIji'Ii cQ m mN 0 Z m --� 16010 Heritage P&C Insurance Company CHECK NUMBER 0000327354 BEATRIZ E CANO CHECK DATE 12/07/21 COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS PAYEE CODE BEATRIZ E CANO NATIONSTAR MORTGAGE LLC 4318 27Th Ct Sw Apt 201 Naples,FL 34116 INVOICE DATE REF ID / INVOICE # AMOUNT PAID CHECK NOTES 1 12/06/21 00237927H74931 6,415.35 H74931 Cano Undisputed Payment BEATRIZ E CANO •t Claim Number H74931 . r O N_ 8 O O NET CHECK AMOUNT $ 6,415.35 CHECK NUMBER: 0000327354 Heritage P&C Insurance Company (c3t) CHECK NUMBER 0000327354 CBEATRIZOLLIER E CANO (_��/l CHECK DATE 12/07/21 COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS J C/ PAYEE CODE BEATRIZ E CANO NATIONSTAR MORTGAGE LLC 4318 27Th Ct Sw Apt 201 Naples,FL 34116 INVOICE DATE REF ID / INVOICE # AMOUNT PAID CHECK NOTES 12/06/21 00237927H74931 6,415.35 H74931 Cano Undisputed Payment BEATRIZ E CANO Claim Number H74931 NET CHECK AMOUNT $ 6,415.35 CHECK NUMBER: 0000327354 10 VERIFY AUTHENTICITY SEE REVERSE SIDE FOR DESCRIPTION OF THE 11 SECURITY FEATURES ilk HERITAGE' Heritage P&C Insurance Company Regions Bank CHECK NUMBER Ur Insure ace 2600 McCo lck Dr., Sulk 300 0000327354 �ds �+a..«. Clearwater,FL 33759 B3-466✓611 CHECK DATE 12/07/21 PAY: SIX THOUSAND FOUR HUNDRED FIFTEEN DOLLARS&35/100 $ 6,415.35 TO THE ORDER OF: P72 COLLIER CCANOn> ja�' � COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS `' '"'�� NATIONSTAR MORTGAGE LLC 000072 4318 27Th Ct Sw Apt 201 AUTHORIZED SIGNATURE Naples,FL 34116 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 D 1 0 TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be reccned in the County Attorney Office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the exception of the Chairman's signature,draw a line through routing fines 41 through#2,complete the checklist,and forward to the County Attorney Office. Route to Addressec(s) (List in routing order) Office Initials Date 1. Lisa N. Carr CHS lnc 6/21/2023 2. Derek Perry County Attorney Office 0 or LP►23Iz3 3. BCC Office Board of County . N/A N/A Commissioners NOTE: Clerk's attestation is not required. Please do not route this item to Clerk's Board Minutes and Records. CAO please scan document after execution by Chairman and email them to Clerk's Minute and Records for its records. PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above,may need to contact staff for additional or missing information. Name of Primary Staff Lisa N.Carr,Senior Grants Coordinator Phone Number 239-252-2339 Contact/ Department CHS Agenda Date Item was June 12,2012 Agenda Item Number 16D10 Approved by the BCC Type of Document Insurance Claim Check Endorsement for: Number of Original 2 Attached (1)Carla Viacava(2)Marie Saintil Daniel Documents Attached PO number or account n/a n/a n/a number if document is to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature? Yes 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be N/A signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney. • 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's N/A signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip N/A should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 06/12/2012 and all changes made during is AI the meeting have been incorporated in the attached document. The County OOP ion for{ Attorney's Office has reviewed the changes,if applicable. ire] 9. Initials of attorney verifying that the attached document is the version approved by the is not BCC,all changes directed by the BCC have been made,and the document is ready for the n 0 +ption fc� Chairman's signature. Y i ' .J I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05:Revised t 1/30/12 16D10 Collier County Community and Human Services Division (CHS) Homeowner Insurance Check Endorsement Policy Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage/lien, then the loan will not have to be repaid. On occasion, the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and.receive money to make the repairs. If the insurance claim check is made payable to the homeowner and Collier County,then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to CHS at the address below for check endorsement consideration: 14. Copy of Homeowner's current insurance policy-Declaration Page. (y%Copy of insurance company's claim report with worksheet including description of repairs and costs. If Copy of photos of claim damage. Copy of Insurance check(s)payable to homeowner, first lien holder and Collier County. Homeowner Name: A - \J P\ cAv ('� Homeowner Address: S 0-`� f \ [ €E S r \K S F� Primary Contact Number: � I S U eA 4` 1 Homeowner Email: (\k -4\ G 1 \J 5'g) & L � C�(`-1 OFFICE USE ONLY CeLdt. Ji / &3 Reviewed CHS- r nt Coordinator Da OJ /, Z-� Approved irecto• Date Denied 1 6 D 0 � Al! rCITIZENS Claim Center PROPERTY INSURANCE ummxmmw 00000820802 Southwest Florida Claims Adjusters LLC 1217 CAPE CORAL PKVVYE@TE 108 CAPE CORAL FL33Q04 UNITED STATES OG208O2 U5/10�O23 �°�^°17�84�8O 001'00414440 A1117335 EC Claim ' (0°afenuar" WHO USA«� m��" »° vm �uv^vm" wr,mw o"mn m�^ n ^�w npx IT womnmm� a mw �nm,.*'� wovow �'a�roonv`p` ^� , , Citizens Property Insurance Corporation PLA 05/10/2023 0620802 P.O.Box 1O748 Claim Indemnity Disbursement DATE Tallahassee,FL323O2'2749 63o413 2670 PAY TO-7ME ! ' Carla V1uuuva and Southwest Florida Claims C » 0RDER,QF 4ndCDLL|ERCOUNTY8OAROOFCOUNTYC0K�N1|SS|[>NERSandHabi 8 / � --for Humanity � ^ | $*°°° 17/484'8O Sevente'en thousand four hundred yimyfour DoUor and80nnnt | �pmm rx oank.w�. ALL PAYEES MUST ENDORSE Two Signatures Required ,^^vm,/"x°oAve . mia,m`n`xom1 ~— — Ike �THORo/uwxrunso W� 1 6 D 1 ci ... 1 z I a) (c 6.4, :::, :„..: 7;'1. !I 7,5 41 5.,,,,23 •t.,,_.i.,'., .— u, VII . a ,t , E -., ".k• ',.: ri •,: ril': 4 i n i 0. . . • , ,,, F. ga,•,-„- 1 .... , t.) '41 , r:', ,..17zi h ,i• 1.]r: '8,, - Li ! ,:.!2:i '2 . 6 6 z 1'1 i., :;c: iz.,' 411i L El '..- .,-,3 - ;:•': 1, 13 t= "' ,,,,:,,, ii t. c !., .r,,.. ti'• F... - 0 0 4 1 - •(7) it, 1 - (..) ° I" k '.-414 ci, I , 0 '''t,,'v_i 011' V e 2•:•., ,)''' .!;.; Lki • i - . cl :. 1 ,_ Cc Ili '''....._ - 1.1.1k. •—b i 0 42 .'t - - • - - • E: 6' --- . i "N., D.-1 :,-,'4 I.: •=3. 4.0 •A UJ - -i .6... ill 8 itt cc b it ..,-0 .5.7 .0 I CC .'"s, t.)'1.• irg 0 - ILI 120,., la cr I I 2 0 Z z I W ; • [ i 0 , 0 1 I 1 6D1 0 kfr' ITIZENS Claim Center PROPERTY INSURANCE CORPORATION 00000620802 001-00-414440 Southwest Florida Claims Adjusters LLC 1217 CAPE CORAL PKWY E STE 198 CAPE CORAL FL 33904 UNITED STATES gift • `Cf*}ROK`#'. 0620802 CHECK DATE: :::<; :: : :: 05/10/2023 ;CHECK AMdU[�'1':::: ****17 464.80 • Cf<#1 o.wioe l: t<>!< >` Claim Cke Safeguard LITHO USA 05n8 L095FOI41231.+ '• ORIGINAL'DOCU ENTP'INTED;ON CNEMIQACREAGTIVEIP RERWITWMI(SROP.RINTED7BORDER O, ANS}16A J},-yj�l•L11LIIiIi4,_-.- _ --- ------— ---- �-I Citizens Property Insurance Corporation ,PLA 05/10/2023 0620802 P.O.Box 10749 Claim Indemnity Disbursement DATE Tallahassee,FL 32302-2749 63-8413 2670 PAY TO•,•THE ...Carla Viacava and Southwest Florida Claims Adjusters, LLC ORDE F COUNTY COMMISSIONERS R,P rend COLLIER COUNTY BOARD OF and • I1for Humanity .............................................�........... E , cSeventeen thousand four hundred sixty four Dollars and 80 cents $*****17,464.80 JPMorgarl'Chase Bank.N.A. ALL PAYEES MUST ENDORSE Two Signatures Required 1450 Brictell Ave •.Miaml,FL 33131 011c Number: Cla' Number: 40§g°��r�9f ,^IAVYwv . LJ THOR ED SIGNATURES rr, 1 6D1 0 . .. SOUTHWEST FLORIDA CLAIMS ADJUSTERS,LLC 1217 CAPE CORAL PKWY E STE 198 gk CAPE CORAL,FL 33904 Scan to View Claim Claim Number: 111111111.11. kkl: (`[F� is 16D10 CITIZENS Citizens Claims P.O.Box 19700 Jacksonville,Florida 32245-9700 Phone: (866)411-2742 Fax: (888)392-6739 email:claims.communications@citizensfla.cotn Insured: Carla Viacava Home: (239)321-0665 f Property: 5205 HARDEE ST NAPLES,FL 34113-7729 Claim Rep.: Conrad J Feller Business: (866)41 1-2742 x 4732 E-mail: Conrad.Feller@citizensfla.com Estimator: Dale Robertson E-mail: claims. communications@citizensfla. corn Claim Number:VlMrilI Policy Number: Type of Loss: Wind Date Contacted: 4/17/2023 12:37 PM Date of Loss: 9/28/2022 12:00 AM Date Received: 4/17/2023 12:00 AM Date Inspected: 5/3/2023 12:00 PM Date Entered: 4/17/2023 10:56 AM Price List: FLNA8X_APR23 Restoration/Service/Remodel Estimate: CARLAVIACAVA 1 6 D 1 0 icr Citizens Claims CMZENS P.O.Box 19700 Jacksonville,Florida 32245-9700 Phone: (866)411-2742 Fax: (888)392-6739 email:claims.communications@citizensfla.corn Dear Carla Viacava, Enclosed is a repair estimate from Citizens Property Insurance Corporation. THIS ESTIMATE REPRESENTS OUR CURRENT EVALUATION OF THE COVERED DAMAGES TO YOUR INSURED PROPERTY AND MAY BE REVISED AS WE CONTINUE TO EVALUATE YOUR CLAIM.IF YOU HAVE QUESTIONS,CONCERNS,OR ADDITIONAL INFORMATION REGARDING YOUR CLAIM,WE ENCOURAGE YOU TO CONTACT US. If you need to contact us,please do so by one of the following methods: Email: claims.communications@citizenstla.corn U.S.Mail: Citizens Property Insurance Corporation P.O.Box 19700 Jacksonville,FL 32245-9700 Fax: 888.392.6739 Call: 866.411.2742 Be sure to include the claim number and policyholder name on each sheet of paperwork submitted. If you obtain an estimate from a contractor that is greater than the enclosed estimate or additional damages are found,prior to signing any contracts or proceeding with the work,you must send the contractor's itemized estimate to Citizens for review. Citizens must have the opportunity to evaluate any supplemental request prior to work being done for any supplemental consideration to be given. In addition,if code upgrades for the repair of covered damages are required by the local building authorities,and if your policy provides coverage for Ordinance and Law,please forward the documentation from them to Citizens for consideration.Ordinance and Law expenses must be incurred before they are payable under your policy. The property owner must authorize repairs,and neither the adjuster or appraiser,if any,may authorize or guaranty repairs. Citizens assumes no responsibility for the quality of repairs that might be made. In accordance with your policy,if a payment is made on the claim,your mortgage company or lien holder may be included as a payee.Since each company has different procedures for endorsing an insurance payment,we suggest you contact the mortgage company or lien holder directly to determine its endorsement process. Please feel free to contact us if we can be of further assistance. Any person who, knowingly and with the intent to injure, defraud, or deceive any insurer files a statement of claim or application containing any false, incomplete, or misleading information is guilty of a felony in the third degree. (Section 817.234(1)(b),Florida Statutes). CARLAVIACAVA Page:2 5/6/2023 tF is t: 1 6 CO ' 0 44 *CITIZENS Citizens Claims P.O.Box 19700 Jacksonville,Florida 32245-9700 Phone: (866)411-2742 Fax: (888)392-6739 email:claims.communications@citizensfla.com CARLAVIACAVA Debris Removal QUANTITY UNIT TAX O&P RCV AGE/LIFE COND. DEP% DEPREC. ACV i. Dumpster load-Approx. 12 yards,1-3 tons of debris 1.00EA 460.00 0.00 92.00 552.00 0/NA Avg. NA (0.00) 552.00 Totals: Debris Removal 0.00 92.00 552.00 0.00 552.00 Water Mitigation QUANTITY UNIT TAX O&P RCV AGE/LIFE COND. DEP% DEPREC. ACV The below 2 referenced line items are for 1 air mover and 1 dehumidifier for 3 days each in the living room,bedroom and hall. 2. Air mover(per 24 hour period)-No monitoring 9.00EA 25.75 0.00 0.00 231.75 0.NA Avg, 0% (0.00) 231.75 3. Dehumidifier(per 24 hr period)-up to 69 ppd-No monitor, 9.00EA 57.62 0.00 103.72 622.30 0/NA Avg. 0% (0.00) 622.30 Totals: Water Mitigation 0.00 103.72 854.05 0.00 854.05 Source-EagleView Roof Roof %. �h a Roof �+5'�. 1989.47 Surface Area 19.89 Number of Squares f"�12''"! L 229.19 Total Perimeter Length 33.66 Total Ridge Length ; r"t't f 49.53 Total Hip Length QUANTITY UNIT TAX O&P RCV AGE/LIFE COND. DEP% DEPREC. ACV The items below are to replace the roof 4. Tear off,haul and dispose of comp.shingles-Laminated 19.89SQ 83.06 0.00 330.42 1.982.48 15;30yrs Avg. NA (0.00) 1,982.48 5. R&R Continuous ridge vent-aluminum 33.66 LF 13.69 9.38 92.16 562.35 15/35 yrs Avg. 42.86% (57.41) 504.94 6. R&R Drip edge 229.19 LF 4.27 20.05 195.72 1,194.41 15/35 yrs Avg. 42.86% (122.78) 1,071.63 CARLAVIACAVA 5/6/2023 Page:3 1 16D► 10 CITIZENS Citizens Claims P.O.Box 19700 Jacksonville,Florida 32245-9700 Phone: (866)411-2742 Fax: (888)392-6739 email:claims.cotmnunications(Ucitizensfla.cotn CONTINUED-Roof • QUANTITY UNIT TAX O&P RCV AGE/LIFE COND. DEP% DEPREC. ACV 7. R&R Flashing-pipe jack 3.00 EA 78.47 3.64 47.08 286.13 15.35 yrs Avg. 42.86% (22.31) 263.82 8. Re-nailing of roof sheathing-complete re-nail 1.989.47 SF 0.38 1.39 151.20 908.59 15%150 yrs Avg. 10% (1.99) 906.60 9. Roofing felt-30 lb. 22.88 SQ 56.10 25.11 256.72 1,565.40 15/20 yrs Avg. 75% (269.07) 1.296.33 10. Laminated-comp.shingle rfg.-w/out felt 23.00 SQ 318.18 202,44 1,463.62 8,984.20 15/30 yrs Avg. 50% (1,446.01) 7,538.19 11. Hip/Ridge cap-composition shingles 50.00LF 6.26 4.83 62.60 380.43 0/25 yrs Avg. 0% (0.00) 380.43 Recoverable depreciation has been applied based upon the age,life expectancy and condition of the applicable items)being repaired/replaced. Totals: Roof 266.84 2,59952 15,863.99 1,919.57 13,944.42 Total: Roof 266.84 2,599.52 15,863.99 1,919.57 13,944.42 Interior ,a, - Living Room Height:8' `T 436.07 SF Walls 255.64 SF Ceiling Living Room °. 691.7I SF Walls&Ceiling 255.64 SF Floor 2t i _i 28.40 SY Flooring 53.34 LF Floor Perimeter • _�• �' _'-s'-'- -�'_'� 60.34 LF Ceil.Perimeter A- rA' • Missing Wall 3'9 7/8"X 8' Opens into HALL Window 5'X 4' Opens into Exterior Window 5'X 4' Opens into Exterior Door 3'2"X 6'8" Opens into Exterior Missing Wall-Goes to Floor 7'X 6'8" Opens into Exterior QUANTITY UNIT TAX O&P RCV AGE/LIFE COND. DEP% DEPREC. ACV The items below are to repair the ceiling • 12. Contents-move out then reset • 1.00 EA 78.43 0.00 15.68 94.11 15NA Avg. 0% (0.00) 94.1 1 i CARLAVIACAVA 5/6/2023 Page:4 1601 0 11 CITIZENS Citizens Claims P.O.Box 19700 Jacksonville,Florida 32245-9700 Phone: (866)41 1-2742 Fax: (888)392-6739 email:claims.communications(ucitizensfla,com CONTINUED-Living Room QUANTITY UNIT TAX O&P RCV ACE/LIFE COND. DEP% DEPREC. ACV 13. Floor protection-plastic and tape-10 mil 255.64 SF 0.35 2.15 17.90 109.52 15/15 yrs Avg. 80% [MI (24.54) 84.98 14. Mask and prep for paint-paper and tape(per LF) 60.34 LF 0.95 0.25 11.46 69.03 15/15 yrs Avg. 80% [MI (2.90) 66.13 15, R&R 5/8"drywall-hung,taped,ready for texture 32.00 SF 3.89 1.64 24.90 151.02 15/150 yrs Avg. 10% (2.34) 148.68 16. R&R Blown-in insulation-8"depth-R 19 32.00 SF 2.11 1.50 13.50 82.52 15/150 yrs Avg. 10% (2.14) 80.38 17. Texture drywall-machine-knockdown 691.71 SF 1.26 2.42 174.32 1,048.29 15/150 yrs Avg. 10% (3.46) 1,044.83 18. Seal part of the ceiling w/latex based stain blocker-one coat 32.00 SF 0.71 0.18 4.54 27.44 15/15 yrs Avg. 80% [M] (2.05) 25.39 19. Paint the ceiling-one coat 255.64 SF 0.80 3.04 40.90 248.45 15/15 yrs Avg. 80% (M] (34.77) 213.68 Recoverable depreciation has been applied based upon the age,life expectancy and condition of the applicable item(s)being repaired/replaced. • Totals: Living Room 11.18 303.20 1,830.38 72.20 1,758 18 Hall Bedroom Height:8' 1 r ,'- . [i • 344.14 SF Walls 115.65 SF Ceiling Be � 459.80 SF Walls&Ceiling 115.65 SF Floor 12.85 SY Flooring 43.02 LF Floor Perimeter I 43.02 LF Ceil.Perimeter 0--ll'Z'-+ . Door 3'X 6'8" Opens into HALL QUANTITY UNIT TAX O&P RCV AGE/LIFE COND. DEP% DEPREC. ACV The items below are to repair the ceiling 20. Contents-move out then reset I.00EA 78.43 0.00 15.68 94,11 15/NA Avg. 0% (0.00) 94.11 21. Floor protection-plastic and tape-10 mil 115,65 SF 0.35 0.97 8.10 49.55 15/15 yrs Avg. 80% [M] (11.10) 38.45 22. Mask and prep for paint-paper and tape(per LF) 43.02LF 0.95 0.18 8.18 49.23 15/1 yrs Avg. 80% [MI (2.06) 47.17 CARLAVIACAVA 5/6/2023 Page:5 1 J .6 D 1 1 CITIZENS Citizens Claims 464'1.5r P.O.Box 19700 Jacksonville,Florida 32245-9700 Phone: (866)411-2742 Fax: (888)392-6739 email:claims.communications@citizensfla.corn CONTINUED-Bedroom QUANTITY UNIT TAX O&P RCV AGE/LIFE COND. DEP% DEPREC. ACV '�'�,4; 23, R&R 5/8"drywall-hung,taped,ready for texture 32.00SF 3.89 1.64 24.90 151.02 15.'150yrs Avg. 10% (2.34) 148.68 24. R&R Blown-in insulation-8"depth-R19 32.00 SF 2.11 1.50 13.50 82.52 15/150 yrs Avg. 10% (2.14) 80.38 25. Texture drywall-machine-knockdown 459.80 SF 1.26 1.61 115.88 696.84 15/150 yrs Avg. 10% (2.30) 694.54 26. Seal part of the ceiling++;latex based stain blockcr-one coat 32.00 SF 0.71 0.18 4.54 27.44 15/15 yrs Avg. 80% [MI (2.05) 25.39 27. Paint the ceiling-one coat 115.65 SF 0.80 1.38 18.50 112.40 15/15 yrs Avg. 80% [M] (15.73) 96.67 Recoverable depreciation has been applied based upon the age.life expectancy and condition of the applicable item(s)being repairedIreplaced. Totals: Bedroom 7.46 209.28 1,263.11 37.72 1,225.39 Hall Height:8' 178.67 SF Walls 42.07 SF Ceiling 110 - 220.73 SF Walls&Ceiling 42.07 SF Floor rs 4.67 SY Flooring 22.33 LF Floor Perimeter 22.33 LF Ceil.Perimeter Missing Wall 3'9 7/8"X 8' Opens into LIVING_ROOM Door 3'X 6'8" Opens into BEDROOM Missing Wall 3'9 7/8"X 8' Opens into Exterior QUANTITY UNIT TAX O&P RCV AGE/LIFE COND. DEP% DEPREC. ACV 1 t: The items below are to repair the ceiling 28. Contents-move out then reset 1.00 EA 78.43 0.00 15.68 94.11 15/NA Avg. 0% (0.00) 94.11 29. Floor protection-plastic and tape-10 mil 42.07 SF 0.35 0.35 2.94 18.01 15/15 yrs Avg. 80% [M) (4.04) 13.97 ` 30. Mask and prep for paint-paper and tape(per LF) 22.33 LF 0.95 0.09 4.24 25.54 15/15 yrs Avg. 80% [M] (1.07) 24.47 31. R&R 5/8"drywall-hung,taped,ready for texture 32.00 SF 3.89 1.64 24.90 151.02 15/150 yrs Avg. 10% (2.34) 148.68 I. t' CARLAVIACAVA 5/6/2023 Page:6 16D1p ' Citizens Claims `'CITIZENS P.O.Box 19700 Jacksonville,Florida 32245-9700 Phone: (866)411-2742 Fax: (888)392-6739 email:claims.comntunications(iicitizensfla.corn CONTINUED-Hall QUANTITY UNIT TAX O&P RCV AGE/LIFE COND. DEP% DEPREC. ACV 32. R&R Blown-in insulation-8"depth-R l9 32.00SF 2.11 1.50 13.50 82.52 151150yrs Avg. 10% (2.14) 80.38 ' 33. Texture drywall-machine-knockdown 220.73 SF 1.26 0.77 55.62 334.51 15/150 yrs Avg. 10% (1.10) 333.41 34. Seal part of the ceiling w/latex based stain blocker-one coat 32.00 SF 0.71 0.18 4.54 27.44 15/15 yrs Avg. 80% [M] (2.05) 25.39 35. Paint the ceiling-one coat 42.07 SF 0.80 0.50 6.74 40.90 15/15 yrs Avg. 80% [MI {5.72) 35.18 Recoverable depreciation has been applied based upon the age,life expectancy and condition of the applicable item(s)being repaired/replaced. Totals: Hall 5.03 128.16 774.05 18.46 755.59 Total: Interior 23.67 640.64 3,867.54 128.38 3,739.16 Total: Source-EagleView Roof 290.51 3,240.16 19,731.53 2,047,95 17,683.58 Labor Minimums Applied QUANTITY UNIT TAX O&P RCV AGE/LIFE COND. DEP% DEPREC. ACV 36. Insulation labor minimum* 1.00 EA 21.02 0.00 4.20 25.22 0/NA Avg. 0% (0.00) 25.22 Totals: Labor Minimums 0.00 4.20 25.22 0.00 25.22 Applied Line Item Totals: 290.51 3,440.08 21,162.80 2,047.95 19,114.85 CARLAVIACAVA [%]-Indicates that depreciate by percent was used for this item [M]-Indicates that the depreciation percentage was Limited by the maximum allowable depreciation for this item I CARLAVIACAVA 5/6/2023 Page:7 is 1'. • CITIZENS Citizens Claims P.O.Box 19700 Jacksonville,Florida 32245-9700 Phone: (866)411-2742 Fax: (888)392-6739 email:claims.communications@citizensfla.com Grand Total Areas: 958.88 SF Walls 413.36 SF Ceiling 1,372.24 SF Walls and Ceiling 413.36 SF Floor 45.93 SY Flooring 118.69 LF Floor Perimeter { 0.00 SF Long Wall 0.00 SF Short Wall 125.69 LF Ceil.Perimeter 413.36 Floor Area 448.42 Total Area 958.88 Interior Wall Area 882.02 Exterior Wall Area 88.17 Exterior Perimeter of Walls 1,989.47 Surface Area 19.89 Number of Squares 229.19 Total Perimeter Length 33.66 Total Ridge Length 49.53 Total Hip Length CARLAVIACAVA 5/6/2023 Page:8 I'. I6D1O • ttt' Cal lZENS Citizens Claims P.Q.Box 19700 Jacksonville,Florida 32245-9700 Phone: (866)411-2742 Fax: (888)392-6739 email:claims.communications@citizensfla.com • Summary for Building Coverage Line Item Total 17,432.2I Overhead Profit 1,720.04 Material Sales Tax 1,720.04 290.51 Replacement Cost Value $21,162.80 Less Depreciation (2,047.95) Actual Cash Value $19,114.85 Less Deductible (3,698.00) Net Claim $15,416.85 Total Recoverable Depreciation 2.047,95 Net Claim if Depredation is Recovered $17,464.80 Dale Robertson CARLAVIACAVA 5/6/2023 Page:9 ti 16D10 �x'ClTIZENS Citizens Claims P.O.Box 19700 Jacksonville,Florida 32245-9700 Phone: (866)411-2742 Fax: (888)392-6739 email:claims.communications@citizensfla.corn Recap of Taxes,Overhead and Profit Overhead(10%) Profit(10%) Material Sales Tax Laundering Tax(2%) Manut.Home Tax Storage Rental Tax ;Oft (7%) (6%) (7 o 4�?k1w /o) Line Items 1.720.04 1,720.04 290.51 0,00 0.00 0.00 Total 1,720.04 1,720.04 290.51 0.00 0.00 0.00 CARLAVIACAVA r,. 5/6/2023 Page: 10 GG, 1 6 D 1 0 I CITIZENS Citizens Claims P.O.Box 19700 Jacksonville,Florida 32245-9700 Phone: (866)411-2742 Fax: (888)392-6739 email:claims.communications@citizensfla.corn -----,v,-;-,,-,•). .•.-7.-- m....-7-; • ' ..''''',.'"'2• 1`.4:, -, rk7.r--P;-.''g9.749te• -.:-2.,;•:*:"4,t44*:".7I:f•t:'' , 't'.''"'.'*. 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CARL AVIACAVA , ii 1 I, li ii z It 6i a .0 CITIZENS PROPERTY INSURANCE CORPORATION 4Licer-- 301 WBAY ST LITIZENS \/ t JACiCSONVILLILLE FL 32202 D2 ?1OPLRW INSVPANCr CORPORMIOti ��ccc------ POLICY CHANGE SUMMARY POLICY NUMBER POLICY PERIOD FROM 12/18/2022 TO 12/18/2023 at 12:01 a.m.Eastern lime Transaction:RENEWAL Item Prior Policy Information Amended Policy Information Property Address Info Policy Address(1:5205 HARDEE ST,Naples,FL) City NAPLES Naples • County COLLIER Collier Dwelling Dwelling at 5205 HARDEE ST,Naples,FL Four Point Inspection Date 12/02/2019 0612812021 Roof Remaining Useful Life(years) 3 7 Dwelling Coverages Coverage A Coverage A-Dwelling 184,900 220,800 Coverage B Coverage B-Other Structures Amount 3,700 4,420 Coverage G Coverage C-Personal Property 46,230 55,200 External Inspections • James Carithers Added Line Coverages Coverage D Coverage D-Loss of Use 18,490 22,080 Hurricane Hurricane-Deductible Amount 3,698 4,416 Ordinance Or Law Ordinance Or Law-Amount 46,230 55,200 This summary is for informational purposes only and does not change any of the terms or provisions on your policy.Please carefully review your policy Declarations and any attached forms for a complete description of coverage. tr PCS 01 14 Page 1 of 1 1 6D 1 0 CITIZENS PROPERTY INSURANCE CORPORATION rr: 301 W BAY STREET, SUITE 1300 CITIZENS JACKSONVILLE FL 32202-5142 PROPERTY OISORANCC CORPORATION Homeowners HO-3 Special Form Policy - Declarations , POLICY NUMBER: POLICY PERIOD: FROM 12/18/2022 TO 12/18/2023 at 12:01 a.m.Eastern Time at the Location of the Residence Premises Transaction:RENEWAL Named Insured and Mailing Address: Location Of Residence Premises: Agent: Fl.Agent tic.#:W011739 First Named Insured: 5205 HARDEE ST MANNY MORIN NAPLES INSURANCE Carla Viacava Naples FL 34113-7729 AGENCY INC 5205 HARDEE ST County:Collier ELISE MENDEZ NAPLES, FL 34113 10651 N KENDALL DR STE 111 Phone Number:239-776-1422 MIAMI,FL 33176 Phone Number:239-776-7341 Primary Email Address: Citizens Agency ID#:30395 olga1954@embarqmail.com Additional Named Insured: Please refer to"ADDITIONAL NAMED INSURED(S)"section for details Coverage is only provided where a premium and a limit of liability is shown 0 All Other Perils Deductible:$1,000 Hurricane Deductible: $4,416 (2%) LIMIT OF LIABILITY ANNUAL PREMIUM SECTION I-PROPERTY COVERAGES $2,432 A.Dwelling: $220,800 B.Other Structures: $4,420 co C.Personal Property: $55,200 D.Loss of Use: $22,080 § SECTION II-LIABILITY COVERAGES E.Personal Liability: $100,000 $11 F. Medical Payments: $2,000 INCLUDED OTHER COVERAGES Ordinance or Law Limit(25%of Coy A) (See Policy) Included SUBTOTAL: $2,443 Florida Hurricane Catastrophe Fund Build-Up Premium: $43 Premium Adjustment Due To Allowable Rate Change: ($297) MANDATORY ADDITIONAL CHARGES; .- 2022 Florida Insurance Guaranty Association(FIGA)Regular Assessment $15 2022-B Florida Insurance Guaranty Association(FIGA)Regular Assessment $28 Emergency Management Preparedness and Assistance Trust Fund(EMPA) $2 Tax-Exempt Surcharge $38 — TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES: $2,272 The portion of your premium for: ®_ Hurricane Coverage is $1,013 Non-Hurricane Coverage is$1,176 r • Authorized By:ELISE MENDEZ Processed Date: 10/28/2022 DEC H03 12 19 Mortgageholder Page 1 of 5 1 601 0 CITIZENS PROPERTY INSURANCE CORPORATION c)1 (.)v_ , ILL W BAY ST 02CITIZENS JACKSONVILLE FL 32202FROP(R(Y IO9IMN((('OW'OMIIOI( POLICY CHANGE SUMMARY POLICY NUMBER: POLICY PERIOD FROM 12/18/2022 TO 12/18/2023 at 12:01 a.m.Eastern Time Transaction:RENEWAL Item Prior Policy Information Amended Policy Information Property Address Info Policy Address(1:5205 HARDEE ST,Naples,FL) City NAPLES Naples County COLLIER Collier Dwelling Dwelling at 5205 HARDEE ST,Naples,FL Four Point Inspection Date 12/02/2019 _ 06/28/2021 Roof Remaining Useful Life(years) 3 7 Dwelling Coverages Coverage A Coverage A-Dwelling 184,900 _ 220,800 Coverage B Coverage B-Other Structures Amount 3,700 4,420 Coverage C Coverage C-Personal Property 46,230 55,200 External Inspections James Carlthers Added Line Coverages Coverage D ---__—_--_ _ Coverage D-Loss of Use 18,490 22,080 Hurricane Hurricane-Deductible Amount 3,698 4,416 Ordinance Or Law Ordinance Or Law-Amount 46,230 55,200 This summary is for informational purposes only and does not change any of the terms or provisions on your policy. Please carefully review your policy Declarations and any attached forms for a complete description of coverage. PCS 01 14 -1 Page 1 of 1 CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY STREET, SUITE 1300 CITIZENS JACKSONVILLE FL 32202-5142 rnaron insunnnu amPOnA111/14 Homeowners HO-3 Special Form Policy -Declarations Policy Number:WIN POLICY PERIOD: FROM 12/18/2022 TO 12/18/2023 First Named Insured:Carla Vlacava at 12:01 a.m.Eastern Time at the Location of the Residence Premises { Forms and Endorsements applicable to this policy: CIT 24 07 08, IL P 001 01 04,CIT 04 85 02 21,CIT 04 96 0216,CIT HO 01 09 06 22,CIT 04 86 02 21,CIT HO-3 02 22, CIT 27 06 13 Rating/Underwriting Information Year Built: 1981 'Protective Device-Burglar Alarm: No Town/Row House: No?Protective Device-Fire Alarm: No Construction Type: Frame Protective Device-Sprinkler: None BCEGS: Ungraded No Prior Insurance Surcharge: No Territory/Coastal Territory: 551 /00 Terrain: B Wind!Hall Exclusion: No Roof Cover: FBC Equivalent Municipal Code-Police: 999 Roof Cover-FBC Wind Speed: N/A Municipal Code-Fire: 999 Roof Cover-FBC Wind Design: N/A Occupancy: Owner Occupied Roof Deck Attachment: Level C- Use: Primary Roof-Wall Connection: Clips Number of Families: 1 Secondary Water Resistance: Na Protection Class: 4 Roof Shape: Hip Distance to Hydrant(ft.): 500 Opening Protection: Class A Distance to Fire Station(mi.): 1 A premium adjustment of($1,875)is included to reflect the building's wind loss mitigation features or construction techniques that exists. A premium adjustment of$0 is included to reflect the building code effectiveness grade for your area.Adjustments range from a 2% surcharge to a 13%credit. Your property coverage limits have been adjusted for Inflation, Your policy premium has increased by$604. Of this amount: The premium difference due to an approved rate change Is$212 The premium difference due to changes in your coverage is$329 The premium difference due to mandatory additional charges plus FHCF Build-up is$63 • DEC HO3 12 19 Mortgageholder Page 2 of 5 16D 0 CITIZENS PROPERTY INSURANCE CORPORATION NOV 7 2022 301 W BAY STREET, SUITE 1300 CITIZENS JACKSONVILLE FL 32202-5142 PROPIRN INSURANCE CORPORATION Homeowners HO-3 Special Form Policy - Declarations Policy Number: POLICY PERIOD: FROM 12/18/2022 TO 12/18/2023 First Named Insured:Carla Viacava at 12:01 a.m.Eastern Time at the Location of the Residence Premises ADDITIONAL NAMED INSURED(S) Name Address No Additional Named Insureds ADDITIONAL INTEREST(S) it Interest type Name and Address Loan Number 1 1st Mortgagee Habitat for Humanity 9021 11145 Tamiami Trl E Naples, FL 34113-7753 2 2nd Mortgagee COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS CHS DIVISION 3339 TAMIAMI TRAIL E STE 211 NAPLES,FL 34112 M 0 v O 8 Ih U1 r- N O O U7 U) U7 03 O 0 0 DEC H03 12 19 Mortgageholder Page 3 of 5 >_ 16D10 • CITIZENS PROPERTY INSURANCE CORPORATION NOV 0 7 2022 301 W BAY STREET,SUITE 1300 CITIZENS JACKSONVILLE FL 32202-5142 PROPLRIY INSURANCE CORPORATION Homeowners HO-3 Special Form Policy - Declarations Policy Number: POLICY PERIOD: FROM 12/18/2022 TO 12/18/2023 First Named insured:Carla Viacava at 12:01 a.m.Eastern Time at the Location of the Residence Premises ADDITIONAL NAMED INSURED(S) Name Address No Additional Named Insureds ADDITIONAL INTEREST(S) # Interest Type Name and Address Loan Number 1 1st Mortgagee Habitat for Humanity 9021 11145 Tamiami Tri E Naples, FL 34113-7753 2 2nd Mortgagee COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS CHS DIVISION 3339 TAMIAMI TRAIL E STE 211 NAPLES, FL 34112 0 lO CO ID I ii ti 6 � r- > DEC HO3 12 19 Mortgageholder Page 3 of 5 f'. 3: i6D10 CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY STREET, SUITE 1300 CITIZENS JACKSONVILLE FL 32202-5142 PROPERTYIRSUOANC(COflPONAPIOU Homeowners HO-3 Special Form Policy - Declarations Policy Number: POLICY PERIOD: FROM 12/18/2022 TO 12/18/2023 First Named Insured:Carla Viacava at 12:01 a.m.Eastern Time at the Location of the Residence Premises FLOOD COVERAGE IS NOT PROVIDED BY THIS POLICY. THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES, WHICH MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU. YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM. LAW AND ORDINANCE: LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. PLEASE DISCUSS WITH YOUR INSURANCE AGENT. DEC H03 12 19 Mortgageholder Page 4 of 5 1 6 D 1 0 CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY STREET,SUITE 1300 CITIZENS JACKSONVILLE FL 32202-5142 PROP[RIY 11ISORANCr CORPARA110N Homeowners HO-3 Special Form Policy - Declarations Policy Number: POLICY PERIOD: FROM 12/18/2022 TO 12/18/2023 First Named insured:Carla Viacava at 12:01 a.m.Eastern Time at the Location of the Residence Premises FLOOD INSURANCE: YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE. YOUR HOMEOWNER'S INSURANCE POLICY DOES NOT INCLUDE COVERAGE FOR DAMAGE RESULTING FROM FLOOD EVEN IF HURRICANE WINDS AND RAIN CAUSED THE FLOOD TO OCCUR. WITHOUT SEPARATE FLOOD INSURANCE COVERAGE, YOU MAY HAVE O UNCOVERED LOSSES CAUSED BY FLOOD. PLEASE co DISCUSS THE NEED TO PURCHASE SEPARATE FLOOD INSURANCE COVERAGE WITH YOUR INSURANCE AGENT. TO REPORT A LOSS OR CLAIM CALL 866.411.2742 S IN CASE OF LOSS TO COVERED PROPERTY,YOU MUST TAKE REASONABLE EMERGENCY MEASURES SOLELY TO PROTECT THE PROPERTY FROM FURTHER DAMAGE IN ACCORDANCE WITH THE POLICY PROVISIONS. PROMPT NOTICE OF THE LOSS MUST BE GIVEN TO US OR YOUR INSURANCE AGENT. EXCEPT FOR REASONABLE EMERGENCY MEASURES, THERE IS NO COVERAGE FOR REPAIRS THAT BEGIN BEFORE THE EARLIER OF: (A) 72 HOURS AFTER WE ARE NOTIFIED OF THE LOSS,(B)THE TIME OF LOSS INSPECTION BY US, OR (C)THE TIME OF OTHER APPROVAL BY US. THIS POLICY CONTAINS LIMITS ON CERTAIN COVERED LOSSES,ALL SUBJECT TO THE TERMS AND CONDITIONS OF YOUR POLICY. THESE LIMITS MAY INCLUDE A $10,000 LIMIT ON COVERAGE FOR COVERED LOSSES CAUSED BY ACCIDENTAL DISCHARGE OR OVERFLOW OF WATER OR STEAM FROM SPECIFIED HOUSEHOLD SYSTEMS, SEEPAGE OR LEAKAGE OF WATER OR STEAM, CONDENSATION, MOISTURE OR VAPOR, AS DESCRIBED AND INSURED IN YOUR POLICY (HEREAFTER COLLECTIVELY REFERRED TO AS ACCIDENTAL DISCHARGE OF WATER IN THIS PARAGRAPH).AS ANOTHER EXAMPLE,THERE IS ALSO LIMIT OF$3,000 APPLICABLE TO REASONABLE EMERGENCY MEASURES TAKEN TO PROTECT COVERED PROPERTY = FROM FURTHER DAMAGE BY ACCIDENTAL DISCHARGE OF WATER.THE AMOUNT WE PAY FOR THE NECESSARY REASONABLE EMERGENCY MEASURES YOU TAKE SOLELY TO PROTECT COVERED PROPERTY FROM FURTHER DAMAGE BY ACCIDENTAL DISCHARGE OF WATER WILL BE DEDUCTED FROM THE $10,000 LIMIT ON COVERAGE FOR ACCIDENTAL DISCHARGE OF WATER. INFORMATION ABOUT YOUR POLICY MAY BE MADE AVAILABLE TO INSURANCE COMPANIES AND/OR AGENTS TO ASSIST THEM IN FINDING OTHER AVAILABLE INSURANCE MARKETS. PLEASE CONTACT YOUR AGENT IF THERE ARE ANY QUESTIONS PERTAINING TO YOUR POLICY. IF YOU ARE UNABLE TO CONTACT YOUR AGENT,YOU MAY REACH CITIZENS AT 866.411.2742. DEC H03 12 19 Mortgageholder Page 5 of 5 16D1 O CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY STREET,SUITE 1300 CITIZENS JACKSONVILLE FL 32202-5142 PROP[OIY INSOMNC[CORPOMIION • Homeowners HO-3 Special Form Policy -Declarations Policy Number:MN POLICY PERIOD: FROM 12/18/2022 TO 12/18/2023 First Named Insured:Carla Vlacava at 12:01 a.m.Eastern Time at the Location of the Residence Premises FLOOD INSURANCE: YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE. • YOUR HOMEOWNER'S INSURANCE POLICY DOES NOT INCLUDE COVERAGE FOR DAMAGE RESULTING FROM FLOOD EVEN IF HURRICANE WINDS AND RAIN CAUSED THE FLOOD TO OCCUR. WITHOUT SEPARATE FLOOD INSURANCE COVERAGE, YOU MAY HAVE UNCOVERED LOSSES CAUSED BY FLOOD. PLEASE co DISCUSS THE NEED TO PURCHASE SEPARATE FLOOD INSURANCE COVERAGE WITH YOUR INSURANCE AGENT. co TO REPORT A LOSS OR CLAIM CALL 866.411.2742 IN CASE OF LOSS TO COVERED PROPERTY,YOU MUST TAKE REASONABLE EMERGENCY MEASURES SOLELY TO PROTECT THE PROPERTY FROM FURTHER DAMAGE IN ACCORDANCE WITH THE POLICY PROVISIONS, I PROMPT NOTICE OF THE LOSS MUST BE GIVEN TO US OR YOUR INSURANCE AGENT. EXCEPT FOR REASONABLE EMERGENCY MEASURES,THERE IS NO COVERAGE FOR REPAIRS THAT BEGIN BEFORE THE EARLIER OF: (A) 72 HOURS AFTER WE ARE NOTIFIED OF THE LOSS, (B)THE TIME OF LOSS INSPECTION BY US,OR(C)THE TIME OF OTHER APPROVAL BY US. THIS POLICY CONTAINS LIMITS ON CERTAIN COVERED LOSSES,ALL SUBJECT TO THE TERMS AND CONDITIONS OF YOUR POLICY. THESE LIMITS MAY INCLUDE A $10,000 LIMIT ON COVERAGE FOR COVERED LOSSES CAUSED BY ACCIDENTAL DISCHARGE OR OVERFLOW OF WATER OR STEAM FROM SPECIFIED HOUSEHOLD SYSTEMS, SEEPAGE OR LEAKAGE OF WATER OR STEAM, CONDENSATION, MOISTURE OR VAPOR, AS DESCRIBED AND INSURED IN YOUR POLICY (HEREAFTER COLLECTIVELY REFERRED TO AS ACCIDENTAL DISCHARGE OF WATER IN THIS PARAGRAPH).AS ANOTHER EXAM PLE,THERE IS ALSO LIMIT OF$3,000 APPLICABLE TO REASONABLE EMERGENCY MEASURES TAKEN TO PROTECT COVERED PROPERTY >= FROM FURTHER DAMAGE BY ACCIDENTAL DISCHARGE OF WATER.THE AMOUNT WE PAY FOR THE NECESSARY REASONABLE EMERGENCY MEASURES YOU TAKE SOLELY TO PROTECT COVERED PROPERTY FROM FURTHER DAMAGE BY ACCIDENTAL DISCHARGE OF WATER WILL BE DEDUCTED FROM THE $10,000 LIMIT ON COVERAGE FOR ACCIDENTAL DISCHARGE OF WATER. C INFORMATION ABOUT YOUR POLICY MAY BE MADE AVAILABLE TO INSURANCE COMPANIES AND/OR AGENTS TO ASSIST THEM IN FINDING OTHER AVAILABLE INSURANCE MARKETS. r PLEASE CONTACT YOUR AGENT IF THERE ARE ANY QUESTIONS PERTAINING TO YOUR POLICY. IF YOU ARE UNABLE TO CONTACT YOUR AGENT,YOU MAY REACH CITIZENS AT 866.411.2742. I rDEC H03 12 19 Martgageholder Page 5 of 5 16D10 kAdhattrti SOUTHWEST FLORIDA CLAIMS ADJUSTERS, LLC 1217 CAPE CORAL PKWY E. STE. 198 CAPE CORAL, FL 3390 TEL: (855) 910-1212 Email: swflcasvcs@gmail.com Invoice # 2023-5205 (INI) Client Name: Carla Viacava Property Address:5205 Hardee Street Naples, FL 34113 Claim# Policy# Date of Loss: 09/28/2022 Type of Loss: Hurricane Ian Carrier's Check No:0620802 Carrier's Check Date: 05/10/2023 Service Rendered: Claim's Adjusting Adjusting Fee Amount/Description: adjusting service fee, 10%of initial undisputed payment. Total Initial Payment Amount: $17,464.80 Amount Due:$1,746.48 Provide payment with a Cashier's Check and/or Check made to the order of Southwest Florida Claims Adjusters, LLC displaying Claim number on the Memo. Mail payment to the is address referenced-above. Once the contract fee payment has cleared,Southwest Florida Claims Adjusters, LLC will provide Client(s) a copy of the Invoice displaying a "PAID"stamp. • ty fi 16D10 ,, • • . Porno Request for Taxpayer cite Form to the (Rev,October2013) Identification Number and Certification requester.Do not IDnloanem na anus Service ry send to the IRS. Go to www.lrs.gov/FormW9 for instructions and the latest Information. I Name(os shown on your Income tax return).Name is required on this tine;do not leave this Me blank. SOUTHWEST FLORIDA CLAIMS ADJUSTERS,LLC 2 Business name/disregarded entity name,if different from above 3 Check aperi propriate ppropriate box for federal tax classification of the person whose name is entered on line4 Exemptions(codes apply only to fallowing seven boxes. 1.Check only one of the certain entities,not Individuals;see instructions on page 3): o El Individual/sole proprietor or ❑ C Corporation 0 S Corporation 0 Partnership 0 TrusVeslate c ignore-member LLC o Exempt payee code(if any) F' 0 limited liability company.Enter the tax classification(C=C corporation,S=5 corporation,P=Partnership)Y. `o Note:Check the appropriate box in the line above for the lee Classification of the single-member owner.Do not check Exemption from FATCA reporting e LLC if the LLC Is classified as a single.member LLC that Is disregarded from the owner unless the owner of the LLC is E O another LLC that Is not disregarded from the owner for U.S.federal tex purposes.Otherwise,a single member LW that coda(F any! le Is disregarded from the owner should check the appropriate box for the tax classification of he owner. ❑ Other(see instructions)► (Aopr•,ro.aew„r,,..wru,•d•ur,w.m•as) • q 5 Address(number,street,end opt.or suite no.)See Instructions. Requester's name and address(opttanai) $ 1217 CAPE CORAL PARKWAY E STE.198 a City,state,and ZIP code CAPE CORAL,FL 33904 7 List account number(s)here(optional) WEI Taxpayer Identification Number(TIN) Enter your TIN In the appropriate box.The TIN provided must match the name given on line I to avoid (Social security number backup withholding.For Individuals,this Is generally your social security nt•mber(SSN).However,for a resident alien,sole proprietor,or disregarded entity,see the Instructions for Part I,later.For other — entities,it is your employer Identification number(EIN).It you do not have is number,see How to get a �J —l___ TIN,later. or Note:If the account Is in more than one name,see the Instructions for line 1.Also see What Name and Empiayer Identincagon number I Number To Give the Requester for guidelines on whose number to enter. 8 3 - 3 5 3 8 8 0 4 Part II Certification ti Under penalties of perjury,I certify that: 1.The number shown on this form is my correct taxpayer identification number(or I ant waiting for a number to be Issued to me);and 2.I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified one that I am no longer subject to backup withholding;and 3.I am a U.S.citizen or other U.S.person(defined below); 4.The FATCA code(s)entered on this form(If ar y Ind rig that I am exempt from FATCA reporting Is correct. Certification Instructions.You must cross out item bone it you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all Interest and dividends o your tax return.For real estate transactions,Item 2 does not apply.For mortgage interest paid, acquisition or abandonment of secured pro rty, ncellatien of debt,contributions to an Individual retirement arrangement(IRA),and generally,payments other than interest and dividends,you are no r [red to sign the certification,but you must provide your correct TIN.See the instructions for Part Ii,later, Sign Signature of Here U.S.person Date► (J (/L� ? f 02 �62_3 General Instructions •Form 1099-0IV(dividends,Meier tog thos rem stocks or mutual funds) �i. Section references are to the internal Revenu de unless otherwise noted. •Form 1099-MISC(various types of income,prizes,awards,or gross proceeds) Future developments,For the latest informal n bout developments •related to Form W-9 and its instructions,such glslation enacted Form 1 ons.13(stock Of mutual fund sales and certain other transactions by brokers)after they were published,go to www.irs.gov/Fo W9. •Form 1099-S(proceeds from real estate transactions) Purpose of Form •Form 1099-K(merchant card and third partytransactions) network An Individual or entity(Form W-9 requester)who Is required to file en •Form 1098(home mortgage interest),1098•E(student loan Interest),information return with the IRS must obtain your correct taxpayer 1098-T(tuition) Identification number(Tit)which may be your social security number (SSN),Indlviduai taxpayer identification number((TIN),adoption • 'Form 1099-C(canceled debt) taxpayer Identification number(ATIN),or employer Identification number •Form 1099-A(acquisition or abandonment of secured property) (EIN),to report on an information return the amount paid to you,or other Use Form W-9 only If you are a U.S.person(including a resident amount reportable on an information return.Examples of Information alien),to provide your correct TIN. returns Include,but are not limited to,the following. If you do not return Form W-9 to the requester with a TIN,you might •Form 1099-INT(interest earned or paid) be subject to backup withholding.See What Is backup withholding, later, Cat.No.10231X Form W-9(Rev.lo-2d1a) , • is 1' 16D10 Collier County Community and Human Services Division (CHS) Homeowner Insurance Check Endorsement Policy Collier County has provided purchase assistance and/or rehabilitation assistance to income qualified recipients. As long as the recipient continues to own and occupy the assisted property during the term of the mortgage/lien,then the loan will not have to be repaid. On occasion,the recipient may file a property insurance claim with their homeowner insurance company for damages to the assisted property and receive money to make the repairs. If the insurance claim check is made payable to the homeowner and Collier County, then the homeowner can request in writing that Collier County endorse the check for deposit in order to pay for the repairs. The following documents must be provided to CHS at the address below for check endorsement consideration: � t/,/(1 Copy of Homeowner's current insurance policy-Declaration Page. V �; Copy of insurance company's claim report with worksheet including description of repairs and costs. /. Copy of photos of claim damage. .— i,J4. Copy of Insurance check(s)payable to homeowner, first lien holder and Collier County. Homeowner Name: /4/4(!_ -!�N 1 L Homeowner Address: (4- Primary Contact Number: 39- -3 Homeowner Email: wi /k(J/l j'S C,)-7-///7& i ?//. ( ;72 OFFICE USE ONLY Wi 4,,f/ G / Reviewed C - rant Co •dinator Date Fl--M �� pproved CHS Dir ctor Dat Denied AMERICAN INTEGRITY INSURANCE Check filo. 0000723846 COMPANY OF FLORIDA,INC. CLAIMS ACCOUNT PO BOX 26349 PNC BANK,N.A. PAMPA, FL 33623 1669 Phoenix Pkwy Ste 210 1 86ti 27%9£371 College Park,GA 10349.5463 63-1392/6°"11 $ 14,000.00I PAY EXACT Y Fourteen Thousand Dollars And Zero Cents TO THE Marie-Rose Saintil-Daniel, Dutroff Law Firm rlabile( for Humanity VOID AFTER 90 DAYS ORDER and Collier County board of County Commissioners CHS Division OF 5426 BAN'CENTER DR / - , STE 600 TAMPA.FL.33609-3440 -• MEMO Soo attached for details • 4101AMERICAN INTEGRITY INSURANCE COMPANY OF FI.ORIDA, INC I CLAIMS ACCOUNT (-fleak No. U J0'23C'11i tvfanr.4o:.n Sa4-1;1)aniar, Dubod i aw r-inn. I1abi!al for i4.,rnandy ant C;ol:u•r Cunr;y board of Counry Commissioners CHS Dwrsron Check F)atr t 5471;FP.Y GIN f I ft DR SIE6JO TAtAu.A,I L 33:{13O!):f44I Ct 10-001 1074'3 Payment • Reference Date Description 11111111111111111 02/28/21 CHO-00110746/Saintil Daniel Fnl Prnt l-IT "' L7IRT Check.Amount Stt..0;)':n'i AMERICAN INTEGRITY INSURANCE COMPANY OF FLORIDA,INC.I CLAIMS ACCOUNT Check No 000072384E Woo e Rose Sainul-Daniel. 1)ubull Lane I um, Hab.tat for Humanly and(k,lhe,count,hoard of i:nunto Ccmm,ss,(,nyrs CHS!)i•nson Cheek Daft. lJf,81Y Cf N11-R DR SI! 3Q'1 CI-tO-00110/Ili Pay111e• nt Reference Date Description 02/28l2' 111111111111111Pattltil-Dattlei I nl Pout LI I "' LU131 • Check Amount 16D10 , 1 tk n 0 \.... iii •_.t i . 0 • -,1 n . 0 n 0 3 3 0) u) o n) cn o AMERtCAN IN[EGRITY iNSJRAr•iCE Check No. 000(1723873 COMP 01 FLORIDA, INC. Chuck Ilalc • :. CLAIMS ACCOUNT • PC)BC))!26349 PNC DANK,N.A. TAMPA FL 33623 1669 Phoena Pkwy Ste 210 Colle0e Park,:;A 30349-5461 1 866 277 b13/1 63-1392/630 $ 7,000.02] ..,Y s en Thousand Dollars And Zero Cents • O THE Marie-Rosa Saintii Daniel, Duboff Law Firm, Habitat for Humanity VOID Al CER 9C DAYS " ORDER and Collier County Board of County Commissioners CHS Division OF 5426 BAY CENT ER DR 2 STE 600 TAMPA,FL 33609-3440 — -- -- — CHO-00110747 MEMO See attached for details AMERICAN INTE1_RlTY INSURANCE COMPANY OF FLORIDA, INC./CLAIMS ACCOUNT i, u:ck 1Vv. UtJ(0 2:i873 tdane t,. u.nm.:,, ITrbol' law 1 not riabitai for Iturr,an'l ar c CdLr;•CoLL,r-Fioar,t c1 t:cuuty('munis:.,Onert.CHS Div-lion (;hncK Dote, litY t;l',II I?lii2 it I At II'•. l 1. ','hu:I-Lear) Cn:)-t101 1074.' Paymqul Re erence Date cri Lion 03/03/21 til-Daniel I nl Pint LIT I_Z/RT '".a • Check Amount B/,Iin U.) AMERICAN INTEGRITY INSURANCE COMPANY OF FLORIDA, INC. I CLAIMS ACCOUNT Check No. 0000723873 I),'bclt Law I,rni. II,.U,tat tor Ii,ns�.,tp Cl14;C4!r)iilC .. , •... ,ru C.,;f C�.,n:',y Bo lid of(. t'ty Con,ii ocr:n:CHS.Dii-- ,or, . •;i,}IIA1 !:!I•::r-il I/l� ! �J(sitl`.irl% Reftrrttnce Date De .cri Mori Check Amount $/,.)00,U0) 1 6 D 1 CD 0 U.0 (3) a , 0 ) n 0 t \II 3 3 (h. a 16D10 American Integrity Insurance Company of Florida AMERICAN' � 5426 Bay Center Drive, Suite 600 INTEGRITY Tampa, FL 33609 POLICY NUMBERMIIIII HOMEOWNERS POLICY DECLARATIONS POLICY FORM: H03 ❑New Issue CI Renewal ❑Change IMPORTANT PHONE NUMBERS: Your Agency: (239)657-3614 Policy Effective Date: 07/29/2022 Customer Service: (866)968-8390 Policy Expiration Date: 07/29/2023 Claims Reporting: (866)277-9871 12:01 a.m. STANDARD TIME at the residence premises INSURED NAME AND MAIL ADDRESS: YOUR AMERICAN INTEGRITY AGENCY IS: Marie R Saintil Daniel Bruce Hendry Insurance,LLC 13536 Koinonia Dr 711 W. Main Street Naples, FL 34114-8766 lmmokalee, FL 34142 Residence Premises covered by this policy Is: 13536 Koinonia DR, Naples, FL 34114-8766 County: Collier TOTAL ANNUAL POLICY PREMIUM: $2,671,91 The Hurricane portion of the premium is: $753.60 The non-Hurricane portion of the premium is: $1,818.38 Insurance is provided only with respect to the following coverages for which a limit of liability and/or premium is specified, subject to all conditions of this policy. Based on the information available to us, the premium shown is the lowest we offer for which you qualify. SECTION I—PROPERTY COVERAGES LIMIT OF LIABILITY PREMIUM Coverage A—Dwelling $184,000 $2,686.11 Coverage B—Other Structures $3,680 Included Coverage C—Personal Property $92,000 Included Coverage D—Loss of Use $18,400 Included Ordinance or Law: 10% of Coverage A $18,400 -$114.13 SECTION I—DEDUCTIBLES: is In case of a property loss,we only cover that part of the loss over the deductible(s)stated: All Other Perils: $1,000 Windstorm or Hail (Other Than Hurricane) $1,000 HURRICANE: 2% of Coverage A $3,680 Sinkhole: 10% of Coverage A $18,400 SECTION II—LIABILITY COVERAGES Coverage E-Personal Liability $100,000 Included Coverage F-Medical Payments to Others $1,000 Included • AIIC DEC 07 19 Print Date:05/30/2022 Page 1 16010 Ai1 ERIC 1t �t American Integrity Insurance Company of Florida � v 1 5426 Bay Center Drive, Suite 600 INTEGRITY Tampa, FL 33609 POLICY NUMBS IMill— OPTIONAL COVERAGES: LIMIT OF LIABILITY PREMIUM Sinkhole Loss $184,000 Included Ordinance or Law $18,400 -$114.13 Water Back Up and Sump Overflow Coverage $5,000 $20.58 DISCOUNTS AND SURCHARGES: Electronic Policy Distribution Senior/Retiree Windstorm Loss Mitigation Total discounts and/or surcharges applied: -$5,346.57 POLICY FEES: Managing General Agency (MGA)Fee $25.00 Emergency Management Preparedness and Assistance Surcharge $2.00 Florida Insurance Guaranty Association 2022 Assessment $52.35 FORM AND ENDORSEMENTS: Greeting Letter AIIC RN GL 08 19 Policyholder Notice AIIC H03 PHN CSAU 11 21 Privacy Statement AIIC PS 05 19 Deductible Notification Options AIIC H03 DO 07 19 Limitations on Roof Coverage AIIC RWT 01 19 Assignment Agreement Notice AIIC AA 02 20 Policy Jacket AIIC PJ 07 15 Notice of Change in Policy Terms AIIC H03 NOC 06 22 Homeowners 3 Special Form AIIC H03 10 21 Sinkhole Loss Coverage AIIC SK 11 14 Water Back Up and Sump Discharge or Overflow Coverage AIIC WBU 07 18 Outline of Your Homeowners Policy AIIC H03 OC 07 18 Checklist of Coverage OIR B1 1670 Notice of Premium Discounts for Hurricane Loss Mitigation OIR B1 1655 02 10 Notice of Consumer Reports Ordered and information Used in Premium AIIC NCRS 08 19 Determination These Declarations together with the Policy Jacket, Policy Form and endorsements,if any, issued to form a part thereof, complete the above numbered policy. • Authorized Countersignature: Date Signed:05/30/2022 AIIC DEC 07 19 Print Date;05/30/2022 Page 2 16D1p AME R N4 IC American Integrity Insurance Company of Florida i V 11 �l 5426 Bay Center Drive, Suite 600 INTEGRITY Tampa, FL 33609 POLICY NUMBER: OPTIONAL COVERAGES: LIMIT OF LIABILITY PREMIUM Sinkhole Loss $184,000 Included Ordinance or Law $18,400 -$114.13 Water Back Up and Sump Overflow Coverage $5,000 $20.58 DISCOUNTS AND SURCHARGES: Electronic Policy Distribution Senior/Retiree Windstorm Loss Mitigation Total discounts and/or surcharges applied: -55,346.57 POLICY FEES: Managing General Agency(MGA) Fee $25.00 Emergency Management Preparedness and Assistance Surcharge $2.00 Florida Insurance Guaranty Association 2022 Assessment $52.35 FORM AND ENDORSEMENTS: Greeting Letter AIIC RN GL 08 19 Policyholder Notice AIIC H03 PHN CSAU 11 21 Privacy Statement AIIC PS 0519 Deductible Notification Options AIIC H03 DO 07 19 Limitations on Roof Coverage AIIC RWT 01 19 Assignment Agreement Notice AIIC AA 02 20 Policy Jacket AIIC PJ 07 15 Notice of Change in Policy Terms AIIC H03 NOC 06 22 Homeowners 3 Special Form AIIC H03 10 21 Sinkhole Loss Coverage AIIC SK 11 14 Water Back Up and Sump Discharge or Overflow Coverage AIIC WBU 07 18 Outline of Your Homeowners Policy AIIC HO3 OC 07 18 Checklist of Coverage OIR B1 1670 Notice of Premium Discounts for Hurricane Loss Mitigation OIR B1 1655 02 10 Notice of Consumer Reports Ordered and Information Used in Premium AIIC NCRS 08 19 Determination These Declarations together with the Policy Jacket, Policy Form and endorsements, if any,issued to form a part thereof, complete the above numbered policy. 1 L:27C Authorized Countersignature: Date Signed:05/30/2022 AIIC DEC 07 19 Print Date:05/30/2022 Page 2 1i la 16D1 AJvtE American Integrity Insurance Company of Florida RI �- 5426 Bay Center Drive, Suite 600 INTEGRITY Tampa, FL 33609 POLICY NUMBER: is RATING INFORMATION: Construction Type: Frame Year of Construction: 2009 Year of Roof/Updated:2009 Type of Residence: Owner Occupied Dwelling Type: Row/Town House Number of Months Occupied: 9 to 12 Months Occupancy: Owner ADDITIONAL INTEREST(S): Second Mortgagee Collier County Board of County Commissioners CHS Division 3339 Tamiami TrI E Ste 211 Naples, FL 34112-5361 1076 THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES, WHICH MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU. THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR SINKHOLE LOSSES, WHICH MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU. A rate adjustment of -$4,918.07 is included to reflect the Windstorm Loss Mitigation Device Discount. This discount applies only to the wind portion of your premium and can range from a 0%to 89%discount. A rate adjustment of-$418.05 is included to reflect the Building Code Effectiveness Grade in your area. Adjustments range from a 1%surcharge to a 12%discount. Property Coverage limits have increased at renewal due to an inflation factor of 10%, as determined by an industry approved replacement cost estimator index to maintain insurance to an approximate replacement cost of the home. The difference in premium due to an approved rate Increase$1,174.43. AIIC DEC 07 19 Print Date:05/30/2022 Page 3 16D1 0 DUBOFF LAW FIRM 680 N.E.127 STREET / NORTH MIAMI / FLORIDA 33161 TEE.No. (305)899-0085 / FAX No.(305)899-0091 Attention: Habitat for Humanity [ March 2, 2023 Re: Mortgage Loan#: Mortgagor: Marie-Rose Saintil Daniel Premises: 13536 Koinonia Drive,Naples,Florida 34114 Ins. Claim No. WI Date of Loss - - 1 Dear Sir/Madam: Our law firm represented Marie-Rose Saintil Daniel in an insurance claim submitted to American Integrity Insurance Company of Florida for property damages at the mortgaged premises. As a result of a compromised negotiated settlement,we received the insurance company's coverage check in the amount of$7,000.00 for property damages made payable to Marie-rose Saintil Daniel Saintil representing the negotiated settlement amount for covered repairs. Because this was a compromised negotiated settlement,the insurance company did not provide us with any accompanying estimate relating to the payment of the$7,000.00. Should you require any further information,please feel free to contact us. Very truly yours, //Kenneth R. Duboff// KENNETH R. DUBOFF KRD/sw is 16CO10 CNI Concepts Enterprises INC Certified Building Contractors 6065 NW 167th St SB14 Miami FL 33015 cniconcepts.com cnicorp@live.com Phone(305)504-8884 Fax(305)504-8885 Certified General Contractor CGC1529534 Licensed Mold Assessor and Remediator MRSR3042,MRSA2850 Insured: Marie-Rose&Saintil Daniel Property: 13536 Koinonia Drive Naples,FL 34114 Claim Number: Policy Number:OW Type of Loss: Water Damage-Bath Date of Loss: 3/3/2021 12:00 AM Date Received: Date Inspected: Date Entered: Price List: FLNA8X_APR21 Restoration/Service/Remodel Estimate: SAINTIL-ROSE-BATH Gross Estimate of Total Repairs:$15,082.18 Gross Estimate of Structural Repairs COV A:$15,082.18 Recoverable Depreciation$190.75 Net Estimate of Total Repairs:(After depreciation)$14,891.43 is This estimate is presented utilizing the Xactimate estimating software customized to reflect the specific scope of work presented in this loss. In every monthly pricing publishing Xactware strongly recommend customers monitor their local markets for any such changes and adjust their estimate pricing as deemed appropriate. The FLNA8X_APR21 price list for the Naples,FL market was used for some or all of the unit costs.The estimator also may have relied on the use of written or verbal quotes from subcontract labor or suppliers who were deemed capable of completing their respective scopes of work. Estimate/Loss Report Closing Disclaimer: Determinations within this Loss Report is solely an opinion and based on information obtained from the insured,insurer,third parties and visual non-destructive inspections and investigations.Determination is further based on this provider's receiving a Certified Copy of the Policy,per FL statute 627.4137(Admitted)or FL Statute 626.9372(Surplus),from the carrier,and prior to this submission.Absent such,this provider has the right to amend this report by supplemental or otherwise as may later be determined necessary and/or once a true Certified Copy of the Policy is furnished as originally requested.Hidden structural defects,unforeseen/code required repairs,possible hidden damages,missing items,items of coverage not yet incurred or determined,would be additional scope and amounts to later be submitted under supplementation.This provider has the right to amend this report in the event of the above,or if it is determined there is an unintentional mistake/error or clerical typo error within.It is the responsibility of the recipient,of these herein documents,to carefully review this report in its entirety and notify this provider(delivered in writing)of any possible mistake(s)/error(s)or omissions,in order to give this provider an opportunity to make appropriate updates and/or corrections.The provider of this entire report is not responsible for any mistake(s)/error(s)or omissions not brought to the providers attention,or if not given an opportunity to update and/or correct same. This estimate may contain duplicate/overlapping items from other estimates for adjacent damages not related to this loss. COMPLETION TIME FOR INTERIOR REPAIRS: APPROXIMATE 3-4 WEEKS it 16D1 .0 CNI Concepts Enterprises INC Certified Building Contractors 6065 NW 167th St SB 14 Miami FL 33015 cniconcepts.com cnicorp@live.com Phone(305)504-8884 Fax(305)504-8885 Certified General Contractor CGC1529534 Licensed Mold Assessor and Remediator MRSR3042,MRSA2850 SAINTIL-ROSE-BATH Main Level Bathroom Height:8' . 10'9" ' I 250.78 SF Walls 74.74 SF Ceiling T t' Bathroom 325.52 SF Walls&Ceiling 74.74 SF Floor N 8.30 SY Flooring 30.08 LF Floor Perimeter Hal' - . 37.67 LF Ceil.Perimeter 0-s s•--+ Door 2'6"X 6'8" Opens into HALL / Subroom: Closet3 I Bathroom ) Height:8' g 82.11 SF Walls 9.63 SF Ceiling T. t T 91.74 SF Walls&Ceiling 9.63 SF Floor ci.aou ' '" 1.07 SY Flooring 9.42 LF Floor Perimeter i s'6 t 14.50 LF Ceil.Perimeter 5 8"-4 Door 5' I"X 6'8" Opens into BATHROOM DESCRIPTION QTY RESET REMOVE REPLACE TAX O&P TOTAL The following items comprised the labor and/or materials to Detach.Remove.Install or Replace items attached to walls and/or ceilings that are necessary to restore the property to it's condition prior to the loss, Floor Areas: 1. Remove Tile floor covering 72.37 SF 2.97 0.00 0.00 42.99 257.93 Water intrusion affected base and flooring. 2. Tile floor covering 85.02 SF 0.00 12.01 37.97 211.81 1,270.87 3. Additional labor to remove tile from 72.37 SF 2.02 0.00 0.00 29.24 175.43 concrete slab 4. Floor leveling cement-Average 72.37 SF 0.00 2.28 4.81 33.96 203.78 5. Grout sealer 68.37 SF 0.00 1.18 0.77 16.29 97.73 6. R&R Baseboard 23.50 LF 0.59 8.38 8.77 43.91 263.48 7. Paint baseboard-two coats 23.50 LF 0.00 1.50 0.23 7.10 42.58 8. Clean floor 84,37 SF 0.00 0.89 0.59 15.14 90.82 Wall Areas: 9. R&R Fiberglass tub&shower 1.00 EA 98.80 1,388.02 64.81 310.33 1,861.95 combination 10. Rough in plumbing-floor/laundry 1.00 EA 0.00 176.33 3.69 36.00 216.02 pan drain is SAINTIL-ROSE-BATH 4/1/2021 Page:2 is is i 16D10 06. -` CNI Concepts Enterprises INC Certified Building Contractors 6065 NW 167th St SB14 Miami FL 33015 cniconcepts.com cnicorp@live.com Phone(305)504-8884 Fax(305)504-8885 Certified General Contractor CGC1529534 Licensed Mold Assessor and Remediator MRSR3042,MRSA2850 CONTINUED-Bathroom DESCRIPTION QTY RESET REMOVE REPLACE TAX O&P TOTAL Includes:Floor drain assembly,couplings,p-trap,drain pipe,and installation labor. 11. R&R Vanity 5.00 LF 8,90 277.47 80.50 302.47 1,814.82 Extensive water intrusion affected vanity. 12. R&R Countertop-Flat laid plastic 5.00 LF 5.12 42.37 9.10 49.31 295.86 laminate 13. R&R Backsplash-plastic laminate 1.67 SF 1.07 7.85 0.34 3.05 18.29 14. Sink-single-Detach&reset 1.00 EA 0.00 136.12 0.00 27.22 163.34 15. Sink faucet-Detach&reset 1.00 EA 0.00 109.17 C.00 21.83 131.00 16. Caulking-silicone 8.00 LF 0.00 2.60 0.10 4.18 25.08 Moisture protection and sealant around the sink and faucet fixture. 17. R&R Mirror 9.00 SF 0.33 15.77 6.50 30.28 181.68 18. R&R Bath accessory 4.00 EA 5.93 29.61 4.23 29.28 175.67 19. R&R P-trap assembly-ABS 1.00 EA 8.90 56.35 0.48 13.15 78.88 (plastic) 20. Toilet-Detach&reset 1.00 EA 0.00 221.99 0.44 44.49 266.92 21. R&R Angle stop 2.00 EA 5.93 31.92 1.01 15.34 92.05 22. Medicine cabinet-Detach&reset 1.00 EA 0.00 60.34 0.00 12.07 72.41 23. Interior door-Detach&reset 1.00 EA 0.00 96.73 0.06 19.36 116.15 r 37.98 f. 24. Door hinges(set of 3)and slab- 1.00 EA 0.00 31.65 0.00 6.33 Detach&reset 25. Paint door slab only-2 coats(per 3.00 EA 0.00 38.77 1.71 23.60 141.63 side) 26. R&R Door opening(jamb& 2.00 EA 7.46 195.64 18.83 85.01 510.04 ! casing) 27. Caulking-acrylic 31.66 LF 0.00 2.40 0.20 15.24 91.42 28. Paint door/window trim&jamb-2 1.00 EA 0.00 32.35 0.33 6.54 39.22 coats(per side) 29. Door lockset-Detach&reset 1.00 EA 0.00 24.87 0.00 4.97 29.84 30. Detach&Reset Light bar-4 lights 1.00 EA 53.52 0.00 0.00 0.00 10.70 64.22 is Ceiling Areas: Tile replacement will affect ceiling drywall.Replacement of continuous texture is recommended. 31. Drywall tape joint/repair-per LF 52.17 LF 0.00 9.68 1.13 101.23 607.37 32. Texture drywall-smooth/skim 84.37 SF 0.00 1.64 0.65 27.80 166.82 coat 33. Bathroom ventilation fan-Detach 1.00 EA 0.00 53.94 0.00 10.79 64.73 &reset 34. Heat/AC register-Mechanically 1.00 EA 0.00 13.87 0.00 2.77 16.64 attached-Detach&reset SAINTIL-ROSE-BATH 4/1/2021 Page:3 s 16D10 CNI Concepts Enterprises INC Certified Budding Contractors 6065 NW 167th St SB 14 Miami FL 33015 eniconcepts.com cnicorp@live.com Phone(305)504-8884 Fax(305)504-8885 Certified General Contractor CGC1529534 Licensed Mold Assessor and Remediator MRSR3042,MRSA2850 CONTINUED-Bathroom DESCRIPTION QTY RESET REMOVE REPLACE TAX O&P TOTAL General,Painting and Contents Manipulation: 35. Clean the walls and ceiling 417.26 SF 0.00 0.43 0.29 35.94 215.65 36. Seal/prime part of the walls-one 133.16 SF 0.00 0.62 0.65 16.64 99.85 coat 37. Paint part of the walls-two coats 133.16 SF 0.00 1.01 2.33 27.36 164.18 38. Floor protection-self-adhesive 84.37 SF 0.00 0.66 0.83 11.30 67.81 plastic film i 39. Mask and prep for paint-plastic, 52.17 LF 0.00 1.43 0.95 15.11 90.66 paper,tape(per LF) 40. Drywall Installer/Finisher-per 4.00 HR 0.00 106.49 0.00 85.19 511.15 hour Additional labor to decreased productivity in enclosed spaces.i.e.Closets,bathrooms,etc. 41. Peel&seal zipper 2.00 EA 0.00 12.77 1.30 5.37 32.20 Use during and after drywall and cabinet replacement for dust removal. 42. R&R Ground fault interrupter(GFI) 2.00 EA 5.97 36.23 2.91 17.46 104.77 outlet-tamper resistant 43. Electrician-per hour 6.00 HR 0.00 100.02 0.00 120.02 720.14 Additional labor to install GFCI outlet,in accordance with Section 210.8(A),(1-10),2017 National Electrical Code. 44. HEPA Vacuuming-Detailed- 417.26 SF 0.00 0.66 P.00 55.08 330.47 (PER SF) Use during and after floor tile replacement for dust and debris removal. Based on OHSA guidelines"Controlling Silica Exposures in Construction".OSHA 3362-05 2009 Vacuum dust collection or similar methods. Use during and after drywall and cabinet replacement for dust removal. Totals: Bathroom 256.51 2,003.26 12,019.54 is SAINTIL-ROSE-BATH 4/1/2021 Page:4 is . 16D10 CNI Concepts Enterprises INC Certified Building Contractors 6065 NW 167th St SBI4 Miami FL 33015 cniconcepts.com cnicorp@live.com Phone(305)504-8884 Fax(305)504-8885 Certified General Contractor CGC 1529534 Licensed Mold Assessor and Remediator MRSR3042,MRSA2850 • Hall Height:8' 21 . a 287.33 SF Walls 80.03 SF Ceiling 367.36 SF Walls&Ceiling 80.03 SF Floor 8.89 SY Flooring 33.42 LF Floor Perimeter • r to 48.42 LF Ceil.Perimeter 1 9" 11" Door 2'6"X 6'8" Opens into Exterior Door 2'6"X 6'8" Opens into Exterior Door 2'6"X 6'8" Opens into BATHROOM Door 2'6"X 6'8" Opens into Exterior Missing Wall. 3'7"X 8' Opens into FAMILY Door 2'6"X 6'8" Opens into BEDROOM2 Door 2'6"X 6'8" Opens into BEDROOM DESCRIPTION QTY RESET REMOVE REPLACE TAX O&P TOTAL Traffic/Access Area.Walls.Doors.Contents and Flooring to be protected from Laborers,materials.Equipment and debris hauling. 45. Clean floor 80.03 SF 0.00 0.89 0.56 14.36 86.15 46. Mask the walls per square foot- 287.33 SF 0.00 0.25 1.01 14.57 87.40 plastic and tape-4 mil 47. Floor protection-self-adhesive 80.03 SF 0.00 0.66 0.78 10.72 64.32 plastic film Totals: Hall 2.35 39.65 237.88 Total:Main Level 258.86 2,042.90 12,257.42 is Debris Removal DESCRIPTION QTY RESET REMOVE REPLACE TAX O&P TOTAL 48. A/C-heavy clean,replace filters 1.00 EA 0.00 387.35 5.12 78.49 470.96 and service 49. Final clean up-punch list items 8.00 HR 0.00 24.56 0.69 39.43 236.60 50. Progressive daily clean up- 10.00 EA 0.00 26.34 0.92 52.86 317.19 Approx one hour per day of work i.: Additional daily labor to remove and clean dust and debris Totals: Debris Removal 6.73 170.79 1,024.75 SAINTIL-ROSE-BATH 4/1/2021 Page:5 is is 16Db CNI Concepts Enterprises INC Certified Building Contractors r 6065 NW 167th St S1314 Miami FL 33015 cniconcepts.com cnicorp@live.com Phone(305)504-8884 Fax(305)504-8885 Certified General Contractor CGC1529534 Licensed Mold Assessor and Remediator MRSR3042,MRSA2850 Job Conditions DESCRIPTION QTY RESET REMOVE REPLACE TAX O&P TOTAL 51. Residential supervision-per hour 12.00 HR 0.00 65.00 0.00 156.00 936.00 Labor to supervise the project,meet with sub-contractors,county/city inspectors,discuss with homeowner,etc. The above item is a Direct Cost related to this specific project and not a"General Overhead" Due to the size.complexity,code upgrades and the number of trades involved,a superintendent/project manager is required to ensure that the trades are being executed in accord with a workmanship manner and in the optimal order. The law requires that a contractor(or subcontractor)provide adequate supervision for their construction project.Construction contracts generally imply a duty to provide sufficient supervisory personnel on the project..Moreover,Contractors have a duty to perform work in a good and workmanlike manner,in our jurisdiction,the contractor has an implied covenant that the workperformed will be fit and proper for its intended use.The implied covenant encompasses the quality of both the work and materials. is 52. Permit runners and processing 1.00 EA 0.00 325.00 0.00 65.00 390.00 53. Taxes,permits&fees 1.00 EA 0.00 395.00 0.00 79.00 474.00 In accordance with Section 713.13(1)(h)of the Florida Statutes,a Notice of Commencement Is required for the construction of, (; improvements to,alteration of or repair of real property Totals: Job Conditions 0.00 300.00 1,800.00 Line Item Totals:SAINTIL-ROSE-BATH 265.59 2,513.70 15,082.17 Grand Total Areas: 2,029.67 SF Walls 775.31 SF Ceiling 2,804.97 SF Walls and Ceiling 775.31 SF Floor 86.15 SY Flooring 249.83 LF Floor Perimeter 0.00 SF Long Wall 0.00 SF Short Wall 311.83 LF Ceil.Perimeter 775.3 i Floor Area 856.67 Total Area 2,029.67 Interior Wall Area 1,093.00 Exterior Wall Area 153.50 Exterior Perimeter of Walls 0.00 Surface Area 0.00 Number of Squares 0.00 Total Perimeter Length 0.00 Total Ridge Length 0.00 Total Hip Length SAINTIL-ROSE-BATH 4/1/2021 Page:6 is I 6 D 1 0 CNI Concepts Enterprises INC Certified Building Contractors thk. 6065 NW 167th St SB14 Miami FL 33015 cniconcepts.com cnicorp@live.com Phone(305)504-8884 Fax(305)504-8885 Certified General Contractor CGC1529534 Licensed Mold Assessor and Remediator MRSR3042,MRSA2850 Summary for Dwelling Line Item Total 12,302.89 Material Sales Tax 265.59 12,568.48 Subtotal 1,256.85 Overhead 1,256.85 Profit Replacement Cost Value $15,082.18 Less Depreciation (190.75) Actual Cash Value $14,891.43 Net Claim $14,891.43 Total Recoverable Depreciation 190.75 Net Claim if Depreciation is Recovered $15,082.18 FKF: s{(F I SAINTIL-ROSE-BATH 4/1l2021 Page:7 1 6 D 1 +0 CNI Concepts Enterprises INC Certified Budding Contractors 6065 NW 167th St SB14 Miami FL 33015 cniconcepts.com cnicorp@live.com Phone(305)504-8884 Fax(305)504-8885 Certified General Contractor CGC1529534 Licensed Mold Assessor and Remediator MRSR3042,MRSA2850 Recap of Taxes,Overhead and Profit Overhead(10%) Profit(10%) Material Sales Tax Laundering Tax(2%) Manuf.Home 6�j Storage Rental Tax) (7%) Line Items 1,256.85 1,256.85 265.59 0.00 0.00 0.00 Total 1,256.85 1,256.85 265.59 0.00 0.00 0.00 fi { SAINTIL-ROSE-BATH 4/1/2021 Page:8 16DlI0 CNI Concepts Enterprises INC Certified Building Contractors 6065 NW 167th St SB14 Miami FL 33015 cniconcepts.com cnicorp@live.com Phone(305)504-8884 Fax(305)504-8885 Certified General Contractor CGC 1529534 Licensed Mold Assessor and Remediator MRSR3042,MRSA2850 Recap by Room Estimate:SAINTIL-ROSE-BATH Area:Main Level Bathroom 9,759.78 79.33% Hall 195.88 1.59% Area Subtotal: Main Level 9,955.66 80.92% Debris Removal 847.23 6.89% Job Conditions 1,500.00 12.19% Subtotal of Areas 12,302.89 100.00% Total 12,302.89 100.00% SAINTIL-ROSE-BATH 4/1/2021 Page:9 16D10 CNI Concepts Enterprises INC Certified Building Contractors tt.) 6065 NW 167th St SB14 Miami FL 33015 cniconcepts.com cnicorp@live.com Phone(305)504-8884 Fax(305)504-8885 Certified General Contractor CGC1529534 Licensed Mold Assessor and Remediator MRSR3042,MRSA2850 Recap by Category with Depreciation O&P Items RCV Deprec. ACV CABINETRY 1,672.65 48.37 1,624.28 CLEANING 785.62 785.62 GENERAL DEMOLITION 620.00 620.00 DOORS 96.73 96.73 DRYWALL 1,069.34 1,069.34 ELECTRICAL 672.58 2.17 670.41 FLOOR COVERING-CERAMIC TILE 1,266.77 30.63 1,236.14 PERMITS AND FEES 720.00 720.00 FINISH CARPENTRY/TRIMWORK 588.21 17.65 570.56 FINISH HARDWARE 174.96 3.55 171.41 HEAT, VENT&AIR CONDITIONING 455.16 455.16 LABOR ONLY 780.00 780.00 LIGHT FIXTURES 53.52 53.52 MOISTURE PROTECTION 96.78 96.78 MIRRORS&SHOWER DOORS 141.93 4.26 137.67 PLUMBING 2,151.82 45.25 2,106.57 ( PAINTING 655.89 655.89 WATER EXTRACTION&REMEDIATION 300.93 300.93 O&P Items Subtotal 12,302.89 151.88 12,151.01 Material Sales Tax 265.59 7.05 258.54 Overhead 1,256.85 15.91 1,240.94 Profit 1,256.85 15.91 1,240.94 Total 15,082.18 190.75 14,891.43 3 SAINTIL-ROSE-BATH 4/1/2021 Page: 10 1. 16E110 CNI Concepts Enterprises INC Certified Building Contractors 2 06. 6065 NW 167th St SB14 Miami FL 33015 cniconcepts.com cnicorp@live.com Phone(305)504-8884 Fax(305)504-8885 Certified General Contractor CGC1529534 Licensed Mold Assessor and Remediator MRSR3042,MRSA2850 1 1-Exteriors 3� v r ti: Date Taken:3/23/2021 �" Taken By:OFFICE! • ,, � �, ,'.', w. - a11't � � N in / 5 'ss, 4 . S D 7 ,s^ .+ .•.y� ice --3 214 Mr r d • t" ' n� i ii) �� ., jaw TTT � �s v7'' ! .4 ''Y t w ; *. sF � k '•.yy I '✓ " 7 / _ 2 2-Exterior Date Taken:3/23/2021 Taken By:OFFICE! ... a .? ' r jC .?" -p4. 4 ' E Mom, "`-7",:4 y''"ter x 'FF 1 ya.Y� ti" Y'r',a.,�, ' " ,S. �sfnc� ,:�::n._,. y-c � sue' � s € , rl ✓E ry S�'n"YY1& C ^tt'4�i`."t'z ' ~ ! •F5+-6F� X^w t' xi , " '' `,�✓ L 3NY"'_2 ' ''ate" �.Tr' .n gs r -** `aye r ,�,� f vfi i r 3 • �,, �. 3t S 4 3 # i f -,..„;._:,.„,:„...„.--_,-,t—7„j.:,,,,,dj,.:,,_Ai; •",,,„--7,24 ri„7".g..1 ,.= 4N:7,.-...%71. ftir,,I.,1," ,-''',"...^,„b'— '.,I.-,,,,-....e.1.,„:: ia : T r .t S��,F�"-s --- e I; SAINTIL-ROSE-BATH 4/1/2021 Page: 11 s t 16010 ,. DUBOFF LAW FIRM 680 N.E. 127 STREET / NORTH MIAMI / FLORIDA 33161 TEL.No. (305)899-0085 / FAx No.(305)899-0091 Attention: Habitat for Humanity March 2, 2023 Re: Mortgage Loan#: Mortgagor: Marie-Rose Saintil Daniel Premises: 13536 onia Drive,Naples,Florida 34114 Ins. Claim No. Date of Loss - -2021 Dear Sir/Madam: Our law firm represented Marie-Rose Saintil Daniel in an insurance claim submitted to American Integrity Insurance Company of Florida for property damages at the mortgaged premises. As a result of a compromised negotiated settlement,we received the insurance company's coverage check in the amount of$14,000.00 for property damages made payable to Marie-rose Saintil Daniel Saintil representing the negotiated settlement amount for covered repairs. Because this was a compromised negotiated settlement,the insurance company did not provide us with any accompanying estimate relating to the payment of the$14,000.00. Should you require any further information,please feel free to contact us. Very truly yours, //Kenneth R. Duboff// KENNETH R. DUBOFF KRD/sw 1 6D 1 0 CM Concepts Enterprises INC Certified Building Contractors 6065 NW 167th St SB 14 Miami FL 33015 cniconcepts.com cnicoip@live.com Phone(305)504-8884 Fax(305)504-8885 Certified General Contractor CGC1529534 Licensed Mold Assessor and Remediator MRSR3042,MRSA2850 Insured: Marie-Rose&Saintil Daniel Property: 13536 Koinonia Drive Naples,FL 34114 Claim Number:10ft Policy Number:WIMP Type of Loss: Water Damage-Kitchen Date of Loss: 2/28/2021 12:00 AM Date Received: Date Inspected: Date Entered: Price List: FLNA8X_APR21 Restoration/Service/Remodel Estimate: SAINTIL-ROSE-KIT Gross Estimate of Total Repairs:$21,756.08 Gross Estimate of Structural Repairs COV A:$21,756.08 Recoverable Depreciation$335.63 Net Estimate of Total Repairs:(After depreciation)$21,420.45 This estimate is presented utilizing the Xactimate estimating software customized to reflect the specific scope of work presented in this loss. In every monthly pricing publishing Xactware strongly recommend customers monitor their local markets for any such changes and adjust their estimate pricing as deemed appropriate. The FLNA8X_APR2 1 price list for the Naples,FL market was used for some or all of the unit costs.The estimator also may have relied on the use of written or verbal quotes from subcontract labor or suppliers who were deemed capable of completing their respective scopes of work. Estimate/Loss Report Closing Disclaimer: Determinations within this Loss Report is solely an opinion and based on information obtained from the insured,insurer,third parties and visual non-destructive inspections and investigations.Determination is further based on this provider's receiving a Certified Copy of the Policy,per FL statute 627.4137(Admitted)or FL Statute 626.9372(Surplus),from the carrier,and prior to this submission.Absent such,this provider has the right to amend this report by supplemental or otherwise as may later be determined necessary and/or once a true Certified Copy of the Policy is furnished as originally requested.Hidden structural defects,unforeseen/code required repairs,possible hidden damages,missing items,items of coverage not yet incurred or determined,would be additional scope and amounts to later be submitted under supplementation.This provider has the right to amend this report in the event of the above,or if it is determined there is an unintentional mistake/error or clerical typo error within.It is the responsibility of the recipient,of these herein documents,to carefully review this report in its entirety and notify this provider(delivered in writing)of any possible mistake(s)/er or(s)or omissions,in order to give this provider an opportunity to make appropriate updates and/or corrections.The provider of this entire report is not responsible for any mistake(s)/error(s)or omissions not brought to the providers attention,or if not given an opportunity to update and/or correct same. is This estimate may contain duplicate/overlapping items from other estimates for adjacent damages not related to this loss. 1 COMPLETION TIME FOR INTERIOR REPAIRS: APPROXIMATE 3-5 WEEKS : r fi ii 1' I is i6D10 CNI Concepts Enterprises INC Certified Building Contractors rt 6065 NW 167th St SB14 Miami FL 33015 cniconcepts.com cnicorp@live.com Phone(305)504-8884 Fax(305)504-8885 Certified General Contractor CGC1529534 Licensed Mold Assessor and Remediator MRSR3042,MRSA2850 SAINTIL-ROSE-KIT Main Level .,. ,6't..., Kitchen Height:8' i t 253.56 SF Walls 116.20 SF Ceiling 2 369.76 SF Walls&Ceiling 116.20 SF Floor e csrn 12.91 SY Flooring 30.92 LF Floor Perimeter 35.58 LF Ceil.Perimeter -lI------ ------J i Door 2'6"X 6'8" Opens into Exterior Missing Wall 8'9"X 8' Opens into FAMILY 1-2'6"-1 Subroom: Pantry(1) Height:8' 2 ■ J 57.56 SF Walls 5.00 SF Ceiling ° cn 62.56 SF Walls&Ceiling 5.00 SF Floor \ Picv 0.56 SY Flooring 6.83 LF Floor Perimeter l 9.00 LF Ceil.Perimeter 1-2'4" Door 2'2"X 6'8" Opens into KITCHEN DESCRIPTION QTY REMOVE REPLACE TAX O&P TOTAL The following items comprised the labor and/or materials to Detach.Remove.Install or Replace items attached to walls and/or ceilings that arc necessary to restore the property to it's condition prior to the loss. Cabinetry: 1. R&R Cabinetry-lower(base)units 9.67 LF 8.90 257.85 142.41 544.38 3,266.25 Water damages to Lower Cabinets.Replacement of Lower and Upper cabinets is recommended for matching purposes.Due to age of cabinets is very unlikely that a close match can be found. 2. R&R Countertop-Flat laid plastic 11.92 LF 5.12 46.66 25.28 128.50 771.00 laminate Laminate countertops will get damaged during lower cabinets removal.Replacement of continuous areas and backsplash is recommended. is 3. R&R 4"backsplash for flat laid 15.92 LF 1.07 11.90 3.16 41.93 251.57 countertop-Solid hardwood 4. R&R Cabinetry-upper(wall)units 15.33 LF 8.90 192.29 155.41 647.93 3,887.59 5. R&R Cabinet panels-side,end,or 16.33 SF 2.31 20.11 11.77 75.58 453.47 back Appliances&Plumbing Fixtures 6. Refrigerator-Remove&reset 1.00 EA 0.00 39.48 0.00 7.90 47.38 7. Range-electric-Remove&reset 1.00 EA 0.00 29.61 0.00 5.92 35.53 SAINTIL-ROSE-KIT 4/1/2021 Page:2 is is I t 1 6 D 1 0 iCNI Concepts Enterprises INC Certified Building Contractors I 6065 NW 167th St SB14 Miami FL 33015 i to) cniconcepts.com cnicorp@live.com Phone(305)504-8884 Fax(305)504-8885 i Certified General Contractor CGC 1529534 Licensed Mold Assessor and Remediator MRSR3042,MRSA2850 i CONTINUED-Kitchen DESCRIPTION QTY REMOVE REPLACE TAX O&P TOTAL 8. Range hood-Detach&react 1,00 EA 0.00 92.77 0.00 18.55 111.32 9. Sink-double-Detach&reset 1.00 EA 0.00 145.46 0.00 29.09 174.55 10. R&R P-trap assembly-ABS 2.00 EA 8.90 56.35 0.96 26.29 157.76 (plastic) 11. R&R Angle stop 2.00 EA 5.93 31.92 1.01 15.34 92.05 12. Labor to move out then reset 6.00 HR 0.00 28.75 0.00 34.50 207.00 Kitchen cabinet's disbware,groceries, glassware,silverware etc 13. R&R Ground fault interrupter(GFI) 4.00 EA 5.97 36.23 5.82 34.92 209.54 outlet-tamper resistant 14. R&R Circuit breaker-arc-fault 4.00 EA 11.50 76.60 14.19 73.32 circuit-interrupter(AFCI) 15. Electrician-per hour 10.00 HR 0.00 100.02 0.00 200.04 1,200.24 Additional labor to install GFCI outlet,in accordance with Section 210,8(A),(1-10),2017 National Electrical Code;all receptacles installed to serve the countertop surfaces of the kitchen shall have ground-fault circuit interrupter(GFCI)protection for personnel. 16. Electrician-per hour Labor to 3.00 HR 0.00 85,35 7.35 52.68 316.08 detach and reset Electrical connection in kitchen cabinets 17. Licensed Plumber needed to 1.00 EA 0.00 325.00 9.33 66.87 401.19 disconnect/attach drain/supply connections-2 Trips Wall Areas: IB. Drywall-Minimum charge- 1.00 EA 0.00 325.00 9.33 66.87 401.19 Repairs behind affected kitchen cabinets 19. Texture repair after removing 1.00 EA 0.00 275.00 7.89 56.58 339.47 kitchen cabinets and backsplash rTexture repair to walls after drywall replacement and cabinet removal. 1 20. Paint door slab only-2 coats(per 1.00 EA 0.00 38.77 0.57 7.87 47,21 I side) 1; 21. Paint door/window trim&jamb-2 1.00 EA 0.00 32.35 0.33 6.54 39.22 F coats(per side) 22. Door lockset-Detach&reset 1.00 EA 0.00 24.87 0.00 4.97 29.84 Floor Areas: 23. Paint baseboard-two coats 24.08 LF 0.00 1.50 0.24 7.27 43.63 j 24. Clean floor 121.20 SF 0.00 0.89 0.85 21.74 130.46 General,Painting and Contents Manipulation: f 25. Clean the walls 311.11 SF 0.00 0.43 0.22 26.80 160.80 26. Seal/prime part of the walls-one 77.78 SF 0.00 0.62 0.38 9.72 58.32 coat 27. Paint part of the walls-two coats 77.78 SF 0.00 1.01 1.36 15.98 95.91 SAINTIL-ROSE-KIT 4/1/2021 Page:3 16D14 1 i 1 CNI Concepts Enterprises INC Certified Budding Contractors ` 6065 NW 167th St SB I4 Miami FL 33015 eniconcepts.com cnicorp@live,com Phone(305)504-8884 Fax(305)504-8885 Certified General Contractor CGC1529534 Licensed Mold Assessor and Remediator MRSR3042,MRSA2850 CONTINUED-Kitchen DESCRIPTION QTY REMOVE REPLACE TAX O&P TOTAL 28. Floor protection-self-adhesive 121.20 SF 0.00 0.66 1.19 16.24 97.41 plastic film 29. Mask and prep for paint-plastic, 44.58 LF 0.00 1.43 0.81 12.91 77.47 paper,tape(per LF) 30. Contents-move out then reset 121.20 SF 0.00 0.43 0.00 10.42 62.54 31. HEPA Vacuuming-Detailed- 432.31 SF 0.00 0.66 0.00 57.06 342.38 (PER SF) Based on OHSA guidelines"Controlling Silica Exposures in Construction".OSHA 3362-05 2009 Vacuum dust collection or similar methods. Use during and after drywall and cabinet replacement for dust removal. Totals: Kitchen 399.85 2,324.72 13,948.30 • -,o_ 0 1"-, '5'2^-I ,-srs"--I Height:8' 1•2,1 . r,�.. 0-1 Family T;1. /-4,s" i 1 4•lo•a 1-8'b� i a 339.67 SF Walls 234.14 SF Ceiling 11` j r 1 573,81 SF Walls&Ceiling 234.14 SF Floor it. Family I 26.02 SY Flooring 46.50 LF Floor Perimeter T } tt tt 49.00 LF Ceil.Perimeter -, ir' . .t' 11'I I" 3'7"Missing Wall 8'9"X 8' Opens into KITCHEN Window 2'X 2'11" Opens into Exterior Door 2'6"X 6'8" Opens into Exterior Window 2'X 2'11" Opens into Exterior 6'X 4' Opens into Exterior I' Window, Missing Wall 3 X 8' Opens into HALL , DESCRIPTION QTY REMOVE REPLACE TAX O&P TOTAL 1 Continuous walls from Kitchen. Wall Areas: i ' 32. Prime&paint door slab only- 1.00 EA 0.00 46.48 0.97 9.49 56.94 is exterior(per side) 33. Paint door/window trim&jamb-2 1.00 EA 0.00 32.35 0.33 6.54 39.22 coats(per side) 34. Door lockset-Detach&reset 1.00 EA 0.00 24.87 0.00 4.97 29.84 • 35. Clean window unit(per side) 3.00 EA 0.00 20.39 0.00 12.23 73.41 36. Window drapery-hardware- 3.00 EA 0.00 37.25 0.00 22.35 134.10 Detach&reset Floor Areas: SAINTIL-ROSE-K1T 4/1/2021 Page:4 ii 16D1 II p CNI Concepts Enterprises INC Certified Building Contractors 6065 NW 167th St SB14 Miami FL 33015 • cniconcepts.com cnicorp@live.com Phone(305)504-8884 Fax(305)504-8885 Certified General Contractor CGC1529534 Licensed Mold Assessor and Remediator MRSR3042,MRSA2850 CONTINUED-Family DESCRIPTION QTY REMOVE REPLACE TAX O&P TOTAL 37. Paint baseboard-two coats 46.50 LF 0.00 1,50 0.46 14.04 84.25 38. Clean floor 234.14 SF 0.00 0.89 1,64 42.00 252.02 General,Painting and Contents Manipulation: 39. Clean the walls 339.67 SF 0.00 0.43 0.24 29.26 175.56 40. Seal/prime the walls-one coat 339.67 SF 0.00 0.62 1.66 42.45 254.72 41. Paint the walls-two coats 339.67 SF 0.00 1.01 5.94 69.80 418.82 42. Floor protection-self-adhesive 234.14 SF 0.00 0.66 2.29 31.36 188.19 plastic film 43. Mask and prep for paint-plastic, 49.00 LF 0,00 1.43 0.89 14.19 85.15 paper,tape(per LF) 44. Contents-move out then reset 234.14 SF 0.00 0.43 0.00 20.14 120.82 Totals: Family 14.44 318.84 1,913.04 Hall Height:8' 287.33 SF Walls 80.03 SF Ceiling 367.36 SF Walls&Ceiling 80.03 SF Floor 8.89 SY Flooring 33.42 LF Floor Perimeter ' 48.42 LF Ceil.Perimeter • i 8" li" Door 2'6" X 6'8" Opens into Exterior Door 2'6"X 6'8" Opens into Exterior Door 2'6"X 6'8" Opens into BATHROOM Door 2'6"X 6'8" Opens into Exterior Missing Wall 3'7"X 8' Opens into FAMILY Door 2'6"X 6'8" Opens into BEDROOM2 Door 2'6"X 6'8" Opens into BEDROOM DESCRIPTION QTY REMOVE REPLACE TAX O&P TOTAL Continuous walls from Kitchen, Wall Areas: 45. Prime&paint door slab only- 1,00 EA 0.00 46.48 0.97 9.49 56,94 exterior(per side) 46. Paint door slab only-2 coats(per 5.00 EA 0.00 38.77 2.85 39.34 236.04 side) 47. Paint door/window trim&jamb-2 6,00 EA 0.00 32.35 2.01 39.22 235.33 coats(per side) SAINTIL-ROSE-KIT 4/1/2021 Page:5 i6D1O I N`` CI Concepts Enterprises INC Certified Building Contractors 1 ,t 6065 NW 167th St SD 14 Miami FL 33015 I cniconcepts.com cnicorp@live.com Phone(305)504-8884 Fax(305)504-8885 Certified General Contractor CGC1529534 Licensed Mold Assessor and Remediator MRSR3042,MRSA2850 I CONTINUED-Hall DESCRIPTION QTY REMOVE REPLACE TAX O&P TOTAL 48. Door lockset-Detach&reset 6.00 EA 0.00 24.87 0.00 29.84 179.06 49. Thermostat-Detach&reset 1.00 EA 0.00 46.35 0.00 9.27 55.62 50. Heat/AC register-Wall attached- 3.00 EA 0.00 14.85 1,28 9.17 54.99 Detach&reset Floor Areas: 51. Paint baseboard-two coats 33.42 LF 0.00 1.50 0.33 10.09 60.55 52. Clean floor 80.03 SF 0.00 0.89 0.56 14.36 86.15 General,Painting and Contents Manipulat on: 53. Clean the walls 287.33 SF 0.00 0.43 0.20 24.75 148.50 54. Seal/prime the walls-one coat 287.33 SF 0,00 0.62 1.41 35.91 215.46 55. Paint the walls-two coats 287.33 SF 0.00 1.01 5.03 59.05 354.27 56. Floor protection-self-adhesive 80.03 SF 0.00 0.66 0.78 10.72 64.32 plastic film 57. Mask and prep for paint-plastic, 48.42 LF 0.00 1.43 0.88 14.02 84.15 paper,tape(per LF) Totals: Hall 16.30 305.23 1,831.39 Total:Main Level 430.59 2,948.79 17,692.73 Debris kemoval DESCRIPTION QTY REMOVE REPLACE TAX O&P TOTAL 58. A/C-heavy clean,replace filters 1.00 EA 0.00 387.35 5,12 78.49 470.96 and service 59. Dumpster load-Approx. 12 yards, 1.00 EA 420.00 0.00 0.00 84.00 504.00 1-3 ton of debris As a general rule,the dumpster must be emptied every 5 to 7 days or additional fees may be charged 60. Dumpster floor protection- 1.00 EA 175.00 0.00 0.00 35.00 210.00 Landing Pad to protect Driveway/ Landscape 61. Final clean up-punch list items 10.00 HR 0.00 24.56 0.86 49.29 295.75 62. Progressive daily clean up- 12.00 EA 0.00 26.34 1.11 63.44 380.63 Approx one hour per day of work . Additional daily labor to remove and clean dust and debris 7.09 310.22 1,861.34 Totals: Debris Removal it r SAINTIL-ROSE-KIT 4/1/202 i Page:6 5 l D1O CNI Concepts Enterprises INC Certified Building Contractors :It. \ 6065 NW 167th St SB14 Miami FL 33015 cniconcepts.com cnicorp@live.com Phone(305)504-8884 Fax(305)504-8885 Certified General Contractor CGC 1529534 Licensed Mold Assessor and Remediator MRSR3042,MRSA2850 Job Conditions DESCRIPTION QTY REMOVE REPLACE TAX O&P TOTAL 63. Residential supervision-per hour 16.00 HR 0.00 65.00 0.00 208.00 1,248.00 Labor to supervise the project,meet with sub-contractors,county/city inspectors,discuss with homeowner,etc. The above item is a Direct Cost related to this specific project and not a"General Overhead" Due to the size.complexity,code upgrades and the number of trades involved,a superintendent/project manager is required to ensure that the trades are being executed in accord with a workmanship manner and in the optimal order. The law requires that a contractor(or subcontractor)provide adequate supervision for their construction project.Construction contracts generally imply a duty to provide sufficient supervisory personnel on the project..Moreover,Contractors have a duty to perform work in a good and workmanlike manner,in our jurisdiction,the contractor has an implied covenant that the workperformed will be fit and proper for its intended use,The implied covenant encompasses the quality of both the work and materials. 64. Permit runners and processing 1.00 EA 0.00 370.00 0.00 74.00 444.00 65. Taxes,permits&fees 1.00 EA 0.00 425.00 0.00 85.00 510.00 In accordance with Section 713.13(1)(h)of the Florida Statutes,a Notice of Commencement is required for the construction of, improvements to,alteration of or repair of real property Totals: Job Conditions 0.00 367.00 2,202.00 Line Item Totals:SAINTIL-ROSE-KIT 437.68 3,626.01 21,756.07 Grand Total Areas: 2,029.67 SF Walls 775.31 SF Ceiling 2,804.97 SF Walls and Ceiling 775.31 SF Floor 86.15 SY Flooring 249.83 LF Floor Perimeter 0.00 SF Long Wall 0.00 SF Short Wall 311.83 LF Cell.Perimeter 775.31 Floor Area 856.67 Total Area 2,029.67 Interior Wall Area 1,093.00 Exterior Wall Area 153.50 Exterior Perimeter of Walls 0.00 Surface Area 0.00 Number of Squares 0.00 Total Perimeter Length 0.00 Total Ridge Length 0.00 Total Hip Length is SAINTIL-ROSE-KIT 4/1/2021 Page:7 1 6D b CNI Concepts Enterprises INC Certified Building Contractors ' ft& 6065 NW 167th St S1314 Miami FL 33015 cniconcepts.com cnicorp@live.com Phone(305)504-8884 Fax(305)504-8885 Certified General Contractor CGC1529534 Licensed Mold Assessor and Remediator MRSR3042,MRSA2850 Summary for Dwelling Line Item Total 17,692.38 Material Sales Tax 437.68 18,130.06 Subtotal 1,813.01 Overhead 1,813.01 Profit Replacement Cost Value $21,756.08 Less Depreciation (335.63) Actual Cash Value $21,420.45 Net Claim $21,420.45 Total Recoverable Depreciation 335.63 Net Claim if Depreciation is Recovered $21,756.08 is is ; SAINTIL-ROSE-KIT 4/1/2021 Page:8 is 1 6 D 1 0 CNI Concepts Enterprises INC Certified Building Contractors 6065 NW 167th St SB14 Miami FL 33015 cniconcepts.com cnicorp@live,com Phone(305)504-8884 Fax(305)504-8885 Certified General Contractor CGC1529534 Licensed Mold Assessor and Remediator MRSR3042,MRSA2850 Recap of Taxes,Overhead and Profit `• Overhead(10%) Profit(10%) Material Sales Tax Laundering Tax(2%) Manuf.(WOHome(Tax Storage Rental (7°Tax ) ( ) Line Items 1,813.01 1,813.01 437.68 0.00 0.00 0.00 Total 1,813.01 1,813.01 437.68 0.00 0.00 0.00 1{. SAINTIL-ROSE-KIT 4/1/2021 Page:9 is 16D10 CNI Concepts Enterprises INC Certified Building Contractors 6065 NW 167th St SB14 Miami FL 33015 cniconcepts.com cnicorp@live.com Phone(305)504-8884 Fax(305)504-8885 Certified General Contractor CGC1529534 i Licensed Mold Assessor and Remediator MRSR3042,MRSA2850 i Recap by Room Estimate:SAINTIL-ROSE-KIT Area:Main Level Kitchen 11,223.73 63.44% Family 1,579.76 8.93% Hall 1,509.86 8.53% Area Subtotal: Main Level 14,313.35 80.90% Debris Removal 1,544.03 8.73% Job Conditions 1,835.00 10.37% Subtotal vl'Areas 17,692.38 100.00% Total 17,692.38 100.00% is f.' SAINTIL-ROSE-KIT 4/1/2021 Page: 10 CNI Concepts Enterprises INC Certified Building Contractors .3 tk 6065 NW 167th St Miami 33015 cniconccpts.com en5814icorp@live.comFL Phone(305)504-8884 Fax(305)504-8885 Certified General Contractor CGC1529534 Licensed Mold Assessor and Remediator MRSR3042,MRSA2850 Recap by Category with Depreciation O&P Items RCV Deprec. ACV 161.86 161.86 CABINETRY 6,515.26 195.45 6,319.81 CLEANING 1,413.72 1,413.72 CONTENT MANIPULATION 152.80 152.80 GENERAL DEMOLITION 1,032.82 1,032,82 DRYWALL 600.00 600.00 ELECTRICAL 1,707.57 13.54 1,694.03 PERMITS AND FEES 795.00 795.00 FINISH HARDWARE 198.96 198.96 478.25 478.25 1,212.50 1,212.50 PLUMBING 647.00 5.30 641.70 PAINTING 2,379.57 53.88 2,325.69 WINDOW TREATMENT 111.75 111.75 WATER EXTRACTION&REMEDIATION 285.32 285.32 O&P Items Subtotal 17,692.38 268.17 17,424.21 Material Sales Tax 437.68 11.48 426.20 Overhead 1,813.01 27.99 1,785.02 Profit 1,813.01 27.99 1,785.02 Total 21,756.08 335.63 21,420.45 is SAINTIL-ROSE-KIT 4/1/2021 Page: 11 i'. 1. 1 . 01 0 . I I t SETTLEMENT AGREEMENT,CONFIDENTIALITY AGREEMENT AIDEer,REL OF ALi,_CL�M� i This Settlement Agreement, Confidentiality Agreement and General Release of All Claims (the "AGREEMENT") is made and entered into by and between , AMERICAN INTEGRITY INSURANCE COMPANY OF FLORIDA, and its I predecessors, parents, successors, affiliates, divisions, assigns, officers, directors, shareholders, representatives, benefits administrators, contractors, employees, former employees, employers, former employers, attorneys, and agents and 1 employees and representatives thereof and their respective spouses, heirs, agents, j employees and representatives ("AMERICAN I NITERIT") and pea O S E SAINTIL•DANIIL, and their successors, assigns, rs, representatives, attorneys,public adjusters,agents,spouse,heirs,and those purportedly claiming any rights through them ("INSURED(S)") (allparties arties to the AGREEMENT collectively referred to as the "PARTIES") in connection ' h the eventss nued i sRnto MAE ROSE claim j under AMERICAN INTEGRITY'S Policy No gAINTIL-DANIEL, for the policy period of July 2 , 0 through July 29, 2021, i ("POLICY"), including but not limited to the investigation, claim handling and/or I adjustment of the claim,and attorney's fees and costs,relating to a claim for payment under the POLICY for mdame PROPERTY')allegedly resulting from water damage to the property located at 13536 Koinonia a rive, Naples,FL 34114(hereaft th erred on or about February 28,2021 1ch was iesued to igned claim number CHO- MARIE-ROSE gAiNTIo- j nd under Policy No,ANI , or the policy period of u y , 020 through July 29, 2021, ("POLICY'), including but not limited to the investigation,claim handling and/or adjustment of the claim,and attorney's fees and costs,relating to a claim for payment under the POLICY for damages to the property located at 13536 Koinonia Drive, Naples, FL arr d 14 4 (hereinafter"PROPERTY") allegedly resulting from water damage t 1 or about March 3, 2021, which was assigned claim number (hereinafter"RELEASED CLAIMS)"), as well as any other property damage c aims of any kind occurring during any poan�tperiod r up framuthe allegations contained in il and through the date of the signing of this AGREEMENT, the complaints in the litigation filed pr'►da the st IedCounty ,HL4RIE--ROSES eNTIL DANIEL Judicial Circuit in and for Collier County, Fl Y u. AMERICAN INTEGRITY INSURANCENTIL DANIEL OF AM FLORIDA, INTEGRITY e number 2021•CC•001766 and MARIE-ROSE (hereinafter INSURANCE COMPANY OF FLORIDA,case numbs "LITIGATION). to, and intend to, By means of this AGREEMENT, the INSURED(S) agree k � their fully, unconditionally, and generally release any and all claims that they,sters, successors, assigns, administrators, representatives, attorneys, public agents,spouse,heirs, and those purportedly claiming any rights through them have, may have, or ever may claim to have, against AMERICAN INTEGRITY and, as Initials„eXa_ 1 I II 16D10 I I Iapplicable, each of their affiliates, predecessors, successors, parents, subsidiaries, j divisions, assigns, officers, directors, shareholders, representatives, benefits 1 administrators, contractors, employees, former employees, employers, former I emp loyers, attorneys, and agents and employees and representatives thereof ), including but not limited to all ims that were I asserted or uld have 90n"asse asserted in the RELEASED CLAIM(S),whether known I asserted or could have b I or unknown,accrued or unaccrued,past,present or future,in connection with,related to,or in any way arising out of the events and insurance claims that are the subject of the RELEASED CLAIM(S), as welt as we all claims a any and all pertainingotherextra-contractualtMIA INTEGRITY'S handling of said claims,as I liability related thereto. 1 I The remaining terms of the AGREEMENT are fully set forth below. I E 1. consideration and case number In (a) As to claim 00/100 consideration of the total payment of TWENTY-SEVEN THb USAANDRICAN Dollars ($27,000.00) ("SETTLEMENT AMOUNT") 1 I INTEGRITY to the INSURED(S),the receipt and sufficiency of which is hereby acknowledged,the INSURED(S)give the releases,covenants,representations, I I and warranties stated in the AGREEMENT. The SETTLEMENT AMOUNT shall be made payable as follows: i. One check in the amount of ROSE eSAINTIL DANIELarDUBOFF s 00/100 ($14,000.00) payable to MARIE LAW FIRM, IiABITAT FOR HUMANITY and COLLIER COUNTY I BOARD OF COUNTY COMMISSIONERS OHS DIVISION;and j ii. One check in the amount of Three Thousand Dollars 00/100 ($8,000.00) payable to NAECA RESTORATION LLC;and iii. One check in the amount of Ten Thousand Dollars 00,100 ($10,000,00) I payable to DUBOFF LAW FIRM. i I MARIE-ROSE SAINTIL•DANIEL hereby e 0 y directs A directlyl� and solely RIto to make payment to the amount of$ see that they will be omitted from such payment based or his and direction to pay. i omitted I; MARIE•ROSE SAINTIL•DANIEL INITIALS: , li 2 of 11 is Initials 10. I'. , i is I 6 D 1 0 and case number In As to claim 011In (b) consideration of atotal payment of SEVENTEEN AMERICAN0 Do17,000.00) (SETTLEMENT AMOUNT") by INTEGRITY ($ the receipt and sufficiency of which is hereby INTEGRITY to the INSURED(S), acknowledged,the INSURED(8)give the releases,covenants,representations, and warranties stated in the AGREEMENT. The SETTLEMENT AMOUNT shall be made payable as follows: 000.00) i. One check in the amount EoESSAeIvNTYLhDANiE D011ars 00/100 DUBOFF LAWS FIRM, payable to MAR.IE•ROS HABITAT FOR HUMANITY a and DIVI COLLIER, COUNTY BOARD OF COUNTY COMMISSIONERS CHB ii. One cheek in the amount of Three Thousand LLC;andDollars 00/100 ($5,000.00) I payable to NAECA RESTORATION One check in the amount of Seven Thousand Dollars 00/100 ($7,000.00) payable to DUBOFF LAW FIRM. MARIE-ROSE SAINTIL-DANIEL hereby directs AMERICAN INTEGRITY to make payment in the amount of$7,000.00 above directly and solely to DUBOFF LAW FIRM and acknowledges and agrees that they will be omitted from such payment based on this direction to pay. AS MARIE-ROSE SAINTIL-DANIEL INITIALS: (c) The settlement checks will be provided to counsel for the INSURED(S) within thirty (30) days of receipt of the mutually agreeableredice by defense counsel for Stipulation for Final Order of Dismissal AMERICAN INTEGRITY. (d) INSURED(S) agree to have her counsel execute a Joint Stipulation of Dismissal with Prejudice of the Proceedings to be providedcounsel for contemporaneously AMERICAN with the executed release and held in trust by DUBOFF LAW FIRMIC INTEGRITY until receipt of the settlement checks by behalf of the INSURED(S). No sooner than ten (10) days ERICAN INTEGRITYtwillofilenthe ed receipt of the settlement checks, AM executed Joint Stipulation of Dismissal with Prejudice and proposed Order of Dismissal with Prejudice to the Court. 2. denial Releas6 3001 Initial i 1 6 D 1 0 f f (a) The INSURED(S) hereby voluntarily and knowingly, individually and collectively, releases es and forever discharges the RELY Sa ysandlall state, separately, and severally, directly, and vicariously, � local, and federal claims, causes of action,ttli but not limited to, all claims ins, and judgments of every and description whatsoever (including, 1 equity, under local, federal, or state tort, contract, extra-contractual, or their successors, assigns, administrators, statutory law) that they, spouse, heirs, and those purportedly representatives, attorneys, agents,claiming any rights through them, have, or may ever claim to have, against or unitive damages or other legal or the RELEASERS for type tion whatsoever,including but not limited equitable reliefsh of any tYp to all claims that were asserted or conic have ti n��her�i��Ther known or arising or unknown, accrued or unaccrued, out of,the events and insurance claim that is thhsubjectw of LITIGATION, about as well as all claims arising out of allegeddamage February 28,2021 and/or on or about March 3,to 1,at 13696 6loss of use Drive, art damageu claims of Naples, FL 34114 (including but not limited other property alternative living expenses), as well as any any kind occurring during any policy period up and until and through he dat to of the signing of this AGREEMENT, as well as any related thereto. The claim, causes of action, security bi erefer tad liabilities,collectively hereindgments as the (b) released in Paragraph 2(a)above shall "RELEASED CLAIM(S)". (e) The INSURED(S) hereby covenant and agree, individually and collectively, will they will forever refrain and forebear ingof any kind, sgainstgany prosecuting any lawsuit, action,or other proceed , action, based on, of the RELEASEES, individually, collectively or via cla h the RELEASED arising out of, related to, or connected any CLAIM(S). The INSURED(S) understand and agree that the AGREEMENTrainiet afore, (f) on them as well as upon their successors,l assigns, administrators, and those binding public.adjusters, agents,i representatives, attorneys, p purportedly claiming any rights through them. 1 S. wr eanionment.D Tr sfe slaw Ie of this irelaint (a) The INSURED(S) represent and warrant transferred, or hypothecated,ing drson,firm,corporation, or AGREEMENT, they have not othecate,to any p purported to assign,transfer,or hyp of the RELEASED CLAIM(S). Th® association, or entity whatsoever any 4 of 11 Initial: f 16D10 I i i further represent and warrant that as of the signing of this i INSURED(S) AGREEMENT, there are no unpaid obligationsapanies� water extraction d and owing by INSURED(S) to any contractors, remed companies, public adjusters and/or other persons related to entities as a result have provided servi3es of any kind to the INSURED(S) 888 of the RELEASED CLAIM(S), or if such liens the SE►rTxist, LEMENT AMOUNT to satisfy any such liens out of the proceeds indicated in paragraph 1. hereby agree to indemnify and hold harmless e RELEASEESdemand (b) against,The INSURED(S)without (S)he Yc 's and/or es,o wgation ,liabilities, cYst%expen es(including attorn9Y feesout of, debts,obligations,habit � based on, arising uster fees),causes of action,and judgments or public ne such transfer, assignment, or hypothecation, or connected with any purported transfer,assignment,or hypothecation. n..ien sric�tudea U+c k - 1 'm 4. and that the The INSURED(S)understand and agreen does include any andall claims of (a) RELEASED CLAIM(S) is intended to andsuspected, or everynaturehave against or accrued ue whatsoever which they have or may sus unsuspected or un the RELEASERS in connection with the RELEASED CLAIM(5)• ant (b) The INSURED(S) acknowledge that they may hereafter discover facts differ agrees that,in any such event, this or in addition to those which they now know or believe to be true with from and respect to the RELEASED CLAIM(S) thereof. ts, th not AGREEMENT shall nevertheless be and remain ee a aeffective iecon all respects, notwithstanding such different or additional r n.,.i Fai h1C�actua� r . 5. (a) The INSURED(S) waive and hereby forever release any claims s causes oknownf f action past, present or future, asserted or unasserted, unknown, and whether accrued or unaccrued against fa red Eli gASEES for f "bad faith", breach of the covenant of good faith tractual and extra-contractual contract, Unfair Trade Practices, tort,e, including punitive damages, causes of action and damages of any type, related statutory and common law, of arisingl fed damage om,connected whichwith, o occurred on way or about t to, all u claims arising out of alleged kind February 28,2021 and/or on or abouo�March pg�t�2damage$c aims of any Naples, FL 34114, as well as any P during any policy per1od up and until and through the date oft e occurring 5 of 11 Initials % l signing of this AGREEMENT,as well as any extra-contractual liability related thereto. e Fe o d r 6. SETTLEMENT AMOUNT a The INSURED(S) understand and agree that the ( ) and all claims with respect to attorneys' fees, includes and encompasses any public public adjuster fees,costs, and ultants,expenses of any kind who havearepresented the adjusters, experts, and cons anythingin M S .The INSURED(S)agree to release INSURED(S)or with whom they have consulted or who has done connection with the RELEASED Cfurther agree any claim for past, present or futeRELrEAS�ES against anyS�aim that may to indemnify and hold harmless thekind,by any utes regarding any unpaid fees and costs, of any kind,who allarise outa toof diep public adjusters,experts, and consultants,of any havenv r attorneys, with whom they have ` represented the INSURED(S)°rthe RELEASED CLAIM(S)ulted or who M j has done anything in connection with 7. Lia '1't (a) The PARTIES understand and agree that this AGREEMENT is a release n iabi ity on the of disputed claim and does not constitute at oeverland thatl theIPARTIES part of any party as to any matter w merely intend by this AGREEMENT to avoid further dispute litigation all The INSURED(S) understands that the RELEASEES expressly allegations of coverage and wrongdoing in connection with the RELEASED CLAIM(S). B. Co aon rtiality(a) tise or The INSURED(S) Covenant that they will not disclose,p ublicize,the adverterm advers or I use,in any manner imaginable other than as set forth herein, AGREEMENT, including but not limited to thet SETTLEMENT AMOUNT, and and s agree to hold theand claim specifically covenant and related facts, circumstances, legal theories, causes of action, Sin strictest confidence and shall not, surrounding the RELEASED CLAIM( ) without the prior written consent of the RELEASEES, disclose court hat information in any manner,exceCo,�the rio extent for this d disclosed by any confidentiality i One of competent jurisdiction. The Hundred and OO/100 Dollars 0100.00)of the total settlement amount listed in paragraph 1(a). (b) This obtain tx,legal, confidentiality provision shall not be applicable to disclosures necessary to obtain tax,lega financial,or accounting advice or services,but such service 6 of 11 Initial 16D10 I I providers shall,at the outset,be advised of this confidentiality obligation,and the INSURED(S) agrees to disclose only that o�r accour,t accounting advice oation that is r service• solutely that tax,legal,financial, necessary to receivingprohibits the I (c) This covenant of confidentiality by the INSURED(S) specifically p i. following non-exhaustive types of disclosure which are identified for illustrative purposes only: I (i) This AGREEMENT prohibits his AGREEMENT in the course of losure by the attorneys for the INSURED(S)of the terms oft their professional practices as attorneys including but not limited to use in advertisements, future lawsuits (or other g le al education material,interviews of any 1 lawsuits of any kind),kind(regardless of the media), � (ii) This AGREEMENT prohibits disclosure by the INSURED(S) of I any of this material to any print publication, television reporter, radio reporter, 'on-line" media reporter, r,t reporter AGREEMENTinst of any other kind, and shall not disclose recording, or any video recording, audio recording, writing,of any kind. 1 1 (d) ttle regards to inquiries about their insurance policy, AGREEMENT, or this has INSURED(S) covenant and agree to simply respond that the In matterthe INSUR ( ) of its resolution and facts been concluded, and that thecae tiality agreement and cannot related thereto are subject to a binding confident to disclose any part of this i be disclosed. IF the INSURED(S) are requested to promptly notify the AGREEMENT, they also covenant and agree LEASEES to permit RELEASES to seek a protectiveordnr or take then REwill also coop appropriate action. The INSURED(S) ES' r b t c!Tao to obtain a protective orforder,d e d t or,e AGREEMENTI If�in the bBence confidential treatment will be af of a p rotective order, the INSURED(S),in the written oprnof slaw of ttoheir disclose unsel addressed to RELEASEEB, is compelled asmaydisclose to the third party information relating to this AGREEMENT,t i atilon as is required by law to be compelling the disclosure only l advise disclos ed(in which case,prior to such disclosure,as t INSURED(S) land the ' and consult with RELEASERS and their counsel nature and wording of such disclosure)andh AGREEMENT. Further,SURED(S)will etheir beet � ! efforts to maintain the confidentiality of thisthird party seek or attempt to obtain any information aid from dethexo PARTIES e ould anyconsideration udicial, quasi- ' related to this AGREEMENT °r the a overnment action, ]' � � AGREEMENT through legal process, g 1 judicial or extra-judicial methods,the PARTIES covenant and mutually agree, j � 7 of 11 Initi ls,� l� 0.— , i i 1: 1 5D 1 0 yi trial or notify the other, in writing,before any hearing, ands this sal ction each tan Ymust report if is there is o As time is of mt e toe report in writing, he requested party is not sufficient time rep in person or by telephone. (e) The term of this confidentiality begins on the date the claim was resolved, August 26,2022 and continues forever,without end. (i) The INSURED(S) warrant and represent that they a e not AGREE disclosed the terms of the AGREEMENT as of the date of signing enter into this otherwise, the RELEASEES' interest in confidentiality is frustrated and an essential element of consideration for the RELEASEES AGREEMENT is missing. 9. .3 ins agree that the RELEASEES have made no representations (a) The INSURED(S) of the payment of the to them concerning the tax conaeyuencee, ifany, SETTLEMENT AMOUNT as provided for in this AGREEMENT. If any governmental taxing authority determines that RELEASEES should have thheld any sum from the SETTLEMENTEAMO AMOUNT, thehI INSURED(S) a 1 w hereby agree to indemnify and hold RELEASERS a taxes, if any, due damage arising �mh,AMOUNT i,the INSUREDS) tap Y on the SETTLEMENT 10. (or rhdir authorizede No revision of this AGREEMENT may be e PARTIES changed, ltered, modifiedor (a) p t in writing signed by waived exc�p shall specifically reference this AGREEMENT representatives),which writingT it.provisions of this that the PARTIES intend to waive or modify te The waiver by any and indicateuhis i party to this AGREEMENT or a breach of any o AGREEME NT shall not operate or be construed as a waiver of any subsea ent or simultaneous breach. 1 111. eo..Sg ility provision of this AGREEMENT shouldbe held to hbe I i (a) In the event any all unenforceable,each and all of the other provisions of this A remain in full force and effect. 12. EntinAgnenumt { a of t l Initials, Y,6 1 16D10 1 1 I (a) The PARTIES acknowledge that this AGREEMENT constitutes a full, final, and complete settlement of their differences and supersedes nderela es any and all other written or exchanges, among them relating to the arrangements, or nog RELEASED CLAIM(S), and affirmatively state that nteere are arrangements, no other prior Ior contemporaneous agreements, exchanges, rep I or understandings, written or oral, between orinn this AGREEMENT, the ong them relating to the subject matter hereof other than that as set o rthi that this AGREEMENT contains the sole and entire agreement The PARTIES further acknowledge etween them with respect the language proposed sed for, deleted from, or otherwise changed in and gree that fang g p p interpretation and application of this the various drafts of this AGREEMENT but not included here shallnot e considered in any way in the P i AGREEMENT and shall not in any way affect the rights and obligations of the PARTIES. 1 13. APIALCAhle_ This AGREEMENT shall be construed and enforced according to the laws of ` application of conflicts of law I (a) the State of Florida, without regard to the i principles. 14. i=o on ra Profere tum acknowledge that. this is a negotiated AGREEMENT and that (a) The PARTIES ro eremtum is Ithe principle of contract interpretation known as contra p f Iinapplicable to its construction. 16. ligadinakAnd-C--gatiem The headings and captions used in this AGREEMENT are for convenience affect the 1 (a) i reference only,and shall in no way ,of this AGREEMENT. meaning or construction of any provision I 16. geeperafignand all (a) The PARTIES agree to cooperate fully and to execute any e supplemenS�oraryappro. pri documateentsto angkd Ve�futak kforcel to tadihe terms and itnhteant of this necessary Ligni AGREEMENT I .. ,s L......,,ioss a d inde�'gillti i \ 11. 1 9 of 11 Initial i t. I 1 16D10 ee, as further consideration and inducement for this (a) The INSURED(S) a gr compromised settlement,to eati,ify�any and all by collates collateral es arising out ut not limited p sing o t to attorney liens and/or claim for benefits p proceeds,:end furthermore,the INSURED(S)promise o of the abme ss an i i d p AMERICAN INTEGRITY for all claims whereby { hold harmless and indemnify t tlimited to any other mortgagees and secured any third party(including cr ees thereof) alleges that all or part of the sums paid by ediIs or assign AMERICAN AMERICAN INTEGRITY should have been paid said third party. AddINTEGRITY ally, the INSURED(S) promises to such INTEGRI'I`Y for any coats and a.tc�r,•ieya'fees incurred in defending any allegation made by any such third party. . " 18. Yolutarailm 09 to file a Voluntary (a) The INSURED(S) and DUBOFF LAW FIRM agt' ent Dismissal with Prejudice with the receipt t ourt 1 of settlement £unds;n exchange for the ttloermthe funds within ten (10) days of p INSURED(S) agree to have their counsel execute a Joint btipule provided of Dismissal with Prejudice of the Proceedings tod held contemporaneously with the executed NTEGRITY until ttlement erecnt e A of t he trust by counsel for AME Kl C settlement checks by DUBOI"F LAW FIRM on behalf of the INSURED(S). [TH E REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK] SIGNATURES BL IN ON NEXT PAGE 10 of 11 Initial ' _.... 16D10 i I 1 HEBY ACKNOWLEDGE THAT I HAVE READ THIS GENERAL RELEASE ANDTHE TERMS AND ONDITIONS " 1 UNDERSTAND AND ACCEPT AIL O THEREIN AND THAT I HAVE DONE SO WITH THE ADVICE OF MY COUNSEL AT DUBOFF LAW FIRM. NOTICE: Section 817.284, Florida Statutes, provides in part: "Any person who knowingly and with intent to injure, defraud or deceivees incny ompletr e files a statement of claim or an application containing any r or misleading information is guilty of a felony of the third degree." F SIGNATURES:} MARIE- OSE SAINTIL•DANIEL r , fit- I� PRINT NAME I STATE OF — COUNTY OF_. l ls�-. SWORN TO AND SUBSCRIBEDBEFORE ME by means o physical ,2022 by presence OR____online notarization, on thief..day o c , personally known to me or who has ��aldentificaiand who didA or did not take an producedF' ----- oath. tuts) 44\ INELDACYRIAQUE•JEAN 2 Notary Public•State of Floridapr( ) P CommissltM#GG149812` ,,� My Comm.Expl►es Jun I0,202I Bonded through National Notary Assr. ; (Seal) Notary Public, State of C.or► __ My Commission Expires: tz,' 3612d2-3 i II of 11 iigsa • Initials 1 I 6D1 0 Retn: 4307421 OR: 4461 PG: 3615 OBLD 3000,00 PORTER WRIGHT ET AL RECORDED in the OFFICIAL RECORDS of COLLIER COUNTY, IL ORLI 3000.00 { 5801 PELICAN BAY BLVD 1300 06/15/2009 at 10:19AN DWIGRT B. BROCK, CLERK AEC PEE 27.00 NAPLES FL 34108 2709 SECOND MORTGAGE THIS SECOND MORTGAGE("Security Instrument")is given on .11 day of OVI t—, ,2009. The Second Mortgagor is: Marie R.Saintil Daniel,a single person ("Borrower"). This Security Instrument is given to Collier County ("Lender'),which is organized and existing under the laws of the United States of America,and whose address is 3301 E. Tamiami Trail, Naples, Florida 34112 , Borrower owes Lender the sum of Three Thousand and 00/100 Dollars ($3,000.00). This debt is evidenced by Borrower's Note dated the same date as this Security Instrument("Second Mortgage"),which provides for monthly payments,with the full debt, if not paid earlier,due and payable on sale of property, refinance, or lose of homestead exemption . This Security Instrument secures to Lender:(a)the repayment of the debt evidenced by the Note,with interest,and all renewals,extensions and modifications;(b)the payment of all other sums,with interest advanced under paragraph 7 to protect the security of the Security Instrument;and(c)the performance of Borrower's covenants and agreements under this Security Instrument and the Note. For this purpose, Borrower does hereby second mortgage,grant and convey to Lender the following described property located in Collier County.Florida. As more particularly described as Vot 187,Trail Ridge,Collier County,Florida and which has the address of: ("Property Address"): • 56 Roinonia Drive, Naples, FL 34114 TOGETHER WITH all the pro rttents now or hereafter erected on the property,and all easements,rights,appurtenances,rents, royalties,mineral,oil and gas rights and re refits,water rights and stock and all fixtures now or hereafter a part of the property. All replacements and additions shall also be covered by theS,pcurjty Instrument. All of the foregoing is referred to in this Security Instrument as the"Property", BORROWER COVENANTS tli FBorrr66wer is lawfully seized of the estate hereby conveyed and has the right to mortgage,grant and convey the Property and that the Property is unencumbered,except for encumbrances of record. Borrower warrants and will defend generally the title to the Property against all claims and demands,subject to any encumbrances of record. THIS SECURITY INSTRUMENT nt combar uniform covenants for national use and non-uniform covenants with limited variation by jurisdiction to constitute a uniform security instrU covering real properly. UNIFORM COVENANTS. Borrower an4 Lender covenant and agree as follows: t. Payment of Principal and Interest;Pfertayme t and Late Charges. Borrower shall promptly pay when due the principal of and interest on the debt evidenced by the Note, 2. Taxes. The Mortgagor will pay all taxes;-as essfpents,sewer rents or water rates prior to the accrual of any penalties or interest thereon. ",-•`;,+ The Mortgagor shall pay or cause to be paid,as the ante respectivoly become due,(A)(1)all taxes and governmental charges of any kind whatsoever which may at any time be lawfully assessedror ledted against or with respect to the Property,(2)all utility and other charges, lr3 including"service charges",incurred or imposed for the operation, tenance,use,occupancy,upkeep and improvement of the Property,and (3)all assessments or other governmental charges that may IavN y be paid in installments over a period of years,the Mortgagor shall be obligated under the Mortgage to pay or cause to be paid only suetinstallrn is as are required to be paid during the term of the Mortgage,and shall,promptly after the payment of any of the foregoing,forward td.idrtgag fee evidence of such payment. 3. Application of Payments. Unless applicable law provideiggtlfeiwike,all payments received by Lender shall be applied;first,to interest due;and,to principal due;and last,to any late charges due uridbr t e'Fio(. 4. Charges;Liens. Borrower shall pay all taxes,assessments;charges fines and impositions attributable to the Property which may attain priority over this Security Instrument,and leasehold payments or ground rents,'it any. Borrower shall promptly furnish to Lender all notices of amounts to be paid under this paragraph,and all receipts evidencing'1'he payments. Borrower shall promptly discharge any lien which has priority over this Secty)Rstrument unless Borrower:(a)agrees in writing to the payment of the obligation secured by the lien in a manner acceptable to Lender,p-( )`o9 nllests in good faith the lien by,or defends against enforcement of the lien in,legal proceedings which in the Lender's opinion operatelo;pr€venithe enforcement of the lien;or(c)secures from the holder of the lien an agreement satisfactory to Lender subordinating the lien to this 5ecynty Instrument. If Lender determines that any part of the Property is subject to a lien which may attain priority over the Security Instrument-render may give Borrower a notice identifying the lien. Borrower shall satisfy the lien or take one or more of the actions set forth above within 10 daysaof th giving of notice. 6. Hazard or Property Insurance. Borrower shall keep the improvements now exlS�ting'o hereafter erected on the Property insured against loss by fire,hazards included within the term"extended coverage"and any other hazards,i eluding floods or flooding,for which Lender requires insurance. This insurance shall be maintained in the amounts and for the periods thaTCe9der•repires. The insurance carrier providing the insurance shall be chosen by Borrower subject to Lender's approval which shall not be unreasonably withheld. If Borrower fails to maintain coverage described above,Lender may,at Lender's option,obtain coverage to protect ilerigoirigirts in the Property in accordance with paragraph 7. At all times that the Note is outstanding,the Mortgagor shall maintain insurance with, s`pecl to the Premises against such risks and for such amounts as are customarily insured against and pay,as the same become due andlayo¢je,•a I premiums in respect thereto, including,but not limited to,all-risk insurance protecting the interests of the Mortgagor and Mortgagee against I'ss or damage to the Premises by fire,lightning,and other casualties customarily insured against(including boiler explosion,if appropriate),w}ta.rr h iform standard extended coverage endorsement,including debris removal coverage. Such insurance at all times to be in an amounlnlit less than the full replacement cost of the Premises,exclusive of footings and foundations. ( All insurance policies and renewals shall be acceptable to Lender and shall include a standard mortgage clause. Lender shall have the right to hold the policies and renewals. If Lender requires,Borrower shall promptly give to Lender all receipts of paid premiums and renewal notices. In the event of loss,Borrower shall give prompt notice to the insurance carrier and Lender. Lender may make proof of loss if not made promptly by Borrower. Unless Lender and Borrower otherwise agree in writing,insurance proceeds shall he applied to restoration or repair of the Property damaged,if the restoration or repair is economically feasible and Lender's security is not lessened. If the restoration or repair is not economically feasible or Lender's security would be lessened,the insurance proceeds shall be applied to the sums secured by the Security Instrument,whether or not then due,with any excess paid to Borrower. If Borrower abandons the Property,or does rot answer within 30 days a notice from Lender that the insurance carrier has offered to settle a claim,then Lender may collect the insurance proceeds. Lender may use •the proceeds to repair or restore the Property or to pay sums secured by this Security Instrument,whether or not then due. The 30-day period will begin when the notice is mailed. Unless Lender and Borrower otherwise agree in writing,any application of proceeds to principal shall not extend or postpone the due date of the monthly payments referred to in paragraph 1 or change the amount of the payments. If under paragraph 21 the Property is acquired by Lender,Borrower's right to any insurance policies and proceeds resulting from damage to the Property prior to the acquisition shall pass to Lender to the extent of the sums secured by this Security Instrument immediately prior to the acquisition. 6. Occupancy,Preservation,Maintenance and Protection of the Property;Borrower's Loan Application,Leaseholds. Borrower shall occupy,establish,and use the Property as Borrower's principal residence within sixty days after the execution of this Security Instrument and shall continue to occupy the Property as Borrower's principal residence for at least one year after the date of occupancy,unless Lender otherwise agrees in writing,which consent shall not be unreasonably withheld,or unless extenuating circumstances exist which are beyond Borrower's control. Borrower shall not destroy,damage or impair the Property,allow the Property to deteriorate,or commit waste on the Property. Borrower Shall be in default if any forfeiture action or proceeding,whether civil or criminal,is begun that in Lender's good faith judgment could result in forfeiture of the Property or otherwise materially impair the lien created by this Security Instrument or Lender's security interest. Borrower may cure such a default and reinstate,as provided in paragraph 16,by causing the action or proceeding to be dismissed with a ruling that,in Lender's good faith determination,precludes forfeiture of the Borrower's interest in the Property or other material impairment of the lien created by this Security Instrument or Lender's security interest. Borrower shall also be in default if Borrower,during the 1 6D1 0 II1. i OR: 4461 PG: 3616 loan application process,gave materially false or inaccurate information or statements to Lender(or failed to provide Lender with any material information)in connection with the loan evidenced by the Note,including,but not limited to,representations concerning Borrower's occupancy of the Property as a principal residence. If this Security Instrument is on a leasehold,Borrower shall comply with all the provision of the lease. If Borrower acquires fee title to the Property,the leasehold and the fee title shall not merge unless Lender agrees to the merger in writing. 7. Protection of Lender's Rights In the Property. If Borrower fails to perform the covenants and agreements contained in this Security Instrument,or there is a legal proceeding that may significantly affect Lender's rights in the Property(such as a proceeding in bankruptcy,probate,for condemnation or forfeiture or to enforce laws or regulations),then Lender may do and pay for whatever is necessary to protect the value of the Property and Lender's rights in the Property. Lender's actions may include paying any sums secured by a lien which has priority over this Security instrument,appearing in court,paying reasonable attorneys'fees and entering on the Property to make repairs. Although Lender may take action under this paragraph 7,Lender does not have to do so. Any amounts disbursed by Lender under this paragraph 7 shall become additional debt of Borrower secured by this Security Instrument. Unless Borrower and Lender agree to other terms of payment,these amounts shall bear interest from the date of disbursement at the Note rate and shall be payable,with interest,upon notice from Lender to Borrower requesting payment. 8. Mortgage Insurance. if Lender required mortgage insurance as a condition of making the loan secured by this Security Instrument,Borrower shall pay the premiums required to maintain the mortgage insurance in effect. ff,for any reason,the mortgage insurance coverage required by Lender lapses or ceases to be in effect,Borrower shall pay the premiums required to obtain coverage substantially equivalent to the mortgage insurance previously in effect,at a cost substantially equivalent to the cost to Borrower of the mortgage insurance previously in effect,from an alternate mortgage insurer approved by Lender. if substantially equivalent mortgage insurance coverage is not available,Borrower shall pay to Lender each month a sum equal to one-twelfth of the yearly mortgage insurance premium being paid by Borrower when the Insurance coverage lapsed or ceased to be in effect. Lender will accept,use and retain these payments as a loss reserve in lieu of mortgage insurance. Loss reserve payments may no longer be required,at the option of Lender,if mortgage insurance coverage(in the amount and for the period that Lender requires)provided by an insurer approved by Lender again becomes available and is obtained. Borrower shall pay the premiums required to maintain mortgage insurance in effect,or to provide a loss reserve,until the requirement for mortgage insurance ends In accordance with any written agreement between Borrower and Lender or applicable law. 9. Inspection. Lender g��yt�its agent may make reasonable entries upon and inspections of the Property. Lender shall give Borrower notice at the time of or priorJfr rvin9ection specifying reasonable cause for the inspection. 10. Condemnation. The proceeds of any award or claim for damages,direct or consequential,in connection with any condemnation or other taking of any part of(tte'1?ro,nerty;or for conveyance in Ileu of condemnation,are hereby assigned and shall be paid to Lender. In the event of a total taking of the Proper ,+,tthe. receeds shall be applied to the sums secured by this Security Instrument,whether or not then due, with any excess paid to Borrower...lfr veaat of a partial taking of the Property,in which the fair market value of the Property immediately before the taking is equal to or greater than eaa mount of the sums secured by this Security Instrument immediately before the taking,unless Borrower and Lender otherwise agree invifting;the sums secured by this Security Instrument shall be reduced by the amount of the proceeds multiplied by the following fraction:(a)the total amount of the sums secured immediately before the taking,divided by(b)the fair market value of the Property immediately before the taking. Any'L lance shall be paid to Borrower. In the event of a partial taking of the Property in which the fair market value of the Property immediatel. re the taking is less than the amount of the sums secured immediately for the taking, unless Borrower and Lender otherwise agree in ling or unless applicable law otherwise provides,the proceeds shall be applied to the sums secured by this Security Instrument whether or'n6t the suing are then due. Unless Lender and Borrower otherwise agree in writing,any . application of proceeds to principal shall not extend;er eetp ne the due date of the monthly payments referred to in paragraphs 1 or change the amount of such payments. rr , 11. Borrower Not Released,Forbearanc'eB .l.en er Not a Waiver. Extension of the time for payment or modification of amortization of the sums secured by this Security Instrudi nt'gran ed by Lender to any successor in interest of Borrower shall not operate to release the liability of the original Borrower or Borrower's's eeessOrs an interest. Lender shall not be required to commence proceedings against any successor in interest or refuse to extend time feu payni2n'or otherwise modify amortization of the sums secured by this Security Instrument by reason of any demand made by the original Bb wer falorrower's successors in interest. Any forbearance by Lender in exercising any right or remedy shall not be a waiver of or prectude�tfse exerticise of any right or remedy. 12. Successors and Assigns Bound;Joint and Several Li billy;Cosigners. The covenants and agreements of this Security instrument shall bind and benefit the successors and assigns of Lepeand rrower,subject to the Provisions of paragraph 17. Borrower's covenants and agreements shall foint and several. Any Borrower who co-signs this Security Instrument but does not execute the Note;(a)is co-signing this Securi ' ristrifere e only to mortgage,grant and convey that Borrower's interest in the Property under the terms of this Security Instrument;(b)is not persdnal)6 ji aced to pay the sums secured by this Security Instrument; and(c)agrees that Lender and any other Borrower may agree to extend,modify„eleter or make any accommodations with regard to the terms of this Security Instrument or the Note without that Borrower's consent. .a '. 13. Loan Charges. If the loan secured by this Security Instrument Is a bj6&gt*a law which sets maximum loan charges,and that law is finally interpreted so that the interest or other loan charges collected or to be.,cd11ectect in connection with the loan exceed the permitted limits,then:(a)any such loan charge shall be reduced by the amount necessary($re¢u itl'tp charge to the permitted limit;and(b)any sums already collected from Borrower which exceeded permitted limits will be refunded td Borrower. Lender may choose to make this refund by reducing the principal owed under the Note or by making a direct payment to Borroweeel a refund reduces principal,the reduction will be treated as a partial prepayment without any prepayment charge under the Note. ` 14. Notices. Any notice to Borrower provided for in this Security Instrument shall ae giver by delivering it or by malting it by first Gass mail unless applicable law required use of another method. The notice shall be directed teqte- Property Address or any other address Borrower designates by notice to Lender. Any notice to Lender shall be given to Borrower or reed rwh' given as provided in this paragraph. 15. Governing Law;Severabllity. This Security Instrument shall be governed by federal lad,'rid the law of the jurisdiction in which the Property Is located, in the event that any provision or clause of this Security Instrument or th'eSiNeega nfflicts with applicable law,such conflict shall not affect other provisions of this Security Instrument or the Note which can be given effedtvvjtho;t the conflicting provision. To this end the provisions of this Security Instrument and the Note are declared to be severable. .f `•.. 16. Borrower's Copy. Borrower shall be given one conformed copy of the Note and of this Security I_strument. 17. Transfer of the Property or a Beneficial Interest in Borrower. If all or any pan of the Propert or,,.py interest in it is sold or transferred(or if a beneficial interest in Borrower is sold or transferred and Borrower is not a natural persoh)4ithout Lender's prior written consent,Lender may,at its option,require immediate payment in full of all sums secured by this Security instrument. However,this option shall not be exercised by Lender if exercise is prohibited by federal law as of the date of this Security Instrument. If Lender exercised this option,Lender shall give Borrower notice of acceleration. The notice shall provide a period of not less than 30 days from the date the notice is delivered or mailed within which Borrower must pay all sums secured by this Security instrument. If Borrower fails to pay these sums prior to the expiration of this period,Lender may invoke any remedies permitted by this Security Instrument without further notice or demand on Borrower. 18. Borrower's Right to Reinstate. If Borrower meets certain conditions,Borrower shall have the right to have enforcement of this Security Instrument discontinued at any time prior to the earlier of:(a)5 days(or such other period as applicable taw may specify for reinstatement)before sale of the Property pursuant to any power of sale contained in this Security Instrument;or(b)entry of a judgment enforcing this Security Instrument. Those conditions are that Borrower:(a)pays Lender all sums which then would be due under this Security Instrument and the Note as If no acceleration had occurred;(b)cures and default of any other covenants or agreements;(c)pays all expenses incurred in enforcing this Security Instrument,including,but not limited to,reasonable attorney's fees;and(d)takes such action as Lender may reasonably require to assure that the lien of this Security instrument,Lender's rights In the Property and Borrower's obligation to pay the sums secured by this Security instrument shall continue unchanged. Upon reinstatement by Borrower,this Security Instrument and the obligations secured hereby shall remain fully effective as If no acceleration had occurred. However,this right to reinstate shall not apply in the case of acceleration under paragraph 17. 19. Sale of Note;Change of Loan Servicer. The Note or a partial interest in the Note(together with this Security Instrument)may be sold one or more times without prior notice to Borrower. A sale may result in a change in the entity(known as the"Loan Servicer")that collects monthly payments due under the Note and this Security Instrument. There also may be one or more changes of the Loan Servicer unrelated to a sale of the Note. If there is a change of the Loan Servicer,Borrower will be given written notice of the change in accordance with paragraph 14 and applicable law. The notice will state the name and address of the new Loan Servicer and the address to which payments should be made. The notice will also contain any other information required by applicable law. T0. Hazardous Substances. Borrower shall not cause or permit the presence,use,disposal,storage,or release of any Hazardous Substances on or in the Property. Borrower shall not do,nor allow anyone else to do,anything affecting the Property that is in violation of any I 6 D 1 0 * OR: 4461 PG: 3617 eft Environmental Law. The preceding two sentences shall not apply to the presence,use,or storage on the Property of small quantities of Hazardous Substances that are generally recognized to be appropriate to normal residential uses and to maintenance of the Property. Borrower shall promptly give Lender written notice for any investigation,claim,demand,lawsuit or other action by any governmental or regulatory agency or private party involving the Property and any Hazardous Substance or Environmental Law of which Borrower has actual knowledge. If Borrower learns,or is notified by any governmental or regulatory authority,that any removal or other remediation of any Hazardous Substance affecting the Property is necessary,Borrower shall promptly take all necessary remedial actions in accordance with Environmental Law. As used in this paragraph 20,"Hazardous Substances"are those substances defined as toxic or hazardous substances by Environmental Law and the following substances: gasoline,kerosene,other flammable or toxic petroleum products,toxic pesticides and herbicides,volatile solvents,materials containing asbestos or formaldehyde,and radioactive materials. As used in this paragraph 20,"Environmental Law"means federal laws and laws of the jurisdiction where the Property is located that relate to health,safety or environmental protection. 21. Acceleration;Remedies. Lender shall give notice to Borrower prior to acceleration following Borrower's breach of any covenant or agreement in this Security instrument(but not prior to acceleration under paragraph 17 unless applicable law provides otherwise). The notice shall specify: (a)the default;(b)the action required to cure the default;(c)a date,not less than 30 days from the date the notice is given to Borrower,by which the default must be cured;and(d)that failure to cure the default on or before the date specified in the notice may result in acceleration of the sums secured by this Security Instrument,foreclosure by judicial proceeding and sale of the Property. The notice shall further inform Borrower of the right to reinstate after acceleration and the right to assert in the foreclosure proceeding the non-existence of a default or any other defense of Borrower to acceleration and foreclosure. If the default is not cured on or before the date specified in the notice, Lender,at its option,may require immediate payment in full of all sums secured by this Security instrument without further demand and may foreclose this Security Instrument by judicial proceeding. Lender shall be entitled to collect all expenses incurred in pursuing the remedies provided in this paragraph 21,including,but not limited to,reasonable attorney's fees and costs of the title evidence. 22. Release. Upon payment of all sums secured by this Security Instrument,Lender shall release this Security Instrument,without charge,to Borrower Borrower sha)I pay any recordation costs. 23. Attorneys'Fees,,A.g used In this Security Instrument and the Note,"attorneys'fees"shall include any attorneys'fees awarded by an appellate court. ",l •,- 24. Riders to this Sec}trflyinstrument. If one or more riders are executed by Borrower and recorded together with this Security Instrument,the covenants and dgre dnt of each such rider shall be incorporated into and shall amend and supplement the covenants and agreements of this Security InstriMenttas'f the rider(s)were a part of this Security Instrument. (Check Applicable Box) • ❑Adjustable Rate Rider �❑`iiate mprovement Rider ❑Condominium Rider ❑Graduated Payment Rider a1-4 Family Rider ❑Second Home Rider ❑Balloon Rider ❑filiweekllIyment Rider ❑Planned Unit Development Rider U Other(s)(specify ' SIGNING BELOW,Borrower accepts and agrees too+`Morn and covenants contained in this Security Instrument and in any rider(s)executed by Borrower and recorded with it. ` ., Signed,sealed and delivered in the presence of: i. ".,;:f. ,.;�;, 31g afore: ..,,./02‘.4/. ' ��C`�u t nosier Marie R 3aintil Daniel • Signature: . _ ! ,/ Witness#2: ei/i.Pez 6 r, - 5ignatur , .... Cd= p'riow,en, Signature: '• /'. e' /.:� ':,.y:, ? :t. Address ,,73S '•Roinonia Drive • •Nadi ai Florida 34114 STATE OF FLORIDA COUNTY OF COLLIER •` J I hereby certify that on this day,before me,an officer duly authorized in the state afof ai and in the county aforesaid to take t acknowledgements,personally appeared Marie R.Sainttl Daniel to me known to be the person(sj, escribed in and who executed the foregoing instrument and acknowledged before me that(He/she/they)executed the same for the`,urges ,ttterein expressed, C;; WITNESS my hand and official seal in the County and State of e . this Say of U'tee . 20 C9y . My Commission Expire*d"""rrrrgq,� % 11 LA '. •_ ..tt 1 #� tl' ' 1Oq ti a Public's Sign tore < l sti (Seal) �..�.. '{jOTj cd I A Nota Printed Name dc r V No.p01g?Orpf O Fife#: 09-117 I I . 1 6 D 1 0 . • . .. . . , . . . •• 1 • •1,..sio . , - • . . . i •• .'' ‘ ..•/ ...'P'ii'.' .'''''' . '.' 'ii.:?.d• i;..1.4. ; -•' -'' ' -' '''''''''t; 'I '4001.,;.,. .2 ''',. 7'.... L ',„ • „„,.• . ,„ . ,-, 44tt4."' Li, Si 1 t. 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