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Backup Documents 06/27/2023 Item #16D10ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 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 infomration needed. If the document is already complete with the c.t. It...:. ..;--- I- A—., . i;n,. m— not, rnntino tin— a t thronah fi? complete the checklist. and forward to the County Attorney Office. CXCCIioi, Ul UiM •.nuu n.u.. .i .,a uuau. v, u. u+. u ....v .... v.. .. ......... Route to Addressees (List in routing order) ...._... Office Initials Date 1. Lisa N. Carr CHS Inc 6/21/2023 2. Derek Perry County Attorney Office 00e (p,231 Z3 Office E!! Board of County Commissioners N/A 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 .da.......e......{.infnmintinn 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 16D 10 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 Chainman'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 docurnents 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 OOP opt' Attorne 's Office has reviewed the changes, if applicable. is'' Initials of attorney verifying that the attached document is the version approved by the A is n L BCC, all changes directed by the BCC have been made, and the document is ready for the o Chairman's signature. 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 l 1130/12 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 tern 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 cut -rent insurance policy -Declaration Page. VZ Copy of insurance company's claim report with worksheet including description of -repairs and costs. VA. Copy of photos of claim damage. ,sl': Copy of Insurance check(s) payable to homeowner, first lien holder and Collier County. Homeowner Name: Homeowner Address: , Primary Contact Number: . - `- o n t� 1 Homeowner Email: 11- �lG l q \ �i �` L • `� / Reviewed Da h -3 0 Date I �f Approved aDenied 16p10 Claim Center 00000620802 Southwest Florida Claims Adjusters LLC 1217 CAPE CORAL PKWY E STE 198 CAPE CORAL FL 33904 UNITED STATES 0620802 14HECK t AT is 05/10/2023 All117335 Claim *safeguard LITHO USA 05118 LOSSF011129M 001-00-414440 04 CITIZENS PROPERTY INSURANCE CORPORATION $'--' 17,464.80 E Citizens Property Insurance Corporation PLA 05/10/2023 0620802 P.O. Box 10749 Claim Indemnity Disbursement DATE Tallahas§ee, FL 32302-2749 63-8413 2670 PAY TO,THE : Carla Viacava and Southwest Florida Claims Adjusters, LLC RDE F COLLIER COUNTY BOARD OF COUNTY COMM ISSIONERS and Habit O R..Q and -sfor Humanity Seventeen 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 BrAell Ave Miami,. FL,33131 Polic mber: Claim Nu ber: Y THOR ED SIGNATURES c•b tK 1 6 ID 1 0 Ma r2a NOR 16 D 1 t? Claim Center 00000620802 001-00-414440 Southwest Florida Claims Adjusters LLC 1217 CAPE CORAL PKWY E STE 198 CAPE CORAL FL 33904 UNITED STATES - 0620802 L 05/10/2023 Claim ke �� C rCrITIZENS PROPERTY INSURANCE CORPORATION i """"` `"'" "� 6"�':'ORIGINAC'DOGU ENhP IN EDiONtGHEMIGA4REAG7IVEPARERtW1THiMIDR .gINTED7BORDE 'ND A A NS`HE"A fi F�1 $*****17,464.80 1 Citizens Property Insurance Corporation ' PLA 05/10/2023 0620802 P.O. Box 10749 Claim Indemnity Disbursement DATE Tallahasbee, FL 32302-2749 63-8413 2670 PAY TOTHE Carla Viacava and Southwest Florida Claims Adjusters, LLC ORDE F i d COLLIER COUNTY COUNTY COMMISSIONERS and RAP ��an COLL EBOARD OF for Humanity Z l sE 4i $*****17,464.80 Seventeen thousand four hundred sixty four Dollars and 80 cents JPMorgarl Chase Bank, N.A. ALL PAYEES MUST ENDORSE Two Signatures Required 1450 Brl'tell Ave Miami,, FL 33131�d/ olic Kf'mber: Cla' Number: t�Ci'' L1 1F THOR ED SIGNATURES rr• r 'i I ep, SOUTHWEST FLORIDA CLAIMS ADJUSTERS, LLC 1217 CAPE CORAL PKWY E STE 198 CAPE CORAL, FL 33904 Scan to vMw Clam Claim Number: 1sD10 CITIZENS Citizens Claims P.O. Box 19700 Jacksonville, Florida 32245-9700 Phone: (866)411-2742 Fax: (888)392-6739 email: claims.communications((gcitizensfla.com Insured: Carla Viacava Property: 5205 HARDEE ST NAPLES, FL 34113-7729 Claim Rep.: Conrad J Feller Estimator: Dale Robertson Claim Number: 'VlMiil� Date Contacted: 4/17.2023 12:37 PM Date of Loss: 9i28/2022 12:00 AM Date Inspected: 5/3/2023 12:00 PM Policy Number: Pricc List: FLNA8X_APR23 Restoration/Service/Remodel Estimate: CARLAVIACAVA Home: (239) 321-0665 Business: (866) 411-2742 x 4732 E-mail: Conrad.Feller@citizeiisfla.coni E-mail: claims. communications(a citizensfla, com Type of Loss: Wind Date Received: 4/17/2023 12:00 AM Date Entered: 4/17/2023 10:56 AM ``� CITfZEN5 Citizens Claims P.O. Box 19700 Jacksonville, Florida 32245-9700 Phone: (866) 411-2742 Fax: (888)392-6739 entail: claims.communications@citizensfla.com Dear Carla Viacava, Enclosed is a repair estimate from Citizens Property Insurance Corporation BWNFA 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: Ernail: claims.coinn7unicationas@citizenslla.coni 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, latowingl), and with the intent to injure, defraud, or deceive ante insurer files a statement g1'clahn or application containing an}t false, incomplete, or mislea.ling information is guilty of a felonry in the third degree. (Section 817.234(1)(b), Florida Statutes). CARLAVIACAVA 5/6(2023 Page:2 `s CITIZENS Citizens Claims P.O. Box 19700 Jacksonville, Florida 32245-9700 Phone: (866) 411-2742 Fax: (888)392-6739 email: claims -communications a Icitizensfla,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 LOOFA 460.00 0.00 92.00 552.00 OINA Avg. NA (0.00) 552.00 Totals: Debris Removal 0.00 92.00 552.00 0.00 $52.00 Rater Mitigation QUANTITY UNIT TAX O&P RCV AGEILIFE 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 OINA Avg. 0% (0.00) 231.75 3. Dehumidifier (per 24 hr period)- up to 69 ppd- No munitor. 9.00 EA 57.62 0.00 103.72 622.30 OINA Avg. 00/0 (0.00) 622.30 Totals: Water Mitigation 0.00 103.72 854.05 0.00 854.05 fifiti `o�'� i QUANTITY Roof Source - EagleView Roof Roof 1989.47 Surface Area 19.89 Number of Squares 229.19 Total Perimeter Length 33.66 Total Ridge Length 49.53 Total Flip Length 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 5. R&R Continuous ridge vent - aluminum 33.06 LF 13.69 9.38 92.16 6. R&R Drip edge 229.19 LF 4.27 20.05 195.72 CARLAVTACAVA 1.982.48 l5/30 vrs Avg. NA (0.00) 1.992.48 562.35 15135 yrs Avg. 42.86% (57.41) 504.94 1,194.41 15/35yrs Avg. 42.86% (122.78) 1,07L63 5/6/7-023 Page:3 CITIZENS Citizens Claims P.O. Box 19700 Jacksonville, Florida 32245-9700 Phone: (866)411-2742 Fax: (888)392-6739 email: claims.communications(geitizensfla.cotn CONTINUED - Roof QUANTITY UNIT TAX O&P RCN" AGE/LIFE COND. DEP % DEPREC ACV 7. R&R Flashing - pipe jack 3.00 EA 78.47 3.64 47.08 286.13 15.•55 yrs Avg. 42.96% (22.31) 263.82 S. Re -nailing of roof sheathing - complete re -nail 1.989.47 SF 0.38 1.39 151.20 908.59 I S%I50 yrs Avg. 10% (1.99) 906.60 9. Roofing felt - 30 lb. 22.89 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. - Wout felt 23.00 SQ 318.18 202,44 1,463.62 8,984.20 i 5/30 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 item(s) being repaired/replaced. Totals: Roof 266.84 L599.52 15,863.99 1,919.57 13,944.42 Total: Roof 266.84 2,599.52 15,963.99 1,919.57 13,944.42 Interior -,o T Living Room Height: 8' w 436.07 SF Walls 255.64 SF Ceiling Liviag Room �. 691.7I SF Walls & Ceiling 255.64 SF Floor ' 28.40 SY Flooring 53.34 LF Floor Perimeter 60.34 LF Ceil. Perimeter Missing Wall 3' 9 7/8" X 8' Opens into HALL Window S' 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 15,'NA Avg. 0% (0.00) 94.11 CARLAVIACAVA 5/6/2023 Page:4 a 1 6 1)1 0 CITIZENS Citizens Claims P.O. Box 19700 Jacksonville, Florida 32245-9700 Phone: (866)411-2742 Fax: (889)392-6739 email: claims.coinniunicationsCe citizensfia.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% [M) (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 I5/l5 yrs Avg. 80% [,bl] (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 151150 yrs Avg. 10% (2.34) 148.68 16. R&R Blown -in insulation - 8" depth- 1119 32,00 SF 2.11 1.50 13.50 82.52 151150 yrs Avg. 10% (2.14) 80.38 17. Texture drywall - machine - knockdown 691.71 SF 1.26 2,42 174,32 1,048.29 151150 yrs Avg. 10% (3.46) 1,044.83 18, Seat part of the ceiling w/tatex based stain hlocker - one coat 32.00 SF 0.71 0.18 4.54 27.44 15115 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 15115 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 nan iacdmom 1 Bedroom 344A4 SF Walls 459.80 SF Walls & Ceiling 12.85 SY Flooring 43.02 LF Ceil. Perimeter Height: 8' 115.65 SF Ceiling 115.65 SF Floor 43.02 LF Floor Perimeter 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 1.00 FA 78.43 0.00 15.68 94.11 15!1NIA 21. Floor protection - plastic and tape - 10 mil It 5.65 SF 0.35 0.97 8.10 49.55 15/15 yrs 22. Mask and prep for paint - paper and tape (per LF) 43.02 LF 0.95 0.18 8.18 49.23 1511 yrs CARLAVIACAVA Avg. 0% (0.00) 94.11 Avg. 80% [M] (11.10) 38.45 Avg. 80% [M) (2.06) 47A7 5/6/2023 Page:5 1 6 D I C CITIZENS Citizens Claims �t P.O. Box 19700 Jacksonville, Florida 32245-9700 Phone: (866) 411-2742 Fax: (888) 392-6739 email: claims.eommunicationsCi)eitizensfla.com CONTINUED - Bedroom QUANTITY UNIT TAX O&P RCV AGE/LIFE COND. DEP % DEPREC. ACV 23• R&R 519" drywall - hung, taped, ready for texture 32.00 SF 3.89 1.64 24.90 151.02 15.'150yrs Avg. 10% (2.34) 148.68 24. R&R Slow n-in insulation - 8" depth - RI9 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 151150 yrs Avg. 10% (2.30) 694.54 26. Seal part of the ceiling w•/latex based stain blockcr - one coat 32.00 SF 0.71 0.18 4,54 27A4 15115 yrs Avg. 801/6 [M] (2.05) 25.39 27. Paint the ceiling - one coat 115.65 SF 0.80 1.38 18.50 112.40 I S/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 repaired/replaced. 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 220.73 SF Walls & Ceiling 42.07 SF Floor 4.67 SY Flooring 22.33 LF Floor Perimeter 22.33 LF Ceil. Perimeter Missing Wall Door Missing Wall QUANTITY UNIT TAX The items below are to repair the ceiling 28. Contents - move out then reset 1.00 EA 78.43 0.00 29. Floor protection - plastic and tape - 10 mil 42.07 SF 0.35 0.35 30. Mask and prep for paint - paper and tape (per LF) 22.33 LF 0.95 0.09 31. R&R 5/8" drywall - hung, taped, ready for texture 32.00 SF 3.89 1.64 CARLAVIACAVA 3' 9 7/8" X 8' Opens into LIVING _ROOM 3' X 6' 8" Opens into BEDROOM 3' 9 7/8" X 8' Opens into Exterior O&P RCV AGE/LIFE COND. DEP % DEPREC. ACV 15.68 94.11 15NA Avg. 0% (0,00) 94.11 2.94 19,01 15115 yrs Avg. 80% [M) (4.04) 13.97 4.24 25.54 1515 yrs Avg. 80°/u (M) (1.07) 24.47 24.90 151.02 15i 150 yrs Avg. 10% (2.34) 148.68 5/6/2023 Page:6 a 16D10 `y.CITIZENS Citizens Claims P.O. Box 19700 Jacksonville, Florida 32245-9700 Phone: (866) 411-2742 Fax: (888) 392-6739 email: claims.communications�ivcitizensfla.com CONTINUED - Hall QUANTITY UNIT TAX O&P RCV AGE/LIFE COND. DEP % DEPREC. ACV 32. R&R Blown -in insulation - 8° depth - R 19 32.00SF 2.11 1.50 13.50 82.52 15.A50yrs Avg. 10% (2.14) 80.38 33. Texture drywall - machine - knockdown 220.73SF 1.26 0.77 55,62 334.51 151150yrs Avg. 1000 (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 IS/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% [M) (5.72) 35.18 Recoverable depreciation has been applied based upon cite 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 - EaglvView 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 OeNA 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 1.9,114.85 CARLAVIACAVA r/u] - 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 CARLAVIACAVA 5/6/2023 Pabe:7 �JOD1J0 kcl-�CITIZENS Citizens Claims .� P.O. Box 19700 Jacksonville, Florida 32245-9700 Phone: (866)411-2742 Fax: (888)392-6739 email: claims.comiiiunications@citizcnsfla.com Grand Total Areas: 958.88 SF Walls 413.36 SF Floor 0.00 SF Long Wall 413.36 Floor Area 882.02 Exterior Wall Area 1,989.47 Surface Area 33.66 Total Ridge Length 413.36 SF Ceiling 45.93 SY Flooring 0.00 SF Short Wall 448.42 Total Area 88.17 Exterior Perimeter of Walls 19.89 Number of Squares 49.53 Total Hip Length 1,372.24 SF Walls and Ceiling 118.69 LF Floor Perimeter 125.69 LF Ceil, Perimeter 958.88 Interior Wall Area 229.19 Total Perimeter Length CARLAVIACAVA 5t612023 Page:8 16DIp CITIZENS Citizens Claims P.O. 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 Overhead Profit Material Sales Tax Replacement Cost Value Less Depreciation Actual Cash Value Less Deductible Net Claim Total Recoverable Depreciation Net Claim if Depreciation is Recovered Dale Robertson 17,432.2I 1,720.04 1,720.04 290.51 $21,162.80 (2,047.95) $19,114.85 (3,698.00) $15,416.85 2,047.95 $17,464.80 CARLAVIACAVA 5/6/2023 Page:9 16D1p Vk.6TIZEN5 Citizens Claims r �..�w P.O. Box 19700 Jacksonville, Florida 32245-9700 Phone: (866) 411-2742 Fax: (888)392-6739 entail: claims. communications@citizenstla.com Recap of Taxes, Overhead and Profit Overhead (10%) Proji t (10%) Material Sales Tax Laundering Tax (2%) Manur. Home Tax Storage Rental Tax (7%) (6%) MoM 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 5/6/2023 Page:10 TVINSOX , w N.-V CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST CITIZENS<�r_ t JACKSONVILLE FL 32202 rnortnrc wsurunct cnaronnnarl POLICY CHANGE SUMMARY POLICY NUMBER POLICY PERIOD FROM 12/18/2022 TO 12/1812023 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 12/0212019 v v 06128/2021 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 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. PCS 01 14 Page 1 of 1 1 6p1 CITIZENS PNOPLRTY INSURANCE CORPORATION CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY STREET', SUITE 1300 JACKSONVILLE FL 32202-5142 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: Fi. Agent Lie. #: 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 otgal954@embarqmaii.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 All Other Perils Deductible: $1,000 SECTION 1 - PROPERTY COVERAGES A. Dwelling: B. Other Structures: C. Personal Property: D. Loss of Use: SECTION It - LIABILITY COVERAGES E. Personal Liability: F. Medical Payments: OTHER COVERAGES Ordinance or Law Limit (25% of Cov A) Florida Hurricane Catastrophe Fund Build -Up Premium: Premium Adjustment Due To Allowable Rate Change: MANDATORY ADDITIONAL CHARGES: Hurricane Deductible: $4,416 (2%) LIMIT OF LIABILITY $220,800 $4,420 $55,200 $22,080 $100,000 $2,000 2022 Florida Insurance Guaranty Association (FIGA) Regular Assessment 2022-B Florida Insurance Guaranty Association (FIGA) Regular Assessment Emergency Management Preparedness and Assistance Trust Fund (EMPA) Tax -Exempt Surcharge TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES: The portion of your premium for: Hurricane Coverage is $1,013 Authorized By: ELISE MENDEZ (See Policy) SUBTOTAL: Non -Hurricane Coverage is $1,176 ANNUAL PREMIUM $2,432 $11 INCLUDED Included $2,443 $43 ($297) $15 $28 $2 $38 $2,272 Processed Date: 10/28/2022 DEC H03 12 11 Mortgageholder Page 1 of 5 CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST 'T'ZENS J JACKSONVILLE FL 32202 4�rrC PNOPOTY INIUMNU CORMRATIOU 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 06/2812021 Roof Remaining Useful Life (years) 3 7 Dwelling Coverages _ Coverage A Coverage A -Dwelling 184,900 220,800 Coverage B Coverage 8 - Other Structures Amount 3,700 4,420 Coverage C 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 4,416 Hurricane - Deductible Amount 3,698 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 Page 1 of 1 4'�rrC ITIZENS nwrory INslRA"a ClllmUILImm CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY STREET, SUITE 1300 JACKSONVILLE FL 32202-5142 Homeowners HO-3 Special Form Policy - Declarations Policy Number, POLICY PERIOD: FROM 12118/2022 TO 12/18/2023 First Named Insured: Carla Viacava 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 0109 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 I Row House: No Protective Device - Fire Alarm: No Construction Type: Frame Protective Device - Sprinkler: None BCEGS: Ungraded No Prior Insurance Surcharge: No TerritoryI Coastal Territory: 551 100 Terrain: a Wind I Hail Exclusion: No Root Cover: FSC Equivalent Municipal Code - Police: 999 Roof Cover - FBC Wind Speed: NIA Municipal Code -Fire: 999 Roof Cover - FBC Wind Design: NIA Occupancy: Owner Occupied Roof Deck Attachment: Level C Use: Primary Roof -Wall Connection: Clips Number of Families: 1 Secondary Water Resistance: No Protection Class: 4 Root Shape: Hip Distance to Hydrant (ft.): 500 Opening Protection: Class A Distance to Fire Station (mi.): i 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 H03 12 19 1 Mortgageholder Page 2 of 5 MOW CITIZENS PROPERTY INSURANCE CORPORATION NOV 0 7 2022 301 W BAY STREET, SUITE 1300 49'..'ra TIZE N S JACKSONVILLE FL 32202-5142 PROrmy mumnl CORPORAMN 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 INSUREO(S1 Name Address No Additional Named Insureds ADDITIONAL INTEREST(Sl # 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 DEC H03 12 19 1Mortgageholder Page 3 of 5 M 0 t O 8 M r- h O O in 00 Ln w 0 0 0 16010 NOV O 7 2022 CITIZENS PROPOTY INSURANCE CORPORATION CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY STREET, SUITE 1300 JACKSONVILLE FL 32202-5142 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 Locatlon of the Residence Premises ADDITIONAL NAMED INSUREDlS1 game Address Vo Additional Named Insureds ADDITIONAL INTERESTlSI # Interest Type Name and Address Loan Number 1 1 st Mortgagee Habitat for Humanity 9021 11145 Tamiaml 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 co 0 0 0 m Ln n r 0 0 to a i= r~ DEC H03 12 19 Mortgageholder Page 3 of 5 . k 0 41911-'rCITIZENS PROPERTY INWRAHC[ CORPORATION CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY STREET, SUITE 1300 JACKSONVILLE FL 32202-5142 Homeowners HO-3 Special Form Policy - Declarations Policy Number: � POLICY PERIOD: FROM 12/18/2022 TO 12/1812023 First Named Insured: Carla Viacava at 12;01 a.m. Eastern Time at the LocaEon 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. flEC H03 121 Mortgageholder Page 4 of 5 1 6D 1 <�rQTIZENS PROKRIY INSNRANU CORPORA)ION CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY STREET, SUITE 1300 JACKSONVILLE FL 32202-5142 Homeowners HO-3 Special Form Policy - Declarations Policy Number: POLICY PERIOD: FROM 12/18/2022 TO 1211812023 First Named Insured: Carla Viacava at 12:01 a:m. Eastern Time at the Location of the Residence Premises CONSIDERFLOOD INSURANCE: YOU MAY ALSO NEED TO THE PURCHASE OF FLOOD INSURANCE. YOUR HOMEOWNER'S . POLICYDOES NOT INCLUDE COVERAGE FOR DAMAGE RESULTING FROM FLOOD EVEN IF HURRICANE r1- AND RAIN CAUSED FLOOD TO OCCUR. WITHOUT SEPARATE FLOOD INSURANCE COVERAGE, UNCOVERED LOSSES CAUSEDFLOOD. DISCUSS NEED . TO PURCHASE J:. SEPARATE FLOOD IIISURANCE COVERAGE • YOUR INSURANCE AGENT. 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. 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 T Mortgageholder Page 5 of 5 v 0 v O 00 o co N n t- 0 O LO m �n 0 0 O 16D1 O �... CITIZENS Pf1OM Y INS ORANCI CORPORANON CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY STREET, SUITE 1300 JACKSONVILLE FL 32202-5142 Homeowners HO-3 Special Form Policy - Declarations Palicy Number: POLICYPERIOD: FROM 12/1$12022 TO 12/3812023 First Named Insured: Carla Viacava at 12:01 a.m. Eastern Time at the Location of the Residence Promises 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. 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. 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 BYACCIDENTAL DISCHARGE OF WATER. THEAMVNT WE PAY FOR THE NECESSARY REASONABLE SOLELYEMERGENCY MEASURES YOU TAKE OPROTECT COVERED PROPERTY FURTHER DISCHARGE OF ATER WILL BE DEDUCTED FROM THE $1d 000 LIMIT COVERAGE 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 1 Mortgageholder Page 5 of 5 0 0 co 0 Cl) n r O 0 in r 0 0 1�Dxp SOUTHWEST FLORIDA CLAIMS ADJUSTERS, LLC 1217 CAPE CORAL PKWY E. STE. 198 CAPE CORAL, FL 3390 TEL: (855) 910-1212 1 Email: swflcasvcs@gmail.com Invoice # 2023-5205 (INI) Client Name: Carla Viacava Property Address: 5205 Hardee Street Naples, FL 34113 Claim 41 Policy # Date of Loss: 09/29/2022 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 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. 16p1Q Form VY-H . Request for Taxpayer - Give Form to the (Rev, October2018) Identification Number and Certification requester. Do not Dapadment of the Treasury send to the IRS. Internet Revenue Bar $ ► GO to www.1r8.gov/FormW9 for instructions and the latest Information. t Nome (as shown on your Incamq fax return}. Name Is required on IN. ling; do not leave this fine blank. SOUTHWEST FLORIDA CLAIMS ADJUSTERS LLC 2 BusEness namo/tlisregardsd entity name. if differgnt from aoovo m d 3 Chock a p pale box for federal tax classification of the person whose name is entered an line 1. Chock only one of the seven fallowing seven boxes, 4 Exemptions (codes apply only to 4 certain entitles, not Individuals; see o Intlivtdual/sole proprietor or p p ❑ CCorporation ❑ 6Corporaticn ❑ Partnership ❑ Trusvestato instructions on pegs 3): o single -member LLC 0 't © umited (lability company. Enter the tax olessificallon (C=C corporation, Exempt payee code {if any) `o S=S corporation, A=Partnership)) Note: Check the appropriate box in the line above for the lax classification of the single -member owner. Do not check LLC if the LLC Is classified as a single -member U-C that Is disregarded ham the Exemption from FATCA reporting' owner unless the owner of the LLC Is another LLC that Is not disregarded from the owner for U.S. federal tax purposes. Olherwfse, a single-embw LLC that m Code (F anyj 16 is disregarded from the owner should check the appropriate box for the lax classification of Ile ovmer. ElOther(see instructlons)► tti,pro,r„�ra,,,,r„�r..d,veyd,m,ast In s Address (number, street, end apt. or suite no.) See instructions. 1217 CAPE CORAL PARKWAY E STE. 198 Requester's name and address.(opitonaq 8 Cky, state, and ZIP code CAPE CORAL FL 339(14 T UST account number(s) here(optlonal} 1- F,� 1— nunr rler1G1 oEe name given on line 1 to aycic backup withholding. For individuals, this Is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Instructions for Part I, later. For other entitles, it is your employer Identification number (EIN). It you do not have a number, see Now to get a TIN, later. Note; If the account is in more than one name, see the Instructions for line 1. Also see What Name and Number To Give the RequerVerfor guidelines on whose number to enter. or Under penalties of perjury, I certify that: 1. The number shown on this form Is my correct taxpayer Identification number (or I am waiting for a number to be Issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Infernal 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 me that I am no longer subject to backup withholding; and 3.1 am a U.S. citizen or other U.S, person (defined below); 4. The FATCA code(s) entered on this form (if ar y Indl ng that I am exempt from FATCA reporting Is correct. Certification Instructions. You nrasi cross out item Bove 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 div�nds o your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured pro rty, ncellation of debt, contributions to an Individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are no r red 10 sign the certification, but you must provide your correct TIN. See the instructions for PaA 11, later. Sign Here General Instructions Section references are to the Internal Revenu de unless otherwise noted, Future developments, For the lates[informaE n bout developments related to Form W-9 and its instructions, such gistation enacted after they were published, go to www.irs.gov/Fo W9. Purpose of Form An Individual or entity (Form W-9 requester) who Is required to file an information return with the IRS must obtain your correct taxpayer Identification number (TIM which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer Identification number (ATIN), or employer Identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following. • Form 1099-INT Interest earned or paid) Dato) U 1 / V2—I 262-- • Form 1099-DIV (dividends, inclining those{fom stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sates and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 {home mortgage Interest), t 098-E {student loan Interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1090-A (acquisition or abandonment of secured property) Use Form W-9 only If you are a U.S, person (including a resident alien), to provide your correct TIN. It you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What Is backup withholding, later, - cat. No. 10231X perm W»9 (Rev. tit -late) . • 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 teen 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: rf (l , Copy of Homeowner's current insurance policy -Declaration Page. ^Copy of insurance company's claim report with worksheet including description of repairs and costs. f . Copy of photos of claim damage. ,r- Copy of Insurance check(s) payable to homeowner, first lien holder and Collier County. Homeowner Name: Homeowner Address: - (i ��0 N)(4 DR 14-1?L F,_ Primary Contact Number: Homeowner Email: W//A I1'3SCil7z'�!ILYO/?3011 r—all) OFFICE USE ONLY C - rant Co dinator Date CHS Dir ctor Dat Reviewed Fjpproved Denied AMFRICAN INTEGRITY INSURANCE COMPANY OF FLORIDA, INC, CLAIMS ACCOUNT PO BOY. 2049 TAMPA, FL 33623 1-866-277-9871 PNC BANK, N.A. 1669 Phoenix Pkwy Sir, 210 College Park, GA.1049-5463 63-1392/630 I 6D I G' Check No. 0000723846 rhock Date u,", $14,000.00 PAY FXACTLYFourfeen Thousand Dollars And Zero Cents TO THE Marie -Rose Saintif-Daniel, Dut,off Law Firm Habitat for Humanity VOID AFTER 90 DAYS ORDER and CollierCounty board of County Commissioners CHS Division OF 542613A1'CENTER DR STE 600 TAMPA, FL. 33609-3440 AMERWAN INTEGRITY INIS(WANCE COMPANY OF FLORIDA, INC. I CLAIMS ACCOUNT Check No. 000072:3E'l Mainj r�c!,v Sairl.-Darilei. Dubod t-aw Firm, Habitat for Humanity Check Date 22/ 1 1, /V 3 j,lj Coj;jt�r Citaq board of Count )(Commissioners C118 Division 542E PPY Gf`NTER OR 31 E Wo TAMPA, I L 33609-3440 CHO-001 10745 E9yf_nq_n_t Reference Date Description 14,00000 02128/21 CHO-001 10746/Saintil, Daniel FnI Pnit LIT *** LZIST Check Amount S14,()03 (19 AME-RICAN INTEGRITY INSURANCE COMPANY OF FLORIDA, INC. / CLAIMS ACCOUNT Marie Rose Saintil-Danici, Dubufl Lae Hill), Habitat for HuManftY and ('oljier County board of County OHS Division !,42f; SAY CVNI FI? DR sj!1500 .,-1j,!!'A, CHO-001 10746 Reference Date Description 02/28/21 ainfil-Damel VnI Prnt LIT LZ/BT Check No. 0000723846 Check Date, 02/ 1"It 21 Pa went 1000-00 Check Arnount $14,00 00 I I o � n e o. I � n j •;� o 3 � � 0 3 ull a m AMEWCAN IN [EGRITY COMRt ,N)'Or FLORIDA, INC. CLAIMS ACCOUNT PO BOX 26349 T/WPA, FI-3362,1 1-866 277 9811 PAY EXA111 I I Y Seven Thousand Dollars And Zero Cents VNC BANK, N.A, ISM Photmix Pkwy Slo 210 College Park, GA 30349,5463 10 THE Marie-Rosc S-ji.,jtj;-Daniel, Dubott Law Firm, Habitat for Himianity ORDER wid Collier County Board of County Commissioners CHS Division OF 6426 BAY CENTER DR STE COO TAMPA, FL 33609-3,140 CHO-001 10747 I ��'f )DI Check No. 0007238 Chock Data W/ A VOID ArTER-mmys-j 2 MEMO Soo attached for AMERICAN INTEG 31RITY INSURANCE COMPANY OF FLORIDA, INC. / CLAIMS ACCOUNT m,v,e,:.'rjsv Sa W4i Danjol, Duboll l aw I Itn't ii, bitat f i liurnanity w,c cciiw cyuoy Board of ccuwy conifnistioFters CHS Div;sion I AN BAY (:FN I LR DR I'AMPA. I L CHO-001 1074 Date cri Rion 03103!21 il-Danief VnI flmt LIT—' LIJBT Chuck (qu. u000a)V3 ut)u'LK Dote .,;�: ' ,� r I Check Amount $ 11,000 "K, AMERICAN INTEGRI FY INSURANCE COMPANY OF FLORIDA, INC. I CLAIMS ACCOUNT 5-'ioo 1 Oowtf Law I ani, I 4,bJll fix H1, o_jt1ty jio:u(i of crtotyeonmi5c cwum CliF ti;F. 00 1 W /17 Reft-risrice slate Do - -ri tion :s)l Prnt LIT 1,"44T Check No. 0000723873 Chuck Date ,r.! i i, ',? , wlclk Amoxit Prtyrrtpiet 16010 FA n 0 3 3 1 6 D 1 0 AMERICAN �1 INTEGRITY American Integrity Insurance Company of Florida 5426 Bay Center Drive, Suite 600 Tampa, FL 33609 POLICY NUMBEBE R HOMEOWNERS POLICY DECLARATIONS POLICY FORM: H03 ❑ New Issue O 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: Marie R Saintil Daniel 13536 Koinonia Dr Naples, FL 34114-8766 Residence Premises covered by this policy Is: 13536 Koinonia DR, Naples, FL 34114-8766 County: Collier YOUR AMERICAN INTEGRITY AGENCY IS: Bruce Hendry Insurance,LLC 711 W. Main Street lmmokalee, FL 34142 TOTAL ANNUAL POLICY PREMIUM: $2,671.91 The Hurricane portion of the premium is: $753.60 $1,818.38 The non -Hurricane portion of the premium is: 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 Coverage A — Dwelling Coverage B — Other Structures Coverage C — Personal Property Coverage D — Loss of Use Ordinance or Law: 10% of Coverage A LIMIT OF LIABILITY $184,000 $3,680 $92, 000 $18,400 $18,400 SECTION I — DEDUCTIBLES: 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 $100,000 Coverage E - Personal Liability Coverage F - Medical Payments to Others $1,000 PREMIUM $2,686.11 Included Included Included -$114.13 Included Included AiIC DEC 07 19 Print Date :05/30/2022 Page 1 '- AMERICAN INTEGRITY American Integrity Insurance Company of Florida 5426 Bay Center Drive, Suite 600 Tampa, FL 33609 POLICY NUMBE 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: POLICY FEES: Managing General Agency (MGA) Fee Emergency Management Preparedness and Assistance Surcharge Florida Insurance Guaranty Association 2022 Assessment FORM AND ENDORSEMENTS: Greeting Letter Policyholder Notice Privacy Statement Deductible Notification Options Limitations on Roof Coverage Assignment Agreement Notice Policy Jacket Notice of Change in Policy Terms Homeowners 3 Special Form Sinkhole Loss Coverage Water Back Up and Sump Discharge or Overflow Coverage Outline of Your Homeowners Policy Checklist of Coverage Notice of Premium Discounts for Hurricane Loss Mitigation Notice of Consumer Reports Ordered and Information Determination Used in Premium -$5,346.57 $25.00 $2.00 $52.35 AIIC RN GL 08 19 AIIC H03 PHN CSAU 11 21 AIIC PS 05 19 AIIC H03 DO 07 19 AIIC RWT 01 19 Al IC AA 02 20 AIIC PJ 07 15 AIIC H03 NOC 06 22 AIIC H03 10 21 AIIC SK 11 14 AIIC WBU 07 18 AIIC H03 OC 07 18 OIR 131 1670 OIR B1 1655 02 10 AIIC NCRS 08 19 These Declarations together with the Policy Jacket, Policy Form and endorsements, if any, issued to form a part thereof, complete the above numbered policy. �� -E �- -4. . Authorized Countersignature: Date Signed: 05/3012022 AIIC DEC 07 19 Print Date; 05/30/2022 Page 2 AMERICAN INTEGRITY American Integrity Insurance Company of Florida 5426 Bay Center Drive, Suite 600 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: -$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 Policyholder Notice Privacy Statement Deductible Notification Options Limitations on Roof Coverage Assignment Agreement Notice Policy Jacket Notice of Change in Policy Terms Homeowners 3 Special Form Sinkhole Loss Coverage Water Back Up and Sump Discharge or Overflow Coverage Outline of Your Homeowners Policy Checklist of Coverage Notice of Premium Discounts for Hurricane Loss Mitigation Notice of Consumer Reports Ordered and Information Determination AIIC RN GL 08 19 AIIC H03 PHN CSAU 11 21 AIIC PS 05 19 AIIC H03 DO 07 19 AIIC RWT 01 19 AIIC AA 02 20 AIIC PJ 07 15 AIIC H03 NOC 06 22 AIIC H03 10 21 AIIC SK 11 14 AIIC WBU 07 18 AIIC H03 OC 07 18 OIR B1 1670 OIR B1 1655 02 10 Used in Premium AIIC NCRS 08 19 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-,05/3012022 Page 2 '6D1 �(&AMrECKiAN RATING INFORMATION: Construction Type: Frame Year of Construction: 2009 Year of Roof/U pdated: 2009 Type of Residence; Owner Occupied Dwelling Type: Row/Town House Number of Months Occupied: 9 to 12 Months Occupancy: Owner ADDITIONAL INTERESTS}: Second Mortgagee Collier County Board of County Commissioners CHS Division 3339 Tamiami Trl E Ste 211 Naples, FL 34112-5361 1076 American Integrity Insurance Company of Florida 5426 Bay Center Drive, Suite 600 Tampa, FL 33609 POLICY NUMBER 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 16DI D U B O F F 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 Koinonia Drive, Naples, Florida 34114 Ins. Claim No. Date of Loss 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 fiirther information, please feel free to contact us. Very truly yours, //Kenneth R. Duboff// KENNETH R. DUBOFF KRD/sw 16010 VNI Cnnrentc F.nternrises INC Certified Building Contractors 6065 NW 167th St SB14 Miami FL 33015 cniconcepts.com enicorp@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: Type of Loss: Water Damage - Bath Date of Loss: 3/3/2021 12:00 VA 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 Estimat"f Structuralepairs : $15,082.18 Recoverable Depreciation $190.75 Net Estimate of Total Repairs:(After depreciation) $14,891.43 This estimate is presented utilizing the Xactimatc estimating software customized to reflect the specific scope of work presented in this loss, mmend customers monitor their local markets for any such changes In every monthly pricing publishing Xactware strongly reco 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: etennmations within t s oss eport 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. i xnr vrvnwt grimv Ting INTERIOR REPAIRS: APPROXIMATE 34 WEEKS c CNI Concepts Enterprises INC Certified Building Contractors 01 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 , NMSA2850 SAINTIL-ROSE-BATH Main Level •--:I Bathroom 10, 9" �+ Bathroom a T N xau aoaeu ts�_ ►-s s" = Door 250.78 SF Walls 325.52 SF Walls & Ceiling 8.30 SY Flooring 37.67 LF Ceil. Perimeter TVX618" Subroom: Closet3 (I) 82.11 SF Walls 91.74 SF Walls & Ceiling 1.07 SY Flooring 14.50 LF Ceil. Perimeter Height: 8' 74.74 SF Ceiling 74.74 SF Floor 30.08 LF Floor Perimeter Opens into HALL Height: 8' 9.63 SF Ceiling 9.63 SF Floor 9.42 LF Floor Perimeter Door 5 ltv X 6 8 Opens into BATHROOM MOVE REPLACE TAX O&P TOTAL DESCRIPTION QTY RESET RE 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 21 L81 i,210.87 0 00 000 29.24 175.43 3. Additional labor to remove the from 72.37 SF 2.02 concrete slab 0.00 2.28 4.61 33.96 203.78 4. Floor leveling cement -Average 72.37 SF 68.37 SF 0.00 1.18 0.77 16.29 97.73 5. Grout sealer 0.59 8.38 8.77 43.91 263.48 6, R&R Baseboard 23.50 LF 0.23 42.58 7. Paint baseboard - two coats 23.50 LF 0.00 1 .50 .1 90.82 84.37 SF 0.00 0.89 0.59 15.i4 8. Clean floor Wail Areas: 98.80 1,388.02 64.81 310.33 L,861.95 9. R&R Fiberglass tub & shower 1.00 EA combination 0.00 176.33 s.69 36.00 216.02 10. Rough in plumbing - floor/laundry 1.00 EA pan drain 4/1/2021 Page:2 SAINTIL-ROSE-BATH 16 D I ter CNI Concepts Enterprises INC Certified Building Contractors 16 6065 NW 167th St SB14 Miami FL 33015 eniconcepts.com cnicorp@live.com �Ull 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. H. 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 I.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 G.00 21.83 131.00 16. Caulking - silicone &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 44.49 266.42 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. l5 24. Door hinges (set of 3) and slab - 1.00 EA 0.00 31.65 0.00 6.33 37.98 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 0.04 2.40 0.20 15.24 91.42 28. Paint door/window trim & jamb - 2 1.00 EA 0.00 32.35 033 6.54 39.22 coats (per side) 1.00 EA 0.00 24.87 0.00 4.97 29.64 29. Door tockset - Detach & reset 30. Detach & Reset Light bar - 4 lights 1.00 EA 53.52 0.00 0.00 0.00 10.70 64.22 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 4/L/2021 Page:3 SAINTIL-ROSE-BATH 16D10 CNI Concepts Enterprises INC Certified Building Contractors 6065 NW 167th St SB14 Miami FL 33015 cniconcepts.com cnicorp@live.com �tg 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 1b.64 99.85 coat 37. Paint part of the walls - two coats 133.16 SF 0.00 1.01 .33 .3 164. 38. Floor protection - self-adhesive 84.37 SF 0.00 0.66 0.83 11.30 b7.81 plastic film 39. Mask and prep for paint - plastic, S2.17 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 1 Ob.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 i 7.46 104.77 outlet - tamper resistant 0.00 100.02 0.00 120.02 72U.14 43. Electrician - per hour 6.00 HR 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 55.08 330.47 (PER SF) Use during and after floor tale replacement for dust and debris removal. "Controlling Silica Exposures in Construction". OSHA 3362-05 2009 Vacuum dust collection or similar Based on OHSA guidelines methods. Use during and after drywall and cabinet replacement for dust removal. 256.51 2,003.26 12,019.54 Totals: Bathroom 4/1/2021 Page:4 SAINTIL-ROSE-BATH • 1 1 CNI Concepts Enterprises INC Certified Building Contractors 6065 NW 167th St SB14 Miami FL 33015 cniconcepts.com cnicorpClive.com Phone (305) 504-8884 Fax (305) 504-8885 Certified General Contractor CGC 1529534 Licensed Mold Assessor and Remediator MRSR3042 , MRSA2850 Hall 287.33 SF Walls 367.36 SF Walls & Ceiling 8.89 SY Flooring 48.42 LF Ceil. Perimeter Height: 8' 80.03 SF Ceiling 80.03 SF Floor 33.42 LF Floor Perimeter 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 Door Missing Wall Y 7" X 8' Opens into FAMILY 2' 6" X 6' 8" Opens into BEDROOM2 Door 2' 6" X 6' 8" Opens into BEDROOM Door 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 0.00 0.66 0.78 10.72 64.32 47. Floor protection - self-adhesive 80.03 SF plastic film 2.35 39.65 237.88 Totals: Hall 258.86 2,042.90 12,257.42 Total: Main Level Debris Removal DESCRIPTION QTY RESET 48. A/C - heavy clean, replace filters 1.00 EA REMOVE REPLACE TAX O&P TOTAL 0.00 387.35 5.12 78.49 470.96 and service 49. Final clean up - punch list items 8.00 HR 50. Progressive daily clean up - 10.00 EA Approx one hour per day of work Additional daily labor to remove and clean dust and debris 0,00 0.00 24.56 26.34 0.69 0.92 39.43 52.86 236.60 317.14 6.73 170.79 1,024.75 Totals: Debris Removal 4/1/2021 Page:5 SAINTIL-ROSE-BATH 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 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" o Due to the size. complexity, code upgrades and the number of trades involved, a super intendent/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. 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 0.00 300.00 1,800.00 Totals: Job Conditions 265.59 2,513.70 15,082.17 Line Item Totals: SAINTII,ROSE-BATH Grand Total Areas: 2,029.67 SF Walls 775.31 SF Floor 0,00 SF Long Wall 775.31 Floor Area 1,093.00 Exterior Wall Area 0.00 Surface Area 0.00 Total Ridge Length 775.31 SF Ceiling 86.15 SY Flooring 0.00 SF Short Wall 856.67 Total Area 153,50 Exterior Perimeter of Walls 0.00 Number of Squares 0.00 Total Hip Length 2,804.97 SF Walls and Ceiling 249.83 LF Floor Perimeter 311.83 LF Ceil. Perimeter 2,029.67 Interior Wall Area 0.00 Total Perimeter Length 4(LI2021 Page:6 SAINTIL-ROSE-BATH 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 Summary for Dwelling I2,302.89 Line item Total 265.59 Material Sales Tax 12,568.48 Subtotal 1,256.85 Overhead 1,256.85 Profit $15,082.I8 Replacement Cost Value (190.75) Less Depreciation $14,891.43 Actual Cash Value $14,891.43 Net Claim 190.75 Total Recoverable Depreciation $15,082.18 Net Claim if Depreciation is Recovered 4/1/2021 Page:7 SAINTIL-ROSE-BATH 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 NMSR3042 , MRSA2850 Recap of Taxes, Overhead and Profit Overhead (10%) Profit (10%) Material Sales Tax Laundering Tax (2%) ManuE Home Tax6° j Storage Rental a j (7%) Line Items 0.00 0.00 0.00 1,256.85 1,256.85 265.59 Total 1,256.85 1,256.85 265.59 4/l/2021 Page; 8 SAINTIL-ROSE-BATH MOM 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 9,759.78 79.33% Bathroom 195.88 1.59% Hall Area Subtotal: Main Level 9,955.66 80.92% 6.89% 847.23 Debris Removal 1,500.00 12.19% Job Conditions 12,302.89 100.00% Subtotal of Areas 12,302.89 100.00% Total 4/1/2021 Page:9 SAINTIL-ROSE-BATH 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 by Category with Depreciation O&P Items RCV CABINETRY CLEANING GENERAL DEMOLITION DOORS DRYWALL ELECTRICAL FLOOR COVERING - CERAMIC TILE PERMITS AND FEES FINISH CARPENTRY / TRINtWORK FINISH HARDWARE HEAT, VENT & AIR CONDITIONING LABOR ONLY LIGHT FIXTURES MOISTURE PROTECTION MIRRORS & SHOWER DOORS PLUMBING PAINTING WATER EXTRACTION & REMEDIATION O&P Items Subtotal Material Sales Tax Overhead Profit Total 1,672.65 785.62 620.00 96.73 1,069.34 672.58 1,266.77 720.00 588.21 174.96 455.16 780.00 53.52 96.78 141.93 2,151.82 655.89 300.93 Deprec. 48.37 2.17 30.63 17.65 3.55 4.26 45.25 12,302.89 151.88 265.59 7.05 1,256.85 15.91 1,256.85 15.91 15,082.18 190.75 ACV 1,624.28 785.62 620.00 96.73 1,069.34 670.41 1,236.14 720.00 570.56 171.41 455.16 780.00 53.52 96.78 137.67 2,106.57 655.89 300.93 12,151.01 258.54 1,240.94 1,240.94 14,891.43 4/1/2021 Page:10 SAINTIL-ROSEBATH r CNI Concepts Enterprises INC Certified Building Contractors 6065 NW 167th St SB14 Miami FL 33015 cniconcepts.com cnicorp@Iive.com Phone (305) 504-8884 Fax (305) 504-8885 Certified General Contractor CGC1529534 Licensed Mold Assessor and Remediator MRSR3042 , MRSA2850 1 I -Exterior Date Taken: 3/23/2021 Taken By: OFFICE 2-Exterior Date Taken: 3/23/2021 Taken By: OFFICE 4/1/2021 Page:11 SAINTIL-ROSE-BATH II D U B 0 F F LAw FIRM II 680 N.E.127 STREFT / NORTH MIAMF / 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 I ' 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 16p1Q CNI Concepts Enterprises INC Certified Building Contractors 6065 NW 167th St SB 14 Miami FL 33015 cniconcepts.com cnicotpLiive.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: Date of Loss: Date Inspected: Price List: Estimate: Policy Number: slow 2/28/2021 12:00 AM FLNA8X APR21 Restoration/Service/Remodel SAINTIL-ROSE-KIT Date Received: Date Entered: Type of Loss: Water Damage - Kitchen Gross Estimate of Total Repairs: $21,756.08 Gross stimate o tructura epairs : $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_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 t s oss eport is so ely 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 mistakes)/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 duplicateloverlapping items from other estimates for adjacent damages not related to this loss. COMPLETION TIME FOR INTERIOR REPAIRS: APPROXIMATE 3-5 WEEKS 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-KIT Main Level Door Missing Wall f---2t L„- PL ry Door DESCRIPTION Kitchen 253.56 SF Walls 369.76 SF Walls & Ceiling 12.91 SY Flooring 35,58 LF Ceil. Perimeter 2'6"X6'8„ 8' 9" X 8' Subroom: Pantry (1) 57.56 SF Walls 62.56 SF Wails & Ceiling 0.56 SY Flooring 9.00 LF Ceil. Perimeter 2'2"X6,8" QTY REMOVE REPLACE Height: 8' 116.20 SF Ceiling 116.20 SF Floor 30.92 LF Floor Perimeter Opens into Exterior Opens into FAMILY Height: 8' 5.00 SF Ceiling 5.00 SF Floor 6.83 LF Floor Perimeter Opens into KITCHEN 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. 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. 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 4/1/2021 Page:2 SAINTIL-ROSE-KIT 1 6 D 1 0 CNI Concepts Enterprises INC Certified Building Contractors 6065 NW 167th St SB 14 Miami FL 33015 cniconcepts.com cnicorp@1ive.com Phone (305) 504-8884 Fax (305) 504-8885 Certified General Contractor CGC 1529534 Licensed Mold Assessor and Remediator MRSR3042 , MRSA2850 CONTINUED - Kitchen DESCRIPTION QTY REMOVE REPLACE TAX O&P TOTAL & Range hood - Detach & reset 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 dishware, 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. l9 73.32 439.91 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 40l .19 disconnect/attach drain/supply connections - 2 Trips Wall Areas- I8. 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 Texture repair to walls after drywall replacement and cabinet removal. 20. Paint door slab only - 2 coats (per 1.00 EA 0.00 38.77 0,57 7.87 47.21 side) 21. Paint door/window trim & jamb - 2 1.00 EA 0.00 32.35 0.33 6.54 39.22 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 24. Clean floor 121.20 SF 0.00 0.89 0.85 21.74 130.46 General, Painting and Contents Manipulation: 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/l/2021 Page:3 I6oi.o CNI Concepts Enterprises INC Certified Building Contractors 6065 NW 167th St SB 14 Miami FL 33415 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 Silles 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 r--4 Family h•! 4- . f f � »i 4'f0"i �-g6• r•�aY a o Missing Wall Window Door Window Window Missing Wall DESCRIPTION Continuous walls from Kitchen. Wall Areas: 32. Prime & paint door slab only - exterior (per side) 33. Paint door/window trim & jamb - 2 coats (per side) 34. Door lockset - Detach & reset 35. Clean window unit (per side) 36, Window drapery - hardware - Detach & reset Floor Areas: SAINTIL-ROSE-KIT 339.67 SF Walls 573.81 SF Walls & Ceiling 26.02 SY Flooring 49.00 LF Ceil. Perimeter Height: 8' 234.14 SF Ceiling 234.14 SF Floor 46.50 LF Floor Perimeter 81911 X 8' Opens into KITCHEN 2' X 2' 11" Opens into Exterior 2' 6" X 6' 8" Opens into Exterior 2' X 2' 11" Opens into Exterior 6' X 4' Opens into Exterior X 7" X 81 Opens into HALL QTY REMOVE REPLACE TAX O&P TOTAL 1.00 EA 0.00 46.48 0.97 9.49 56.94 1.00 EA 0.00 32.35 0.33 6.54 39.22 1.00 EA 0.00 24.87 0.00 4.97 29.84 3.W EA 0.00 20.39 0.00 12.23 73.41 3.00 EA 0.00 37.25 0.00 22.35 134.10 4/1/2021 Page:4 1 6D i 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 0.99 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 31.36 198.19 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 14.44 318.84 1,913.04 Totals: Family Hall Door Door Door Door Missing Wall Door Door DESCRIPTION Continuous walls from Kitchen, Wall Areas: 45. Prime & paint door slab only - exterior (per side) 46. Paint door slab only - 2 coats (per side) 47. Paint doorlwindow trim & jamb - 2 coats (per side) SAINTIL-ROSE-KIT 287.33 SF Walls 367.36 SF Walls & Ceiling 8.89 SY Flooring 48.42 LF Coil. Perimeter 2'6"X6'8" 2'6"X6'8" 2'6"X6'8" 2'6"X6'8" 3'7"X8' 2'6"X6'8" 2'6"X6'8" QTY REMOVE REPLACE Height: 8' 90.03 SF Ceiling 80.03 SF Floor 33.42 LF Floor Perimeter Opens into Exterior Opens into Exterior Opens into BATHROOM Opens into Exterior Opens into FAMILY Opens into BEDROOM2 Opens into BEDROOM TAX O&P TOTAL 1.00 EA 0.00 46.48 0.97 9.49 56.94 5.00 EA 0.00 38.77 2.85 39.34 236.04 6.00 EA 0.00 32.35 2.01 39.22 235.33 4/l/2021 Page:5 16DI CNI Concepts Enterprises INC Certified Building Contractors 6065 NW 167th St SB14 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 NMSR3042 , NMSA2850 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 1. 52. Clean floor 80.03 SF 0.00 0.89 0.56 l4..36 86.15 5 General, Painting and Contents Manipulation: 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) 16.30 305.23 1,831.39 Totals: Halt 430.59 2,948.79 17,692.73 Total: Main Level Debris Removal 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 b10.00 HR 0.00 l. Final clean up -punch list items 24.56 0.86 49.29 295.75 62. Progressive daily clean up - 12.00 EA 0.00 2b.34 L11 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 4/1/2021 Page:6 SAINTIL-ROSE-KIT k C:NI C.oncents 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 Job Conditions DESCRIPTION 63. Residential supervision - per hour QTY REMOVE REPLACE TAX O&P TOTAL 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 Floor 0.00 SF Long Wall 775.31 Floor Area 1,093.00 Exterior Wall Area 0.00 Surface Area 0.00 Total Ridge Length 775.31 SF Ceiling 86.15 SY Flooring 0.00 SF Short Wall 856,67 Total Area 153.50 Exterior Perimeter of Walls 0.00 Number of Squares 0.00 Total Hip Length 2,804.97 SF Walls and Ceiling 249.83 LF Floor Perimeter 311.83 LF Ceil. Perimeter 2,029.67 Interior Wall Area 0,00 Total Perimeter Length 4/1l2021 Page:7 SAINTIL-ROSE-KIT 16D10 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 Summary for Dwelling Line Item Total Material Sales Tax Subtotal Overhead Profit Replacement Cost Value Less Depreciation Actual Cash Value Net Claim Total Recoverable Depreciation Net Claim if Depreciation is Recovered SAINTIL-ROSE-KIT 17,692.38 437.68 18,130.06 1,813,01 1,813.01 $21,756.08 (335.63) $21,420.45 $21,420.45 335.63 $21,756.0B 4/ 1 /2021 Page: 8 CNI Concepts Enterprises INC Certified Building Contractors 6065 NW 167th St SB 14 Miami FL 33015 cniconcepts.com enicorp@live.com Phone (305) 504-8884 Fax (305) 504-8885 Certified General Contractor CGC1529534 Licensed Mold Assessor and Remediator MRSR3042 , NMSA2850 Recap of Taxes, Overhead and Profit Overhead (10%) Profit (10%) Material Sales Tax Laundering Tax (2%) Manuf. Home 6Tax Storage Rental a) (7%) 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 4/1/2021 Page:9 SAINTIL-ROSE-KIT 1 6 D 1 0 CNI Concepts Enterprises INC Certified Building Contractors 6065 NW 167th St SB14 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 Recap by Room Estimate: SAINTIL-ROSE-KIT Area: Main Level 11,223.73 63.44% Kitchen 1,579.76 8.93% Family 1,509.86 8.53% Hall 14,3I3.35 80.90% Area Subtotal: Main Level 1,544.03 8.73% Debris Removal 1,835.00 10.37% Job Conditions 17,692.38 100.00% Subtotal of Areas 17,692.38 100.00% Total 4/l/2021 Page:10 SAINTIL-ROSE-KIT IGDI CNI Concepts Enterprises INC Certified Building Contractors 6065 NW 167th St SB14 Miami FL 33015 cniconeepts.com cnieorp@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 CABINETRY CLEANING CONTENT MANIPULATION GENERAL DEMOLITION DRYWALL ELECTRICAL PERMITS AND FEES FINISH HARDWARE PLUMBING PAINTING WINDOW TREATMENT WATER EXTRACTION & REMEDIATION O&P Items Subtotal Material Sales Tax Overhead Profit Total SAINTIL-ROSE-KIT RCV 161.86 6,515.26 1,413.72 152.80 1,032.82 600.00 1,707.57 795.00 198.96 478.25 1,212.50 647.00 2,379.57 111.75 285.32 17,692.38 437.68 1,813.01 1,813.01 Deprec. 195.45 13.54 5.30 53.88 ri%VA 161.86 6,319.81 1,413.72 152.80 1,032.82 600.00 1,694.03 795.00 198.96 478.25 1,212.50 641.70 2,325.69 111.75 2R5.32 268.17 17,424.21 I I A8 426.20 27.99 1,785.02 27.99 1,785.02 21,756.08 335.63 21,420.45 4/l/2021 Page: II SETTLEMENT AaR�R�AENRE FOASE AGREEMENT niv This Settlement Agreement, Confidentiality Agreement and General Release of All Claims (the "AGREEMENT") is ade and entered COMPANY OF 1nto FI,ORIDA,by 1 and it® etween AMERICAN INTEGRITY INSURANCE predecessors, parents, successors, affiliates, divisions, assigns, officers director", shareholders, representatives, benefits administrators, ers, former employers, attorneys, and agents and former employees, employd their respective spouses, heirs, agents, employees and representatives thereof an employees and representatives ("AMERIassi INTEGRITY),admisators, representatives, SAINTIL-DANIEL, and their successors, assigns, attorneys, public adjusters, agents, s pouse harEtes nd thesAGREEMENTe purportedly Icollec collectively rights through them ( INSURED()) p referred to as the "PARTIES") in connection ' h the events ssued to eMARiE ROSE under AMERICAN INTEGRITY'S Policy 0 through July 29, 2021, BAINTIL-DANIEL, for the policy period of July 2 , ("POLICY'S, including but not limited to the investigation, claim handling any adjustment of the claim, and attoo the �rapertyand slocated a relating 3636 Koanoniato a claim for aDrive, nt under the POLICY for damages� allegedly resulting from water damage Naples, FL 34114 (hereinafter "PROPERTY') g Y that occurred on or about February 28, 2021, 568i18 d assigned ROSE SAINT Q- 00110746, and under Policy No. AGH13 DANIEL, for the policy period of July 29, 2020 through July 29, 2021, ("POLICY'S, ing and/or adjust including but not limited to ment of the the investigation,o a claim foclaim rpaymentunder the POLICY claim, and attorney's fees and costs, relating for damages the property located a, Naples, FL 34114 t 13536 Koinonia Drive ing from water damage (hereinafter "PROPERTY") allegedly relees assigned claim numbert#Aarn ecurred on or about Marsh 3, 2021, which wasgproperty age c alms (hereinafter "RELEASED CLAIMS) ), ae well as any other prop y of any kind occurring during any policy period up and until and through the date of in ohe CountyCourtof theaTwent eth Judtions icial the signing of this AGREEMENT, andt the complaints in the litigation filed in t Circuit in and for Collier COunty, Florida, styledPANYIOF FLOR FLORIDA, casenumber u. AMERICAN INTEGRITY INSURANCE C 2021-CC-001755 and MA.RIE-ROSE S,4INTIL-DANbe 202v. �C 001751(hereinafter INSURANCE COMPANY OF FLORIDA, case ' "I,ITIGATION). AGREEMENT, the INSURED(B) agree �, and intend to, By means of this their fully, unconditionally, and generally ralesse any ves datto attorneys, public t adjusters, y successors, assigns, administrators, representatives, hts through them have, spouse, pouse, heirs, and those purportedly claiming any rig or ever may claim to have, against AMERICAN INTEGRITY and, ae may have, Initlals 16D10 applicable, each of their affiliates, grade shareholders successors, rep esentatives. benefits divisions, assigns, off"caers, directors, former administrators, contractors, employees, formermand representatives thereof employers, attorneys, and �� agents and employees (collectively, "RELEASEES ), including but not limited to all claWhether known asserted or could have been assertedcpast, the ent Slue Cnonnectionwith, related or unknown, accrued or unaccr , claims to, or in any way arising out, the event aandsll claimsepertaining ttorAMERICAN of the RELEASED CLA.IM(S), as well and all other extra -contractual INTEGRITY'S handling of said claims, as well as any liability related thereto. The remaining terms of the AGRI+)EMENT are fully set forth below. I. nsi a io (a) As to claim - and case number 2021•CC-001766: In consideration of the total payment o£ TWENTY- )SEVEN THb THOUSAND Dollars ($27,000.00) (SETTL.EME NT INTEGRITY to the INSURED(S), the receipt and sufficiency of which n hereby acknowledged, the INSURED(he S) give theENT. Thecovenant P SETTLEMENT AMOUNT and warranties ngable ae f follows, AGREEMENT. shall b i, s 00/100 One check in the amount of Fourteen AINTiL DANIELsand grDUBOFF ($14,000.00) payable to MARIE R ITY and COLLIER COUNTY LAW FIRM, HABITAT FOR HUMAN BOARD OF COUNTY COMMISSION Thousand Dalai 00/100 ($8,000.00) ii, One check in the amount of Three payable to NAECA RESTORATION LLC; and iii. One check in the amount of Ten Thousand Dollars 001100 ($10,000.00) payable to DUBOFF LAW FIRM. RIE-ROSE SAINTIL-DANIEL hereby dire is Ave directly and solely INTEGRITY two � payment in the amount of $1Q,000 will be to make paymowledges agrees that they DUBOFF LAW FIRM meet baited on this directin to pay, d ackn omitted from such payment MAR,IE•ROSE S AINTIL-DANIEL INITIALS A!�; 2 of l l lutdals A4 1 6 D 1 0 In and Cass number 01100 (b) claim of atpayment of SEVENTEEN by AMERICAN consideration ota,SETTLEMENT AMOUNT) Dollars ($17,000.00) the receipt and sufficiency of which is hereby INTEGRITY to the INSUREDES)� ive the releases, covenants, representations, acknowledged, the INSURED(S) g d warranties stated in the AGREEMENT. The SETTLEMENT AMOUN an shall be made payable as follows: 000.00) llars 00/100 i. One check in the amount of seven payable to MAR,IE•ROSE SAIN�� Thousand LoDUBOFF LAW FIRM, HABITAT FOR HUMANITY and COLLIER and COUNTY BOARD OF COUNTY COMMISSIONERS CHB DIVISIO ► One check in the amount of Three Thousand dDollars 001100 ($3,000.00) ii. TION LLC, ? 000,00) payable to NAECA RESTORATION One check in the amount of Seven Thousand Dollars 00l100 ($ payable to DUBOFF LAW FIRM, OSE SAINTIL-DANIEL hereby direc AMReot�and solely MA,RIE R to make payment in the amount of $71ge,% a above ees that they will be DUBOFF LAW FIRM and acknowledges and ate' omitted from such payment based on this direction to pay. MARIE-ROSE BAINTIL RANI EL INITIALS:A settlement checks will be provided to counsel for the INSURED(S) within (c) The Batt agreeable executed release and the thirty (30) days of receipt of the mutually Stipulation far Final Order o£ Dismissal with Prejudice by defense counsel for AMERICAN INTEGRITY. joint S of agree to have her counsel execuxov dad cont emporane Dismissai with ously (d) INSUREDS ) Prejudice of the proceedings to b p counsel for AMERICAN with the executed release and held in trust by DUBOFF LAW FIRM on INTEGRITY until receipt of the settlement checks by (10} days after confirmed behalf of the INSURED(S), No sooner than ten file the receipt o f the settlement checks, AMERICAN INTEGRITY T Gnd proposed Order of executed Joint Stipulation dice to the sesmi a, withprejudicea Dismissal with l 2. OMMLR&M 3of11 InlNsl 1 6 1)1 0 (a) The INSURED(S) hereby voluntarily and knowingly, individually and collectively, releases and forever discharges the RELY anysandlall state, separately, and severally, directly, and vicariously, ud ments of every local, and federal claims, causes Of action, liabilities, not and to, all claims , extra -contractual, e type and description whatsoever (including, equity, under local, federal, or state tort, ors.conassigns$ administrators, statutory law) that they, their successors, representatives, attorneys, agents, spouse, heirs, and those purportedly claiming any rights through therm, have, or may es or other legal or ver claim to have, against the RELEASERS for compensatory or punitive damage equitable reliof of any type or description whatsoever, including but not limits q known to all claims that were asserted or could nne 'bon �tiheT�� Thor arising or unknown, accrued or unaccrued, i ect out of, the events and insurance claim that is thaeg which of fethe LITIGATION, about as well as all claims arising out of alleged am g March February 28, 2021 andlor on or about d �antent �io s of use and/or Naples, FL 84114 (including but not limited damage Claims of alternative living expenses}, as well as any other property h the date any kind occurring during any policy period up and until and throng f the signing of this AGREEMENT, as well as any extra -contractual liability 0 related thereto. liabilitie, and � e claim, causes of action, security interests, e red to collectively herein gments ron as the releaaedgED CI,AiM(S)��} above shall be re "RELEA The INSURED(S) he covenant and agre e individually and collectively, (e) will forever refrain and forebear from commencing, instituting,any that they proceeding, of any kind, against prosecuting any lawsuit, action, or other the RELEASERS, individually, collectively or via class the RELEASED of or connected in any way arising out of, related to, CLAMS). ENT shall (� The I NSURED(S) understand and agree that the AGREE administrators, binding on them as well as upon their successors, spouse, heirs, and those public- adjusters, agents, purporepresrtedly claiming ranysrights through them. PuY'partedly ,.Y., Anu:onmen or Tr fe el..��' S. of this The INSURED(S) represent and warrant that as of the hypothecated, ated, or (a) have not assigned, transferred, or hr AGREEMENT, they hypothecate, to any person, firm, corporation, purported to assign, transfer, or hyp o€ the RELEASED CI,p,IM(S). The association, or entity whatsoever any 4 of 11 1111041VAa 16DIo of the signing of this DS) further represent and warrant that as INSURE CIREEMENT, there are no unpaid obligations incompanies, water extraction A INSURED(S) to any contractors, remearsons and/or entities who have companies, public adjusters and/or other persons related to or as a result of the RELEASED CLAIM(S) provided services of any kind to the , or if such liana exist, INSURED(S) agrees UNT satisfy any such liens out of the proceeds from the SETTLEMENT indicated in paragraph 1. � hereby agree to indemnify and hold harmless RELEASEES (b) The INSURCD(S) sea including attorn9y's fees and/or against, without limitation, any and ales gh �, claims, warranties, demands, B debts, obligations, liabilities, coats, n, ud ments based on, arising out Of, adjuster fees), causes of action, and j hypothecation, or public adj such transfer, assignment, or or connected with any purported transfer, assignment, or hypothecation. 4. ,�..i.,oeo T„�ludea Unki�o ,/aim URED(S}understand and agree, in and collectively, that the (a) The INS is intended to and does include any and all claims of RELEASED CLAIM(S) every have against nature and kind whatsoever (whetherhich they have or may suspected, o unsuspected or accrued or unaccrue ) the RELEASEES in connection with the RELEASED CLAIM(S)' ant (b) The INSURED(S) acknowledge that they may hereafter discover facts differ ass that, in any such event, this or in addition to those which they now know or believe to be true with from NT g and agr reapoct to the RELEASED CLAI O thereof - notwithstanding shall nevertheless dd and remain £a to or the discov all respects, AGREEMENT such different or additions - ED S waive and hereby forever releaaeeany , whether known or (a) aims or ,uses Of The INSUIt ( } action past. present or future, asserted or unagaainst the RELEASEES for unknown, and whether accrued or unaccru fa against breach of 'bad faith"► breach of the covenalit f oocontractual ith and land extraair -contractual contract, Unfair Trade Practices, type, e including punitive damages, b related causes of action and damages of any which occurred on or about statutory and common law, arising from, connected with, or in any ways Drive, to, all claims arising out of alleged damagekind February 28, 2p21 and/or on or about March s02damage c aims of any the g4114, as well as any other property Naples, FL eriod up and until and through the date of occurring during any policy p 5 of 11 Initlale ISDI signing of this AGREEMENT, as well as any extra -contractual liability related thereto. . 6' SETTLEMENT AMOUNT (a) The INSURED(S) understand and agree that the includes and encompasses any and all claims with respect to attorneys' public an and all attorneys' P public adjuster fees, coats, and expenses for or by Y 'asters, experts, and consultants, of any lted orkind w ha has done anything in adjusters, or with wham they have con The INSUREDS) agree to release connection with the RELEASED CLAIM(S). further agree any claim for past, present or future interest. The INFIS SURED(S) any8c aim that may to indemnify and hold harmless the RE ► ee and coats, of any kind, by any arise out of disputes regarding anyunpaid of any kind, who d consultill" a nd all attorneys, public adjusters, experts, ahom they have�con consulted or who `II have represented the INSURED(0) or with w f has done anything in connection with the RELEASED CLMM(S). 7. NaAs 'a1 1' x iability on the (a) The PARTIES understand and agree that this AGREEMENT is a release Of dission iepufisd claim and does not after constitute whatsoever thatOf the PARTIES Part of any Party as to any matter merely intend by this AGREEMENT toe RELEA5EESoid further Iexpesslyldeny all The 1NSURED(S) understands that th Ile ations of coverage and wrongdoing in connection with the RELEASED a Q CLAIM(S). S. Sl nt that they will not disclose, Publicize, advertise or (a) The INSURED(S) covenant other than as set forth herein, the terms of the use, in any manner imaginable AGREEMENT, including but not limited to to® m�TofEhe settlENT emeUa d A(IRE agree to hold the and claim and specifically covenant and agr related facts, circumstances, legal theorise, causes of action, S in strictest confidence and shall not, surrounding the RELEASED CLAIM() an court ut the prior written consent of the ordered disclosed osed by as y that without to the extent information in any manner, she consideration o total settlement amount listed in f competent jurisdiction. The cansiderat r� or this confidentiality is Ono Of P Hundred and 001100 Dollars ($100.04) of paragraph 1(a). (b) This confdentiaiity provision shall not be applicable to disclosures necessary to obtain tax, legal, financial, ar accounting advice or services, but such service 6 of 11 1111021 16010 confidentiality 'and ders shall, at the outset, be advised of thismation that is absolut ly prO� ass to disclose only that the INSURED(S) agr that tax, legal, financial, or accounting advice or semee- neceesary to receiving 's covenant of confidentiality by the INSURED(S) specifically prohibits the (c) '�� es of disclosure which are identified for following non -exhaustive types illustrative purposes only: ure by the attorneys for the (i) This AGREEMENT prohibits hiscAGREEMENT in he course of INSURED(S) of the terms of t tices as attorneys; including but not their professional praclawsuits limited to use in advertisement,future interviews of any lawsuits of any kind), legal education kind (regardless of the media). This AGREEMENT prohibits disclosure by the INSURED(S) of (ii) print publication, television reporter, any of this material to any p journalistrp reporter or of radio reporter, "on•lizde'�ll not die lomedia se this AGREEMENT in any aide other kind, any ado recording, stenographic recording, or video recordin kind. writing, of any agree to simply respond that the to inquiries about thei►• insurance policy, AGREEMENT, or the (d) In regards settlement, the INSUREDS) covenant an g facto ter has boon concluded, and that the de tiality agreement and cannot matter art of this related thereto are subject to a b) aregrequested to disclose any part the be disclosed. If the INSURED() agree to promptly AGREEMENT, they also cove T►tdnt and or take other ASEES to permit RELEAS"S to seek leorcooperateotective rinrRELEASEES' RELEINSwill a appropriate action. The protective Orders s to obtain a protective order, or other reasonable if, n the absence surance that effort confidential tdreatment will be afforded this written opinion of ; f their disclose of a unsel protective order, the INSURI'r,D(S) addressed to RELEASEES, is ca MENT they may disclose to the third party information relating to this AGR hat information as is required by law to be compelling ( the disclosure only as such disclosure and the disclosed in which case, prior to such disclosure, the INSUREDS) will advise and consult with RELEASEES and their counselAGREEMENT Further, should nature and wording of such disclosure) and thseAll`1S'URED(fi) will use their best efforts to maintain the confide oft aid in consideration f this • d arty seek or attempt t<► obtain at information formation from the PARTIES any third p judicial, quasi - related to this AGREEMENT oa government action, j AGREEMENT through legal process, ' ial or extra -judicial methods, the PARTIES covenant and mutually agree, ludic I of 11 Initials. — 1 6DI 0 (0) (0 before any each to notify the other, in writing, hearing, trial or formal action n the duty to ort under this section, if is taken. As time is of the essence in writing, he requested party must report there is not sufficient time to report in person or by telephone. The term of this confidentinlity lzegins on the ate the claim was resolved, August 26, 2022 and continues forever, without t disclosed the The INSURED(S) warrant and represent a to o£ signing thisoAGREEMENT; at they terms of the AGREEMENT as of the d otherwise, dentialitY is frustratd and an the RELEAS ,ES? intereSt in eng LEAgEEB to enterein� this essential element of consideration for th AGREEMENT is missing- g, T9x Iicn,. nlia ins de ons (a} The INSURED(S) agree that the IELEASEES have of theopaymenttoflth� to them concerning the tax co cfur in this AGREEMENT. ES ouldf have SETTLEMENT AMOUNT as provided governmental taxinany g authhe SEWLEMENT aAMOUNTS the INSURED(S) l withheld any sum from t hereby agree to indemnify and uP the INSURED(S) iolpaY taxes, f anRELEASER y, due damage arising from the failure on the SETTLEMENT AMOUNT. 10. No rovired, modified or aion of this AGREEMENT roahbe ARTIES (orbtheir authorized (a) p t in writing signed by t waived excr�p which writing shall specifiaaUy reference this AGREEMENT representatives), w Provisions of this and indicate that the PARTIES intend to owaive any modify the The waiver y any party to this AGREEMENT or a b EEMENT shad not operate or be construed as a waiver of any subsequent AGR or simultaneous breach. d be held to be (a) In the event any provision of this AGREEM s of his AGREEMENT hall unenforceable, Each and all of tho other provis remain in full force and effect. 12. Wx§t 8 of 11 Initial', 16p10 (a) The PARTIES acknowledge that ff �xencee and supersedes and replacesEEMENT constitutes a full, any and complete settlement of theiragreements, understandings, and all other written or oral exchanges, arrangements, or negotiations between or among them relating to the �� natively state that there are no then prior RELEASED CLAIMS), and a or contemporaneous agreeme�to�hjx hanges, representations, arrangements, or understandings, written o between or among them relating to the in this EMENT, and subject matter hereof other than that le end entire agreementEbetween them that this AGREEMENT contains The PARTIES further acknowledge with respect to the RELEASED CLMM(S). and agree that language proposed for, deleted from, or otherwise changed in the various drafts of this AGREEMENT Nt ntl�T interpretation not included adapplication shall lof ot be this considered in any way in the F AGREEMENT and shall not in any way affect the rights and obligations of the PARTIES. lg, Auvl'cr .able �w WO Of a This AGREEMENT shall be construed anden fo''c1icat on of confli tsd according to thelof law s (} the State of Florida, without regard to FF principles. 14. ':o r`,on ra ProferentuM negotiated (a} that this ownesA contra Profs mt�m i The PARTIES acknowledge EMENT and s the principle of contract interpretation inapplicable to its construction. Hwadinas and Cant (a} nience of The headings and captions used ill tl1ine AGREEMENT or ath�rw es affect the reference only, and shall in no ws�� defvi ion�of this AGREEMENT. meaning or construction of any p a and to execute ft The PARTIES agree to cooperate fully additional actions that may be C) supplementary documents and to take a necessary or apFropride to give full force to the terms and intent of this AGREEMENT. 17. v..= Le—g and indexr�l�'i� 9 oft 1 inlltsl (a) The INSURED(S) agcoe, as furtiler consideration and inducement for this compromised settlement, to satisfy any and all liens, including but not limited to attorney liens and/or claim for bens:fits paid by collateral the INSURED(Sarisi) promise to ng out of the above -described proceeds, :knd furthermore, hold harmless and indemnify ANtFiICdNTto � 4her mortgageeaiand eau ed any third party (including but n creditors or assignees thereof] alleges that all or part of the sums paid by AMERIC�AN INTEGRITY td promisesbeen to paid indemn indemnify third AMERICAN Additionally, the INSURED(S) INTEGRITY for any costs end attorneys' fees incurred in defending any sucht allegation made by any such third 1 Y 18. "^�"�'tery Dismissal le & Voluntary (a) The INSURED(S) and DUB hTi �� FIRM exchange agree t fare the settlement Dismissal with Prejudice w funds within ten (10) days of receipt of settlement funds; or the ion of INSURED(S) agree to have t}10o� he eePexecute a eed rigs Joint hePuprovided Dismissal with Prejudice contemporaneously with the RICAN INTEGRITY ttlement agreement ereceipt of t he in trust by counsel for AME settlement checks by DUBOF F I.AW FIRM on behalf of the INSURED(S). [THE REMAINDER OF THIS pikGrE INTENTIONALLY LEFT BLANK) )SIGNATURES BIC. gIIN ON NEXT PAGE 10 of 11 InWRI 1 61) 1 0 I HAVE READ THIS GENERAL RELEASE ANDTERMS ANDWCONDITIONS THAT 1 UNDERSTAND AND ACCEPT A7�i, OF THE THEREIN AND THAT I HAVE DONE SC) WITH THE ADVICE OF MY COUNSEL AT I}UgOFF LAW FIRM• rovldes in part: "Any person NOTICE: Section 817.284, Florida S-tat�utee, p anyInsurer who knowingly and with intent to :ig>�jure, defraud or deaf�l� incomplete files a statement of claim or an application containing any , or misleading information in guilty, of a felony of the third degree." 9IaNATUREB: MAg,IE. OSE SAiNTIL•DANIEL , /�jJ t PRINT NAME STATE OF �� COUNTY OF- SWORN TO AND SUBSCRIBr,,ii BEFORE ME by means o physical Y isalb presence OR — online notarisatioup on this day 2022 y ^ �, t►w,i personally known to me or who has VroducedF' N ��s&entif d who dldA or did not _ _take an oath. ('001" rY$INEIDACYRIAQUE•JEAN Notary PublicSiate of Florida Commission 4 GG 14961I ,, My Comm, Expires Jun 10, 2011 Bonded through National Notary Asir.qpq (Seal) State Notary Public, MY Commission Expires: 6. 11 of 11 initials Aa 1 6 D 1 Retnt 4307421 OR; 4461 PG, 3615 OBLD 3000,00 PORTER WRIGHT ET AL RECORDED in the OFFICIAL RECORDS of COLLI8R COUNTY, FL OB1I 3000.00 5801 PELICAN BAT BLVD 1300 06/15JZ009 at 101190 DWIGHT 8, BROCK, CLERK RIC 111 27.00 NAPLES FL 34108 2709 SECOND MORTGAGE THIS SECOND MORTGAGE ("Security Instrument") is given onday of 2009. The Second Mortgagor is: Marie R. Saintil Daniel, a single person 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 B. 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 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 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 iiso! 187, Trail Ridge, Collier County, Florida and which has the address of: ("Property Address"): r235�36 Roinonia Drive, Naples, FL 34114 TOGETHER WITH all the(impro rpents now or hereafter erected on the property, and all easements, rights, appurtenances, rents, royalties, mineral, oil and gas rights an r0f s, 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 St]irity Instrument. All of the foregoing is referred to in this Security Instrument as the "Property". BORROWER COVENANTS th t-Hortfiwer is lawfully seized of the estate hereby conveyed and has the right to mortgage, grant and convey the Property and that the Properly is unencumbered, except for encumbrances of record. Borrower warrants and will defend generally the title to the Property against ell claims and 4e'miin s, subject to any encumbrances of record. THIS SECURITY INSTRUMENT combrineY uniform covenants for national use and non-unifomn covenants vrith limited variation by jurisdiction to constitute a uniform security instr0ra6rit covering real property. UNIFORM COVENANTS. Borrower and Lender variant and agree as follows: f. Payment of Principal and Interest; Pfeswfie It 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;�Jesstfrents, sewer rents orwater rates prior to the accrual of any penalties or interest thereon. `;.''% S.} The Mortgagor shall pay or cause to be paid, as;thesdme respectively become due, (A)(1) all taxes and governmental charges of any kind whatsoever which may at any time be lawfully assessm,or lely d gainst or with respect to the Property, (2) all utility and other charges, including "service charges", incurred or imposed for the operali�n tenance, use, occupancy, upkeep and improvement of the Property, and (3) all assessments or other govemmental charges that may lawf y be p id in installments over a period of years, the Mortgagor shall be obligated under the Mortgage to pay or cause to be paid only suc )nst, lmr 'Its as are required to be paid during the term of the Mortgage, and shall, promptly after the payment of any of the foregoing, forward t i,M rtgag�ea evidence of such payment. 3. Application of Payments. Unless applicable law providet'3g10fel`wihe, all payments received by Lender shall be applied; first, to interest due; and, to principal due; and last, to any late charges due unde��r �t e,NQt, . 4. Charges; Liens. Borrower shall pay all taxes, assessment s(eh'arjenes and impositions attributable to the Property which may attain priority over this Security Instrument, and leasehold payments or ground (ents,1t any. Borrower shall promptly furnish to Lender all notices of amounts to be paid under this paragraph, and all receipts evidenc'iggh payrttants. Borrower shall promptly discharge any lien which has priority over this $eGiilly Rstrument unless Borrower: (a) agrees in writing to the payment of the obligation secured by the lien in a manner acceptable to Londe O" n gists in good faith the lien by, or defends against enforcement of the lien in, legal proceedings which in the Lenders opinion aperaW' o,pr€ven the enforcement of the lien; or (c) secures from the holder of the lien an agreement satisfactory to Lender subordinating the lien to tfils Se6 , Instrument. If Lender determines that any part of the Property is subject to a lien which may attain priority over the Security Instrument; Lender may give Borrower a notice identifying the lien. Borrower shall satisfy the lien or take one or more of the actions set forth above within 10 day$ f th giving of notice. 6. Hazard or Property insurance. Borrower shall keep the improvements now e41ing:o hereafter erected on the Property insured against loss by fire, hazards included within the term "extended coverage" and any other hazards, j cluding floods or flooding, for which Lender requires insurance. This insurance shall be maintained in the amounts and for the periods thaTE ' pdr-49uires. 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 Lend n 14 in the Property in accordance with paragraph 7. At all times that the Note is outstanding, the Mortgagor shall maintain insurance wiih, peq to the Premises against such risks and for such amounts as are customarily insured against and pay, as the same become due an' aygp,)e,'d I premiums in respect thereto, Including, but not limited to, all-risk insurance protecting the interests of the Mortgagor and Mortgagee against 1 s, or damage to the Premises by fire, lightning, and other casualties customarily insured against (including boiler explosion, if appropriate). Wihalniform standard extended coverage endorsement, including debris removal coverage. Such insurance at all limes to be t 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, it 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 10 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 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 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 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 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 falls 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. 6. 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 he 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 Its agent may make reasonable entries upon and inspections of the Property, Lender shall give Borrower notice at the time of or p io"tp `an/in!ection specifying reasonable cause for the inspection. 10, Condemnatlon: T,}}�e,proTeds of any award or claim for damages, direct or consequential, in connection with any condemnation or other taking of any part of itle'Pte rty}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 I rop;, , , o rpceeds shall be applied to the sums secured by this Security Instrument, whether or not then due, with any excess paid to Borrower �tp'th ve)>t of a partial taking of the Property, in which the fair market value of the Property immediately before the taking is equal Eo or greaser than' mount of the sums secured by this Security Instrument immediately before the taking, unless Borrower and Lender otherwise agree,in, vfitirig 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. -My b, 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 immedlater¢�re the taking is less than the amount of the sums secured immediately for the taking, unless Borrower and Lender otherwise agree in" ing or unless applicable law otherwise provides, the proceeds shall be applied to the sums secured by this Security Instrument whether or` n t the sump are then due. Unless Lender and Borrower otherwise agree in writing, any application of proceeds to principal shall not extend,ov,6§tp' ne the due date of the monthly payments referred to in paragraphs t or change the amount of such payments. r.. 11. Borrower Not Released, Forbearance B�.LenVier Not a Waiver. Extension of the time for payment or modification of amortization of the sums secured by this Security Instrurn$a,(g� *d by Lender to any successor in interest of Borrower shall not operate to release the liability of the original Borrower or Borrowers s1(censors In interest. Lender shall not be required to commence proceedings against any successor in interest or refuse !o extend time fofpayrt`nil otherwise modify amortization of the sums secured by this Security Instrument by reason of any demand made by the original Borundjyver or orrowers successors in interest. Any forbearance by Lender in exercising any right or remedy shall not be a waiver of or preclud4 t2e 6Artcise of any right or remedy. 12. Successors and Assigns Bound; Joint and Several L'1 bill�Y; Cosigners. The covenants and agreements of this Security Instrument shall bind and benefit the successors and assigns of Leer aril mower, subject to the Provisions of paragraph 17, Borrower's covenants and agreements shall joint and several. Any Borrower who ca-signs this Security Instrument but does not execute the Note; (a) is co-signing this Securi nstri{rtueht only to mortgage, grant and convey that Borrowers interest in the Property under the terms of this Security Instrument; (b) is not persenalt�b li ated to pay the sums secured by this Security Instrument; and (c) agrees that Lender and any other Borrower may agree to extend, modify„f�rtiaar 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 fs s0bjdclt,a law which sets maximum loan charges, and that law is finally interpreted so that the interest or other loan charges collected or td'p cQt(ectec( in connection with the loan exceed the permitted limits, then: (a) any such loan charge shall be reduced by the amount necessary l r"Q&e1http charge to the permitted limit; and (b) any sums already collected from Borrower which exceeded permitted limits will be refunded to Bbrroiv€ir. Lender may choose to make this refund by reducing the principal owed under the Note or by making a direct payment to Borrower i rolun_d 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 qee gi a by delivering it or by mailing it by first class mail unless applicable law required use of another method. The notice shall be directed t,c�th Property Address or any other address Borrower designates by notice to Lender. Any notice to Lender shall be given to Borrower or tgrid r-h', given as provided in this paragraph. 15. Governing Law; Severabllity. This Security Instrument shall be govemed by fedewl law nd 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; -6t „ niiipts with applicable law, such conflict shalt not affect other provisions of this Security Instrument or the Note which can be given e,,ect wjthI 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 Istrument. 17. Transfer of the Property or a Beneficial Interest in Borrower. if ail or any part of the Propeit oy 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 ithout 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 nohoe 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 of demand on Borrower. 1s. Borrowees 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 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 limes 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 *** OR; 4461 PG. 3617 *** �& 1 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 dale 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. fine 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 used In this Security Instrument and the Note, "attomeys' fees" shall include any attorneys' fees awarded by an appellate court. 24. Riders to this �;ec rr(yingtrument, If one or more riders are executed by Borrower and recorded together with this Security Instrument, the covenants and 'agrei�ient of each such rider shall be incorporated into and shall amend and supplement the covenants and agreements of this Security Instrtlrr€ent as'.f the riders) were a part of this Security Instrument. (Check Applicable Box) ❑ Adjustable Rate Rider _❑`k 8Q)mprovement Rider ❑ Condominium Rider ❑ Graduated Payment Rider 2`1 4 Family Rider ❑ Second Home Rider ❑ Balloon Rider ❑ 5iweek1y'P. ymenl Rider ❑ Planned Unit Development Rider ❑ Other(s) (specify J SIGNING BELOW, Borrower accepts and agrees tq tttern 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: Witness#1: La @ S Signature: `77�« Lug Witness#2: Signature, Address'."X' STATE OF FLORIDA COUNTY OF COLLIER ZOL Marie R Saintil Da I hereby certify that on this day, before me, an officer duly authorized in the state acknowledgements, personally appeared Marie R, Saintlt Daniel to me known to be the foregoing instrument and acknowledged before me that (He/ she/ they) executed the same for WITNESS my hand and official seal in the County and State af4{�this —:; My Commission (Seal) Notary's Printed Name File#: 09-117 Drive a 34114 and in the county aforesaid to take :scfibed in and who executed the rposl t) erein expressed, 16D1Q 1 6 D 1 12