NACM Services Corp

N A C M T a m p a NACM Services Corporation P.O. BOX 22827  TAMPA, FLORIDA 33622 800.329.6226  813.289.8894  fax 813.289.4261 email [email protected]  web www.nacmtampa.com

PLEASE DELIVER TO: JOY BODOH COMPANY : NACM Services Inc. ADDRESS : PO BOX 21798 TAMPA FL 33622

FROM : COMPANY : ADDRESS :

Thank you for your interest in NACM Services Corp. We are certain that we can provide you with the top quality service that the construction industry has come to expect from one of the largest Notice to Owner companies in Florida.

Please return the completed application to our office by fax to 813-289-4261 or email to [email protected]. We MUST receive your completed application and *$50 application fee BEFORE we can process your first NTO request. (*Please note that your application fee will be applied to your first month’s invoice).

Once your application is processed you will receive a welcome letter providing you with your account information and an access code with instructions for our website. Your access code will allow you to submit your requests electronically through our secure website as well as many other features. If you prefer, you may also make copies of the NTO request, included with the application, for future use.

It is important that your NTO request include the following: Complete JOB NAME (including specific JOB LOCATION), your CUSTOMER NAME, ADDRESS AND PHONE #, and your job START DATE. All NTO information will be verified.

Our normal processing is done within 10 – 14 business days or less and our coverage is statewide.

Again, thank you for your interest in NACM Services Corp. N A C M T a m p a NACM Services Corporation P.O. BOX 22827  TAMPA, FLORIDA 33622 800.329.6226  813.289.8894  fax 813.289.4261 Email [email protected]  web www.nacmtampa.com

APPLICATION FOR FL NOTICE TO OWNER SERVICES – Page 1 of 2

Please provide the following information (type or print carefully):

Company Name ______

Physical Address ______Suite ______

City ______State ____ Zip ______

Mailing Address (if different) ______

City ______State ____ Zip ______

Contact Name(s) ______

Email Address ______

Phone ______Fax ______

Standard Materials/Services (optional) ______

NTO Job Information Contact (if different from above) ______

Select preferred method of contact: Email______Fax______

Approximate Notices per month: *initial in the space next to your selection

01-100 _____

101-299 _____

300-499 _____

500 or more _____

*Please note: The approximate number of notices that you indicate on the application is the pricing rate NACM Services Corporation will provide to your company. If the number of notices increases, it will be customer’s responsibility to contact NACM Services Corporation for a possible rate change. N A C M SERVICES CORPORATION

5521 W. CYPRESS ST. #200 - P0 BOX 21798 - TAMPA, FL 33622 - 813/289-8894 800/329-6226 FAX# 813/289-4261

APPLICATION FOR FL NOTICE TO OWNER SERVICES – Page 2 of 2

Applicant Disclaimer Statement & Terms and Conditions (Please acknowledge with Signature below)

Applicant acknowledges, that despite the information it has provided herein, NACM Services Corporation may not be able to ascertain to whom the Notice to Owner should be sent. Accordingly, IT IS EXPRESSLY UNDERSTOOD AND AGREED THAT THE APPLICANT WAIVES ANY CLAIM AGAINST NACM SERVICES CORPORATION, THAT IT NOW HAS OR MAY HAVE IN THE FUTURE DUE TO THE INABILITY OF NACM SERVICES CORPORATION TO ASCERTAIN THE PARTY OR PARTIES WHO SHOULD RECEIVE THE NOTICE TO OWNER OR COPIES THEREOF.

Further, in the event NACM Service Corporation fails to timely and properly serve a Notice to Owner, as a result of negligence on the part of NACM Services Corporation, its employees, officers, shareholders or assigns, SUCH LIABILITY IS AND SHALL BE LIMITED TO THE TOTAL SUM OF $1,000.00 WHICH AMOUNT THE PARTIES AGREE IS REASONABLE IN LIGHT OF THE ANTICIPATED OR ACTUAL HARM CAUSED BY THE BREACH OR NEGLIGENCE, THE DIFFICULTIES IN PROVING THE LOSS, AND THE INCONVENIENCE OR NONFEASIBLIITY OF OTHERWISE OBTAINING AN ADEQUATE REMEDY.

Applicant understands that time is of the essence regarding the assertion of any claims against NACM Services Corporation as a result of NACM’s failing to timely and properly serve any requested Notice to Owner. Accordingly, applicant agrees that within five (5) calendar days of receipt by mail or posted electronically at NACM’s website, applicant shall diligently review its correctness. In the event there is any error in the Notice to Owner, including the parties to whom it is sent or served, applicant shall have ten (10) days from receipt of said copy (or posting electronically at NACM’s website) within which to notify NACM Services Corporation of such defect or admission, and in which to make a claim for liquidated damages but in no event, shall any claim be asserted more than one calendar year after the Notice to Owner was sent or served.

There will be an additional $10.00 rush charge for requests received 33 days or beyond from the job start date. In addition, all Notices sent beyond 40 days will be expedited and an additional fee per copy sent will be charged.

The applicant agrees to pay for any research preparation and the cost of service as a result of its request for service of a Notice to Owner. In the event payment is not made within thirty (30) days of the date of invoicing by NACM Services Corporation, the applicant agrees to pay interest at the highest rate permitted by law, as well as all cost of collection, including reasonable attorneys fees. x______Signature of Authorized Agent Date N A C M T a m p a NACM Services Corporation P.O. BOX 22827  TAMPA, FLORIDA 33622 800.329.6226  813.289.8894  fax 813.289.4261 Email [email protected]  web www.nacmtampa.com

APPLICATION FEE PAYMENT FORM:

Company Name______Member #______

TO PAY BY CREDIT CARD ______

Card Type Cardholders’ Name (printed):

MasterCard Card Number:

Visa Expiration Date Sec Code: American Express Cardholder Billing Address:

Discover Cardholder Signature:

TO PAY BY EFT ______

Account Holder Name: Check # Routing/ABA Number: (if applicable) Account Number:

Account Holder Signature:

If paying by check please mail, along with completed application, to:

NACM Services Corporation P.O. BOX 21798 TAMPA, FLORIDA 33622

*Please note that your $50 application fee will be applied to your first month’s invoice. N A C M SERVICES CORPORATION

5521 W. CYPRESS ST. #200 - P0 BOX 21798 - TAMPA, FL 33622 - 813/289-8894 800/329-6226 FAX# 813/289-4261 REQUEST FOR NOTICE TO OWNER SERVICES

Please prepare and attempt to serve a Notice to Owner by certified mail, return receipt requested, based on the information we have furnished below. Where you are able to determine that additional copies of the Notice to Owner should be served, please attempt to serve the additional copies by certified mail. We understand that aside from the information we have furnished, you may or may not be able to determine who to send copies to. WE HEREBY WAIVE ANY CLAIM AGAINST YOU THAT WE NOW HAVE OR MAY HAVE IN THE FUTURE BECAUSE OF YOUR FAILURE TO ASCERTAIN WHO SHOULD RECEIVE COPIES OF THE NOTICE TO OWNER. IN THE EVENT THAT THE UNDERSIGNED SUFFERS ANY DAMAGES AS A RESULT OF NEGLIGENCE OF NACM SERVICES CORPORATION IN RESEARCHING, PREPARING, OR ATTEMPTING TO SERVE NOTICE TO OWNER OR PRELIMINARY NOTICE, OR ANY COPY THEREOF, THEN IT IS AGREED THAT THE LIMIT OF LIABILITY OF NACM SERVICES CORPORATION, AND/OR ITS AFFILIATES, EMPLOYEES AND ASSIGNS INCLUSIVE OF ANY INTEREST AND ALL COSTS SHALL BE $1000.00

JOB REFERENCE #______RUSH ___Y ___N

NAME OF YOUR CUSTOMER______PHONE______

ADDRESS______CITY______ST____ ZIP______

PROJECT OR JOB NAME______DATE ON JOB______

SPECIFIC JOB ADDR______CITY______

ADDITIONAL JOB INFO______COUNTY______

MATERIALS/SERVICES______

OPTIONAL INFORMATION which may help us in our research to expedite the processing of your Notice to Owner.

LEGAL: LOT______BLOCK______PLAT BOOK______PAGE______PERMIT #______

SUBDIVISION______

NOC O.R. BOOK______PAGE______SECTION______TOWNSHIP______RANGE______

GEN. CONTRACTOR NAME______PH______

ADDRESS______CITY______ST____ZIP_____

BONDING COMPANY______ADDRESS______CITY______ST___ ZIP_____

OWNER’S NAME______ADDRESS______CITY______ST____ZIP_____

YOUR COMPANY NAME______MEMBER#______

ADDRESS______CITY______ST____ ZIP______

AUTHORIZED SIGNATURE______PHONE______