Mortgage Auth/Payment 2017-09-24T07:35:51+00:00

GO PRO CONSTRUCTION AND RESTORATION INC.

1930 VETERANS MEMORIAL HIGHWAY, STE 12, ISLANDIA NEW YORK 11749
EMAIL: GOPRO4102@GMAIL.COM
PHONE: (844) 517-8418
FAX: (631) 410-5522
SUFFOLK LICENSE NO 53984

 

MORTGAGE AUTHORIZATION AND DIRECT PAYMENT REQUEST

THIS AUTHORIZATION IS MADE ON THIS DATE OF



BY AND BETWEEN GO PRO CONSTRUCTION AND RESTORATION INC, HEREINAFTER REFERRED TO AS THE COMPANY, AND



HEREINAFTER REFERRED TO AS THE HOMEOWNER, TO PROCEED WITH ITS RECOMMENDED PROCEDURES TO PRESERVE, PROTECT AND SECURE FROM FURTHER DAMAGE THE PROPERTY LOCATED AT


PROVIDING THE HOMEOWNER(S) HAS VALID EFFECTIVE COVERAGE FOR ALL OR PART OF THE SERVICES TO BE PERFORMED BY THE COMPANY, THE HOMEOWNER(S) FURTHER AUTHORIZES AND DIRECTS THEIR MORTGAGE COMPANY TO PAY THE COMPANY DIRECT, AND TO NAME THE COMPANY ON ANY AND ALL INSURANCE DRAFTS APPLICABLE TO THIS LOSS.

TIME IS OF THE ESSENCE FOR ALL PAYMENTS DUE TO THE COMPANY.

THE COMPANY SHALL BILL ALL CHARGES AND/OR COSTS DIRECT TO THE HOMEOWNER(S) AND, AS A COURTESY ONLY; A COPY OF THESE INVOICES SHALL BE MAILED TO THE INSURANCE CARRIER. IT IS FULLY UNDERSTOOD AND AGREED TO BY THE HOMEOWNER(S) THAT ANY AND ALL CHARGES ARE DUE UPON COMPLETION OF WORK. IT IS FULLY UNDERSTOOD THAT THE HOMEOWNER(S) IS PERSONALLY RESPONSIBLE FOR ANY AND ALL DEDUCTIBLES, DEPRECIATION OR ANY CHARGES OR COSTS NOT COVERED BY THE INSURANCE. ANY AND ALL CHARGES FOR SERVICE NOT REIMBURSED BY AN INSURANCE CARRIER ARE THE SOLE RESPONSIBILITY OF THE HOMEOWNER AND ARE TO BE PAID UPON COMPLETION OF WORK. ANY EXCEPTION MUST BE APPROVED BY THE COMPANY GENERAL, AND A FINANCE CHARGE OF 1.5% PER MONTH (MINIMUM OF $5.00) WILL BE APPLIED TO ANY UNPAID BALANCE AFTER THIRTY (30) DAYS.

THE LIABILITY OF THE COMPANY IS EXPRESSLY LIMITED TO THE TOTAL AMOUNT OF THE SERVICES AUTHORIZED HEREIN AND IN NO EVENT SHALL THE COMPANY, ITS AGENTS OR ASSIGNS, BE LIABLE FOR CONSEQUENTIAL DAMAGES OF ANY KIND. IN THE EVENT ANY LEGAL PROCEEDINGS MUST BE INSTITUTED TO RECOVER THE AMOUNT DUE. THE COMPANY SHALL BE ENTITLED TO RECOVER THE COSTS OF COLLECTION INCLUDING REASONABLE ATTORNEYS FEES.


EXECUTED AT



ON THE DAY AND YEAR FIRST ABOVE WRITTEN.

PRINT NAME:
SOCIAL SECURITY NUMBER
MORTGAGE/LENDER
ACCOUNT NUMBER
AUTHORIZED SIGNATURE



YOUR DIGITAL SIGNATURE IN THE ABOVE FIELD CONSTITUTES ENTERING INTO A LEGALLY BINDING AGREEMENT.