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Office Use Only p ‘ 1) Pennit# Cs �t7 �i O �� Amount ti.1 . th U ��. � . Permit expires 180 days from . issue date EXPRESS BUILDING PERMIT APPLICAT TOWN OF YARMOUTH R E C E V 7 D Yarmouth Building Department 1146 Route 28 MAY 16 2023 South Yarmouth,MA 02664 (508) 398-2231 Ext. 1261 BUILDING DEPARTMENT By — CONSTRUCTION ADDRESS: 32 Niagara Ln , West Yarmouth , MA 02673 ASSESSOR'S INFORMATION: Map: 24 Parcel: 83 OWNER: Adele McGuinntkr 32 Niagara Ln W. Yarmoii (774)368-0099 NAME PRESENT ADDRESS TEL. # CONTRACTOR: Brian Dennison 10 Reservoir Rd Smithfielcb 401-452-0550 NAME MAILING ADDRESS TEL.# O Residential ['Commercial Est.Cost of Construction$ 11,252.00 Home Improvement Contractor Lie.#0634555 Construction Supervisor Lic.#095707 Workman's Compensation Insurance: (check one) ❑ I am the homeowner 0 I am the sole proprietor 0 I have Worker's Compensation Insurance Insurance Company Name: Acadia Insurance Co. Worker's Comp.Policy#WCA5534403 WORK TO BE PERFORMED Tent n Duration (Fire Retardant Certificate attached?) Wood Stove Ell Siding: #of Squares Replacement windows:#5 Replacement doors: # Roofing: #of Squares (❑)Remove existing*(max.2 layers) Insulation I I El Old Kings Highway/Historic Dist. Replacing like for like Pool fencing I I *The debris will be disposed of at: 10 Reservoir Rd Smithfield RI 02917 Location of Facility I declare under penalties of pe' that the statem rein contained are true and correct to the best of my knowledge and belief. I understand that any false answer(s) will be just cause for denial ocatio of m d for prosecution under M.G.L.Ch.268,Section I. Date: 5/3/23 Owners Signature(or attachm t) Date: Approved By: Date: Building Official(or designee) EMAIL ADDRESS: b{�p a ) Q n rev)®�Q J� •/'11 Zoning District: 1 C Historical District: LI Yes `C[I No Flood Plain Zone: C Yes E, No Water Resource Protection District: Within 100 ft.of Wetlands: L Yes 0 No L Yes [ No »-,en a) ■73■F. C 2rnrn v m 2_ z gm ,g @ CA I 2§§ 2 � j�\z 0 E� q20 § n\ : w � §} 2 � 3 I-7z e (\G ® g%\ § \ jhg] §« ®§ 22 $ wƒp^ll Age|Ei /ƒ4 , 2q m\ . / @ eOz \ j , y \± a ■ Q § 1 ƒ ƒ \ ° ` ¢ z % : ; z - <0• 0f§ * 0 a_ 22ca1 o 2 o m o o _ CD E k ° . / — CD k 7 - 2 a ] oo ¢ .aa asNa o o 3 0 . . | % a• * k , �[ . 20 !!1II1!fflU , , ) &i � r , i a1��7 . ill\ \�■ , \ Cm \ 2 O • . ' ,< a:7 � � lio 1111111111111111111 } D _ Wm W a #»Ez I a m ■ a£ . ` % g �� �� ; � ga§ � c k k� $ 2 e -��■ 1 $ \� I ' �■ " , m § $4 c 1 c - �� » 1 ! \ § 9 N. g ■ k CD § ® 1. 2 a _ _ .._ E ! i Commonwealth of Massachusetts Division of Occupational Licensure Board of Building Re ulations and Standards Cons ' ISkitp' ervisor CS-095707 , ey. '° = ` Erl$ki.nires: 09/08/2024 BRIAN D DE IS f ,:',„. 1 8 BLACKWE �1 ,,,,,„ CHARLTON 14fik ' • "t 1 it , 04,..,p, Y ft i • II! A' ♦7-+ �i, .;d#I ,~ i ',,ori tiiiSS:011er .witirt? I'.. v art.. .. Ado CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 12/29/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT Linda Cordeiro PRODUCER NAME: Cross Insurance,Inc:RI PHONE (401)431-9200 (FAXA/C,No): (401)431-9201 (A/C.No.Extl: 376 Newport Avenue E-MAILDRE linda.cordeiro@crossagency.com P.O.Box 4830 INSURER(S)AFFORDING COVERAGE NAIC# East Providence RI 02916 INSURER A: Acadia Insurance Co. 31325 INSURED INSURER B: Southern New England Windows,LLC INSURER C: dba Renewal by Andersen of Southern New England INSURER D: 10 Reservoir Rd INSURER E: Smithfield RI 02917 INSURER F: COVERAGES CERTIFICATE NUMBER: CL22122920061 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADUL UkBH POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD NM POLICY NUMBER (MMIDD/YYYY) (MMIDD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 rI-- DAMAGE TO RENTED 300,000 CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 A CPA 5534384 01/01/2023 01/01/2024 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JECT n LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ A OWNED — SCHEDULED CAA5534385 01/01/2023 01/01/2024 BODILY INJURY(Per accident) $ AUTOS ONLY _ AUTOS PROPERTY DAMAGE HIRED NON-OWNED (Per accident) $ X AUTOS ONLY X AUTOS ONLY $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 A EXCESS LIAB CLAIMS-MADE CUA5534402 01/01/2023 01/01/2024 AGGREGATE $ 10,000,000 DED RETENTION$ $ PER OTH- WORKERS COMPENSATION STATUTE ER AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y�l N/p WCA5534403 01/01/2023 01/01/2024 E.L.EACH ACCIDENT $ 1,00 , 000 A (Mandatory OFFICER/MEMBER NH) EXCLUDED? I I E.L.DISEASE-EA EMPLOYEE $ 1,000,000 (Mandatory In NH) 1,000,000 If yes,describe under E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Southern New England Windows,LLC dba Renewal by Andersen of Southern New England AUTHORIZED REPRESENTATIVE 10 Reservoir Rd IbmizeleSmithfield RI 02917 Vimsgf, ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD L ne t.umn{onweustn Of 1r1U33U[:SU3i iia . cam►\ Department of Industrial Accidents _:zi Office of Investigations lttt�r Nor v Lafayette City Center :/ 2 Avenue de Lafayette, Boston,MA 02111-1750 www mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Southern New England Windows Address: 10 Reservoir Rd City/State/Zip:Smithfield Phone#:401-452-0550 Are you an employer? Check the appropriate box: Type of project(required): 1.® I am a employer with 165 4. 0 I am a general contractor and I 6. El New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. II Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp. insurance.$ required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions officers have exercised their 11. Plumbing❑ I am a homeowner doing all work repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Acadia Insurance Co. Policy#or Self-ins. Lic.#:WCA5534403 Expiration Date:01/01/2024 Job Site Address: 32 Niagara Ln City/State/Zip: West Yarmouth , MA 02673 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un ' the 'ain j of perjuty that the information provided above is true and correct i/ Date: 01/03/2023 Phone#: 4014520550 Official use only. Do not write n this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(check one): 10Board of Health 2❑Building Department 3.DCity/Town Clerk 4.0 Electrical Inspector 5Elumbing Inspector 6.0Other Contact Person: Phone#: DBA:RENEWAL BY ANDERSEN OF SOUTHERN NEW ENGLAND Adele McGuinness $ Legal Name:Southern New England Windows,LLC 32 Niagara Ln RI#36079,MA#173245,CT#0634555,Lead Firm#1237 West Yarmouth,MA 02673 10 Reservoir Rd I Smithfield,RI 02917 H:(774)368-0099 RENEWAL Phone:401-753-2223 I Fax:(null)I contracts@ASmarterWindow.com brANDERSEN Thank you for your order Please find, enclosed for your convenience,the contents of your agreement with Southern New England Windows, LLC d/b/a Renewal By Andersen of Southern New England Table of Contents Agreement Document and Payment Terms 2 Itemized Order Receipt 3 Payment Authorization Form 5 Notice of Cancellation 6 Terms and Conditions of Sale 7 Supply Chain Contract Addendum 9 Sales Cost Savings Program (SCSP) 10 Lead-Safe Form (CT& MA) .11 Important Project Information 12 Price Presentation Discounts 15 04/11/23 Page 1/ 15 $/ily Itemized Order Receipt DBA:RENEWAL BY ANDERSEN OF SOUTHERN NEW ENGLAND Adele McGuinness RENEWAL Legal Name:Southern New England Windows,LLC 32 Niagara Ln RI#36079,MA#173245,CT#0634555,Lead Firm#1237 West Yarmouth,MA 02673 bYANDERSEN" 10 Reservoir Rd I Smithfield,RI 02917 H:(774)368-0099 wimnnwo W{DOOR MOM Phone:401-753-2223 I Fax:(null)I contracts@ASmarterWindow.com ID#: ROOM: SIZE: DETAILS: PRICE: Misc Misc, Job Note, Quantity 1, START TIMES ARE AN ESTIMATE AND ARE SUBJECT TO CHANGE. As a reminder, it is the customer's responsibility to do any painting, staining or touch up work after installation. We appreciate your business and look forward to exceeding your expectations Misc Misc, Job Note, Quantity 1, Customer has paid Renewal by Andersen to secure a building permit for their project. Permit fees are non-refundable once the permit is applied for Misc Misc, Job Note, Quantity 1, When installing any replacement window or door, due to different frame design, glass loss is typical. By signing the agreement, you agree that glass loss was discussed and you fully understand there will be less visible glass with new windows and doors 101 kitchwn sink Window Double-Hung (DG) 1:1 Slope Sill, Base Frame, Traditional Checkrail, Exterior White, Interior White, Glass, All Sash: High Performance, No Pattern, Hardware, White, Screen, Fiberglass, Full Screen, Grille Style, Grilles Between Glass (GBG), Grille Pattern, All Sash: Colonial 3w x 2h, Misc, None 102 kitchwn sink Window Double-Hung (DG) 1:1 Slope Sill, Base Frame, Traditional Checkrail, Exterior White, Interior White, Glass, All Sash: High Performance, No Pattern, Hardware, White, Screen, Fiberglass, Full Screen, Grille Style, Grilles Between Glass (GBG), Grille Pattern, All Sash: Colonial 3w x 2h, Misc, None 04/11/23 Page 3/ 15 . Payment Authorization Form �%�' DBA:RENEWAL BY ANDERSEN OF SOUTHERN NEW ENGLAND Adele McGuinness Legal Name:Southern New England Windows,LLC 32 Niagara Ln RENEWAL RI#36079,MA#173245,CT#0634555,Lead Firm#1237 West Yarmouth,MA 02673 byANDERSEN 10 Reservoir Rd I Smithfield,RI 02917 H:(774)368-0099 Russu➢Ie00t ooI ABumen Phone:401-753-2223 I Fax:(null)I contracts@ASmarterWindow.com Adele McGuinness BUYER NAME 32 Niagara Ln West Yarmouth ADDRESS CITY MA 02673 (774)368-0099 STATE ZIP CODE PHONE NUMBER 1 PHONE NUMBER 2 Charles Berkowitz $11,252 SALES REP CONTRACT BALANCE PAYMENT SCHEDULE ($11,252) RWWOW SM MMMY alEIXT $3,750 $3,750 $3,752 BY SIGNING BELOW,I/WE,THE BUYER(S): 1.Agree to all payment terms as outlined in terms and conditions of the sale. 2. Agree to pay upon substantial completion of the project. 3. Cash projects are paid: 1/3 deposit, 1/3 at the start of the job and 1/3 at substantial completion of the project. 4. Final 1/3 payment must be made to the installer on the last day of the installation. Adele McGuinness 04/11/23 BUYER NAME SIGNATURE DATE 04/11/23 Page 5/ 15 Terms and Conditions of Sale 41.4,1 DBA:RENEWAL BY ANDERSEN OF SOUTHERN NEW ENGLAND Adele McGui s RRENEWAL Legal Name:Southern New England Windows,LLC 32 Niagara Ln R RI#36079,MA#173245,CT#0634555,Lead Firm#1237 West Yarmouth,MA 02673 byENDER A L SEN 10 Reservoir Rd I Smithfield,RI 02917 H:(774)368-0099 warm MOW tDOMRUUMIm Phone:401-753-2223 I Fax:(null)I contracts@ASmarterWindow.com "I", "my," and "me" means each person who signs this Agreement as a buyer. "Contractor"means Southern New England Windows,LLC d/b/a Renewal by Andersen of Southern New England. "We"and"us"mean both the buyer,or buyers if more than one,and the Contractor.Renewal by Andersen of Southern New England is an authorized and independent dealer of Renewal by Andersen.You are entering into a contract with Renewal by Andersen of Southern New England.I agree and understand that if I finance the work with Contractor or a third party,my separately provided financing documents will include the number of monthly payments and the amount of each payment,including any finance charge. Warranties/Intended Use: I understand that Andersen Corporation("Andersen")is providing me with a warranty in connection with my purchase. I understand that I should read Andersen's written warranty for complete details of my warranty coverage and that the Andersen warranty is available for my complete review before I sign this Agreement. I understand that the Andersen warranty will not be effective or enforced while a balance due remains on this Agreement. Contractor's Promises:Contractor promises to perform all work in a professional manner and within industry standards.Contractor will remove and transport away from the premises any debris and waste materials that are generated by Contractor.Contractor shall obtain all building permits for the work to be performed under this Agreement. My Promises:I promise to Contractor that(a)I will provide Contractor with reasonable access to my property,including access to electrical outlets;(b)I will be responsible for preparation,moving,and reinstalling of any materials,personal property,cars,or equipment as may be needed for Contractor to perform its work;(c)The walls and surfaces upon which the work is to be performed are sound and suitable for the work being performed;(d)When the work is"substantially complete", I will pay Contractor the balance due under this Agreement.I understand that"substantially complete"means the work has been materially finished and is functional as intended;(e)In the event that I disagree with Contractor that the work is substantially complete, I agree that I will not withhold more than 10%of the Total Job Amount;and(f)If taxes are necessary to complete the work,I will pay them unless the law requires Contractor to pay them.Contractor may place a small advertising sign in my yard at the time of install. Measurements: I understand that dimensions referred to in this Agreement are estimates and used only for arriving at the Total Job Amount.I understand that the actual measurements will be determined during a follow-up visit by a qualified measurement technician. I understand that if Contractor must make changes to the estimated measurements, I will have to sign an addendum to this Agreement. Late Cancellation: I understand that I have 3 business days to cancel this Agreement,as described on the front page of this Agreement.I understand that if I want to cancel this Agreement after those 3 business days,Contractor does not have to allow that.I understand that if Contractor does let me cancel, however, I will have to pay to Contractor a late cancellation fee equal to 25%of the Total Job Amount for Contractor's labor,administrative,and material costs. Delay/Unknown Conditions: I understand that if Contractor determines that Contractor cannot perform the work according to Contractor's normal professional standards,then Contractor can cancel this Agreement,notify me in writing of the cancellation,and return my money to me.I understand that some of the things that could cause Contractor to cancel this Agreement would be incorrect pricing, unforeseen structural defects,or unknown pre-existing conditions to my property. I understand that Contractor is not responsible for structural or other defects in my property,and that Contractor's products do not cure those types of problems. I also understand that the work could be delayed by events that Contractor does not control,and that is acceptable to me.Some of the things that could cause the work to be delayed would be acts of God,labor strikes, inclement weather,material shortages, my inability to qualify for or obtain financing,delays by local government authorities in issuing or otherwise approving inspections, permitting,or other required authorizations for the work. Late Payment/Default:I agree that if I do not pay Contractor any of the money owed when it is due, I can be charged a late fee of 1.5%on the amount owed for each month the money is owed and not paid.I also agree that if I default on my promises under this Agreement,and Contractor hires an attorney to enforce this Agreement,I will pay Contractor its reasonable legal fees and related costs or expenses,as long as it is legal for me to do that.I agree and understand that in the event that I do not pay Contractor any of the money owed when it is due,Contractor may have a claim against me,which may be enforced against my property in accordance with the applicable lien laws. I also understand that if I finance the work with Contractor or a third party,my separately provided financing documents may include a security interest. I understand that I should read those documents closely. I agree and understand that I will assert a dispute,claim,or controversy(hereafter referred to as a"Claim")arising under or relating to this Agreement only on behalf of my own self and that I will not assert a Claim on behalf of,or as a member of,a class or group In either an arbitration proceeding,a private attorney general action,or in any other forum or action.lf a court determines that this specific paragraph is not fully enforceable,the court's determination shall be subject to appeal.This paragraph does not apply to any lawsuit or administrative proceeding filed against Contractor by a state or federal government agency. SIGNATURE OF SALES PERSON SIGNATURE SIGNATURE Charles Berkowitz Adele McGuinness PRINT NAME OF SALES PERSON PRINT NAME PRINT NAME 04/11/23 Page 7/ 15 tRENEWAL brANDERSEN wow WgIDOW&DOOR IEPIA(EMENT March 08,2022 Hello, First,thank you for choosing Renewal by Andersen. It is both an honor and a privilege to be trusted with something as meaningful as providing products and services for your home.As many of us have seen our homes transformed into places of work and school over the last year and a half, "home" has never been more important. While these times are unprecedented on many fronts,we are thankful for our retailers continued hard work and grateful for homeowners like you,who are choosing Renewal by Andersen in record numbers. Unfortunately,as you may be aware,the pandemic has stressed labor markets and created tremendous challenges for materials suppliers who are struggling to keep up with demand from companies and manufacturers.We are not alone in facing this difficulty, but it does not make it any less of an inconvenience. Ultimately,these challenges have resulted in extended lead times in our manufacturing process and in our shipping product to you. We apologize for these delays and want you to rest assured we are doing everything possible to reduce lead times to normal levels. Your satisfaction—your delight—with your Renewal by Andersen experience is paramount to all of us. I assure you that we are working diligently with our suppliers to resolve these issues as quickly as possible, and I thank you for your business and for your patience as we continue to work through these challenges. Sincerely, Troy Barrow President Renewal by Andersen IftLead-Safe Form (CT & MA) l DBA:RENEWAL BY ANDERSEN OF SOUTHERN NEW ENGLAND Adele McGui Legal Name:Southern New England Windows,LLC 32 Niagara Ln RENEWAL RI#36079,MA#173245,CT#0634555,Lead Firm#1237 West Yarmouth,MA 02673 bYANDER_SEN. 10 Reservoir Rd I Smithfield,RI 02917 H:(774)368-0099 Phone:401-753-2223 I Fax:(null)I contracts@ASmarterWindow.com Lead Safe Work Pamphlet Receipt and Lead Testing Permission Form Pamphlet Receipt I have received a copy of the lead hazard information pamphlet informing me of the potential risk of the lead hazard exposure from renovation activity to be performed in my dwelling. I received this pamphlet before the work began. Permission to Test I confirm if my house was built between the years of 1940 and 1977, I understand and give permission to have my house tested for Lead Paint at time the measure technician comes out to take final measurements. I understand that if the test does show the presence of lead paint, that the firm performing the renovation will be required to use the lead-safe work practices required by EPA's Lead-Based Paint Renovation, Repair, and Painting Rule. I also understand that there is no added charge for using the lead safe work practices. By signing below, I hereby agree to the terms and conditions above. SIGNATURE OF SALES PERSON SIGNATURE SIGNATURE Charles Berkowitz Adele McGuinness PRINT NAME OF SALES PERSON PRINT NAME PRINT NAME 04/11/23 Page 11/ 15 $/2 Important Project Information DBA:RENEWAL BY ANDERSEN OF SOUTHERN NEW ENGLAND Adele McGuinness RENEWAL Legal Name:Southern New England Windows,LLC 32 Niagara Ln RENA EWAL RI#36079,MA#173245,CT#0634555,Lead Firm#1237 West Yarmouth,MA 02673 by N `--------- 10 Reservoir Rd I Smithfield,RI 02917 H:(774)368-0099 wumaawwrow&ee:aeumew Phone:401-753-2223 I Fax:(null)I contracts@ASmarterWindow.com WINDOW COVERINGS Please remove all blinds, shades or shutters before we arrive. Should you need assistance removing and reinstalling your existing blinds, shades or shutters, we offer that as a fee based service, but we are not responsible for the fit or operation of the blinds, shades or shutters. We also assume no liability for any new blinds or shutters: that includes fit, measuring and installation. All of these processes should be handled by a professional window treatment company. AIR CONDITIONING UNITS Owner is responsible for the removal and reinstallation of any AC units and brackets. ALARM SYSTEMS Owner is responsible for the removal and reinstallation of any existing alarm systems. PLEASE CONTACT ALARM COMPANY FOR DETAILS. PETS Because not all pets react favorably to the excitement of the construction process, we ask that you keep all of your pets confined during the time we are working on your home.This should keep them from becoming stressed, accidentally escaping or possible injury. PAYMENTS For check and credit card customers, second 1/3 payment is due at start of installation and final 1/3 payment is due at substantial completion of the installation. The check is made payable to "Renewal by Andersen of SNE". You may hand the check to the installer who will then bring the check into the office. If you have financed your project, there will be a finance sign off form made available to you by the installation crew for final payment. WHAT IS INCLUDED Renewal by Andersen will insulate, caulk and seal windows with our 3—point defense system to prevent water and air infiltration VISIBLE ROT RbA of SNE will replace or repair VISIBLE rot on sills or exterior casings. SIGNATURE OF SALES PERSON SIGNATURE SIGNATURE Charles Berkowitz Adele McGuinness PRINT NAME OF SALES PERSON PRINT NAME PRINT NAME 04/11/23 Page 13/ 15 Price Presentation Discounts DBA:RENEWAL BY ANDERSEN OF SOUTHERN NEW ENGLAND Adele McGuinness RENEWAL Legal Name:Southern New England Windows,LLC 32 Niagara Ln REN L RI#36079,MA#173245,CT#0634555,Lead Firm#1237 West Yarmouth,MA 02673 byEN EWAL' --- DERSE 10 Reservoir Rd I Smithfield,RI 02917 H:(774)368-0099 Reisaganror ooxPMMONn Phone:401-753-2223 i Fax:(null)i contracts@ASmarterWindow.com PROJECT PRICE BEFORE DISCOUNTS 514,805 INDIVIDUAL SAVINGS BASED ON 5 UNITS Advertised Offer Savings: 20% Off Project $2,961 Sales Cost Savings Plan (5%) Savings: $592 i * , V V ►► k L L TOTAL PRICE: 511 252 $3,553 44 SAVINGS q 440 p 4s4A.h04' 04/11/23 Page 15/ 15 I , Ds not remove until Sisal code inspect . Save label for future reference, 0.dmr, 2 i t) :cda`�f for arr tnt1 C i1<;t;. siblo prsur nos re ��gion:u:dir�ur ,.: f �t �11 . t fir" l .4: s t�.>*.tGF +.r v W • a.OutoltnodiAdmisalbtof i, i Rrcpcswal. •=-4,- - - "1 wine ow..a,►IApg,i.Mt wn AaMrom Vinyl/Wood Composite Material MEM Dual Argon Low:E4 Product Type: Picture ENERGY PERFORMANCE RATINGS U=Factor Solar Heat Gain Coefficient 0i27 a.34 U.SP) 11 .53 (Ma ic/Si) ADDITIONAL PERFORMANCE RATINGS Visible Transmittance 0.59 f a m p. . .. 1 ItsmouwipfatSWNootonNrorwnal a;naa ow*omelet sew MC sow out noawot Entracte o wm.adoc.ittontrwmod!oMookkatIeowwarpro. «r«r i%ero Ij. wa. Liens+:CCL 121H-72$.OS ECL 12i*1-723.04 AWi "VDM neon Wind M,a,r carw. +lInd�.to SW Maim olltioirao Standard Rating au LC O5o MAWA06YVCSA(01A324444001 St*MIMt 4e 0o15D in MMOMOKVCSA ions 06 OP Lc-50 pit 1 �� /. ID «warms mew wor ow ,, no..w,paaeo4w.us 100-00 23 011 WWr.rtlS,,..54.4r .1,..0!..)62.4.f.r.....am.7rrCM inure. • s p i�1 s a '111:111' !if 1 � 1III 111 a . I Do not remove until final code ins. ction. Save label for future reference. • ENERGY STAR'Certified in Highlighted Regions• Certifie ENERGY STAR dansles regions en surbriflattce Canada ?I ; f ER/RE 15 energystarg .ce :•1, r;'•^ Nr.,c • ie ENERGY STAR i '• • �:: -1;_"eon:'''.:::: '•�. . ;E.U. '` .. . .., ::�; ` .w,�» «:» energystar.gov — . G D DO NOT REMOVE UfffIL Fi?JAL INSPECTION!NE PAS RETIRER AVANT LIPISPECTION RNALE Renewal ``t: eyAAndersena< NFRC, — WINDOW REPLACEMENT am AndemenCMrcopxny f AND-N-29-00809-00001 NatartelFenestration Vinyl/Wood Composite Material Ram.;Couna4 Dual-Pane with Argon CERTIFIED Product Type: Double Hung ENERGY PERFORMANCE RATINGS U-Factor Solar Heat Gain Coefficient 0 . 281 . 59 0 . 19 (U.S./I-P) (Metric/SI) ADDITIONAL PERFORMANCE RATINGS Visible Transmittance 0 . 42 mom Manufacturer stipulates the:arose rating✓conform to applicable'FRC procedure:for determiningvhole product performance,IF0C rating:'redetermined fora fixed set of environmental conditions and a specific product size. 'FRC does no:recommend soy product and doe:not',arrant the suitability of any product for any specific use. Consult manufacturer':literature for other product performance information. v"nfrc.org Licensee: 129-H-836 Hallmark Certified Andersen Corporation www.wdma.com RbA Double-Hung Manufacturer stipulates certi f ication to the applicable Standards. STANDARD RATING Class lC-P625;Size Tested:45.0 inx 71.0i M MA/NDAA/CSA 1011L5.2/A440-OD DP+3S/-IS MMA/WOMA/CSA 101/1.5.2/A440-11 1C-1,625:45.0 ins 77.0in+15/-35 MM/NDIIA/CSA 101/I.5.241440-08 Class LC-P025 . A44051-09 /7 Important Project Information ' DBA:RENEWAL BY ANDERSEN OF SOUTHERN NEW ENGLAND Adele McGuinness Legal Name:Southern New England Windows,LLC 32 Niagara Ln RENEWAL RI#36079,MA#173245,CT#0634555,Lead Firm#1237 West Yarmouth ,MA 02673 bYANDERSEN'- 10 Reservoir Rd I Smithfield,RI 02917 H:(774)368-0099 RIMING r®mi1onoeREPUM r Phone:401-753-2223 I Fax:(null)I contracts@ASmarterWindow.com NOT INCLUDED Any UNSEEN, HIDDEN or STRUCTURAL rot,that will be addressed at time of discovery. HAUL AWAY/DISPOSAL&CLEAN UP RbA of SNE will clean up all job related debris, including old windows and storms, and will vacuum nightly. FINISH PAPERWORK RbA of SNE will present customer with maintenance manuals and warranty documents upon completion of project and payment in full. PERMITS The fee for any and all required building permits is to be paid by the customer to Renewal by Andersen. Renewal by Andersen will secure any and all required building permits. On occasion, an outstanding customer bill with the municipality will prohibit Renewal by Andersen from securing a permit. When applicable, contractor will notify customer and it is up to the customer to pay any owed balance to the town so contractor can secure the proper permits prior to installation. We ask that the customer close out the permit, after installation, with the issuing municipality when necessary. ALL CURRENT PROMOTIONS AND DISCOUNTS HAVE BEEN APPLIED TO THIS AGREEMENT-ANY FUTURE DISCOUNTS OR SALES CANNOT BE APPLIED AT A LATER DATE. Gl1-"�='erg-„ SIGNATURE OF SALES PERSON SIGNATURE SIGNATURE Charles Berkowitz Adele McGuinness PRINT NAME OF SALES PERSON PRINT NAME PRINT NAME Page 14/ 15 04/11/23 4 Important Project Information DBA:RENEWAL BY ANDERSEN OF SOUTHERN NEW ENGLAND Adele McGuinness Legal Name:Southern New England Windows,LLC 32 Niagara Ln RENEWAL RI#36079,MA#173245,CT#0634555,Lead Firm#1237 West Yarmouth ,MA 02673 bYANDERSEN' 10 Reservoir Rd I Smithfield,RI 02917 H:(774)368-0099 RAJ MOWN IDOAAMOWNr Phone:401-753-2223 I Fax:(null)I contracts@ASmarterWindow.com CUSTOMER RESPONSIBILITIES POSSIBLE GLASS LOSS FOR WINDOWS AND DOORS Customer has been made aware of the possible glass loss that occurs with the installation of replacement windows. POSSIBLE GLASS LOSS FOR BAY AND BOW WINDOWS Customer acknowledges acceptance of substantial glass loss due to the engineering of the frame to properly support the weight of the new unit. It Is recommended when purchasing a bow window to replace the existing unit with one less section. For example, a 5 section bow should be replaced with a 4 section bow to help offset glass loss. PAINTING/STAINING RENEWAL BY ANDERSEN DOES NOT PERFORM ANY PAINTING OR STAINING ON ANY WINDOWS, DOORS OR TRIM. In order to provide you with the best finished product, our installers will not prefill nail holes. These tasks will be completed during the painting/staining process. It is your responsibility to coordinate and pay for all painting and/or staining after the windows are installed, including any new interior stops (replaced as needed)which is a small interior piece of wooden trim removed or installed during the installation of the windows. ENLARGING, WIDENING OR NEW OPENINGS Renewal by Andersen does not have the licensing to perform electrical or plumbing work, nor will the company be held liable for the removal or relocation of any electrical and/or plumbing that is discovered inside of the wall during the installation. If discovered, Renewal by Andersen will leave the opening sealed from exterior elements and notify the customer to discuss your responsibilities in getting said electrical and/or plumbing moved. Once electrical and/or plumbing is moved customer will call Renewal by Andersen to schedule the installation of the balance of the project. EXTERIOR ACCESS TO OPENINGS Customer must provide reasonable access to the exterior of each opening to perform the proper exterior installation and weather proofing guidelines. This may require some shrub and/or tree limbs to be trimmed back so an installer can have access with a ladder to the exterior of an opening. FURNITURE AND DECORATIONS We ask that you remove any furniture that may block access to the windows or door openings. We ask that you remove the pictures from the walls being worked on and any decorations that are in the work area before work begins. This will greatly reduce the likelihood of any accidental damage to personal property. SIGNATURE OF SALES PERSON SIGNATURE SIGNATURE Charles Berkowitz Adele McGuinness PRINT NAME OF SALES PERSON PRINT NAME PRINT NAME Page 12/ 15 04/11/23 $ Sales Cost Savings Program (SCSP) /�� DBA:RENEWAL BY ANDERSEN OF SOUTHERN NEW ENGLAND Adele McGuinness Legal Name:Southern New England Windows,LLC 32 Niagara Ln RENEWAL RI#36079,MA#173245,CT#0634555,Lead Firm#1237 West Yarmouth ,MA 02673 brANDERSEN' H:(774)368-0099 ausmawoow OM MOM 10 Reservoir Rd Smithfield,RI 02917 Phone:401-753-2223 I Fax:(null)I contracts@ASmarterWindow.com To: All Sales Personnel Date: September 1, 2005 From: Matthew Esler- CEO Renewal by Andersen of Southern New England Re: Sales Cost Savings Program (SCSP) At Renewal by Andersen, we are always looking for ways to increase value, and we've found a new way to lower costs to our customers. The majority of customers that we meet love Renewal by Andersen and are comfortable enough to award us the project on the initial appointment. For a variety of reasons, some customers feel they need time to "think it over" for a day or two before placing the order. This requires a second appointment. We are happy to visit our customers as many times at it takes to earn their business. However, when the consumer makes-a buying decision on the first appointment, the sales cost of additional visits is saved and we are happy to pass that savings on to our customers. Please keep in mind, the savings are only realized during the initial appointment. Best Regards, Matthew Esler CEO, Renewal by Andersen By signing below 1 acknowledge receipt of the initial visit, sales cost savings plan. As a way of saying thank you, this savings will be included in all your future orders SIGNATURE OF SALES PERSON SIGNATURE SIGNATURE Charles Berkowitz Adele McGuinness PRINT NAME OF SALES PERSON PRINT NAME PRINT NAME 04/11/23 Page 10/ 15 fq Terms and Conditions of Sale v '�_J DBA:RENEWAL BY ANDERSEN OF SOUTHERN NEW ENGLAND Adele McGuinness Legal Name:Southern New England Windows,LLC 32 Niagara Ln RENEWAL RI#36079,MA#173245,CT#0634555,Lead Firm#1237 West Yarmouth,MA 02673 bYANDERSEN' 10 Reservoir Rd I Smithfield,RI 02917 H:(774)368-0099 mama WINDOW100.1111U011111 Phone:401-753-2223 I Fax:(null)I contracts@ASmarterWindow.com Interpretation of This Agreement:I agree that this Agreement will be enforced under the laws of the state where the work is being performed. If any part of this Agreement is determined to be invalid or illegal,then I agree that the rest of this Agreement will still be valid and enforceable.We both understand that this Agreement and any attachments,make up the entire understanding between us about the work Contractor is doing.There are no other oral or written agreements or representations on which we are relying.We both agree that any change to this Agreement must be in writing and signed by both of us.The paragraph headings contained in this Agreement are for convenience only and will not affect the meaning or interpretation of this Agreement. (Connecticut Sales Only)The owner(s)of the home improvement contractor is or has been a shareholder,member, partner,or owner of the following corporations, limited liability companies,partnerships,sole proprietorships or other legal entities that have been a home improvement contractor during the previous five years:None." (Massachusetts Sales Only)Any deposit required under this Agreement to be paid in advance of the commencement of work shall not exceed the greater of one-third of the total contract price or the actual cost of any materials or equipment of a special order or custom made nature,which must be ordered in advance of the commencement of work,in order to assure that the project will proceed on schedule.No final payment shall be demanded until this Agreement is completed to the satisfaction of the parties. In Massachusetts,all contractors and subcontractors must be registered by the administrator of the board of building regulations and standards and any Inquiries about a contractor or subcontractor relating to a registration should be directed to:Office of Consumer Affairs and Business Regulation, Ten Park Plaza,Suite 5170,Boston,Massachusetts 02116,Telephone:(617)973-8700.In Massachusetts,the contractor Is responsible for applying for and obtaining any and all necessary permitting.Homeowners who secure their own permits will be excluded from the guaranty fund provisions of Massachusetts law. (Rhode Island Sales Only)The contractor and/or subcontractors or material persons may file a lien in accordance with the Rhode Island Mechanics Lien Act,chapter 28 of title 34. (Rhode Island Sales Only)During the term of this Agreement,Contractor shall maintain public liability and property damage insurance covering the work of not less than$500,000 combined single limit,bodily injury and property damage and workers'compensation insurance as required under chapter 29 of title 28. Condensation and Environmental Conditions:Condensation,which can form on or within walls,siding,tiles,or other surfaces results from pre-existing conditions in a home and internal or external temperatures.Reducing the humidity in a home will often remedy any condensation problems.I agree that Contractor is not responsible for condensation or existing or developing spore or mold growth,which can be the result of condensation. SIGNATURE OF SALES PERSON SIGNATURE SIGNATURE Charles Berkowitz Adele McGuinness PRINT NAME OF SALES PERSON PRINT NAME PRINT NAME Page 8/ 15 04/11/23 _ Notice of Cancellation DBA:RENEWAL BY ANDERSEN OF SOUTHERN NEW ENGLAND Adele McGuinness Legal Name:Southern New England Windows,LLC 32 Niagara Ln RENEWAL RI#36079,MA#173245,CT#0634555,Lead Firm#1237 West Yarmouth,MA 02673 bYANDERSEN'- 10 Reservoir Rd I Smithfield,RI 02917 H:(774)368-0099 NIksema NE tDON aeut[MEW Phone:401-753-2223 I Fax:(null)I contracts@ASmarterWindow.com You, the buyer(s) may cancel this transaction at any time prior to midnight on 04/14/2023 NOTICE OF CANCELLATION NOTICE OF CANCELLATION Date of Transaction:04/11/23.You may cancel this Date of Transaction:04/11/23.You may cancel this transaction,without any penalty or obligation,before midnight transaction,without any penalty or obligation,before midnight on 04/14/2023 or the third business day after the date of this on 04/14/2023 or the third business day after the date of this transaction,whichever date is later.If you cancel,any property transaction,whichever date is later. If you cancel,any property traded in,any payments made by you under the Contract or traded in,any payments made by you under the Contract or Sale,and any negotiable instrument executed by you will be Sale,and any negotiable instrument executed by you will be returned within 10 business days following receipt by the Seller returned within 10 business days following receipt by the Seller of your cancellation notice,and any security interest arising out of your cancellation notice,and any security interest arising out of the transaction will be canceled. If you cancel,you must of the transaction will be canceled. If you cancel,you must make available to the Seller at your residence,in substantially make available to the Seller at your residence,in substantially as good condition as when received,any goods delivered to as good condition as when received,any goods delivered to you under this Contract or Sale;or you may,if you wish,comply you under this Contract or Sale;or you may,if you wish,comply with the instructions of the Seller regarding the return with the instructions of the Seller regarding the return shipment of the goods at the Sellers expense and risk.If you shipment of the goods at the Sellers expense and risk.If you do make the goods available to the Seller and the Seller does do make the goods available to the Seller and the Seller does not pick them up within 20 days of the date of your Notice of not pick them up within 20 days of the date of your Notice of Cancellation,you may retain or dispose of the goods without Cancellation,you may retain or dispose of the goods without any further obligation.If you fail to make the goods available to any further obligation. If you fail to make the goods available to the Seller,or if you agree to return the goods to the Seller and the Seller,or if you agree to return the goods to the Seller and fail to do so,then you remain liable for performance of all fail to do so,then you remain liable for performance of all obligations under the Contract.To cancel this transaction,mail obligations under the Contract.To cancel this transaction,mail or deliver a signed and dated copy of this cancellation notice or deliver a signed and dated copy of this cancellation notice or any other written notice,or send a telegram,to: or any other written notice,or send a telegram,to: dba: Renewal By Andersen of Southern New England dba: Renewal By Andersen of Southern New England Legal Name: Southern New England Windows,LLC Legal Name: Southern New England Windows,LLC 10 Reservoir Rd 10 Reservoir Rd Smithfield,RI 02917 Smithfield,RI 02917 Phone:401-753-2223 Phone: 401-753-2223 Fax: (null) Fax: (null) Email:contracts@ASmarterWindow.com Email: contracts@ASmarterWindow.com NOT LATER THAN MIDNIGHT OF 04/14/2023 NOT LATER THAN MIDNIGHT OF 04/14/2023 OR THE THIRD BUSINESS DAY AFTER THE DATE OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION,WHICHEVER DATE IS LATER. OF THIS TRANSACTION,WHICHEVER DATE IS LATER. I HEREBY CANCEL THIS TRANSACTION I HEREBY CANCEL THIS TRANSACTION BUYER SIGNATURE DATE BUYER SIGNATURE DATE Page 6/ 15 04/11/23 • v — Itemized Order Receipt . .-% / DBA:RENEWAL BY ANDERSEN OF SOUTHERN NEW ENGLAND Adele McGuinness Legal Name:Southern New England Windows,LLC 32 Niagara Ln RENEWAL RI#36079,MA#173245,CT#0634555,Lead Firm#1237 West Yarmouth,MA 02673 brANDERSEN' 10 Reservoir Rd I Smithfield,RI 02917 H:(774)368-0099 wimmrt INDOWtmRwmuawn Phone:401-753-2223 I Fax:(null)I contracts@ASmarterWindow.com ID#: ROOM: SIZE: DETAILS: PRICE: 201 upper tv rm Window Double-Hung (DG) 1:1 Slope Sill, Base Frame, Traditional Checkrail, Exterior White, Interior White, Glass, All Sash: High Performance, No Pattern, Hardware, White, Screen, Fiberglass, Full Screen, Grille Style, Grilles Between Glass (GBG), Grille Pattern, All Sash: Colonial 2w x 2h, Misc, None 202 upper tv rm Window Double-Hung (DG) 1:1 Slope Sill, Base Frame, Traditional Checkrail, Exterior White, Interior White, Glass, All Sash: High Performance, No Pattern, Hardware, White, Screen, Fiberglass, Full Screen, Grille Style, Grilles Between Glass (GBG), Grille Pattern, All Sash: Colonial 2w x 2h, Misc, None 207 tv rm bed Window Picture Insert Frame, Exterior White, Interior White, Glass, All Sash: High Performance, No Pattern, Grille Style, Grilles Between Glass (GBG), Grille Pattern, All Sash: Colonial 6w x 4h, Misc, None WINDOWS: 5 PATIO DOORS: 0 ENTRY DOORS: 0 SPECIALTY: 0 MISC: 3 TOTAL $11,252 vEF Renewal by Andersen is committed to our customers'safety by d sR a complying with the rules and lead-safe work practices specified by the EPA. Page 4/ 15 04/11/23 7 Agreement Document and Payment Terms L ',1,..._ /- DBA:RENEWAL BY ANDERSEN OF SOUTHERN NEW ENGLAND Adele McGuinness RENEWAL Legal Name:Southern New England Windows,LLC 32 Niagara Ln RENEWAL RI#36079,MA#173245,CT#0634555,Lead Firm#1237 West Yarmouth,MA 02673 byANDERSEN 10 Reservoir Rd I Smithfield,RI 02917 H:(774)368-0099 nuiaxamiamaimixvrar Phone:401-753-2223 I Fax:(null)I contracts@ASmarterWindow.com Adele McGuinness 04/11/23 BUYER(S)NAME CONTRACT DATE 32 Niagara Ln ,West Yarmouth , MA 02673 (774)368-0099 BUYER(S)STREET ADDRESS PRIMARY NUMBER SECONDARY NUMBER adelercallaghan@hotmail.com PRIMARY EMAIL SECONDARY EMAIL NOTES: Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of Southern New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Contractor"),in accordance with the terms and conditions described in this Agreement Document and Payment Terms,any documents listed in the Table of Contents,and any other document attached to this Agreement Document,the terms of which are all agreed to by the parties and incorporated herein by reference(collectively,this "Agreement"). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. TOTAL JOB AMOUNT: $11,252 By signing this Agreement,you acknowledge that the Balance Due,and the Amount Financed must be made by personal check,bank check,credit card,or cash. DEPOSIT RECEIVED: $3,750 BALANCE DUE: $7,502 Estimated Start: Estimated Completion: 16-20 weeks 16-20 weeks AMOUNT FINANCED: $0 We schedule installations based on the date of the signed contract and secondarily on the date METHOD OF PAYMENT: Credit Card in which we complete the technical measurements.The installation date that we are providing at this time is only an estimate.We will communicate an official date and time at a later date. Rain and extreme weather are the most common causes for delay. NOTES: Permit in Yarmouth Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the parties and that there are no verbal understandings changing or modifying any of the terms of this Agreement.No alterations to or deviations from this Agreement will be valid without the signed,written consent of both the Buyer(s)and Contractor.Buyer(s)hereby acknowledges that Buyer(s)1)has read this Agreement,understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement. NOTICE TO BUYER:Do not sign this contract if blank.You are entitled to a copy of the contract at the time you sign. YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 04/14/2023 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION,WHICHEVER DATE IS LATER. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. SIGNATURE OF SALES PERSON SIGNATURE SIGNATURE Charles Berkowitz Adele McGuinness PRINT NAME OF SALES PERSON PRINT NAME PRINT NAME 04/11/23 Page 2/ 15