Authorization To Perform Services

Property Owner/Property Manager Name*
Address Where Loss Occurred

1131 Benfield Blvd
Millersville, Suite R
MD 21108

___________ ___________, herein referred to as “Customer,” authorizes BYLT, Inc., herein referred to as “BYLT” to perform any and all necessary restoration services on Customer’s property at: ______________, ______________, ______________ Customer authorizes _______________ Insurance Company, herein referred to as “Insurance Company”, to pay BYLT solely and directly.

If for any reason the check should come to or be made payable to Customer, Customer agrees to pay BYLT immediately upon receipt of the check from the Insurance Company. In order to expedite payment to BYLT, Customer hereby appoints BYLT as attorney-in-fact, authorizing BYLT to endorse Customer’s name, and to deposit Insurance Company checks or drafts for BYLT services. Customer agrees to pay Customer’s deductible in the amount of $______, that applies to this claim and also if the loss is not covered by insurance, Customer agrees to pay the total amount to BYLT immediately upon receipt of the invoice amount.

It is fully understood that Customer and it agents, successors, assigns and heirs are personally responsible for any and all deductibles, depreciation, or any costs not covered by insurance. Any and all costs for services not reimbursed by the Insurance Company are the responsibility of the Customer and are to be paid upon completion of work. However, additional work will not be performed unless approved by the customer.

The liability of BYLT is expressly limited to the total amount of the services authorized herein.

BYLT agrees to acquire all necessary demolition and construction permits as needed and to have all necessary inspections completed before any walls are closed in. Property is to be restored to its former state, allowing for modern construction techniques and current building codes.

If BYLT submits this account for collection, Customer agrees to pay interest at 1.5% per month or at the highest rate allowed by law, court costs, reasonable attorney fees and all costs of collection.

Customer agrees that BYLT is working for the Customer and not the Insurance

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