W1 SERVICE

Work Authorization


AGREEMENT
The agreement is made between (hereinafter referred to as “the Owner)” and W 1 SERVICE LLC, (hereinafter referred to as “the Company”). As detailed above, damage has occurred on to hereinafter referred to as “the Property”). I, The Owner/Agent of The Property listed above, wish to and does hereby retain and authorize The Company to enter upon and inspect The Property, and to thereafter determine all work needed to mitigate further damage to the Property and correct existing damage to the Property, and in that regard, and without limitation, to prepare estimates, furnish materials, supply all equipment, and perform all labor as may be necessary to better, protect, repair, replace and/or restore the Property (all of the forgoing collectively herein, “the Work”). I shall provide access to The Property to The Company for these services to be performed. I hereby authorize The Company to begin work in my home/business and authorize and instruct The Company to submit their invoice directly to my insurance carrier. I also agree and authorize the use of commercial antimicrobial agents/products during the mitigation process to limit the growth of microorganisms. I understand it is beyond the expertise of The Company to determine if someone is sensitive to its application and will hold The Company harmless for its use. The Owner is allowed to rescind the agreement, without penalty or fee, by submitting a written notice of rescission signed by The Owner to the Company within 14 days after the execution of the agreement, at least 30 days after the work on the property is scheduled to commence if the Company has not substantially performed, or at least 30 days after the execution of the agreement if the agreement does not contain a commencement date and the Company has not begun substantial work on the property. The Owner understands any contracted Work performed before the assignment agreement is rescinded will still be responsibility of the Owner.

REQUEST TO EXCEED CAP

The Owner understands that the insurance policy may contain an arbitrary cap on services that requires additional approval. Should such a cap be contained in the Owner’s insurance policy, this document hereby operates as a direct request to the insurance company for approval to exceed such cap upon submission of this document. The Company is providing these services to properly minimize and prevent to the best of our ability further damage(s). Any pause or delay in providing the services, presents potential for additional damages that could be avoided. In the event that the
insurance company's involvement impedes the ability for the contractor to perform the needed services and/or as a result of this hindrance, additional property damage or possible health issues arise related to the initial cause of damage, the liability will fall on the insurance provider, not the contractor providing the service.

ASSIGNMENT OF INSURANCE BENEFITS

The Owner hereby assigns any and all insurance rights, benefits, and proceeds which pertain to services rendered in relation to the subject loss under any applicable insurance policies to The Company. Assignment of rights, benefits, and proceeds is limited to the amount of invoice for The Company services rendered in relation to the subject loss, the right and ability to collect same directly from the Owner’s insurer. This includes the right to file suit and to seek attorney’s fees and court costs pursuant to The Law when applicable. Any and all other insurance rights, benefits, and
proceeds shall continue to belong to the Owner. The Owner makes this assignment and authorization in consideration of an agreement with The Company to perform services and supply materials and equipment to perform their obligations under this contract, including not requiring full payment at time of service.

DIRECTION TO PAY

The Owner hereby directs, authorizes and instructs all insurers to issue payment for all or any part of the Work directly to the Company from any and all monies/benefits/proceeds payable under any applicable insurance policies, up to the limit of the costs of services rendered or to be rendered by the Company. The Owner further directs that the Company be named as a payee on any and all settlement checks and drafts, up to the limit of the costs of services rendered or to be rendered by the Company, and that such checks/drafts be sent directly to the Company. The Owner hereby waives any contractual, constitutional, statutory, and/or common law limitations on said insurer(s) acting as directed herein. The Owner makes this direction in consideration of the Company’s agreement to perform the Work, and not require full payment at the time of service. The Owner also hereby directs all insurance carrier(s) to release any and all information requested by the Company, its representative, and/or its Attorney for the purpose of obtaining benefits to be paid by the Owner’s insurance carrier(s) for services rendered or to be rendered. If a spouse or any additional named insured (other than a mortgagee) is not signing this Agreement, Owner represents that Owner has the permission and legal authority to act on behalf of such non-signer and to enter into this agreement on their behalf.

DIRECT PAYMENT AUTHORIZATION

The Owner hereby authorizes and gives the Company an Irrevocable Power-of-Attorney and express permission to endorse the Owner’s name on any and all checks received from my/our insurance Company on Owner’s behalf for services provided by the Company. The Owner agrees that any portion of work, deductibles, betterment, depreciation or additional work requested by the undersigned, not covered by insurance, must be paid by the undersigned on or before its completion. The Owner also hereby authorizes and unequivocally instructs the Owner’s insurance carrier to direct payment/s of or proceeds up to the limit for services rendered or to be rendered by the Company to the Company.

EXCLUSIVE RIGHT

The Owner hereby grants the Company the exclusive right, but not the obligation, to perform the Work. To the extent this exclusive right is breached by the Owner (a breach being defined as the Owner receiving payment from an insurance carrier for all or any part of the Work and the Owner refusing to allow the Company to perform all or such part of the Work for the amount of the insurance payment), the Owner shall be liable to Company for the costs of any services actually performed. Notwithstanding the foregoing, the Company may decline to perform the Work and
relinquish its exclusive right hereunder should the Company determine, in its sole discretion, that the insurance proceeds are insufficient to fund the Work, in which case the Owner shall be liable to Company for any services already performed.

LETTER OF PROTECTION

The Owner authorizes and directs all insurer(s) to furnish the Company with any and all information related to the Property, the Policy, the Claim, and/or the Work. The Owner further authorizes and directs all insurer(s) to pay directly to the Company such sums as may be due and owing for services rendered or to be rendered and to withhold such sums from any payment, settlement, judgment or verdict as may be necessary to adequately protect the Company’s receipt of sums due hereunder. The Owner gives the Company a lien on the Claim for and against any and all proceeds of any payment, settlement, and/or judgment for which services have been, or are to be, rendered. The Owner fully understands that the Owner is directly and fully responsible to the Company for all services rendered and that this agreement is made for the Company’s additional protection and in consideration of, among other things, the Company performing the Work, but awaiting payment for services rendered.

DEDUCTIBLE

A contractor, or a person acting on behalf of a contractor, may not knowingly or wilfully and with intent to injure, defraud, or deceive, pay, waive, or rebate all or part of an insurance deductible applicable to payment to the contractor. The Owner is legally responsible for any deductibles owed. The Owner agrees that any deductibles due under the policy, betterment agreed and approved to, or additional work, requested by Owner/Agent that is not covered by insurance, must be paid for by the The Owner within net thirty (30) days of completion and that the Owner’s deductible cannot be waived pursuant to The Law. The Owner understands as the named insured that the Owner is responsible for the payment of all of the following: (1) any deductible amount due under the policy; (2) any betterment ordered and performed that is approved by the named insured; (3) any contracted work performed before the assignment agreement is rescinded; (4) any contracted work performed by The Company, not covered by insurance. The Owner agrees to comply with all terms and conditions contained in the Owner‘s policy and understands that failure to do so may void coverage for loss and prevent payment by the Owner’s insurance carrier.

PAYMENT TERMS

Payment terms are on a net 30. Late charges of 1.5% will be charged after this time to any and all unpaid Balances. The Company shall be entitled to reimbursement for costs of collection (including attorney’s fees) due by the insured/owner/agent/carrier and for cost of reasonable attorney’s fees and costs for the breach or enforcement of any terms for this entire service agreement. Should loss not be covered by the Owner’s insurance policy and payment is denied by carrier, the Owner agrees to pay the Company for their completed work, use of equipment and/or services provided to protect the Property from further damages.

ADDITIONAL TERMS

All rentals are billed for on a daily basis, and not a 24- hour period, regardless of the hour of day they are setup. It is the responsibility of the Owner to ensure the safety of The Company’s equipment while in mitigation process. Breaking, stealing or destroying equipment will be billed to the Owner. It is the responsibility of the Owner to ensure that all valuables are properly secured during the mitigation process. The Owner agrees that The Company will not be held liable or responsible for any damaged, broken, or lost items. The Owner understands that The Company rates are structured from the Blue Book of Cleaning, Reconstruction, and Repair costs by area and zone, and are not set by The Company.

 

PER Apply Anti-Microbial $0.39/sf Equipment Setup $122/hr HVAC Decontamination $595 Service Call $285
UNIT Advanced Leak Detection $450 Equipment Removal $122/hr Haul Debris Fees $150/truck Shrink Wrap Installation $4.50 /sf
COST Air Mover- $44/day Equipment Monitoring $94.50/hr HEPA Air Scrubber $140.21/day Spider Box $43.89/day
SAMPLE Baseboard Removal $87.89/hr Equipment Sanitizing $46.03/each HEPA Vacuuming $.045/sf Safety Equipment $5 /per unit
PRICES Clean Floor $.039/sf Emergency Services $3,000.00 Initial Moisture Inspection $250 Thermal Imaging $450
  Drywall Removal $87.89/hr Equipment Filter $183.67 Matterport/$500/area Roof Tarp Installation $2.50/sf
  Deodorize Room $0.05/sf Electrical Box $43.89/day Mold Inspection $500/area Wall Cavity Drying $86.78/day
  Dehumidifier Up to $145/day General Cleanup- $195/day Mold Report $250 Water Extraction $0.59/sf

 

The amounts reflect above are an itemized, per-unit cost estimate of the services to be performed by The Company pursuant to industry standards. This is by no means a final estimate for the services rendered herein, and a final estimate will be submitted in accordance to The Law. Although the information in this price list is presented in good faith and believed to be correct at the time of pricing, The Company makes no representations or warranties as to the completeness and accuracy of the information. The Company uses a third- party software to rely on pricing and all pricing are subject to change without notice due to unforeseen cost increases of products, materials or currency fluctuations. Pricing also varies between servicer, location, supply and demand. The Company reserves the right to change prices without notice and reserves the right to supplement additional units unforeseen at the time that the parties agreed to contract.

ACKNOWLEDGEMENT
The Owner acknowledges that The Company will attempt to recover any payment for services rendered from the applicable insurance carrier(s). The Owner hereby appoints The Company as attorney in fact, authorizing The Company to endorse The Owner name and to deposit checks or drafts.

THE OWNER DUTY TO COOPERATE
The Owner will provide The Company with access to the Property so that services may be completed. The Owner also agrees to comply with all terms and conditions contained in Owner’s policy(ies) of insurance; and understands that the failure to do so may void coverage for the loss and prevent payment by Owner’s insurance carrier(s). Owner agrees to cooperate with all requests by The Company necessary to recover payment for services from Owner’s insurance carrier(s) or mortgage company.

THE COMPANY DUTY TO COOPERATE
The Company will guarantee that a copy of the executed agreement will be delivered to the Owner’s insurer within 3 business day after the date on which the assignment agreement is executed or the date on which the Work begins, whichever is earlier and will be delivered to the insurer, by personal service, overnight delivery or electronic submission. The Owner will maintain evidence of delivery in the form of a receipt or other paper or electronic acknowledgment by the insurer, or to the location designated for receipt of such agreements as specified in the policy, if any. The Company also hereby guarantees that all services performed will be done in accordance with the applicable industry standards and in accordance to The Law.

AUTHORIZED ANTIMICROBIAL AGENTS
The Owner understands that, in the best judgment of The Company, materials may be treated with a commercial antimicrobial agent to inhibit the growth of micro-organisms during the drying and cleaning process. The Owner has received advanced notice of the use of antimicrobial agents as part of the mitigation process. The Owner understands that it is beyond the expertise of The Company to determine if someone is sensitive to its application and will hold The Company harmless for its use.

STOP WORK-HOLD HARMLESS
The Owner acknowledges and agrees that in the event that The Company is not allowed or unable to perform its recommended procedures including but not limited to the premature removal of drying and/or other equipment for reasons imposed by the Owner or the carrier, The Owner agrees release the Company from any liability for any damage or potential future damage that could develop due to such actions and to hold The Company harmless and indemnify The Company against all claims or actions that may result from such actions and procedures.

CONSENT TO COMMUNICATE
The Owner hereby directs Owner’s insurance carrier(s) and mortgage company to communicate directly with The Company and release any and all information requested by its representatives, and/or its attorney for the direct purpose of obtaining actual benefits to be paid by the Owner’s insurance carrier for services rendered or to be rendered. In this regard, The Owner waives privacy rights. If payment is made directly to the Owner/Agent by any insurer, for services rendered by The Company, it shall be endorsed over to The Company within ten (10) business days. Should no claim yet exist, The Owner agrees and authorizes that this document shall operate as a first notice of a claim to The Owner’s insurance carrier on Owner’s behalf.

MORTGAGEE CONSENT
The Owner’s Mortgagee explicitly consents to the services rendered herein pursuant to the language of the recorded mortgage of The Property pursuant to the Mortgagor’s covenants provided in the recorded mortgage to The Property. Mortgagee and Mortgagor’s agreed in writing that any insurance proceeds, shall be applied to restoration or repair of the property, if the restoration or repair is economically feasible and Mortgagee’s security is not lessened. Therefore, The Owner agrees that the mortgage agreement is a written extension of consent of this assignment agreement, both explicitly and implicitly, pursuant, to The Law and the mortgage agreement between Mortgagee and Mortgagor, Mortgagee need not be named as a payee by the Insurance Company.

SUPPLEMENTAL CLAIM(S)
The Company reserves the right to request the Owner to file a supplemental claim with Owner's Insurance Carrier in the event such Carrier's estimate is incorrect, missing line items and / or code upgrades, including any such additional damage and/ or needed repairs discovered after work begins. The supplemental claim amount to include overhead and profit and additional depreciated amounts withheld by the Insurance Carrier is due and payable to The Company upon receipt by Owner.

AMENDMENT AND MODIFICATION
This Agreement may be modified, amended, or supplemented only by a written change order signed by the Owner and the Company.

SEVERANCE CLAUSE
The invalidity or unenforceability of any provision of this Agreement will not affect the validity or enforceability of any of the other provisions of this Agreement, which shall remain in full force and effect.

 

YOU ARE AGREEING TO GIVE UP CERTAIN RIGHTS YOU HAVE UNDER YOUR INSURANCE POLICY TOA THIRD PARTY, WHICH MAY RESULT IN LITIGATION AGAINST YOUR INSURER. PLEASE READ AND UNDERSTAND THIS DOCUMENT BEFORE SIGNING IT. YOU HAVE THE RIGHT TO CANCEL THIS AGREEMENT WITHOUT PENALTY WITHIN 14 DAYS AFTER THE DATE THIS AGREEMENT IS EXECUTED, AT LEAST 30 DAYS AFTER THE DATE WORK ON THE PROPERTY IS SCHEDULED TO COMMENCE IF THE ASSIGNEE HAS NOT SUBSTANTIALLY PERFORMED, OR AT LEAST THIRTY (30) DAYS AFTER THE EXECUTION OF THE AGREEMENT IF THE AGREEMENT DOES NOT CONTAIN A COMMENCEMENT DAY AND THE ASSIGNEE HAS NOT BEGUN SUBSTANTIAL WORK ON THE PROPERTY. HOWEVER, YOU ARE OBLIGATED FOR PAYMENT OF ANY CONTRACTED WORK PERFORMED BEFORE THE AGREEMENT IS RESCINDED. THIS AGREEMENT DOES NOT CHANGE YOUR OBLIGATION TO PERFORM THE DUTIES REQUIRED UNDER YOUR PROPERTY INSURANCE POLICY

 

HOMEOWNER'S INFO

Name:  

Phone #:  

Email:  

SERVICE ADDRESS

Street Address:  

Suite #:  

City:  

State:  

ZIP Code:  

Country:  

DAMAGE INFO

Date of Loss:

Cause of Loss:  

Commencement Date:   

Billing Info:

Ins. Carrier:  

Policy #:

Claim #:

I/we have read and understand the information above and have received a copy for my records. This contract contains all the terms between the parties and is intended to be legally binding under Louisiana Law.

 

Insured/Owner/Agent’s:

 

Name:  

Date: June 18, 2024

Company:

 

Name: Dayanis Miranda, Manager

Date: June 18, 2024

Leave this empty:

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Signed by w1service Team
Signed On: August 8, 2023


Signature Certificate
Document name: Work Authorization
lock iconUnique Document ID: 1c18900148cb38a8d9a8cb4addc8d196ab47a9e9
Timestamp Audit
August 2, 2023 12:29 pm EDTWork Authorization Uploaded by w1service Team - Lester@w1service.com IP 142.162.188.202
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