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RESIDENTIAL EXTERIOR IMPROVEMENT GRANT AGREEMENT - NG-R-25-21RESIDENTIAL EXTERIOR IMPROVEMENT GRANT AGREEMENT NG -R-25-21 This Residential Exterior Improvement Grant Agreement (this "Agreement") is made as of 1 (the "Effective Date"), by and between THE COMMUNITY REDEVELOPMENT AGENCY OF THE CITY OF CLEARWATER, FLORIDA, a public body corporate and politic of the State of Florida created pursuant to Part III, Chapter 163, Florida Statutes (the "Agency"), and Cheryl Davis Trueblood, an individual (the "Applicant ")(collectively the Agency and the Applicant are the "Parties"). WITNESSETH: WHEREAS, the Agency was created to implement community redevelopment activities as provided in the Florida Community Redevelopment Act of 1969 (the "Act") codified at Chapter 163, Part III, Florida Statutes; and WHEREAS, on January 12, 2023, the Agency adopted the North Greenwood Community Redevelopment Area Plan (the "Plan"); and WHEREAS, in furtherance of the Plan, the Agency has established the Residential Exterior Improvement Grant Program (the "Program") to rehabilitate single-family homes, improve property conditions, aesthetics, reduce housing cost burden, and aid in the elimination of slum and blight in the North Greenwood Community Redevelopment Area (the "Redevelopment Area"); and WHEREAS, the Agency has approved a grant to the Applicant in an amount not to exceed $20,000.00 in financial assistance under the Program to provide exterior improvement assistance to the property located at 911 North. Garden Ave., Clearwater, FL 33755 (the "Property"). The grant is intended to replace and repair foundation at the Property (the "Project") as further detailed in the Applicant's grant application and plan specifications attached hereto as Exhibit "C" (the "Specifications"); and WHEREAS, the Agency finds that providing fmancial assistance for the exterior improvement of the Property is a permissible use of the Agency's funds; and WHEREAS, the Agency finds that the Project comports with and furthers the goals, objectives, and policies of the Plan. NOW, THEREFORE, in consideration of the mutual promises and covenants contained herein, the Parties hereby agree as follows: I. GENERAL 1. Recitals. The foregoing recitals are true and correct and are incorporated in and form a part of this Agreement. 2. Purpose of Agreement. The purpose of this Agreement is to further the implementation of the Plan by the completion of the Project. 1 3. Legal Description. The legal description for the Property is attached hereto as Exhibit "A". II. APPLICANT WARRANTIES AND RESPONSIBILITIES 1. Development of the Project. The Applicant shall complete the Project in accordance with the Specifications and the grant application. The Applicant shall complete all Project work within one hundred and eighty (180) days from the date of application approval. Such completion shall be evidenced by receipt of a Finding of Project Completion from the Agency. A Finding of Project Completion shall be granted in accordance with the criteria contained in the Agency's Residential Exterior Improvement Grant Policy attached hereto as Exhibit "B" (the "Policy"). The date of application approval shall be the Effective Date. 2. Applicant's Project Contribution. As a condition of receiving reimbursement grant funding from the Agency, the Applicant shall provide two thousand dollars and 00/100 cents ($2,000.00) in monetary contribution (the "Monetary Contribution") toward the Project. Evidence of expenditure of the Monetary Contribution towards the Project shall be submitted to the Agency's satisfaction before disbursement of the Agency's grant funding. Notwithstanding the foregoing, the Applicant may have the Monetary Contribution reduced if the Applicant completes certain community service acts in accordance with the Policy. The Applicant has agreed to complete fourteen (14) hours of community service ("Hours") reducing the Monetary Contribution to zero ($0.00) (the "Reduced Contribution"). In the event the Applicant is unable to provide the number of Hours agreed to herein, the Reduced Contribution shall be calculated only by the number of Hours actually provided. The difference between the Monetary Contribution and the Reduced Contribution shall be added to the balance of the Applicant's available grant funds. For avoidance of doubt, the amount that can be added to the Applicant's available grant funds is the amount of money that is subtracted out of the Monetary Contribution for the completion of Hours to calculate the Reduced Contribution. Proof of completion of Hours shall be provided to the Agency before release of grant funds. 3. Warranties of the Applicant. The Applicant warrants that the following information is true and correct: a. The Applicant is the owner of the Property; b. A single-family home is located on the Property; c. The Property is located in the Redevelopment Area; d. The Property is the, primary residence and legal homestead of the Applicant or meets an alternative qualification under the Policy; e. The Applicant is current on their property taxes for the Property or a payment plan has been approved by the Director; f. The Applicant is current on all mortgage payments, if applicable; 2 g. The Property has no outstanding code enforcement or building code violations or the Applicant has made the Agency aware of such violations and the Agency has agreed to allow the Project to move forward as the renovations will remediate any violations; and h. The Property has not received a grant from the Agency in the preceding thirty-six (36) months prior to the Effective Date. III. AGENCY RESPONSIBILITIES 1. Grant Funding. The Agency shall reimburse the Applicant for the Project's eligible costs up to a base amount of eighteen thousand dollars and 00/100 cents ($18,000.00). Depending upon the number of Hours completed or a waiver of the community service option pursuant to the Policy, the Applicant may receive up to an additional two thousand dollars and 00/100 cents ($2,000.00) in grant funds for a total grant not to exceed twenty thousand dollars and 00/100 cents ($20,000.00) (the "Grant Funds"). The Grant Funds shall be payable within thirty (30) days of receipt of a fully completed reimbursement request after the issuance of a Finding of Project Completion by the Agency assuming the Applicant has also complied with Section II of this Agreement where applicable. 2. Upon agreement between the Agency and the Applicant, the Agency may provide the Grant Funds directly to any approved licensed contractor or vendor in lieu of providing the Grant Funds to the Applicant. Notwithstanding Paragraph 1 of this section, The Agency's director (the "Director") may allow earlier draw requests of the Grant Funds to approved licensed contractors or vendors in accordance with the Policy. However, the Grant Funds disbursed to a contractor or vendor shall not be disbursed more frequently than once every thirty (30) days. The Parties understand and agree that nothing in this Agreement creates any contractual relationship between the Agency and any contractor or vendor and the Agency shall not be liable for any monies owed to any contractor or vendor. The ability of the Agency to pay the contractor or vendor directly is only for the sake of convenience to the Applicant and the Applicant remains exclusively liable for any funds owed to the contractor or vendor. 3. If the Director determines that a reimbursement request does not meet the requirements of this Agreement or the Policy, then the Parties agree that the Agency shall not owe any monies to the Applicant for the requested reimbursement, the Applicant shall have no recourse against the Agency, and the Director's decision shall be final without any means of appeal. IV. APPLICANT DEFAULT 1. Failure to Timely Complete the Project. If the Applicant fails to obtain a Finding of Project Completion within one hundred eighty (180) days of the date of application approval, then the Parties agree that the Applicant shall be in default under this Agreement without notice or opportunity to cure the default. An extension to this timeframe may be granted by the Director for good cause if the Applicant submits a written request for such an extension before the expiration of the one hundred eighty (180) day period. 3 2. Other Events of Default. In addition to the foregoing event of default, the occurrence of any one or more of the following events after the Effective Date shall also constitute an event of default by the Applicant: a. The Applicant makes a general assignment for the benefit of its creditors, or admits in writing its inability to pay its debts as they become due or files a petition in bankruptcy, or is adjudicated a bankrupt or insolvent, or files a petition seeking any reorganization, arrangement, composition, readjustment, liquidation, dissolution or similar relief under any present or future statute, law or regulation or files an answer admitting, or fails reasonably to contest, the material allegations of a petition filed against it in any such proceeding, or seeks or consents to or acquiesce in the appointment of any trustee, receiver or liquidator of the Applicant or any material part of such entity's properties; b. Within sixty (60) days after the commencement of any proceeding by or against the Applicant seeking any reorganization, arrangement, composition, readjustment, liquidation, dissolution or similar relief under any present or future statute, law or regulation, such proceeding shall not have been dismissed or otherwise terminated, or if, within sixty (60) days after the appointment without the consent or acquiescence of the Applicant or any trustee, receiver or liquidator of any such entities or of any material part of any such entity's properties, such appointment shall not have been vacated; or c. A breach by the Applicant of any other term, condition, requirement, or warranty of this Agreement or the Policy. 3. Agency's Remedy Upon Certain Applicant Default. In the event of default and if the Applicant has failed to cure the default within the allotted time prescribed under Section IV, Paragraph 4 (if applicable), then the Parties agree that: a) this Agreement shall be null and void; b) that the Agency will have no further responsibility to the Applicant, including the responsibility to tender any remaining amounts of the Grant Funds to the Applicant; and c) that if the Agency has tendered any of the Grant Funds to the Applicant, the Agency shall be entitled to the return of all the Grant Funds plus default interest at a rate of ten percent (10%) starting from the date of default. The remedial provisions shall survive the termination of this Agreement. 4. Notice of Default and Opportunity to Cure. The Agency shall provide written notice of a default under Section IV, Paragraph 2 of this Agreement and provide the Applicant thirty (30) days from the date the notice is sent to cure such a default. This notice will be deemed received when sent by first class mail to the Applicant's notice address or when delivered to the Applicant if sent by a different means. V. MISCELLANEOUS 1. Notices. All notices, demands, requests for approvals, or other communications given by either party to another shall be in writing, and shall be sent to the office for each party indicated below and addressed as follows: 4 To the Applicant: Cheryl Davis Trueblood 911 North Garden Ave. Clearwater, FL 33755 To the Agency: Community Redevelopment Agency of the City of Clearwater P.O. Box 4748 Clearwater, Florida 33758 Attention: Executive Director with copies to: City of Clearwater P.O. Box 4748 Clearwater, Florida 33758 Attention: Clearwater City Attorney's Office 2. Unavoidable Delay. Any delay in performance of or inability to perform any obligation under this Agreement (other than an obligation to pay money) due to any event or condition described in this section as an event of "Unavoidable Delay" shall be excused in the manner provided in this section. 3. "Unavoidable Delay" means any of the following events or conditions or any combination thereof: acts of God, acts of the public enemy, riot, insurrection, war, pestilence, archaeological excavations required by law, unavailability of materials after timely ordering of same, building moratoria, epidemics, quarantine restrictions, freight embargoes, fire, lightning, hurricanes, earthquakes, tornadoes, floods, extremely abnormal and excessively inclement weather (as indicated by the records of the local weather bureau for a five year period preceding the Effective Date), strikes or labor disturbances, delays due to proceedings under Chapters 73 and 74, Florida Statutes, restoration in connection with any of the foregoing or any other cause beyond the reasonable control of the party performing the obligation in question, including, without limitation, such causes as may arise from the act of the other party to this Agreement, or acts of any governmental authority (except that acts of the Agency shall not constitute an Unavoidable Delay with respect to performance by the Agency). An application by any party hereto for an extension of time pursuant to this section must be in writing, must set forth in detail the reasons and causes of delay, and must be filed with the other party to this Agreement within thirty (30) days following the occurrence of the event or condition causing the Unavoidable Delay or thirty (30) days following the party becoming aware (or with the exercise of reasonable diligence should have become aware) of such occurrence. The party shall be entitled to an extension of time for an Unavoidable Delay only for the number of days of delay due solely to the occurrence of the event or condition causing such Unavoidable Delay and only to the extent that any such occurrence actually delays that party from proceeding with its rights, duties and obligations under this Agreement affected by such occurrence. In the event the party is the Applicant then the Director is authorized to grant an extension of time for an Unavoidable Delay for a period of up to six (6) months. 5 Any further requests for extensions of time from the Applicant under this section must be agreed to and approved by the Agency's Board of Trustees. 4. Indemnification. The Applicant agrees to assume all inherent risks of this Agreement and all liability therefore, and shall defend, indemnify, and hold harmless the Agency and the City of Clearwater, Florida, a Florida municipal corporation ("the City"), and the Agency's and the City's officers, agents, and employees from and against any and all claims of loss, liability and damages of whatever nature, to persons and property, including, without limiting the generality of the foregoing, death of any person and loss of the use of any property, except claims arising from the negligence of the Agency, the City, or the Agency's or the City's agents or employees. This includes, but is not limited to, matters arising out of or claimed to have been caused by or in any manner related to the Applicant's activities or those of any approved or unapproved invitee, contractor, subcontractor, or other person approved, authorized, or permitted by the Applicant whether or not based on negligence. Nothing herein shall be construed as consent by the Agency or the City to be sued by third parties, or as a waiver or modification of the provisions or limits of Section 768.28, Florida Statutes, or the Doctrine of Sovereign Immunity. 5. Assignability; Complete Agreement. This Agreement is non -assignable by either party and constitutes the entire Agreement between the Applicant and the Agency and all prior or contemporaneous oral and written agreements or representations of any nature with reference to the subject of this Agreement are canceled and superseded by the provisions of this Agreement. 6. Applicable Law and Construction. The laws of the State of Florida shall govern. the validity, performance, and enforcement of this Agreement. This Agreement has been negotiated by the Agency and the Applicant, and the Agreement, including, without limitation, the exhibits, shall not be deemed to have been prepared by the Agency or the Applicant, but by all equally. 7. Severability. Should any section or part of this Agreement be rendered void, invalid, or unenforceable by any court of law, for any reason, such a determination shall not render void, invalid, or unenforceable any other section or part of this Agreement. 8. Amendments. This Agreement cannot be changed or revised except by written amendment signed by the Parties. 9. Jurisdiction and Venue. For purposes of any suit, action or other proceeding arising out of or relating to this Agreement, the Parties do acknowledge, consent, and agree that venue thereof is Pinellas County, Florida. Each party to this Agreement hereby submits to the jurisdiction of the State of Florida, Pinellas County and the courts thereof and to the jurisdiction of the United States District Court for the Middle District of Florida, for the purposes of any suit, action or other proceeding arising out of or relating to this Agreement and hereby agrees not to assert by 6 way of a motion as a defense or otherwise that such action is brought in an inconvenient forum or that the venue of such action is improper or that the subject matter thereof may not be enforced in or by such courts. If, at any time during the term of this Agreement, the Applicant is not a resident of the State of Florida or has no office, employee, agency, registered agent or general partner thereof available for service of process as a resident of the State of Florida, or if any permitted assignee thereof shall be a foreign corporation, partnership or other entity or shall have no officer, employee, agent, or general partner available for service of process in the State of Florida, the Applicant hereby designates the Secretary of State, State of Florida, its agent for the service of process in any court action between it and the Agency arising out of or relating to this Agreement and such service shall be made as provided by the laws of the State of Florida for service upon a nonresident; provided, however, that at the time of service on the Florida Secretary of State, a copy of such service shall be delivered to the Applicant at the address for notices as provided in Section V, Paragraph 1. 10. Termination. If not earlier terminated as provided in this Agreement, this Agreement shall expire and shall no longer be of any force and effect one hundred eighty (180) days from the anniversary of the date of application approval. IN WITNESS WHEREOF, the Parties have caused this Agreement to be executed on the date and year first above written. 7 (CRA SIGNATURE PAGE) Approved as to form: COMMUNITY REDEVELOPMENT AGENCY OF THE CITY OF CLEARWATER, FLORIDA, a public body corporate and politic of the State of Florida. By: Matthew J. Mytych, Esq. CRA Attorney f a � Date: l �D� 8 CRA Executive DDj�rector Date: // ll (/ Z‘ Attest: STATE OF FLORIDA ) COUNTY OF PINELLAS ) The foregoing in ent wa notarization, this day of personally known to me or (NOTARIAL SEAL) .04:'-. VicIde L. Shire 14741:6• 1 Comm.: HH 630592 7 Expires: Jan. 26, 2029 Notary Public - State of Florida (APPLICANT SIGNATURE PAGE) APPLICANT: By: Print name: Title: Date: acknowledged before me by means physical prese cee or ❑ online , 2026 by ! .L T1', ho ❑ is/are o has/hav;roduced a driver's license . dentification. 9 Notary Public, State o Name of Notary: My Commission Expires: My Commission No.: Fl rida L EXHIBIT "A" LEGAL DESCRIPTION Beginning at the SW corner of Lot 1, Block 2, of Ira Nicholson's Addition to Clearwater, Florida as recorded in Plat Book 2, Page 44, of the Public Records of Hillsborough County, Florida, of which Pinellas County was formerly a part; run thence East along the South Line of said Lot 1, 82.5 feet; thence Northerly 33.95 feet to a point 75.0 feet East of the West Line of said Lot 1; thence Westerly parallel to the South Line of said Lot 1, 75.0 feet to North Garden Avenue; thence Southwesterly along the said -East Line of North Garden Avenue to the point of beginning. And as amended on 10/20/1970 in Official Records Book 3414, Page 283 of the Public Records of Pinellas County, Florida and any subsequent amendments thereto. 10 EXHIBIT "B" RESIDENTIAL EXTERIOR IMPROVEMENT GRANT PROGRAM POLICY 11 RESIDENTIAL EXTERIOR IMPROVEMENT GRANT PROGRAM APPLICATION FORM City of Clearwater Community Redevelopment Agency North Greenwood Community Redevelopment Area TABLE OF CONTENTS SECTION 1 — PROGRAM GOAL 1 SECTION 2 — PURPOSE AND INTENT 1 2 4 5 6 7 7 8 11 SECTION 3 — AVAILABLE ASSISTANCE AND PROGRAM ELIGIBILITY SECTION 4 — ELIGIBLE RESIDENTIAL IMPROVEMENTS SECTION 5 — PROGRAM REQUIREMENTS AND APPLICATION PROCESS SECTION 6 — DISBURSEMENT POLICY AND PROCEDURE SECTION 7 — GRANT EXPIRATION SECTION 8 — COMPLIANCE WITH THE CITY OF CLEARWATER ETHICS CODE SECTION 9 — APPLICATION SECTION 10 — ELIGIBLE CRA AREA MAP Residential Exterior Improvement Grant Program Approved by the CRA Trustees July 15, 2024 Case Number: RESIDENTIAL EXTERIOR IMPROVEMENT GRANT PROGRAM The Program provides a matching grant of up to $20,000. SECTION 1 — PROGRAM GOAL The City of Clearwater (City) Community Redevelopment Agency (CRA) Residential Exterior Improvement Grant Program (Program) is designed to increase access to redevelopment funding for residential improvements to homesteaded single-family homes in the North Greenwood Community Redevelopment Area (NGCRA). The purpose of the Program is to rehabilitate single family homes, improve property conditions, aesthetics, reduce housing cost burden, and aid in the elimination of slum and blight. The focus of this Program is directed to the exterior improvement of residential properties to enhance neighborhood aesthetics and pride. SECTION 2 — PURPOSE AND INTENT The purpose of the Program is to support the implementation of th'e adopted Community Redevelopment Area Plan (Plan) for the North Greenwood Community Redevelopment Area in accordance with the Florida Community Redevelopment Act of 1969. Sections 163.330, et seq., Florida Statutes, by: 1) Carrying out plans for a program of voluntary or compulsory repair and rehabilitation of buildings or other improvements in accordance with the community redevelopment plan (Sections 163.370(2)(c)(5), Florida Statutes). 2) Reducing the percent of households that are housing cost burdened (Plan Section 3.2, Goals and Objectives, Goal 4 Housing Affordability, Objectives, page 94). 3) Prioritizing keeping existing residents in their homes through funding for addressing property maintenance and building code issues and reducing visual blight (Plan Section 3.3, Redevelopment Policies, Housing, page 95). 4) Developing grant programs to improve the exterior and interior of blighted properties (Plan Section 4.5, Plan Implementation, Table 15, Goal 1 Policy Implementation: Public Safety, page 134). 5) Developing programs to encourage neighborhood pride in yard and home appearance (Plan Section 4.5, Plan Implementation, Table 15, Goal 1 Policy Implementation: Public Safety, page 136). 6) Providing emergency assistance funds for low-income residents for life safety home repairs and renovations to accommodate physicaldisabilities (Plan Section 4.5, Plan Implementation, Table 15, Goal 4 Policy Implementation: Housing Affordability, page 140). 7) Creating a grant program to reduce blight through the repair and preservation of historic homes (Plan Section 4.5, Plan Implementation, Table 15, Goal 4 Policy Implementation: Housing Affordability, page 142). 8) Creating valuefor the citizens, of Clearwater and improving the North Greenwood CRA by (themes stressed throughout the Plan): a) Promoting a resident and neighborhood friendly atmosphere; 1 b) Promoting economic development and neighborhood revitalization; c) Incentivizing property owners to enhance and sustain the values of their property; d) Creating a more inviting and visually appealing atmosphere; and e) Instilling a greater sense of place and civic identity. It is not the intent of the CRA to engage in any rehabilitation activity that requires vacating property or displacing any residents from property. Moreover, this Program does not assist in temporary relocation cost or the development of new construction projects. Rather, it is to rehabilitate existing single-family structures. SECTION 3 — AVAILABLE ASSISTANCE AND PROGRAM ELIGIBILITY The Program provides a matching grant, as specified below, of up to $20,000 to assist applicants with exterior home repairs. Program assistance is based on a sliding scale and adjusted for family size and income limits, which are subject to change from time to time. Applicants with Household incomes that exceed 120% Area Median Income do not qualify for this Program. Applicant will match the grant amount by the percentages listed below (must provide proof of matching funds prior to project work commencing): Area Median Income (AMI) % ,Applicant Contribution/Match 0-30% 5%* 31% — 50% 10%* . 51% — 80% 15%** 81% -120% 20%** 121% — plus Not eligible for grant. *Match may be waived at the rate of one hour of community -service per $150 of approved grant amount and will be added back into the total grant amount not to exceed $20,000. **Up to 50% of Applicant's match may be waived at the rate of one hour of community service per $150 of approved grant amount and will be added back into the total grant amount not to exceed $20,000. (Community Service must be performed by Applicant, or anyone over 18 years of age legally residing in the home, within the NGCRA boundary and through a tax- exempt not-for-profit organization recognized by the CRA or City of Clearwater. Community service must be performed without pay or compensation from the not-for- profit organization, and service must be performed in full hour increments rounding up to the nearest whole hour. Scope of community service must be pre -approved, by the CRA Director, prior to commencement. In addition, said community service must be performed prior to release of grant funds.) The CRA Director may waive, or reduce, on a case-by-case basis, the community service provision for certain individuals with disabilities, including age related disabilities, or other verifiable hardships, that prevent the Applicant, and anyone over 18 years of age legally residing in the home, from performing community service. In the event the waiver is granted, then the Applicant Contribution/Match will be set to zero percent. The grant is a reimbursement grant, unless otherwise approved by the CRA Director to pay an approved licensed contractor directly, no more than one payment within a 30 -day period. The CRA Director may require in all grant applications that licensed contractors 2 be paid directly, eliminating the need for homeowners to pay contractors, and then requesting reimbursement from the CRA. The chart below is data provided by the Florida Housing Finance Corporation (FHFC) which is based upon figures provided by the United States Department of Housing and Urban Development (HUD) and are subject to change. Updated charts by FHFC will supersede any income limit chart provided within this document. When updates are made available by FHFC, the chart below will be updated. County (Metro) Percentage Category Income Limit by Number of Persons at Household 1 2 3 4 5 6 7 8 Pinellas County 30% 21,950 25,050 28,200 32,150 37,650 43,150 48,650 54,150 (Tampa•StPeterstu rg- Clearwater MSA) 50% 80% 38,500, 58,450 41,700 66,800 48,950 75,150 52,150 83,450 56,350 90,150 60,500 96,850 84,700 103,500 68,850 110,200 Median: 98,400 120% 87,800 100, i, 0 112,880 125,160 135,240 145,200 155,280 185,240 140% 102,200 116,760 131,460 146,020 157,780 169,400 181,160 192,780 Eligibility Criteria To be eligible for the Program, the project/property must meet all the following qualifications: • Applicant must be the owner of the subject property. * • The subject property must be a single-family home. • Property must be located within the North Greenwood Community Redevelopment Area. • The single-family home must be the primary residence and legal homestead of the Applicant. In addition, the following may qualify for the Program. • Owners of property that have applied to Pinellas County for homestead exemption consideration may be eligible for this Program. • Applicants that reside at the property, control said property other than through outright ownership, and are authorized to approve the repairs and other work that are the subject of this program, may provide alternative documents to substantiate that they have such control and authority regarding the property. This documentation may include probate court documents, wills, heirship affidavit, letters of administration, or other legal documentation. After review of the documents, the residing applicant(s) may qualify for the Program, provided the applicant(s) wishing to apply for the Program reside at the property as their primary residence. If such control or authority is disputed by another party or parties, the application may be denied until such time as the Applicant resolves such disputes. • Must demonstrate property taxes are current or a satisfactory payment plan is approved by the CRA Director. • Must be current on mortgage payments (if applicable). • Must be in good standing with the city (no outstanding code enforcement or building code violations). This requirement may be waived by the CRA Director if the work proposed under this application will remediate the code violations. • If combined with a Home Rehabilitation Loan from the Economic Development and Housing Department, other requirements may vary. *The owner of the Property (Owner) shall be the Applicant. Owner means a holder of any legal or equitable estate in the premises, whether alone or jointly with others and 3 whether in possession or not shall include all individuals, associations, partnerships, corporations, limited liability companies and others who have interest in a structure and any who are in possession or control thereof as agent of the owner, as executor, administrator, trustee, or guardian of the estate of the owner. No Owner shall receive more than $20,000 in total CRA grant value across all CRA grant programs within a 36 - month rolling year. For the purposes of this application, the total CRA grant value that an Owner has received over such period shall be the combined value, in the 36 month period immediately preceding the submission of an application for this program, of: (1) the amount of CRA grant funds that the applicant has received; (2) the amount of CRA grant funds that any holder of legal title in the subject property other than the applicant has received; and (3) if a business entity holds legal title in the subject property, the total amount of CRA grant funds received by any directors, members, partners, shareholders, any others with an ownership interest in such entity, and any others able to exert managerial control over or direct the affairs of said entity. Previous Participation — Each property may not receive a grant any more than every thirty-six months. The following are ineligible for Program assistance: • Work or improvements that are completed prior to an application being approved. • Any unpermitted work or improvements performed on the property that required a permit and inspections. • Any work or improvements on the property that fail required inspections. • Multi -family properties. • Properties that do not qualify for homestead exemption. • New construction or improvements on vacant land. Project Implementation Projects are to be coordinated, managed, and implemented by the Applicant with close interaction with Community Redevelopment Agency Department staff and the appropriate City departments. Applicant is responsible for obtaining/arrangingany permits required by the city. SECTION 4 — ELIGIBLE RESIDENTIAL IMPROVEMENTS One or more of the following improvements may be eligible for Program assistance: 1) Exterior repairs (walls, foundation, piers, siding, etc.); 2) Exterior painting; 3) Exterior windows and doors; 4) Roof repairs or replacement, including facia board, soffits, and gutters; 5) Window or door awnings and shutters (including hurricane shutters; replacement or repair); 6) Exterior weatherization improvements; 7) The installation, repair, or renovation of porches; 8) The installation of decorative lighting; 9) Decorative fencing; 10) Driveway, pedestrian walkways/pathways, and sidewalk improvements; 11) American with Disabilities Act (ADA) accessibility improvements; 4 12) The installation of landscaping and irrigation systems, not to exceed twenty percent (20%) of the total grant amount; 13) Tree trimming or removal (requires city approval, and city may require a licensed arborist to confirm tree removal is necessary); 14) Heating, ventilation, and air conditioning (HVAC) systems; 15) Certain interior repairs: a. Interior deterioration/damage directly resulting from an exterior defect or damage, may qualify for grant funding to repair said deterioration/damage. Such interior repairs may include, but are not limited to, load bearing walls, drywall,. insulation, and wood repair. However, grant funds must first be used for improvements or repairs to fully remedy the external defect or damage that resulted in such interior deterioration/damage prior to any use of grant funds on interior repairs. b. Interior deterioration/damage that is verified by the city as a life safety issue to home inhabitants. c. ADA accessibility improvements. 16) Home fumigation (including tenting if necessary) for termites; and 17) Other improvements may be submitted for consideration but must demonstrate that the improvement meets the intent of this grant program. The following improvements are not eligible for Program assistance: 1) Repairs to unsafe or substandard structures that cannot be made safe for habitation with Program funds. 2) Room additions, garage conversions, repairs to structures separate from the living units (detached garage, shed, etc.), furnishings, and pools. 3) Repairs covered by insurance. 4) Non -permanent improvements. 5) Enclosing a front porch. 6) Installation of window or door security bars. 7) General interior home improvements and repairs. SECTION 5 — PROGRAM REQUIREMENTS AND APPLICATION PROCESS Program Requirements • All statements and representations made in the application must be correct in all material respects when made. Any applicant requesting grant funding from this program will have their income verified by City staff and must supply the items listed below, and, if requested, any other income or employment documents that are not listed below: • If applicable, self-employed year to date profit and loss statements. • All pages of last two year's tax returns, with all schedules and W-2s/1099(s). • Most recent and consecutive last two months of bank statements (with bank name and account number) (ALL PAGES, even if blank) for all household members with accounts. • If combined with a Home Rehabilitation Loan from the Economic Development and Housing Department, additional information may be required. Applicants that do not wish to have their income verified will automatically be disqualified from Program participation. 5 • • Color digital photographs of the .existing structure exterior, showing all sides of the building, must be provided with application. • An estimated detailed budget must be provided on the attached project budget form (Attachment A). • Work required to be performed by licensed contractors. Applicant must provide, as attachments, three quotes from contractors and copies of their licenses. Quotes to include complete description of materials to be used). o If work is performed by non -licensed workers, then only materials purchased will be eligible for grant funds, unless the work performed was required to be performed by a licensed individual per City codes. • Portions of the project costs not funded by the requested grant must be provided by Owner funding. Owner funding may consist of bank loans, lines of credit, a Home Rehabilitation Loan from the city's Economic Development and Housing Department, and owned assets (Owner Equity), etc. • Owner must demonstrate their source of the Owner Funding and their ability to meet the financial obligations of the Program prior to Program approval. • Proceeds from other City -managed financial assistance programs may be used as Owner Equity to satisfy the Owner Funding requirements of this Program and may be used to assist with funding of remaining portion of larger improvement project. Grant funds cannot be used as Owner Equity to satisfy the Owner Funding requirements of other City -managed financial assistance programs. Grant Application Process • Submittal of an application does not guarantee a grant award: • Grant preference will be given to Applicants at or below 80% AMI, applicants 65 years of age and above, and the disabled. • Completed applications that meet all the Program requirements will be reviewed by the CRA Director. • The CRA Director will approve or deny applications based on the criteria set forth in this document. • Incomplete applications will not be considered submitted until all required documentation has been submitted to Community Redevelopment Agency Department staff. • All construction/design contracts will be between the Applicant and the contractor/design professional. SECTION 6 — DISBURSEMENT POLICY AND PROCEDURE Grant funds will, unless otherwise approved by the CRA Director to allow initial project deposits or other necessary draws, up to fifty percent of the grant amount, to be paid directly to a City/CRA approved licensed contractor, be disbursed upon a "Finding of Project Completion" by CRA Director. A "Finding of Project Completion" will be granted when the following criteria are met: 1) Applicant must demonstrate their ability to meet the financial match/obligations of the Program and any required community service has been completed by qualifying applicants. 6 2) Requests for disbursement of project costs will be viewed as a single, completed package, unlessprior disbursement of funds arrangements have been made to pay licensed contractors directly (no more than one payment within a 30 -day period). Costs not included in the approved application budget will not be considered for disbursement. 3) Required documentation for disbursement of project costs must include: a. Copies of cancelled checks, certified checks or money orders of project costs, or credit card statements of project cost; b. Detailed invoices and paid receipts signed, dated, and marked "paid in full;" c. Name, address,telephone number of design professional(s), general contractor, etc., and d. Photos of the project (before and after photos). 4) The Applicant must have obtained all necessary/required permits (e.g. zoning and building), passed all required inspections, and prior to final disbursement of funds received (if relevant) notice, in the form of a Certificate of Occupancy or Certificate of Completion for the project demonstrating the legal occupancy of the project area. Any work performed without a permit that required a permit will not be eligible for grant funding. 5) The CRA disburses funds to grant recipients within 30 days of fully completed reimbursement request. SECTION 7 — GRANT EXPIRATION Applicants must receive a "Finding of Project Completion" within 180 calendar days from the date of application approval. After the said 180 days, the grant will expire. An extension for the grant funds may be granted by the CRA Director for a good cause. It is the responsibility of the Applicant to request, in writing, from the CRA Director an extension of the grant approval before the expiration date. SECTION 8 — COMPLIANCE WITH THE CITY OF CLEARWATER ETHICS CODE The applicant will comply with all applicable City rules and regulations including the City's Ethics Codes. Moreover, each applicant to the Program acknowledges and understands that the City's Ethics Code prohibit City employees from receiving any benefit, direct or indirect, from any contract or obligation entered with the City. 7 SECTION 9 — APPLICATION 1) Applicant (Property Owner) Full Legal Name(s): Mailing. Address: City/State/Zip: Phone Number: E-mail Address: 2) Subject Property Address commonly known as: Parcel Identification Number(s): 3) Project description, scope of work to be performed, sketch plans and specifications detailing the scope of work (provide attachment(s) if needed). (Applicant understands that depending on the project, certain city departments may require additional documentation, plans, etc. t� properly review and approve the proposed project described in this application.) 8 9 4) Financial and Other Disclosures Annual Household Income: $ (Income examples (not limited to the following): employment or self-employment income, Social Security, Pension, Disability, etc.) Household Size: # Is the subject property current with property tax payments, mortgage payments (if applicable), fees, and in compliance with City codes and regulations? (must provide copies of property tax payment and mortgage payment statements) Yes No If no, please explain: Have you received a loan or grant assistance from a city -managed financial assistance program for a project at the subject property? Yes No If yes, please specify the program(s), dates received, and the loan/grant amount(s) below or provide attachment(s). Program Name: Date Received: Amount Received $ Program Name: Date Received: Amount Received $ 5) Amount of Grant Requested under this program: $ Are you requesting direct payment of approved grant funds to an authorized contractor? Yes No If yes, please specify the contractor's name: Note: This option must be approved by the CRA Director. 9 Attachment A - Project Budget Form (Attach contractor/vendor estimates/quotes for consistency verification of items listed below. Contractor/vendor estimates/quotes improvement item descriptions and cost will supersede if improvement item descriptions and cost are listed different below. If more project budget form lines are need, Applicant may duplicate budget template below on separate sheet. If new Project Budget Form is created, write "See Attached" in Line No. 1 below. For Applicant Use For staff use only Line Item No, Improvement(s) Item Description (Including construction materials, labor, permitting, other fees, etc.) Improvement(s) Cost Amount Line Item Eligible for Grant Consideration Yes/No Cost Amount Eligible for Grant . 1 $ $ 2 $ $ 3 $ $ 4 $ $ 5 $ $ 6 $ $ 7 $ $ 8 $ $ 9 $ $ 10 $ $ 11 $ $ 12 $ $ 13 $ $ 14 $ $ 15 $ $ 16 $ $ 17 $ $ Total Improvement(s) Cost Amount $ Total Cost Amount Eligible for Grant Consideration $ Line No. For Staff. Use Only 1 Total Cost Amount. Eligible for Grant Consideration (from "Attachment A" above and/or from attached contractor estimates/quotes. $ 2 Amount of Grant Requested under this program (Section 9, question 5 of Application). $ 3 Enter the amount with the lower monetary value from either Line No. 1°or Line No. 2; $ 4 Enter required Applicant Contribution/Match (either 5%, 1.0%, 15%,, or 20% contribution/match, see Section 3 of Grant Program). $ 5 Subtract Line No. 4 from Line No. 3 and enter amount. $ 6 Enter value of eligible community service hours for contribution/match waiver, if applicable. (See Section 3 of Grant Program for value of service hours). Number of service hours approved by CRA Director .. _ " $ 7 ` Add Line No. 6 to amount in Line No. 5 and enter amount. $ 8 Enter amount from Line No. 7. This is eligible grantaward amount to enter in approval letter: $ 10 PLEASE NOTE: For multiple signers: This Application may be executed in one or more counterparts, each of which when executed and delivered, shall be an original, but all such counterparts shall constitute one and the same instrument. I ACKNOWLEDGE THAT I HAVE RECEIVED AND UNDERSTAND THE GRANT GUIDELINES HEREIN ABOVE STATED. IN ADDITION, BY EXECUTING THIS APPLICATION, I ACKNOWLEDGE THAT I AM LAWFULLY AUTHORIZED TO EXECUTE THIS APPLICATION AND THAT ALL INFORMATION AND STATEMENTS CONTAINED HEREIN AND ON ANY ATTACHEMENTS ARE TRUE, CORRECT, AND COMPLETE. Applicant Signature Printed Name Date STATE OF FLORIDA ) COUNTY OF PINELLAS ) The foregoing instrument was acknowledged before me by means * physical presence or * online notarization, this day of , 2025 by , who * is/are personally known to me or * who has/have produced a driver's license as identification. Notary Public, State of Florida (NOTARIAL SEAL) My Commission Expires: My Commission No.: Name of Notary: Mail or hand deliver completed application form to: Community Redevelopment Agency City of Clearwater / 600 Cleveland Street, Suite 600 / Clearwater, FL 33755 For question call the Community Redevelopment Department at 727-562-4039 11 SECTION 10 - ELIGIBLE CRA AREA MAP NORTH GREENWOOD COMMUNITY REDEVELOPMENT AREA ..epered try' (* .Himont d p e oe wak.. C.1M.oea OeoQynk TeoMmoMp Ckrisn• 1107 *Me►.., CS...w.. f,.]2716 de. 727)6247K P: i717Y3M-1195 611,0•• rcum North Greenwood CRA Boundary Area not in Clearwater Jurisdiction Map Gen By: KF Reviewed By: ES Aerial Flown 2023 Date: 1 0120 12 0 2 3 Page: 1 of 1 W E Scale.N.T.S. Ducvwl Palk ClUcatirte4n1VoCtly M CYwaWfiryynrnp O.q}aplk T✓1Mpr-Doweeed0316[PAXrwireo0 andCMr0eeene d end Dvmbwn CPAne1 12 EXHIBIT "C" GRANT APPLICATION AND PLAN SPECIFICATIONS 12 SECTION 9 - APPLICATION 1) Applicant (Property Owner) Full Legal Name(s): C%.%Eit,iL DAV 15 TrwEt31-0 Op Mailing Address: 9 i t N U,142.05A1 mc City/State/Zip: etsagmoiteizt 1=t. 33'55 . Phone Number: /rt.- 65-t_"ical E-mail Address: gulsElcy.34Koq 1 e time, .cc, nr► 2) Subject Property Address commonly known as: • q t t N . GAc .c*-. AVE. C 6zI FL 33155 Parcel Identification Number(s): 09 -29 -L5 -G0102.- 002.- 0012 3) Project description, scope of work to be performed, sketch plans and specifications detailing the scope of work (provide attachment(s) if needed). (Applicant understands that depending on the project, certain city departments may require additional documentation, plans, etc. to properly review and approve the proposed project described in this application.) Fo )MDA11014 REPOLS / REPLAGETnnEt4T 8 9 4) Financial and Other Disclosures Annual Household Income: $ 2.4 1312 .00 (Income examples (not limited to the following): employment or self-employment income, Social Security, Pension, Disability, etc.) Household Size: # 1 Is the subject property current with property tax payments, mortgage payments (if applicable), fees, and in compliance with City codes and regulations? (must provide copies ofproperty tax payment and mortgage payment statements) Yes ✓ No If no, please explain: Have you received a loan or grant assistance from a city -managed financial assistance prograrfor a project at the subject property? Yes No ✓✓ If yes, please specify the program(s), dates received, and the loan/grant amount(s) below or provide attachment(s). Program Name: Date Received: Amount Received $ Program Name: Date Received: Amount Received $ 5) Amount of Grant Requested under this program: $ 094 O y) Are you - q - sting dir - ct payment • approved grant funds to an - uthorized • • ntrac o . Y..s No If y- - please specify the contractor's name: Note: This option must be approved by the CRA Director. 9 Atc :.chment A - Project Budget I _:•m (Attach contractor/vendor estimates/quotes for consistency verification of items listed below. Contractor/vendor estimates/quotes improvement item descriptions and cost will supersede if improvement item descriptions and cost are listed different below. If more project budget form lines are need, Applicant may duplicate budget template below on separate sheet. If new Project Budget Form is created, write "See Attached" in Line No. 1 below. For Applicant Use For staff use only Line Item No. Improvement(s) Item Description (Including construction materials, labor, • ermitting, other fees, et .1 Improvements) Cost Amount Line Item Eligible for : Grant•Consideration Yes/No Cost Amount Eligible for Grant 1 . ik -. t _ . . I r $ • • • v,,. r I • _ 2 $ $ 3 4 3 $ ('IP koL $Aa 4129•'.4 4 $ $ 5 $ $ 6 $ $ 7 $ $ 8 $ $ 9 $ $ 10 $ $ '`� •?�' 11 $ $ 12 $ $ 13 $ $ 14 $ $ 15 $ $ 16 $ $ 17 $ $ Total Improvement(s) Cost rn Aount $ 16;01140 Total Cost Amount Eligible for Grant Consideration $ c 2. • b ^ p p °V\ e2•2 i i a 1 tLineiNo^,'1,> 1 '4, ..r;1rL,;.YFor,Staff;tJse3Or%ly:;;.. ,,n,v-,,..,,7��, � �,,, r �;, tal Costount Eligibfor' G .To�Am le` rant: Consideration (from "Attachment A" above and/or from t" '} ; ;!attached contractor estimates/quote`s'., •.... : r t^ + - ' .;.'' " . , s� G ®° 2 'a ' Amount of Grant Requested under this program (Section 9, question 5 of Application). $ 3 'Enter„the'amount with the lower monetaryvalue from el {;L a No '1 or Line No 2 ; $.Uj to` 4 .Enter required Applicant Contnbution/Match (either 5°/ , 10%,' 5%, or 20%contribution/match; saa Section 3 of Grant Program) -' ` y !;, c . (. ,5 : 4 , Subtract Line No 4 from Line Ng,-`3 and enter, amount, r '� t $ `� i 000 :, �6 a ,{ Enter value of eligible,community service hours for contribution/match waiver; iapplicablef ; , t -(See Section 3, of Grant Program for value of service}hours°�J s s ` `y � 0 4 Number of service hours', approved,by.;CRAlDirector . 7 Add Line No 6; to amount inline No 5 and enter amount f , , t �� 8 , y , ; Enter amount' from Line No ;7 This is eligible grant award amountCto enter in approval letter: $t . • 10 i PLEASE NOTE: For multiple signers: This Application may be executed in one or more counterparts, each of which when executed and delivered, shall be an original, but all such counterparts shall constitute one and the same instrument. I ACKNOWLEDGE THAT I HAVE RECEIVED AND UNDERSTAND THE GRANT GUIDELINES HEREIN ABOVE STATED. IN ADDITION, BY EXECUTING THIS APPLICATION, I ACKNOWLEDGE THAT I AM LAWFULLY AUTHORIZED TO EXECUTE THIS APPLICATION AND THAT ALL INFORMATION AND STATEMENTS CONTAINED HEREIN AND ON ANY ATTACHEMENTS ARE T„ E, CORRECT, AND COMPLETE. Applica t ignature Cile}AiLIctot_s Printedme STATE OF FLORIDA ) COUNTY OF PINELLAS ) The foregoing instrument was acknowledged before me by means * physical presence o online notarization, this 15 day of VVLy , 2025 byCtlElbit. takvts t �vno * is/are pe : • - II know to me or * who has/have produced a driver's license as identification. �411111.6 , Notary ' ublic, State of Florida (NOTA;' IAL SEAL) My Commission Expires: l0/d-r12pZs5 My Commission No.: tAtilo01100 Name of Notary: ]-01\ C•taitalotS �” t ' Comm.: C. Battas fHN 601100 Expires: Oct 7, 2028 *".• Notary Public - State of Florida Mail or hand deliver completed application form to: Community Redevelopment Agency City of Clearwater / 600 Cleveland Street, Suite 600 / Clearwater, FL 33755 For question call the Community Redevelopment Department at 727-562-4039 11 Form W -9 (Rev. March 2024) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification Go to www.irs.gov/FormW9 for instructions and the latest information. Give form to the requester. Do not send to the IRS. Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below. 1 Name of entity/individual. entity's name on line 2. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's name on line 1, and enter the business/disregarded r Print or type. Specific Instructions on page 3. '_,..`Z- La S Lu- 1 r 2 Business name/disrenliAed entity name, if different from above. 3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check only one of the following seven boxes. 01, ndividual/sole proprietor ❑ C corporation ❑ S corporation • Partnership III Trust/estate L.L.C. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership) . . . . 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Note: Check the "LLC" box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate box for the tax classification of its owner. SI Other (see instructions) Exemption from Foreign Account Tax Compliance Act (FATCA) reporting code (if any) 3b If on line 3a you checked "Partnership" or "Trust/estate," or checked "LLC" and entered "P" as its tax classification, and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check this box if you have any foreign partners, owners, or beneficiaries. See instructions I. (Applies to accounts maintained outside the United States 5 Address 6mate, (numbe., 11 1`w,_ street, n apt. or no.). Se instructions. Aug.Requester's Coo}—� e,� ug name and address (optional) and QIP code n la( .3�--7 List account (s)'here (optional) Part I Taxpayer Identification Number (TIN) line 1 to avoid Social security number Enter your TIN in the appropriate box. The TIN provided must match the name given on backup withholding. For individuals, this is generally your social security number (SSN). However, for alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other - entities, entities, it is your employer identification number (EIN). if you do not have a number, TIN, later. Note: If the account is in more than one name, see the instructions for line 1. See also What Name and Number To Give the Requester for guidelines on whose number to enter. or Employer identification number Part 11 Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. I am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. I am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of bt, contributions to an individual retirement arrangement (IRA), and, generally, payments other than interest and dividends,.'ou are not; equjredto 5ign thertification l you must provide your correct TIN. See tie instructions for Part II, later. Sign Here Signature of U.S. person 4191 General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9. What's New Line 3a has been modified to clarify how a disregarded entity completes this line. An LLC that is a disregarded entity should check the appropriate box for the tax classification of its owner. Otherwise, it should check the "LLC" box and enter its appropriate tax classification. Date Ct New line 3b has been adddd to this f m. A flow-through entity is required to complete this line to indicat that it has direct or indirect foreign partners, owners, or beneficiaries when it provides the Form W-9 to another flow-through entity in which it has an ownership interest. This change is intended to provide a flow-through entity with information regarding the status of its indirect foreign partners, owners, or beneficiaries, so that it can satisfy any applicable reporting requirements. For example, a partnership that has any indirect foreign partners may be required to complete Schedules K-2 and K-3. See the Partnership Instructions for Schedules K-2 and K-3 (Form 1065). Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS is giving you this form because they Cat. No. 10231X Form W-9 (Rev. 3-2024) Residential Exterior Improvement Grant Program Due Diligence Check Applicant: Cher(1 "DAV tS 'Tr ti lolOOd Property Address: q t l N CZAR EN AJ E CLEASLWArre2.4 FL 33-155 Contact Number: 7» 453 • u.„2 Case Number: IN G- - .0 -S - Requirement: 1 Entered into Grant Log 2 Applicant is the Property Owner 3 Located in CRA Boundary 4 Single -Family Residential Property 5 Primary Residence/Legal Homestead 6 Area Median Income/Applicant Match 7 Self -Employed, Tax Returns, Bank Statements 8 Income Verification SSs-02101. 9 Photographs 10 Quotes from Contractors 11 Requesting Direct Contractor Pay 12 Scope of Work Eligible for Grant Award 13 Volunteer Hours for Applicant's Match 14 Applicant is Requesting a Wavier 15 Property Tax are Current 16 Code Violations 17 W9 19 Vendor Request/PO 20 Create Grant Agreement 21 Completed Application w/ Project Budget Form 22 Additional Information Yes✓No Yes.1o_ Yes_40_ Yes ✓1Go Yes_✓No_ Yes_ No_ Yes_ No_ Yes No Yes ✓ o Yes_4_ Yes_✓ (o_ Yes t o FOUND/KT' arJ Comments: t� ttAf+£ ?own - Yes 4 Yes Nob.'''. Yes_✓1 Yes_ Nd_✓ Yesg)(o_ Yes_ No_ Yes_ No_ Yes_ No p01 Total Project Cost Eligible for Grant Consideration '.- ' aq 34 Applicant's Match Amount 0 oa ?�� —rant Amount Recommendid d by Staff I) 1000 J> CRA AD A rov l�lit' 1 ...- CRA ED Approval. Yew No_ Yesto Date: � i 14102c Date: /2////Z Approval Comments: Entire File Scanned in Sharepoint Na (�.,P�l SC..OiN Yes_ No_ Date: to kit ath.YAA C. fit !,,� \ti)/ ru• 4.3 , IC/UO/"LULL at 02':39 PM, RECORDING 1 PAGES $10.00 D DOC STAMP COL L ''ION $0.70 KEN BURKE, cur OF COURT AND COMPTROLLER PINELLAS COUNz, FL BY DEPUTY CLERK: c1k108 This Instrument Prepared By and Return to: Julius Cooney n _ q)I u. a Ajt Gt ear LOCI -rit gig 3-K7SS QUITCLAIM DEED This Quitclaim Deed, ntadethisci. day of f----" t.1,S-4-- , 2022, between Eugene Davis, Jr., Cheryl Davis Trueblood, and Rosalind Altheia Davlk McQueen, Grantor(s), and Eugene Davis, Jr., whose address is 1538 Carroll St, Clearwater. FL 33755, Cheryl Davis Trueblood, .whose address is 911 N. Garden Avenue, Clearwater, FL 33755, Rosalind Altheia Davis McQueen, whose address is 3044 Easdand Blvd, Bldg. 1, 8207, Clearwater, FL 33761 and Julius Cooney, whose address is 911 N. Garden Avenue, Clearwater, FL 33755,Grantee(s). Witnesseth, that the Grantor, for and in consideration of the sum of TEN & NO/100 (5 10.00)-- —DOLLARS, and other good and valuable consideration to Grantor in hand paid by Grantees, the receipt of which is hereby acknowledged, has granted,bargained and quitclaimed to the said Grantees and Grantees' heirs and assigns forever, the following described land, situate, lying and being in the County of PINELLAS, State of Florida, to -wit: Beginning at the SW corner of Lot 1, Block 2, of Ira Nicholson's Addition to Clearwater, Florida as recorded in Plat Book 2, Page 44, of the Public Records of Hillsborough County, Florida, of which Pinellas County was formerly a part; run thence East, along the South Line of said Lot 1, 82.5 feet; thence Northerly, 33.95 feet to a point 75.0 feet East of the West line of said Lot 1; thence Westerly parallel to the South line of said Lot 1, 75,0 feet to North Carden Avenue; thence Southwesterly along the said -East line of North Garden Avenue to the point of beginning. And as amended on 10/20/1970 in Official Records Book 3414, Page 283 of the Public Records of Pinellas County, Florida and any subsequent amendments thereto. The above property is not and has never been the homestead property of the grantors. To Have and to Hold the same together with all and singular the appurtenances thereunto belonging or in anywise appertaining, and all the estate, right, title, interest, lien, equity and claim whatsoever of Grantor, either in law or equity, for the use, benefit and profit oldie said Grantees forever. In Witness Whereof, the Grantor has hereunto set he/she hand and seal,heday and year first above wtitten, Signed, sealed and delivered in nur resence: lin ss 8l Si ature itness 81 tinted Name Signature Q4J-)e Vt.&c%s ness82-Printed Name STATE oPpricrtaf9A� t (1 S COUNTY OF s 1 The f ing instrument ws�cknowledgcd fprc me by moans of (x) physical presence or ( ) online notarization this day of bc, 2022. by Eugene Davis, Jr., Cheryl Davis Trueblood, and Rosalind Althela Davis McQueen, who is/arc personally known to me or who has produced as identification. SEAL KIMBERLY L JOHNSON Stab of Florida • Notary Public y Com®alllliIOlper4 HH 24728 My Commission Isplres July 28, 2024 7/15/25, 12:00 PM Mike Twitty, MAI, CFA Pinellas County Property Appraiser Parcel Summary (as of 15Ju1-2025) Parcel Number 09-29-15-60102-002-0012 Property Details 1 Pinellas County Property Appraiser 1 • Owner Name TRUEBLOOD, CHERYL DAVIS MCQUEEN, ROSALIND A D TREMCQUEEN, JOHN C JR TRE MCQUEEN, JOHN C JR & ROSALIND A D LIV TRUST COONEY, JULIUS DAVIS, EUGENE JR • Property Use 0110 Single Family Home • Site Address 911 N GARDEN AVE CLEARWATER, FL 33755 • Mailing Address 911 N GARDEN AVE CLEARWATER, FL 33755-3025 • Legal Description NICHOLSON'S, IRA E. ADD BLK 2, S 33.95FT OF W 76FT MOL OF LOT 1 • Current Tax District CLEARWATER (QW) • Year Built 1930 Living SF Gross SF Living Units Buildings 836 1,358 1 1 xepiptions ear 2026 Y Use 25% 2025 es 25% 2024 No 0% Status Assuming no ownership changes before Jan. 1, 2026. Property Exemptions & Classifications No Property Exemptions or Classifications found. Please note that Ownership Exemptions (Homestead, Senior, Widow/Widower, Veterans, First Responder, etc... will not display here). Miscellaneous Parcel Info La e • .: d Deed Sales Comparison Census Tract Evacuation Zone Flood Zone Elevation Certificate Zoning Plat Bk/Pg 22717/1683 $69,200 261.01 NON EVAC Current FEMA Maps Check for EC Zoning Map H2/44 2024 Final Values Year Just/Market Value Assessed Value/SOH Cap County Taxable Value School Taxable Value Municipal Taxable Value 2024 $58,568 $45,371 $45,371 $58,568 $45,371 https://www. pcpao.gov/property-deta i is?s=152909601020020012&x m i n=-9217038.652639054&ym i n=3245866.8717179443&xmax=-9216924.594260... 1/3 7/15/25, 12:00 PM iyalue History' Year Homestead Exemption Just/Market Value Property Details 1 Pinellas County Property Appraiser Assessed Value/SOH Cap County Taxabt' -. School Taxable Value Value Municipal Taxable Value 2023 N 2022 N 2021 N 2020 Y 2019 Y $48,947 $55,382 $34,087 $43,736 $40,016 $41,246 $37,496 $34,087 $22,823 $22,310 $41,246 $37,496 $34,087 $0 $0 $48,947 $55,382 $34,087 $0 $0 $41,246 $37,496 $34,087 $0 $0 2024.Tax Information Do not rely on current taxes as an estimate following a change in ownership. A significant change in taxable value may occur after a transfer due to a loss of exemptions, reset of the Save Our Homes or 10% Cap, and/or market conditions. Please use our Tax Estimator to estimate taxes under new ownership. Tax Bill 2024 Millage Rate Tax District View 2024 Tax Bill 18.9481 (Sr1i1C). 3rSaies History Sale Date Price Qualified / Vacant / Unqualified Improved Grantor Grantee Book / Page 26 -Feb -2024 $100 I MCQUEEN ROSALIND ALTHEIA MCQUEEN JOHN C JR & ROSALIND A D DAVIS LIV TRUST 22717/1683 09 -Aug -2022 $100 Q 1 DAVIS EUGENE JR DAVIS EUGENE JR 22281/2499 28 -Sep -2020 $100 L1 I MCQUEEN ROSALIND ALTHEIA DAVIS PR DAVIS EUGENE JR 21201/0689 19 -Jun -2020 $0 Q I DAVIS ALLIE MAE EST DAVIS EUGENE JR 21051/0554 31 -Dec -1970 $7,000 Q 03414/0283 2024!Land information. Land Area: = 2,587 sf l = 0.05 acres Property Use Land Dimensions Frontage and/or View: None Unit Value Units Method Seawall: No Total Adjustments Adjusted Value Single Family 35x76 $10 2,660 SF 1.0000 $26,600 12024 Building 1 Structural Elements and Sub Area Information Structural Elements - Foundatioh: iFlbor System: `• IExterior Walls:- • Unit Stories: Living Units: 1' Roof Frame: - Gable OrHip Roof Cover: Shingle Composition•• rear BUR: '19301;:' BuiIding'Type: . Single Family Quality: Fair _ Floor Finish: Carpet/ Vinyl/Asphalt Interior Finish: Drywall/Plaster . Heating: _ . Unit/Space/Wall/Floor" Cooling: - - None fixtures: EffectiveAge:' ,. Piers Wood Frame Siding • Sub Area Living Area SF ' Gross.Area SF . • Base (BAS):, 836 X836 Enclosed Porch (EPF) 0'; 26ti Garage Unfinished (GRIJ)c 0 .240 , .Open Porch.(OPF,): ' 0 16 Total Area SF: , " 836 .1,358 • 59 , https://www.pcpao.gov/property-details?s=152909601020020012&xmin=-9217038.652639054&ymin=3245866.8717179443&xmax=-9216924.594260... 2/3 7/15/25, 12:00 PM Property Details 1 Pinellas County Property Appraiser 2024 Extra Features . EP F 7 7 154 22 BAS 38 38 836 4 18 Description 7 EP F 112 6 10 7 OPF 4 16 Value/Unit 7 13 12 GRU 240 12 20 Units Total Value as New Depreciated Value Year No Extra Features on Record. Permit Data Permit information is received from the County and Cities. This data may be incomplete and may exclude permits that do not result in field reviews (for example for water heater replacement permits). We are required to list all improvements, which may include unpermitted construction. Any questions regarding permits, or the status of non -permitted improvements, should be directed to the permitting jurisdiction in which the structure is located. Permit Number Description Issue Date Estimated Value 8CP2024-080245 FENCE )3CP2000-05434 MISCELLANEOUS 08/08/2024 $1,200 07/17/2000 $5,500 https://www.pcpao.gov/property-details?s=152909601020020012&xmin=-9217038.652639054&ymin=3245866.8717179443&xmax=-9216924.594260... 3/3 $10.00 D DOC STAMP COLLECTION $0.70 KEN BURKE, CLERK OF COURT AND COMPTROLLER PINELL*�'' COUNTY, FL BY DEPUTY CLERK: c1k10:*' S9 This instrument was prepared WITHOUT EXAMINATION OF TITLE OR OPINION AS TO TITLE. This instrument prepared by/ return to: Neil R. Covert, Esquire Neil R. Covert, P.A. 311 Park Place Boulevard, Suite 180 Clearwater, FL 33759 (727) 449-8200 Purchase Price $10.00 TRUST WARRANTY DEED THIS TRUST WARRANTY DEED, made as of this 26th day of February 2024 BETWEEN ROSALIND ALTBEIA DAVIS MCQUEEN, whose address is 3044 Eastland Blvd., Bldg. 1, Unit 207, Clearwater Florida 33761, as to her undivided interest, hereinafter referred to as "Grantor(s)," AND John C. McQueen, Jr. and Rosalind A. D. McQueen, Trustees of the John C. McQueen, Jr. and Rosalind A. D. McQueen Living Trust dated February 26, 2024 and any amendments thereto, whose address is 3044 Eastland Blvd., Bldg. 1, Unit 207m Clearwater, Florida 33761, hereinafter referred to as "Grantee(s)." The Grantee(s) shall have the full power and authority to protect, conserve, sell, lease, encumber or otherwise manage and dispose of said real property described herein. Wherever used herein the terms "Grantor(s)" and "Grantee(s)" shall include all the parties to this instrument and their heirs, legal representatives, successors, and assigns. WITNESSETH: That said Grantor(s), for andin consideration of the sum of Ten Dollars ($10.00), and other good and valuable consideration, to said Grantor(s) in hand paid by said Grantee(s), the receipt of which is hereby acknowledged, does hereby grant, bargain, sell and convey to Grantee(s), Grantee(s)'s heirs and assigns forever the following described property in PINELLAS County, Florida, to wit: Beginning at the SW corner of Lot 1, Block 2, of Ira Nicholson's Addition to Clearwater, Florida as recorded in Plat Book 2, Page 44, of the Public Records of Hillsborough County, Florida, of which Pinellas County was formerly a part; run thence East along the South Line of said Lot 1, 82.5 feet; thence Northerly 33.95 feet to a point 75.0 feet East of the West Line of said Lot 1; thence Westerly parallel to the South Line of saki Lot 1, 75.0 feet to North Garden Avenue; thence Southwesterly along the said -East Line of North Garden Avenue to the point of beginning. And as amended on 10/20/1970 in Official Records Book 3414, Page 283 of the Public Records of Pinellas County, Florida and any subsequent amendments thereto. Parcel ID: 09-29-15-60102-002-0012 Property Address: 911 N. Garden Ave. Clearwater, FL 33755 THIS IS NOT THE HOMESTEAD OF THE GRANTOR(S) SUBJECT to covenants, restrictions, easements and zoning of record and taxes for the current year and subsequent years. TO HAVE AND TO HOLD the same, together with all and singular the appurtenances thereunto belonging to or in anywise appertaining to tenements, hereditaments, and all the estate, right, title, interest and claim whatsoever and said Grantor(s) does hereby fully warrant the title to the land and will defend the same against the lawful claims of persons whomsoever, IN WITNESS WHEREOF, the said Grantor(s) have executed this instrument as of the day and year first written above. igned, sealed and deliv- =d by Grantor(s) to Grantee(s) in the presence of the following two witnesses as to all Grantors: Witness: Printed: Neil R. Covert 311 Park Place Blvd. Clearwater, FL 33759 STATE OF FLORIDA ) ss. COUNTY OF PINELLAS Witness: Cies" C:L Printed: Chris M. Covert 311 Park Place Blvd. Clearwater, FL 33759 The foregoin nstrument was acknowledged before me, the undersigned Notary Public, in and for said County and State, by means of physical presence or 0 online notari ation, on this 26th day of February 2024, by ROSALIND A. D. MCQUEEN, who is 0 personally known to me or L has produced, �WC.�j 1,rwi 5`eas identification. Witness my hand and official seal. a R. Black, `'otary Public LARAFBLACK Notary Public State of Florida Comm*1111203533 Expires 11/30/2025 7/15/25, 12:01 PM .5s_arch > Account Summary Real Estate Account #R99974 Owner: TRUEBLOOD, CHERYL DAVIS MCQUEEN, ROSALIND A D TRE Situs: 911 N GARDEN AVE CLEARWATER Pinellas - Payments & Services Parcel details ar_opg.W.MpiajZ V Installments L414 Get bilis by email Amount Due Your account is paid to date. Your next bill will be available for payment by 09/01/2025. Your most recent payment was made on 06/30/2025 for $220.08. Acc isto BILL 2025 eta . _ ..„ . . AMOUNT DUE STATUS ACTION n a Iment Bi 4-0 Upcoming 2025 Bill #3 0 Upcoming 2025 Installment Bill #2 0 2025 Installment Bill #1 Upcoming $0.00 Paid $220.08 06/30/2025 Receipt #1665-25-004317 Paid $220.08 7024 0 2024 Installment 0111 54 0 $0.00 Paid $265.80 2024 Installment 8111 53 0 $0.00 Paid $250.32 2024 Installment 0111 52 0 $0.00 Paid $200.74 2024 Installment Bill #1 0 50.00 Paid $197.50 Paid $914.36 2023 0 7023 Installment Bill #4 2023 Installment Bill #3 0 2023 Installment 0111 52 0 2023 Installment 8111 51 _ • • -1 - • a - • ^ y . 1 ^ • 2022 Annual Bill 0 2021 Annual Bill 0 Print (PDF) + y • - - • 04/30/2025 Receipt #1665-24-115068 r Print (PDF), 12/31/2024 Receipt 51665-24-100026 0 a_tr_k(111:1E1 09/30/2024 Receipt #1665-24-009067 IS Print (PDF). 06/28/2024 Receipt #1665-24-004167 Print (PDF). $0.00 Paid $211.96 03/20/2024 Receipt 50-23-249236 cg3 Print (PDF). $0.00 Paid $205.60 12/05/2023 Receipt #103-23-001924 $0.00 Paid $199.06 09/29/2023 Receipt #103-23-001325 (0 Print (PJLIE) $0.00 Paid $195.93 06/26/2023 Receipt #105-23-000244 0 Print (PDF). Paid $812.55 $0.00 Paid $885.77 05/26/2023 Receipt 5118-22-003018 IP Print (PDF) $0.00 Paid $692.70 03/10/2022 Receipt #903-21-003105 Print (PDF). 2020 Annual Bill 0 $0.00 No Balance Due 2019 Annual Bill 0 $0.00 No Balance Due 7018 Annual Bill 0 $0.00 No Balance Due 2017 Annual Bill 0 $0.00 No Balance Due 0 Print (PDF). 7016 Annual Bill 0 $0.00 No Balance Due . g Erint.(PDF). • .- - _ , . . .., _. ... ._ -.____ . 2015 Annual Bill 0 $0.00 No Balance Due 0 psiateREI .......... 2014 Annual Bill 0 $0.00 No Balance Due 1:;) Print 2013 Annual Bill 0 $0.00 No Balance Due IS Print (PDF). 2012 Annual Bill 0 $0.00 No Balance Due © Print E Ile. ), 2011 Annual Bill 0 $0.00 No Balance Due 0 Print (PDF). 2010 Annual Bill 0 $0.00 No Balance Due 0 Print (PDF). 2009 Annual Bill 0 $0.00 No Balance Due 0 print (Q1), https://county-taxes.net/pinellas/property-tax/cGluZWxsYXM6cmVhbF91c3RhdGU6cGFyZW5OczpiYTY5NjBIZS11MzY4LTExZWItOTRkMS0wMDUwNT... 1/2 IG) Print (PDF). ID Print (PDF). 0 Print (M). 7/15/25, 12:01 PM A0Q8 Annual 13ill 407 AnnuaLBill 406 Annual Bill 0 2005 Annual Bill 0 ... Pinellas - Payments & Services ) _____._.......... .. '... . ... ... _......__ ____.... ____.. Soso No Balance Due ( $0.00 No Balance Due $0.00 No Balance Due $0.00 No Balance Due 2004 Annual Bill 0 2003 Annual Bill 0 2002 Annual Biti0 403. Annual Bill 0 2000 Annual Bill 0 999AnnuaIBUI 0 Total Amount Due $0.00 No Balance Due (8) jat.tRIA), • Print (PDF) • Print (PDF). -. • -- •---- • , ..-••• -^,---1-.• -,-.• ,•--• y •••.. --• $0.00 No Balance Due ----- • - -1-- -.^ ^ •• ..... $0.00 No Balance Due -•.,•,-•. $0.00 No Balance Due _ ._..... $0.00 No Balance Due $0.00 No Balance Due So.00 • Print (PDF). . _ LD Print (PDF). • Print (PDF). Print (PDF), Print (el/E), GI Filial (MEI htt0s://countv-taxes.net/Pinellas/Property-tax/cGluZWxsYXM6cmVhbF91c3RhdGU6cGFyZW5OczpiYTY5NjBIZS11MzY4LTExZWItOTRkMS0wMDUwNT... 2/2 ( C. Shire, Vickie From: Green, Sarah Sent: Friday, October 31, 2025 1:13 PM To: Shire, Vickie Cc: Root, Dana; Garriott, Kevin; Mulder, Rebecca; Kurleman, Scott; Kozak, Ted Subject: RE: Code Violations - Check please No violations from Code Compliance. Sarah Green Code Compliance Supervisor Planning & Development City of Clearwater Office: 727-444-8711 CLEARWATER BRIGHT AND BEAUTIFUL- BAY TO BEACH From: Shire, Vickie <Vickie.Shire@MyClearwater.com> Sent: Thursday, October 30, 2025 3:53 PM To: Kozak, Ted <Ted.Kozak@myclearwater.com>; Kurleman, Scott <Scott.Kurleman@myClearwater.com>; Mulder, Rebecca <Rebecca.Mulder@ MyClearwater.com>; Garriott, Kevin <Kevin.Garriott@myClearwater.com>; Root, Dana <Dana.Root@myClearwater.com>; Green, Sarah <Sarah.Green@MyClearwater.com> Subject: Code Violations - Check please Good afternoon — Can you please let me know if any of the properties have violations. They are applying for a North Greenwood Grant 911 N Garden Ave. Clearwater 33755 712 Nicholson Street Clearwater, Fl 33755 Thank you Vickie Shire, FRA -RP CRA Manager: Programs Community Redevelopment Agency Please note that our office has moved! 100 S. Myrtle Ave, 3rd Floor Clearwater, FL 33756 727-444-7127 1 oL! d a�a�\✓�� T C\(\ 'ii‘.6\the owner of the property located at 911 N GA AVE CLEARWATER, FL 33755, reby state that I have no objection to the work being performed on the property as part of the Residential Exterior Grant Program through Community Redevelopment. Agency, City of Clearwater. If you have any questions, please contact me at: Phone Number: (Y\j)��l�t Email: Cs6SYNAC1f(\Ci;�� "� YY1C�> 14M Owner's Sign-ture: �.� \ �r\CV1 Print Name: Mailing Address: b\J ads \.tc,G\xc• V\-- 551(o\ State of F ---[0(<:-.J.0. County of tip� a.QA1c=,-A The foregoing instrument was acknowledged before me by means *phyaical presence or * online notarization, this 3 day of `Soil , 2025 by ` 0s0,1«.3% f'1 Ooes" , who * is/are personally known to me or * who has/have produced a driver's license as identification. KJotary Public,. State of Florida (NOTARIAL SEAL) My Commission Expires: 's�y�,� x f Za2c, My Commission No.: Z--Tiqg nen 0 MICHAEL RHIEU Notary Public, State of Florida Commission# HH 277881 My comm. expires June 19, 2026 Name of Notary: j4; `-1 7 • .j Date: )D -Oa I, exA e. /vw, IA owner of the property located at 911 N GARDEN AVE CLEARATER, FL 33755, hereby state that I have no objection to the work being performed on the property as part of the Residential Exterior Grant Program through the Community Redevelopment Agency, City of Clearwater. If you have any questions, please contact me at: Phone Number: (194) cO. co\ --TO.,(9'5 Email: c ' , e-si Owner's Signature: Print Name: -ex%e \)o`vlg Mailing Address: C(c'D V. sk U2J203r-x32) 'e( T -c„ 33755 State of County of r-PuNe.14$ The foregoing instrument was acknowledged before me by means * physical presence or * online notarization, this 30 day of .1, , 2025 Liu Pvt S who * is/are personally known to meor * who h /have produced a driver's licenrsepis identifica Notary Public, State of Florida (NOTARIAL SEAL) My Commission Expires: My Commission No.: Wa2 State of Florida, County of Pinellas The foregoininstrument was acknowledged before me, by means of (XI physical presence or [ ) online n/ rizatlon, thishday ofdatp. y / �'L 146 Lam; /70-1'5 Liceelai21 Orme t Type of ID produced or is personally known to Notary Signature Name of Notary: C �'pv ru a :��gT,.•.,B�r� PAMELA A. CANALE 3.: ; 1 MY COMMISSION # HH 198275 '1,40,„.c.„ r EXPIRES: January 27, 2026 �11111�1� Date: ©b1a3idoaS I, A(41((..A.3 C G c''k C , the owner of the property located at 911 N GARDEN 33755, herebystate that I have no to the work being CLEARWATER, FL objection performed on the property as part of the Residential Exterior Grant Program through the Community Redevelopment Agency, City of Clearwater. If you have any questions, please contact me at: Phone Number: 47a7 c79 I ° i I Email: C C) lv 3 a 6 Gm 1411 • C 0 rkl Owner's Signature: Print Name: Mailing Address: q11 z C-{ (.0 Cc` State of FL- Ga\,DA County of IDIYle11aS The foregoing instrument was acknowledged before me by means * phcal presen or * online notarization, this 23 day of QVC__, , 2025 by )-ut-i\ J Lstrvnon , who * is/are personally known to me o has/have pro•uced a •river's licens- -s identification. Notary Public, State of Florida (NOTARIAL SEAL) My Commission Expires: wo/ cr1 laoaa My Commission No.: Ht1 0101 %00 Name of Notary: (:"PUrt C! 1559-S .4:14„Julia C. Balsas . Comm.: HH 601100 v Expires: Oct 7, 2028 glithv4. Notary Public - State of tiorida Date: 3cil(u,3 cGsZn 0- , the owner of the property located at 911 N GARDEN AVE CLEARWATER, FL 33755, hereby state that I have no objection to the work being performed on the property as part of the Residential Exterior Grant Program through the Community Redevelopment Agency, City of Clearwater. If you have any questions, please contact me at: Phone Number: -77 ,721d 007 Email: C_C) Y3a C° GM i'41 Co Owner's Signature: Print Name: Mailing Address: qt Uo( State of GRA Pi\ County of ?%n(1 The foregoing instrument was acknowledged before me by means * ph sical presenor* online notarization, this 23 day of V\rte, , 2025 by Uut,i iJ. LiRmortv CooneA4 , who * is/are personally known to me --h-61-iis/rw—ill—Bpro uced a driver's licens -s identification. Notary Public, State of Florida (NOTARIAL SEAL) My Commission Expires: loi 0-1 /0325 My Commission No.: Hi1coolt00 Name of Notary: CTULIA c.laftt.-Aszts Julia C. Baltas Comm.! HH 801100 Expires: Oct 7,2028 W Notary Public Rate of Rorlda 2;34®re;✓_ • x c Manage Works... secure.ssa.gov my Social Security * Home • EFA Messages r My Profile C4 Sign Out (Cheryl A. Trueblood) or an XML file. < Q MENU Your Benefit Verification Letter This is your proof of income letter. 8 Replace Your Social Security Card Replace Your Tax Form SSA-1099/SSA- 1042S . b Upload Documents Search and submit forms online or documents. • 1/nh Ir%+,r%v Tow lA/i+kkrdrlirnn 0 Toad A Get Help 2.34 :�/• .:6 ,�11� O: • Benefits and Payments Benefit Summary S_Likj,0-1 total month)y benefit before deductions 19 View your payment history and overpayment details Need to update your contact or direct deposit information? Go to £ My Profile. ISI Social Security (Disability) Active $2,031 next payment before deductions Next Payment Date: July 16, 2025 Payments are made on the 3rd Wednesday of every month Payments are made by Direct Deposit Last payment: June 18, 2025 Monthly Benefit Amount: $2,031.00 No deductions Last Payment Total: A Get Help 2:34 • my Social Security 0 MENU Welcome, Cheryl! You last signed in on July 15, 2025at 12:34 PM ET. i. Your Social Security Statement You can download your statement as a PDF or an XML file. Your Benefit Verification Letter This is your proof of income letter. Replace Your Social Security Card A. Replace Your Tax Form SSA-1099/SSA- 1042S El Upload Documents Search and submit forms online or upload documents. do Voluntary Tax Withholding View or change your tax wi A Get Help 2:34 ✓_✓_• • my Social Security MENU Welcome, Cheryl! You last signed in on July 15, 2025 •at 12:34 PM ET .t Your Social Security Statement You can download your statement as a PDF or an XML file. • Your Benefit Verification Letter This is your proof of income letter. Replace Your Social Security Card A. Replace Your Tax Form SSA-1099/SSA- 1042S b Upload Documents Search and submit forms online or upload documents. / Voluntary Tax Withholding View or change your tax wi A Get Help 2:34 • my Social Security MENU Welcome, Cheryl!. You last, signed in on July 15, 2025 at 12:34 PM ET. • Your Social Security Statement You can download your statement as a PDF or an XML file. Your Benefit Verification Letter This is your proof of income letter. 8 Replace Your Social Security Card • Replace Your Tax Form SSA-1099/SSA- 1042S b Upload Documents Search and submit forms online or upload documents. ®' Voluntary Tax Withholding View or change your tax wi A Get Help 111 0 FICARE FCU 26644 Si ver Map e PKwy Wes ey C ape FL Each loan marked • is an open-end Iter. The balance usedin compete the Mama charge on open-end loans is to unpaid principal balance at to rime of to transaction. On the dere an advance s taken. the amoa[dthe advance is added to the unpaid principal balance. On the date a payment is made, the finance charge and any late cages due ere dedmded hum the payment anamt and the remainder. 1 any. is subtracted from the unpaid principal balance. The Annual Percentage Rate (APR) is shown n the kam steamy below. The pluaso (MAY VN means thatths loan has awauable Anwa1 Pentenmge Ram. The Mehl Percentage Ram (APR) is shovm it the bat summary below. The phrase'WAY VARY)' means that this ham has a variable Annual Percentage Rae. CHERYL _ TRUEBI 0OD. 9111:,N GARDENnAVE - - -CL EARWATEILEL-33.7.55 X3O2 5 33755 Ct 813-600-5920 STATEMB.1T PERIOD FROM TO 05-01-25 05-31-25 MEMBER NUMBER - - - 1 SOG SEC. NUMBER PAGE MO DATE DAY Y TYPE OFACCOUNT/TYPE CFTRANSACTION LOAN PAYMENT AMOUNT MAME CHARM FEE OR LATE CHARGES CHANGE TO. BALANCE BALANCE 05 01 LA LA LA LA LI1 LA Lft LA I MEMBER OWNER SHARE PREVIDUS BALANCE 584 05 19 SELF SERVICE TRANSFER' FROM SHARE 75 60000 60584 05 23 SELF SERVICE TRANSFER TO SHARE 75 1000- 59584 05 27 SELF SERVICE TRANSFER TO SHARE 75 9000- 50584 05 27 SELF SERVICE TRANSFER TO SHARE 75 20030- 30584 05 28 SELF SERVICE TRANSFER TO SHARE 75 20000- 10584 05 28 SELF SERVICE TRANSFER TO SHARE 75 10000- 584 05 31 NEW STARE BALANCE 584 05 01 5 CHECKING PREVIDUS'BALANCE 16462 05 02 5 DEBIT CARD WITHDRAWAL AMAZON MKTPL*NB9 5942 8558- 7904 TMA Amzn.com/bill AMAZON MKTPL*N39E4OUS 05 02 5 CHECKING FROM CASH RECEIVED 70900 78804 05 03 5 DEBIT CARD WITHDRAWAL CITY OF CLEARN'AT 4930 8733- 70071 FL CLEARWATER 100 SOUTH MYRTLE AVUS 05 04 5 DEBIT CARD WITHDRAWAL TEMU.COM 5311 2239- 67832 MA 130-248-0611 TEMU.COM US 05 05 5 CHECKING FROM CASH RECEIVED 14030 81832 05 05 5 DEBIT CARD WITHDRAWAL THE DENTIST PLAC 8021 4734- 77C98 FL CLEARWATER THE DENT:ST PLACE OUS 05 05 5 EFT FEDERAL WARRANTY;050525 RETRY PYMT 4475- 72623 05 05 5 EFT Duke Energy ;050525 DUKE PYMNT 10231- 62422 05 05 5 EFT'ADT SECURITY SER;050525 ADTPAPACH 7525- 54897 05 06 5 CHECK NO. 2361 26580- 28317 05 08 5 CHECK NO. 2364 3035- 25282 05 09 5 DEBIT CARD WITHDRAWAL PRIMO BRANDS/NAT 5999 8594- 16688 CA 800-274-5282 PRIMO BRANDS/WATERSUS 05 13 5 CHECKING FROM CASH RECEIVED 58030 74688 05 13 5 DEBIT CARD WITHDRAWAL GOGGLE *Amazor M 5734 1499- 73189 CA Mountain View GOGGLE *Amazon M US 05 13 5 DEBIT CARD WITHDRAWAL AMAZON.COM 4816 1389- 71800 WA SEATTLE AMAZON.COM US 05 13 5 EFT LIBERTY NATIONAL;051225 INS. PREM 14817- 56983 05 13 5 EFT LIBERTY NATIONAL;051225 INS. PREM 9543- 47440 05 13 5 CHECK NO, 2363 4030- 43440 05 13 5 CHECK NO. 2365 10030- 33440 05 14 5 CHECKING FROM. CASH. RECEIVED 10030 43440 05 15 5 DEBIT CARD WITHDRAWAL TIKTOK SHOP 5399 1143- 42297 CA TIKTOK.COM TIKTOK SHOP US 05 15 5 DEBIT CARD WITHDRAWAL MEAT HOUSE OF CL 542 230- 42097 FL CLEARWATER MEAT HOUSE OF CLEARUS 05 15 5 CHECK NO. 2366 652- 41445 05 16 5 EFT T -MOBILE ;051625 FDC PAYMEN- 28697- 12748 05 17 5 DEBIT CARD WITHDRAWAL DOLLAR -GENERAL # 5310 2215- 10533 FL CLEARWATER DG 09256:600 N MYRTUS 05 18 5 DEBIT CARD WITHDRAWAL CVS/PHARMACY #00 5912 462- 10071 FL Clearwater 00104--1 S MissouriUS CONTINUED NEXT PAGE This statement is a permanent record dyad account income tax information appears at the end of to statement To report eaors or make inquiries about bans marled with en • write t: FICARE FCU 26644 Si ver Map e Pavy STATEMENT OF ACCOUNT Wes ey C ape FL 3544 Each loan nwlwd • is an oparwd loan. The balsam used to compute the finance targe on open-end loans is the repaid principal balance at to fmhe of the transaction. On the date an advance is tu&un. the amoud of the advance is added tu to unpaid principal halance. On the date a payment is made, the fawn charge and any late charges' due am deducted from the payment ammmt and the remainder, If any, is subtrected from the unpaid principal balance. The Annual Percentage Rate (APR) is shown in the leap summary below. The phrase 'WAY VARY)' means that this ban has avarrable Annual Percentage Rate. The Moral Percentage Rate (APR) is shown in the loan summary below. The phrase "(MAY VARY)' means that this loan has a variable Annual Percentage Rate. - - 33755 CHERYL TRUEBLOOD 911 N GARDEN AVE CLEARWATER FL 33755-3025 /' fire To report or maim inquiries about electronic d /4 tansfers 'EFT. write m addr s on left or call: 813-600-5920 STATEMENT PERIOD FROM TO 05-01-25 05-31-25 MEMBER UMBER - - 3 SOC. SEC. NUMBER PAGE MO DATE DAY Y TYPE OFACCOUNT/TYPE OFTRANSACTION LOAN PAYMENT 'MST AMMI: FEE OR LATE CHARGES CHANGE TO BALANCE BALANCE 05 28 5 SELF SERVICE TRANSFER FROM SHARE 01 10000 36909 05 30 5 DEBIT CARD WITHDRAWAL AMAZON.COM 4816 2345- 34564 WA SEATTLE AMAZON.COM US 05 30 5 EFT T -MOBILE ;053025 FDC PAW/EN 28697- 5867 05 31 5 NEW SrIARE BALANCE 5867 * * * * DRAFT NUMBER SEQUENCE SUMMARY * * * * 2361 265.80 2362 40.23 2363 40.00 2364 30.35 2365 100.0D 236E 6.52 * BREAK IN DRAFT NUMBER SEQUENCE . • . TOTAL PERIOD FOR : : TOTAL YTD . . : TOTAL OVERDRAFT FEES 0.00 : 0.00 : : TOTAL RETURNED ITEM FEES 0.00 : 35.00 : FEE ADJUSTMENTS MAY BE REFLECTED IN TOTALS ******** 2025 YEAR-TO-DATE FINANCIAL SUMMARY ******** --- - DIV/INT DIV/INT MOR -GAGE MORTGAGE MDRTCAGE OTHER NON-MTG PAID WITHHOLDING PO:NTS LATE CHG FIVANCE CHG FINANCE CHC 0.00 0.00 0.00 3.00 0.00 0.00 This statemad is a permanent record draw accom . Income tax information appears at the end of the statement To repo([ emirs or make inquiries about bears marled w'h an • wire to: FICARE FCU STATEMENT OF ACCOUNT 26644 Si ver Map e P my Wes ey C ape FL 3544 Each loan marled • is an open-end loan. The balance used or compete the finance charge an open-end loans is the unpaid principal balance at the time of dna transaction. On the daze an advance is taken, the amount of the advance is added to the unpaid principal balance. On the date a payment is made, the finance chane and any late charges due am deducted from the payment amount and the remainder, d any, is subtracted from the unpaid principal balance. The Annual Percmrtilly1 Rate (APR) is shown in due loan summary below. The phrase "(MAY VARY)' means that this loan has available Annual Percentage Rate. The Annual Percentage Ram (APR) is shown in the ban summary below. The phrase 'MAY VARY)' meas that this loan has a variable Aroma! Percentage Rate. 33755 CHERYL TRUEBLOOD 911 N GARDEN AVE CLEARWATER FL 33755-3025 ,.+' To report or male cqueG ies about eleonic fund t(`� rummers •EF7'. write to address an Telt or call : 813-600-5920 STATEMENT PERIOD FROM TO 06-01-25 06-30-25 MEMBER NUMBER - - 1 SOC. SEC. NUMBER PAGE MO DATE DAV Y TYPE OFACCOUNT /TYPE OFTRANSACTION LOAN PAYMENT AMOUNT FEE OR LATE CHARGES CHANGE TO BALANCE BALANCE 06 01 5 EMBER OWNER SHARE •REVI'US BALANCE '84 06 02 5 •VERDRAFT TRANSFER TO SHARE 75 0:4- '00 06 30 5 EW S •R: BALANC '00 06 01 'LILA LALALALALA LAL11 LA LLALALAIIA_ HECKING •REVI'US BALANCE 5:67 06 02 NECKING FROM CASH RECEIVED 707.0 76-67 06 02 DEBIT CARD WITHDRAWAL TIKTO SHOP 5 99 4 34- 72 73 . TIKTOK.COM TIKTOK S OP US 06 02 •VERDRAFT TRANSFER FROM SHA "E 01 0:4 72'57 06 02 EFT VW CREDIT, TEL. ;060225 TEL DE:IT 71813- :44 06 02 'VERDRAFT FEE 8.0- 56- 06 03 NECKING FROM CASH RECEIVED 140.0 13:44 06 04 DEBIT CARD WITHDRAWAL TIKTO SHOP 5 99 10.9- 12 75 A TIKTOK.COM TIKTOK S OP US 06 04 HECKING FROM CASH RECEIVED 5.0 13.75 06 05 t'EBIT CARD WITHDRAWAL ADT S CUR *'20 4814 75'5- 5 50 FL WWW.ADT.COM ADT SECU'ITY*3'0 63US 06 06 HECK NO. 2367 4839- :51 06 10 EFT LIBERTY NATIONAL;061025 INS P 4.0- ,51 ..ERIAL#2368 06 11 HECKING FROM CASH RECEIVED 240.0 24.51 06 11 EFT LIBERTY NATIONAL;061025 INS. •R:M 14817- 9:34 06 11 EFT LIBERTY NATIONAL;061025 INS. •R:M 95,3- .91 06 16 : . 310 ,061625 XxsoC s:c 203 .0 203 91 .. . NECKING FROM CAS" Y ' . Al -. 06 16 5 !DEBIT CARD WITHDRAWAL AFFIR PAY IN 6012 4939- 227'92 A SAN FRANCISCO AFFIRM PAY 1'G US 06 16 5 DEBIT CARD WITHDRAWAL Goog1 Amaz.n Mo 5818 1,39- 226.93 A 650-2530000 Google • azon o•i1US 06 16 5 i'EBIT CARD WITHDRAWAL ROYAL CARIB:E•N 4411 379,6- 188 47 FL 800-327-6700 ROYAL CA'IBBEA 'RUUS 06 17 5 DEBIT CARD WITHDRAWAL GIV*S JOHNP•I BA 86.1 250.0- 163 47 FL 727-443-1861 GIV*STJO NPRIM:A•TCUS 06 17 5 DEBIT CARD WITHDRAWAL PRIMO BRAND./ T 5939 8735- 15452 800-274-5282 PRIMO B NDS/W•T:RSUS 06 17 5 EFT T -MOBILE ;061725 FDC P•Y EN 293:1- 124'71 06 17 5 EFT CAPITAL ONE ;061625 PHONE P 'T 150.0- 109'71 06 17 5 EFT VW CREDIT, TEL. ;061725 TEL 'E:IT 71813- 38 58 06 18 5 ,DEBIT CARD WITHDRAWAL MCDON LDS 4:2 58 r 2352- 35:06 FL CLEARWATER 1860 GUL TO B•Y BLUS 06 18 5 ,TM WITHDRAWAL 120.0- 23:06 FL CLEARWATER 619 S,FO'T HAR'I.ONUS 06 18 5 .DEBIT CARD WITHDRAWAL DOLLA TREE 5 31 18.3- 22.03 FL DUNEDIN 928 PATR CIA A E US 06 18 5 EBIT CARD WITHDRAWAL WM SU'ERCEN P. # 5,11 5:8- 21,15 FL CLEARWATER 1803 N H GHLAND •VEUS 06 19 5 DEBIT CARD WITHDRAWAL DOLLA'-GENE•• # 5310 12.1- 20 84 FL CLEARWATER DG 09256 600 N M RTUS CONTINUED NEXT PAGE This statement is a pemmneent ramrd of your exeunt. Income tic odomnatian appears at dee end of the statement ►�� ..55� Clnec�,� To report mars or male inquiries about loans marked with en • write to: FICARE FCU ( STATEMENT OF ACCOUNT 26644 Si ver Map e P<wy Wes ey C ape FL 3 r4 Each ban marled' is an open-end loan. The balance used to compute the finance charge an open-end bans is the unpaid principal balance at the time of the transaction. On the dam an advance is taken, the amount of the advance is added to the unpaid principal balance. On the dam a payment is made, the finance charge and any lam charges due are deducted from the payment amount and the remainder, d any, is subtracted from the unpaid principal balance_ The Annual Percentage Ram (APR) is shown in the loan summary below. The phrase 'WAY VARY)' means that this loan has avertable Annual Pemxmagge Rae. The Annual Percentage Ram (APR) is shown in the loan summary below. The phrase 'WAY VARY)• means that this loan has a variable Amita! Percentage Raze. 33755 CHERYL TRUEBLOOD 911 N GARDEN AVE CLEARWATER FL 33755-3025 To report or make inquiries about electronic fund readers •EFT', vara to address on left or call : 813-600-5920 STATEMENT PERIOD FROM TO 06-01-25 06-30-25 MEMBER NUMBEF CHANGE TO BALANCE - - 2 SOC. SEC. NUMBER PAGE MO DATE DAY y TYPE OFACCOUNT/TYPE OFTRANSACTION LOAN PAYMENT AMOUNT FEE OR LATE CHARGES CHANGE TO BALANCE BALANCE 06 19 5 DEBIT CARD WITHDRAWAL Amazon.com*JA76H 5942 1623- 18561 WA Amzn.com/bill Amazon.com*NA75H3WMUS 06 19 5 DEBIT CARD WITHDRAWAL AMAZON MKTPL*N00 5942 2139- 16422 WA Amzn.com/bill AMAZON MKTPL*NJOCV1US 06 20 5 DEBIT CARD WITHDRAWAL SHEIN COM 5521 4750- 11672 CA US.SHEIN.CO1 SHEIN.COM US 06 20 5 DEBIT CARD WITHDRAWAL TIKTOK SHOP 5399 310- 11362 CA TIKTOK.COM TIKTOK SHOP US 06 21 5 DEBIT CARD WITHDRAWAL AMAZON MKTP,_*h03 5942 4921- 6441 WA Amzn.com/bill AMAZON MKTPL*N03623US 06 21 5 DEBIT CARD WITHDRAWAL MCDONALD'S F4E2 581, 1130- 5341 FL CLEARWATER 1860 GULF TO BAY BLUS 06 21 5 DEBIT CARD WITHDRAWAL DOLLAR -GENERAL # 5310 2140- 3201 FL CLEARWATER DG 09256:600 N MYRTUS 06 23 5 CHECKING FROM CASH RECEIVED 96000 99201 06 24 5 DEBIT CARD WITHDRAWAL TIKTOK SHOP 5399 2022- 97179 CA TIKTOK.COM TIKTOK SHOP US 06 24 5 EFT PROG AMERICAN ;062425 INS PREN 78261- 18918 06 24 5 EFT FREEDOM LIFE INS;062225 INS. PREM 5634- 13284 F AMERICA 800 387 9027 06 25 5 CHECKING FROM CASH RECEIVED 5200 18484 06 27 5 CHECKING FROM CASH RECEIVED 10030 28484 06 27 5 EFT FEDERAL WARRANTY;062725 SVC-PROTEC 4475- 24C09 06 28 5 CHECK NO. 2369 18391- 5618 06 30 5 CHECKING FROM CASH RECEIVED 51030 56618 06 30 5 FROM J COONEY 2000 58618 06 27 5 EFT CA 800-274-5282 PRIMO BRANDS/WAT 8995- 49623 CA 800-274-5282 PRIMO BRANDS/WATERSUS 06 30 5 NEW SLARE BALANCE 49623 * * * * DRAFT NUMBER SEQUENCE SUMMARY * * * * 2367 48.99 2368 4.03 2369 183.91 * BREAK IN DRAFT NUMBER SEQUENCE • • . . TOTAL PERIOD FOR : TOTAL YTD . . : TOTAL OVERDRAFT FEES 3.00 0.00 : TOTAL RETURNED ITEM FEES 3.00 35.00 FEE ADJUSTMENTS MAY BE REFLECTED IN TOTALS --- ******** 2025 YEAR-TO-DATE FINANCIAL SUMMARY ******** --- - DIV/INT DIV/INT MOR -GAGE MORTGAGE MJRTCAGE OTHER NON-MTG PAID WITHHOLDING PO:NTS LATE CHG FINANCE CHG FINANCE CHC 0.00 0.00 0.00 3.00 0.00 0.00 This statement is a permanent record of your account Income rex information appears at the and of the statement E 911 N Garden Ave 911 N Garden Ave Clearwater, Florida Google Street view Feb 2025 See more dates • ,►��oNll�llil`iiii ‘c.‘ CITY OF CLEARWATER COMMUNITY REDEVELOPMENT AGENCY POST OFFICE Box 4748, CLEARWATER, FLORIDA 33758-4748 600 CLEVELAND STREET, CLEARWATER, FLORIDA 33755 TFISPHONE (727) 562-4039 RE: Letter of Intent to Volunteer As part of the North Greenwood Community Redevelopment Agency (NGCRA) Residential Exterior Improvement Grant Program, you are making a commitment to complete volunteer hours in order to waive the financial match portion of the grant. This letter serves as a formal acknowledgment of your commitment to complete this volunteer requirement. \rl-re.LZ Applicant Name: Organization: 1)6 f Address: 1 CO en\--1=taS t Contact Person: 0 0 C-1 Contact Number/Email: `.7 2.1 71 D a Brief Description of Role: Total Volunteer Hours Required: \Th -S Please Note: In the event the Applicant is unable to complete or provide the amount of hours agreed to in the application, the required contribution shall be reduced by the monetary value of the number of hours actually provided. Volunteer Commitment By signing, you confirm your intent to complete the required volunteer hours to fulfill the volunteer match for the North Greenwood Residential Improvement Grant. Upon completion, our organization may verify your service. Print Name: Signature: Date: CRA Staff Signature: Date: Ryan Cotton, Councilmember Mike Mannino, Councilmember Bruce Rector, Mayor David Allbritton, Councilmember Lina Teixeira, Councilmember "Equal Employment and Aflirmative Action Employer" ALPHA FOUNDATIONS A Cho,¢d arks Company Licensed Contractor CBC1257350 Customer and Account, umber Chery Trueblood Project Location 911 N Garden Ave Clearwater , FL 33755 Tampa 1615 118th Ave. N, St. Petersburg, FL 33716 Phone: 813-709-8605 Website: www.alphafoundations.com ork or Home) (727)657-7027 E-mail Not.provided@none.com PROPOSED PRODUCTS QTY Utilities Protection 5 Year Annual Service Plan Permit Package A Engineering A SettleStop IntelliJack (1-3') µ_ Supplemental Beam - S4 Site Work/Obstruction 1.0 1.0 1.0 1.0 14.0 48.0 5.0 Contract Price :$22,929.34 This Contract, along with the Terms and Conditions, the Warranties, the Notice of Cancellation, and the Payment Terms form the contract (the "Contract") between the Customer and Alpha Foundation Specialists, LLC (the "Contractor"). Customer is responsible for removing all personal items X from the work area. X recommended. Customer assumes responsibility for damages to hidden or X unmarked utility lines. X Customer is aware of warranty and all addenda. Stabilization is warrantied. Contractor can attempt to lift at Customer is responsible for providing all necessary X Customer's request. X electrical outlets. A full perimeter drainage system with sump pump was Acceptance of Contract - The above prices, specifications, conditions, and separate warranty are satisfactory and hereby accepted. You are authorized to do work as specified. Payment will be made as outlined above or in accordance with the attached addendum. Subject to the Terms and Conditions, Contractor shall endeavor to start work within one hundred fifty (150) days of the date of the Contract and shall endeavor to complete the work within an estimated one hundred twenty (120) days of the start date of the work.. Customer Contractor X X Date 9/24/2025 X Date 9/24/2025 Supplemental Notes Alpha Foundation Spec 3, LLC to: Product Specifications o Site work and/or obstructions on project. o Permit package includes all administration duties and permit fees associated with project. o Install Intellijack support system to stabilize floor joist or beams as shown. Galvanized steel Intellijack is adjustable and installed with gravel and concrete footing. Lift can be attempted at the customer's request but achievement of any lift or leveling cannot be promised. The customer understands and agrees that attempting lift can cause interior damage and the customer assumes full responsibility for any damage caused by their request for lift. Final location of the Intellijacks are subject to change. Intellijacks come with a 25 -year manufacturer's warranty and a 2 -year adjustability warranty. See warranty section for full details. o Install supplemental steel beam. The total linear feet of beam are specified on the products page of this contract. o Five years of service is included in this contract. Customer is aware this will be on the aniversary date of install completed. This is not refundable and will transfer to new home owners if house is sold. • Utilities protection will cover repairs to private utilities damaged during installation (cable, sprinklers, private water lines, private electric lines etc). Repairs limited to damaged area and do not include full line replacement. • Engineering package includes all administration duties, engineering documentation and fees associated with project. Terms and Conditions 1. Services. Alpha Foundation Specialists, Alpha Foundations, license no.CBC1257350, \` is licensed by the Florida Department of Business and Profesional Regulation. This Contract for the services requested by Customer (the "Work~) is based primarily upon Customer's description of the project and/or the related problem(s) and is intended to remediate those problem(s). Contractor assumes existing construction generally complies with the relevant building codes. Any drawing(s) attached to the Contract are intended solely for illustration purpoven, are not to vra|o, and do not create any additional mpmoontouon, warranty, or commitment on the part of Contractor in connection with the Work. Contractor is not responsible for products, oemicnn, or conditions not expressly reflected herein, not expressly included in the Contract, and not purchased and paid for by Customer. Start dates and completion deadlines for the Work are approximate and may be affected by events beyond Contractor's control, such as weather, permitting ioovoe, access to the property, am. Any delay caused by events beyond the control of Contractor shall not constitute abandonment and shall not be included in calculating timeframes for payment and performance. Contractor reserves the right to amend the scope of the Work In order to best address the project and/or problems. Any changes to the scope of Work which change the cost, materials, work to be performed, or estimated completion date must be made in writing, signed by both parties, and paid for before the Work can be performed. Any deviation from the scope of Work set forth in the Contract that results in additional costs, including but not limited to unforeseen site onndioonv, unusual building conatmmivn, changes needed after Contractor's engineering/ management review of the signed cuntnoct, and/or special requirements from the county/city/agency, will become an extra charge over and above the contract amount set forth in the Contract. If Customer and Contractor cannot agree on the amount of such additional costs and sign an amendment to the Contract, then Contractor has the option, at its sole discretion, of not proceeding with the Work and canceling the Contract for its convenience. Contractor reserves the right to substitute a product with an equivalent or superior product. The Work will be completed in a workmanlike manner according to the standard practices of the industry, and Contractor will comply with local permitting, inspection, and zoning requirements. 2. Acceptance Of Contract. By signing the Contract, Customer acknowledges that he/she understands and accepts all terms, the Terms and Conditions and the Warranties, and desires to enter into a contract with Contractor for the completion of the Work. Customer's signature authorizes Contractor to perform the Work as specified in the Contract. The Contract may be withdrawn by Contractor if it is not accepted within thirty (30) days from the date of delivery. 3. Compensation. Customer agrees to pay Coritractor compensation as set forth in the Contract. Payment must be made in full upon completion of the Work. Failure by Customer to make payments when due shall constitute a breach of the Contract. A service fee of $25 will be charged for each returned check, and interest at a rate of 1% per month shall be applied to any amounts owed by Customer to Contractor (both pre -judgment and post -judgment) if Customer fails to pay the amounts owed for the Work as agreed. 4. Insurance. Contractor represents and warrants that it maintains insurance as set forth in the Contractor's Certificate of Liability lnsurance, which can be made available upon request. 5. Dispute Resolution. Dispute Resolution. Contractor and Customer agree that the Contract evidences a transaction involving or affecting interstate commerce and that their agreement to o,bitrate, including whether an agreement to arbitrate exists or whether the controversy is subject to an agreement to o,uitrate, shall be governed by the Federal Arbitration Act ("FAA"), 9 U.S.C. § 1, et seq. Any c|aim, diapue, or other matter in controversy arising out of or related to this Contract or breach thereof and/or related to the Work shall be settled by arbitration administered by the American Arbitration Association ("AAA") in accordance with its Construction Industry Arbitration Rules and the FAA in the place where the project is located, unless another location is mutually agreed upon, and judgment on the award rendered by the single arbitrator appointed to decide such proceeding may be entered in accordance with applicable law in any court having jurisdiction thereof. The fee schedule is listed on the AAA website at http://info.adr.org/constructionfeeschedule/. For any other issues, the Contract shall be governed by the Iaw of the place where the project is located, excluding that jurisdiction's choice of law rules. lf Customer elects to initiate arbitration, the arbitrator has the discretion and authority to award such remedies as may be available under applicable law. If payment in full is not made when due, Contractor may recover from Customer all expenses of collection, including attorneys' fees, court custo, court reporter fees, and expert witness fees, in such amount as the arbitrator may adjudge reasonable if Contractor prevails on such payment claim. Except as stated in the preceding sentence, each party shall be responsible for its own attorneys' fees for the arbitration. Contractor is also erititled to recovor interest on the unpaid amount from the date due until paid at the rate of 1% per month. EACH PARTY TO THIS CONTRACT FOR ITSELF, ITS SUCCESSORS AND ASSIGNS, WAIVES ALL RIGHTS TO TRTAL BY JLJRY FOR ANY CLAIM, DISPUTE, OR OTHER MATTER IN CONTROVERSY ARISING OUT OF OR RELATED TO THIS CONTRACT. 6. Customer's Responsibility. a. Cosmetic Repairs. Unless specifically noted in the Contract, Contractor is not responsible for any cosmetic repairs. Rather, Customer is responsible for any finished carpentry, paindnn, repvinunQ, electrical work, extending discharge lines, replacement 01' floor tiles, co,po8ny, pane|inu, etc. that may be necessary after Contractor has completed the Work, unless such repairs are specifically identified in the Contract. When trenching or excavation is oaqui,eu. Contractor will backfill and compact soil to the best of its ability; however, Customer may need to add more topsoil at a later date if the excavated area settles. Customer is also responsible for any |*ndacapinn, reneeuino, and resodding that may be necessary after Contractor has completed the Work. b. Utilities. Contractor will call the appropriate utility protection service or damage prevention authority (|.o, 811 or "Miss Utility") to have all public underground utilities located. 1' Customer livesat a rural amuomu, public lines will only be located to the pole or Customer's property line. Customer is responsible for marking any private lines such as satellite dish cables, propane lines, low voltage lighting wires, sprinkler system lines, security system winae, services to outbuildings and swimming pov|x, etc. Customer assumes all responsibility for damage caused to muuen, buried, or unmarked fuel/utility/service/private lines. Unless otherwise noted, electrical work is not included in this Contract and problems with electrical connections are the responsibility of Customer. c. Water Seepage. Customer agrees to maintain positive drainage away from any wall(s) repaired by wall unoxom, foundation piers, and/or carbon fiber strips/reinforcers. In the event of a wall anchor installation, a water management system is recommended to reduce hydrostatic pressure (which increases at greater depths) on the wall(s) and reduce the chance of water seepage into the basement. Water seepage into any area of the basement is NOT covered by the attached Warranties. d. Access and Personal Property. Customer shall provide access to the areas where the Work is to be performed and shall furnish utilities of electric and water at no cost to Contractor. Customer shall prepare such areas so that Contractor can begin work, including moving all items at least 10 feet away from areas where Work is to be performed and adequately sealing off living space from work areas. Customer shall remove or protect personal property, inside and outside of the residence, including but not limited to carpets, rugs, shrubs and plants, and Contractor shall not be responsible for said items. In the event that the removals have not been completed by the schedu!ed start date for Work, Custorner shall be assessed a trip fee of $250. Contractor may offer, but is not required, to assist (i) in the preparation of the Work areas and/or (ii) in the removal and replacement of drywall, paneling, flooring, finish carpentry, wall coverings, or landscaping at a rate of $40 per man hour. e. Representations. Customer warrants that except as described in the request for service, all eiactrico|, p|ummng, xN\C, mam,annn, and handyman services Iocated on the propertyin good repair and condition and agrees to indemnify Contractor for any defective conditions that exist prior to or that occur after performance of the Work through no fault of Contractor. Customer is responsible for protecting the components that Contractor provides from future damage and shall follow all instructions provided in maintaining and protecting such components. 7. on'S|taMo^gingn. Customer shall meet with Contractor on-site before the Work begins and shall meet with Contractor on-site when the Work is completed and ready for inspection such that Contractor can explain the Work and finalize payment by Customer. Customer shall be responsible for being present on- Warranties These Warranties are in effect only after the Work is completed and Customer has paid in full. If payment is not received, these Warranties are null and void. These Warranties are made in lieu of all other warranties, express or implied, and of all other obligations on the part of Contractor to Customer. There are no other oral or written warranties. There are no warranties which extend beyond the descriptions that appear below, including no warranties of express or implied merchantability and no warranties of express or implied fitness for a particular purpose. These Warranties are transferable to future owners of the structure on which the Work is completed. Contractor shall charge a fee of $240 to complete a system inspection and new owner orientation. All warranty claims must be brought prior to the expiration of the applicable warranty period in order to be valid. Contractor does not warrant products not mentioned herein. Some products may be covered by a separate manufacturer's warranty, and Customer is responsible for compliance with any notice and claim procedure included in such warranties. 1. Definitions. The term "stabilize," as used in these Warranties, shall mean to make unlikely to give way or fail. The term "horizontal movement", as used in these Warranties shall mean bowing. The term "vertical movement," as used in these Warranties shall mean settlement. 2. Wall Support Systems. Contractor hereby warrants that wall support systems, including wall anchors, carbon fiber strips, and steel I-beam systems, will stop further inward horizontal movement of the wall(s) in the areas where they are installed for the lifetime of the structure from the date of installation. Wall support systems are warranted only to stabilize repaired walis(s), not straighten. Walls that do not have wall support systems installed by Contractor entirely from corner to corner are not warranted. Contractor recommends annual maintenance for wall support systems. The cost of maintenance is not included in this contract, but maintenance is available from Contractor at an additional charge. For carbon fiber strips, contractor does not warrant against: (1) any tipping or leaning at the top of the wall(s) repaired; (2) shearing or sliding at the bottom of the wall(s) repaired. In the rare instance that the repaired wall(s) experience leaning or shearing, steel brackets or other methods can be installed by Contractor at an additional charge. 3. Foundation Push Piers and Foundation Helical Piers. Contractor warrants that the foundation push piers and foundation helical piers will stabilize the affected area(s) against further vertical movement for the lifetime of the structure from the date of installation. Contractor DOES NOT WARRANT TO LIFT ANY STRUCTURE, to close cracks, to render doors and windows operational, or to move walls back to their original position, but will do its best to achieve positive results in this regard, if lift is requested by Customer. Contractor is not responsible for any damages caused by a lifting operation on Customer's foundation. Foundation push piers and foundation helical piers are sold and installed without the benefit of detailed knowledge of the existing foundation construction or subsurface conditions at the site. Contractor reserves the right to conduct a more thorough subsurface investigation, if necessary. Such an investigation may result in additional charges and delays. 4. Steel Columns/Adjustable Screw Jacks/IntelliJack Supports/SettleStop Floor Supports. Contractor warrants that the support system will stabilize -the affected area(s) against further vertical movement for a period of two (2) years from the date of installation. This two .(2) years warranty against further vertical movement is separate and apart from the manufacturer's warranty of twenty-five (25) years on the product(s). Contractor DOES NOT WARRANT TO LIFT ANY STRUCTURE, to close cracks, to render doors and windows operational, or to move walls back to their original position, but will do its best to achieve positive results in this regard, if lift is requested by Customer. Contractor is not responsible for any damages caused by a lifting operation on Customer's framing. The condition of wood located in crawl spaces can be highly variable and can rapidly deteriorate or move as a result of changes in environmental conditions and/or changes in the building envelope conditions. Contractor is not responsible for wood repair (i.e., joist sistering, beam replacement, sill plate repair, cracking/movement in hardwood flooring or tiles) incidental to changes in environmental conditions and/or changes in the building envelope conditions, unless specifically noted in this Contract. Contractor warrants carpentry work for a period of one (1) year. Steel columns/adjustable screw jacks are sold and installed without the benefit of detailed knowledge of the existing foundation construction or subsurface conditions at the site. Contractor reserves the right to conduct a more thorough subsurface investigation, if necessary. Such an investigation may result in additional charges and delays. 5. Slab Piers. Contractor warrants that the slab piers will stabilize the affected area(s) against further vertical movement for a period of ten (10) years from the date of installation. Contractors DOES NOT WARRANT TO LIFT the slab back to its original position. 6. Water Management. Contractor warrants that if water from the walls or floor wall joint passes through the perimeter of the water management system and into the basement floor, Contractor will provide the additional labor and- materials to fix the leak at no additional charge to the Customer. This warranty applies to water management systems along the specific areas where the system is installed. This warranty will be in effect for the lifetime of the structure and may be transferred to future homeowners provided Contractor is notified within thirty (30) days of the real estate transfer. Annual maintenance is strongly recommended for all water management systems, but is not required for the warranty to be in effect. The water management system shall not rust, rot, or corrode for the life of the structure. If the entire perimeter of the basement was not treated, then additional work at an additional charge may be necessary to extend the system or treat other areas or other problems not addressed by this Work. In addition, a pump or power failure is possible; therefore, this warranty is not a guarantee of a dry basement. This warranty shall not apply to condensation, or any system that has been altered in any way, water vapor transmission, concrete discoloration from capillary action, water squirting out of the walls over the system, window well flooding, plumbing leaks, surface water flooding, leaks from chimneys or garages, wall dampness, or efflorescence (white powder) on concrete, masonry or bricks. Contractor is not responsible for frozen discharge lines or water once it is pumped from the structure. Installation of a water management system does not include extending discharge lines more than five (5) feet from the foundation or electrical work, unless specified. Floor cracks are warranted against leakage only with full perimeter water management systems. Primary AC operated sump pumps and DC back-up pumps may be covered under a separate manufacturer's warranty. Systems that drain to daylight cannot be warranted by Contractor if such system does not drain enough water, does not drain water from under the floor, clogs, or freezes. While, drainage systems clogging or malfunctioning from iron ochre, iron get, or iron bacteria from the soil are rare, Contractor cannot be responsible for these situations, or for a system that requires cleaning, flushing, or other service as necessary to keep it functioning. 7. Crawl Space Encapsulation. A crawl space encapsulation system will isolate the home from the earth. The humidity level in the air will be lowered, reducing moisture; however, the encapsulation system does not claim to be a mold mitigation system and a dehumidification/air purification system is highly recommended to further reduce mold growth. CrawlSeal has a transferable twenty-five (25) years warranty—there will be no charge for service calls on any tears or holes in the CrawlSeal liner (not caused by abuse or misuse), in the unlikely event this occurs. Wet crawl spaces require a drainage system and a sump pump system to remedy any problems with water below the liner. There will be no charge for Contractor to repair tears or holes in the crawl space encapsulation liner, unless Contractor determines that the tear/hole was caused by abuse or misuse. Sump pumps and crawl space encapsulation systems may be covered under a separate manufacturer's warranty. Installation of a crawl space encapsulation system does not include extending discharge lines more than five (5) feet from the foundation or electrical work, unless specified. Contractor is not responsible for frozen discharge lines, water once it is pumped from the structure, or condensation. The condition of wood located in crawl spaces can be highly variable and can rapidly deteriorate or move as a result of changes in environmental conditions and/or changes in the building envelope conditions. Contractor is not responsible for the repair of pre-existing wood damage unless specifically noted in this Contract. 8. PolyRenewal and Expanding Polyurethane Structural Foam. Contractor represents that expanding polyurethane structural foam will fill voids, but will not necessarily lift Customer's slab to meet any criteria of levelness. Contractor recommends sealing all cracks and joints, and Contractor can do so for an additional charge. Contractor warrants that the area where the slab of concrete was stabilized will not settle more than % inch for a period of five (5) years from the date of installation. If it does, Contractor will provide the labor and materials to re-inject the area at no additional charge to Customer. This Warranty does not include patching or caulking between slabs. Customer is aware that the concrete may not be perfectly level or may not lift at all. Contractor guarantees stabilization, NOT LIFT. Any personal items in the work area are to be removed by the Customer prior to the arrival of the Contractor's crew. This warranty is void if Customer does not maintain grade around slabs and seal joints between slabs. NOTICE OF CANCELLATION ( l Transaction Date: You may CANCEL this transaction, without any penalty or obligation, within THREE BUSINESS DAYS from the above date. If you cancel, any property traded in, any payments made by you under the Contract or sale, and any negotiable instrument executed by you will be returned within 10 BUSINESS DAYS following receipt by Contractor of your cancellation notice, and any security interest arising out of the transaction will be canceled. If you cancel, you must make available to Contractor at your residence, in substantially as good condition as when received, any goods delivered to you under this Contract or sale; or you may, if you wish, comply with the instructions of Contractor regarding the return shipment of the goods at Contractor's expense and risk. If you do make the goods available to Contractor and Contractor does not pick them up within 20 days of the date of your notice of cancellation, you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to Contractor, or if you agree to return the goods to Contractor and fail to do so, then you remain liable for performance of all obligations under the Contract. To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice or any other written notice, or send a telegram, to: Alpha Foundation Specialists, LLC at 1615 118th Ave. N, St., Petersburg, FL 33716 NOT LATER THAN MIDNIGHT OF (Date). I HEREBY CANCEL THIS TRANSACTION. (Date) (Customer's signature) If after three business days the transaction has not been canceled, then the deposit will be non-refundable. PAYMENT TERMS We propose hereby to complete the services indicated in this Contract for the sum of: Contract Amount Deposit Due Upon Completion $22,929.34 $5,732.33 $17,197.01 Is the project financed? YES NO (Financing must be set up at the time of the signed contract.) Approval/Account # X (initial) - Customer must be present on final day of install and final walk-through is to be performed with the job foreman. X (initial) - Balance to be paid in full to foreman on last day of install. (Unless financed) BUYER'S RIGHT TO CANCEL. This is a home solicitation sale, and if Customer does not want the goods or services, Customer may cancel the Contract by providing written notice to Contractor in person, by telegram, or by mail. This notice must indicate that Customer does not want the goods or services and must be delivered or postmarked before midnight of the third business day after Customer signs the Contract. The notice must be mailed or delivered to: Alpha Foundation Specialists, LLC at 1615 118th Ave. N, St., Petersburg, FL 33716. If Customer cancels the Contract, Contractor may not keep all or part of any cash down payment. If Customer does not cancel the transaction during the cancellation period listed in this paragraph of the Contract, the deposit will be non-refundable. See the attached Notice of Cancellation form for further explanation of this cancellation right. Customer Contractor X X Date 9/24/2025 X Date 9/24/2025 7/15/25, 3:01 PM Licensing Portal - License S( :I a�F .ilii .,.:. . „ �._-ri. dbpr ONLINE SERVICES Apply for a License Verify a Licensee View Food & Lodging Inspections File a Complaint Continuing Education Course Search I`a` 4,0 7 l'i:. r4 ViewApplicafion Status Find Exam Information Unlicensed Activity Search AS&T Dennquent invoice & ACtivity Ust Scorch HOME CONTACT US LICENSEE SEARCH OPTIONS 3:01:12 PM 711512025 Data Contained In Search Results Is Current As 01 0711 512026 03:00 PM. Search Results - 2 Records Please see our glossary of terms for an explanation of the license status shown in these search results. For additional Information, Including any complaints or discipline, click on the name. License Type Certified Building Contractor Address': Name ALPHA FOUNDATIONS Name Type DBA License Number) StatuslExplres Rank 0801257350 Current, Active Cert Building 08/3112026 License Location 1741 CORPORATE LANDING PARKWAY VIRGINIA BEACH. VA 23454 Main Address': 65 INDUSTRIAL PARK RD MONTICELLO, FL 32344 Certified SHANLEY. Building MATTHEW. Contractor STEPHEN Address': Pr maty CBC1257350 Current, Active Cert Building 08/31/2026 License Location 1741 CORPORATE LANDING PARKWAY VIRGINIA BEACFL VA 23464 Main Address': 66 INDUSTRIAL PARK RD MONTICELLO, FL 32344 •denotes Main Address - This address is the Primary Address an rile. Malting Address -This is ole address where the mail associated with a n061001511104080 045 be sent (i1 di7eren1 ham the Main or License Location addresses). License Location Address -This is lite address wfiere the place of business is physically located. 2601 audr Scone Road. Taftahasoae FL. 32308: Email: Customer Comact Center :: Customer Contact -Canter: 850,487.1395 The State of Florida is an AAIEEO employer. Copyright/12023 Department of Business and Professional Regulation - Stale of Florida. Privacy Statement Under Florida law, email addresses are pubic records. If you clonal want your email address released in response to a pubccrecards request, do not send electronic mail to this entity. Instead, contact the office by phoneorby traditional mal. If you have any questions, please contact 850.487.1395. 'Pursuant to Section 455.276(1), Florida Statutes. effective October 1. 2012, licensees licensed under Chapter 455, P.S. must proVale the Department with an email address if they have one, Ms entails provided may be used for official communication with the licensee. however email addresses are putts record. If you do not wish to supply a personaladdress, please provide the Department whit an email address which an be made availatde to the public. Please see our Chapter 455 page to determine it you are affected by this change. https://www.myfiorida license. com/w111.asp?mode=2&search=LicNbr&SID=&b rd=&typ= 1/2 7/15/25, 3:01 PM Licensing Portal - License Search THE OFFICIAL SITE OF THE FLORIDA DEPARTMENT OF BUSINESS & PROFESSIONAL REGULATION FlDrida 5' r Department of Business & Professional Regulation ONLINE SERVICES Apply for a License Verify a Licensee View Food & Lodging Inspections File a Complaint Continuing Education Course Search View Application Status Find Exam Information Unlicensed Activity, Search AB&T Delinquent Invoice &Activity List Search HOME CONTACT US hAY ACOCuN LICENSEE SEARCH OPTIONS 3:01:12 PM 7/15/2025 Data Contained In Search Results Is Current As Of 07/15/2025 03:00 PM. Search Results -2 Records Please see our glossary of terns for an explanation of the license status shown in these search results. For additional information, including any complaints or discipline, click on the name. License Type Certified Building Contractor Name Name Type ALPHA, s DBA FOUNDATIONS License Location Address.: Main Address*: Certified SHANLEY, Building MATTHEW Contractor STEPHEN License Number/ Status/Expires Rank CBC1257350 Current, Active Cert Building 08/31/2026 1741 CORPORATE LANDING PARKWAY VIRGINIA BEACH, VA23454 66 INDUSTRIAL PARK RD MONTICELLO, FL 32344 Primary CBC1257350 Current, Active Cert Building 08/31/2026 License Location 1741 CORPORATE LANDING PARKWAY VIRGINIA Address`: BEACH, VA 23454 Main Address*: 66 INDUSTRIAL PARK RD MONTICELLO, FL 32344 Back New Scorch • denotes Main Address -This address is the Primary Address on tile. -Mailing Address -This is the address where the mail associated with a particular license will be sent (if different from the Main or License Location addresses). Ucense Location Address - This is the address where the place of business is physically located. 2601 Blair Stone Road, Tallahassee FL 32399 :: Email: Customer Contact Center :: Customer Contact Center. 850.487.1395 The State of Florida Is an AA/EEO employer. Copyright ©2023 Department of Business and Professional Regulation - State of Florida. Privacy Statement Under Florida law, email addresses are public records. 9 you do not want your email address. released in response to a publiarecords request, do not send electronic mail to this entity. Instead, contact the office by phone or by traditional mail. If you have any questions. please contact 850.487.1395. Pursuant to Section 455.275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address H they have one. The emails provided may be used for official communication with the licensee. However email addresses are public record. If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public. Please see our Chapter 455 page to determine if you are affected by this change. httns://www. mvfloridalicense.com/w111.asp?mode=2&search=LicNbr&SID=&brd=&typ= 1/2