Enclosures: Bailment Application Slip Lease Rates, Bailment Agreement Rules and Regulations, Storm Preparedness Plan

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1 Anchorage at Jonathan s Landing Marina The Anchorage at Jonathan s Landing Condominium Association, Inc. c/o Campbell Property Management 401 Maplewood Drive Suite 23 Jupiter, FL PHONE FAX Thank you for your interest in The Anchorage at Jonathan s Landing Marina. Please take time to review each page and provide all requested information. Once complete, either fax back to Campbell Property Management at or a scanned version to jupiter@campbellproperty.com.. If you would like to hand deliver your completed application, simply drop off at 401 Maplewood Drive, Suite 23, Jupiter, FL Upon receipt, the application will be reviewed and you will be contacted with final billing information and slip assignment. If you have any questions, please don t hesitate to contact me. Please initial and return each page along with the full dockage payment, a security deposit equal to one month s dockage, pictures of three sides of the boat, copies of your insurance policy, and registration information. Sincerely, Debbie Ortiz Enclosures: Bailment Application Slip Lease Rates, Bailment Agreement Rules and Regulations, Storm Preparedness Plan APPLICATION CHECKLIST: ALL REQUESTED DOCUMENTS TO BE SUBMITTED TOGETHER IN ORDER FOR MANAGEMENT TO PROCESS FOR BOARD APPROVAL. NO BOATS CAN DOCK UNTIL BOARD APPROVAL. ****APPLICATION TAKE APPROXIMATELY 14 DAY TO PROCESS.**** 1) BAILMENT AGREEMENT COMPLETED 2) SCOTT ROBERTS BACKGROUND AUTHORIZATION FORM SIGNED 3) INSURANCE NAMING ANCHORAGE AS ADDITIONAL INSURED 4) REGISTRATION 5) PHOTO OF BOAT 6) CHECK FOR SLIP (PAYABLE TO JL) 7) CHECK FOR BACKGROUND ($50 PAYABLE TO CAMPBELL PROPERTY MANAGEMENT) 1 P a g e

2 BAILMENT APPLICATION The Anchorage at JL Condominium Association, Inc. c/o Campbell Property Management 401 Maplewood Drive Suite 23 Jupiter, FL PHONE FAX OWNER/APPLICANT: Signature Print Name LOCAL ADDRESS: Street Apt. # City State Zip BILLING ADDRESS: Street Apt. # City State Zip PHONE: FAX: SPONSOR: _ VESSEL NAME: TELEPHONE: VESSEL MAKE: LENGTH (LOA): COLOR: TYPE: INBOARD OUTBOARD I/O SAIL INCLUDES: AIR COND. DEHUMID REFRIG BATTERY CHG FL. REGISTRATION #: USCG DOC. #: TOW PROVIDER NAME/PHONE #:_ INSURANCE NAME/PHONE #:_ INSURANCE POLICY #:_ ELECTRICITY CHARGE: 30A service 50A (or double 30A) 30A Non-standard service BAILMENT PERIOD: SEASONAL ANNUAL BAILMENT TERM: START DATE END DATE DESIRED SLIP #: ****** FOR INTERNAL OFFICE USE ONLY ****** APPROVED BY: ASSIGNED SLIP #: MONTHLY SLIP FEE (WITH ALL FEES/TAXES):_ SECURITY DEPOSIT REQUIRED: _ PREPAID SLIP FEE REQUIRED: _ 2 P a g e

3 STORM PREPAREDNESS PLAN All slip renters are required to have and document a plan to secure their boats during a hurricane or other major storm to prevent damage to the marina and other boats. The plan must identify the methods used to secure the boat and who will be responsible (owner or captain) for making the preparations described. Neither the Anchorage Association nor its employees or service personnel are responsible for securing vessels in the marina. Any damage occurring to the owner s vessel, docks and the marina infrastructure, and other boats is the sole responsibility of the owner. The Anchorage at Jonathan s Landing will undertake actions necessary to recover repair or replacements costs associated with damage created by the owner s vessel. EMERGENCY CONTACT INFORMATION: Emergency Contact Name: Emergency Contact Phone No.: Name of Insurance Co.: Insurance Policy #: Insurance Co. Phone No.: PREPAREDNESS PLAN: How will you secure or remove the boat for impending hurricane or major storm? Who will be responsible for removing or making sure the boat is secure? Owner s Signature: Print Name: Date: 3 P a g e

4 SLIP LEASE RATES ALL RATES ARE PER FOOT PER MONTH MEASURED LOA Up to 22 feet $ feet $ feet $ feet $ feet $12.00 Anchorage Owned Lifts: 33% Surcharge (Slip 45-49) Tenant Installed Lift: 25% Discount Minimum lease period is three (3) months. There is no refund for any unused portion of the lease period. Payment in full is required for a seasonal term and quarterly payment in advance is required for an annual term. A security deposit equal to one month s dockage will be included in the total payment due upon approval of this Bailment Agreement. The security deposit less any assessments for damages or unpaid balances will refunded if the lease is properly terminated and there are no fees due for dockage or any other charges under this Bailment Agreement. There will be no rebate of a month s charges if a boat leaves earlier than the end of the month. Owner is required to provide the Anchorage at least one month s notice in writing on or before the first of the month to terminate this Bailment Agreement. Any exception to this rule (i.e. emergency situations or repairs will be determined on a case by case basis by the Dock Committee). Monthly charge for electricity is as follows: 30A Service -- $35 per month 50A Service or double 30A Service -- $58 per month Non-standard 30A Service -- $17 per month (Standard charge for all boat lifts) Electricity charges are subject to change due to supplier cost increases or abnormal usage Florida sales and use taxes will be added. Lease rates are subject to change at the discretion of the Anchorage Association. Slips will be assigned based on boat size determined as length overall (LOA). Length over all is the length of the vessel from the most forward place to the most aft place inclusive of the bow pulpit and swim platform. Over-sized vessels will not be allowed in slips of inadequate size. The Association reserves the right to measure all vessels in determining length associated with slip size and the Association's determination is final 4 P a g e

5 BAILMENT AGREEMENT The Bailment Agreement is entered into by the following bailer, hereinafter referred to as the Owner, and Bailee, The Anchorage at Jonathan s Landing Condominium Association, Inc., Marina, hereinafter referred to as the Association, whereby in return for certain monies to be paid by the Owner, the Association grants to the Owner the right to store the following described boat in an adequate space under the conditions described below. Anchorage residents shall have the right of first refusal to any vacant slip in the Anchorage marina. 1. This Bailment Agreement shall be deemed a bailment for hire and shall be governed exclusively by the terms and conditions stated herein. This Bailment Agreement and the accompanying Bailment Application contain the entire understanding of the parties and may not be modified except in writing signed by both parties. Every boat owner is required to submit a new Bailment Application and Bailment Agreement yearly as of the first of each year. Failure of any boat owner to pay the agreed upon dockage within 30 days of any due date shall constitute an automatic termination of this Bailment Agreement and the forfeiture of any last month s rent and security deposit. The Anchorage Association shall also be entitled to sue for and obtain all other damages including attorney s fees and costs due hereunder. 2. The Association makes no warranties or representations concerning security of the premises, or about having an agent or employee on the premises. 3. It is expressly agreed by the Owner that the Association is not in any way an insurer of the Owner's property or family, guests, employees, or agents. The Owner is responsible for properly insuring the vessel. A certificate of current insurance accompanying this Bailment Agreement is required naming the The Anchorage at Jonathan s Landing Condominium Association, Inc. at a minimum as a certificate holder. 4. The Association shall not be liable for personal injury, loss of life, property loss or property damage to the Owner s boat, motor, accessories or its contents due to fire, theft, vandalism, collision, Marina equipment failure, windstorm, rain, hurricane, or other casualty loss, or the ordinary negligence of the association, its employees, agents or third parties. The Association shall not be liable for any acts beyond its control including any failure of marina equipment that make it difficult or impossible for the owner to use the boat. 5. The Owner for himself/herself, his/her family, guests, employees, agents, heirs, and assigns hereby releases and agrees to indemnify and hold harmless the Association and all of its employees and agents for any and all liability for personal injury, loss of life and property damage: a. arising out of the use of the storage space or negligence of Association personnel; 5 P a g e

6 b. in connection with the Owners boat, motor and accessories while it is on the premises or while it is being moved or while in the water moored to the Association's docks; c. for loss or damage to the Owners boat, motor, accessories or contents thereof, or Owner s car or personal property in or around the dock area, due to fire, theft, vandalism, collision, and marina equipment failure, windstorm, rain, a hurricane or other casualty loss. The indemnification provided herein shall include all costs, expenses and reasonable attorney's fees including appellate attorney s fees incurred by the Association and the defense of any action based on the foregoing, including any action brought by the Owner, their family, guest, agents, or assigns. 6. Slips will be assigned based on boat size determined as length overall (LOA). Over-sized vessels will not be allowed in slips of inadequate size. The Association reserves the right to measure all vessels in determining length associated with slip size and the Association's determination is final. 7. The Owner agrees to comply with all the posted Rules and Regulations attached, as fully as though they were set forth herein, and should breach of this agreement occur it will terminate immediately, and the Association may remove the boat from the mooring space at the Owner s risk and expense and retake possession of the mooring space. 8. All charges must be paid in full before the boat will be permitted to leave the marina. To secure payment of dockage fees and other services or materials rendered to or supplied to the Owner, the Owner hereby grants to the Association a lien upon the boat, motor, or its accessories. In the event that dockage fees have not been paid for a period of thirty (30) days after becoming due, then it is hereby mutually agreed between the Owner and the Association that the boat, motor and accessories may be sold by the Association at a nonjudicial sale as provided by applicable Florida statutes Chapter 677 or Chapter 85 to satisfy the lien, in addition to any other remedy provided by law. This Agreement shall also be deemed to be a warehouse receipt. In the event that a sale is made or other collection procedures or legal action is required to collect any amount to this agreement, the Owner agrees to pay all costs of sale or collection and reasonable attorney's fees. Notice of the non-judicial sale will be mailed to the boat owner at the local address indicated in this agreement. The security deposit provided by owner may be used by the Association for any default under this Bailment Agreement and the Application thereto. Owner agrees to pay all attorneys fees and costs incurred by Association hereunder as a result of Owner s breach of this Bailment Agreement and the Application. 9. The Bailment Agreement will be renewed yearly. Termination of this Bailment Agreement is the sole responsibility of the owner by mailing written notice to CAMPBELL PROPERTY MANAGEMENT 30 days prior to vacating the slip on or before the first of the month prior to vacating the slip. The Owner and or the Association may terminate this Agreement upon 30 days notice and after all charges against the boat have been paid, the owner may remove the boat from the Association's premises. The minimum term of this bailment agreement for dockage is THREE MONTHS and it is mutually agreed that there will be no refund of any monthly dockage charges when this Bailment Agreement is terminated by the Owner. Any notification to the owner pursuant to any of the provisions of the Bailment Agreement will be sufficient if by mail to the mailing address shown herein. 6 P a g e

7 10. In the event any portion of this Agreement shall be deemed to be in violation of any law of the United States or any law of the State of Florida, said portion, and said portion only, shall be null and void and the balance of this Agreement shall remain in full force and effect. This Agreement shall be interpreted in accordance laws of the State of Florida and the laws of the United States. 11. Hurricane policy: In accordance with Section 59, Chapter 327 of the 2004 Florida statutes, no vessel shall be required to vacate the Anchorage Marina following the issuance of a hurricane watch or warning. However, Owners will be required to file a storm /hurricane preparedness plan as part of this Bailment Agreement specifying details as to how and by whom the vessel will be secured and the docks protected in the event of a storm or hurricane. In the event of a hurricane or tropical storm, it is each owner s express responsibility to adequately secure their vessel using U.S. Coast Guard approved cleats, ropes, lines, fasteners, fenders, etc. in accordance with their recorded Storm Preparedness Plan, using double lines and adequate spring lines to allow for a 4ft. storm surge above mean high tide. Vessel owners will be liable for any and all damages caused by their vessels to The Anchorage Association marina, docks, and facilities and to other vessels moored in the marina. 12. The wet storage charge entitles the Owner to a slip, storage locker, guest parking, and water service. There will be an additional charge of $35 per month for standard 30A electrical service or a charge of $58 per month for standard 50A or double standard 30A electrical service. There will also be an additional charge of $17 per month for trickle charging up to two batteries on an outboard boat, for powering any type of motorized boat lift or for any other use on non-standard electrical service. 13. Seasonal tenants are billed in advance and payment is due in full before the first day of the seasonal term. Annual tenants are billed quarterly in advance and payment is due on or before the first of the quarter and will be considered past due and delinquent after the 15 th of the quarter. In addition to the initial billing of new tenants will be charged a security deposit equivalent to one month's lease rate based upon the current lease charges. The security deposit will be refunded after the final lease payment if there are no damages or other unpaid charges outstanding. If dockage is not paid within 15 days after becoming due, a late charge of $50 per month will be applied to the next bill. Should payments to the Association become delinquent by more than 15 days, the Association has the right to change the storage location of the boat. Further, after delinquency of 30 days, the Association may begin to pursue legal remedies available to it under existing Florida statutes, including the attachment of a lien upon the boat as granted by the owner in item 8 above. 14. Owner is responsible for any damages to the Association s property (including, but not limited to, docks, finger piers, boat lifts and other marina facilities) as well as any damages to other vessels within the marina caused in whole or in part by the negligence, omission or intentional act of Owner, Owner s guests or invitees. 15. The Association owns the lifts in 45 through 49. Tenants leasing these slips will be charged a 33% surcharge of the total monthly lease ate, Upon prior approval of the Association, tenants that install a lift in a currently leased will receive a 25% discount of the monthly lease rate. This discount will cease upon non-renewal of the bailment agreement for that slip. The lift becomes property of the Association upon competition of installation. 7 P a g e

8 RULES AND REGULATIONS In an effort to provide an inviting atmosphere for boat owners docking at The Anchorage Marina, the following rules and regulations are provided for the protection of tenants and Anchorage residents. When a boat enters the marina, the boat, crew, and guests must comply with all rules set forth herein 1. Only pleasure boats in good condition and under their own power shall be admitted to berthing areas. Each owner must make arrangements in advance for a third party to check their vessel for any anomalies that may arise during the owners' absence, and take appropriate and timely actions. If a problem is discovered that requires immediate attention; for example, inoperable bilge pump, hull leaks, broken lines, etc., the Association is authorized (but not required) to make the (or have made by reputable service technician) emergency repairs, on a best efforts basis and as economically as possible. Such repairs will be charged to the vessel owner. The Association assumes no liability and shall be held harmless in the event of having made any such emergency repairs it deems necessary. 2. Under no circumstances shall anyone be permitted to "live aboard" any vessel docked at the Anchorage marina. However, on an exception basis only, permission for Anchorage resident s family members and/or guests to use vessel facilities overnight, for a limited number of days, may be obtained from the Anchorage Association Dock Committee. Vessels shall not anchor in the Marina basin except in rare and emergency situations. 3. Boats leaving for an extended period of time will notify the Association. If no advance notice has been given, and the slip is vacated by the vessel owner for more than two weeks beyond the paid-up date, it will be assumed that the slip has been abandoned and is therefore available for lease. Once the Bailment Agreement is terminated, there is no guarantee that a returning vessel shall have the right to use the same slip. Any returning vessel must submit a new Bailment Application and Agreement and will be assigned the slip designated by the Owner. 4. The Rules of the Road and Navigation Laws of the United States will apply to all vessels in or approaching the marina. Idle, no wake, speed limits will be strictly enforced to protect the manatee population and to minimize excessive wake that could damage other vessels and/or dock facilities. 5. Discharge of MSD holding tanks in the marina is a violation of federal laws and is strictly prohibited. 6. Refuse shall not be thrown overboard. Garbage is to be maintained on board the vessel and deposited in onshore waste disposal containers supplied for that purpose. No person shall discharge oil, spirits, or other flammable liquids from vessels in the marina. Charcoal fires are not permitted at the docks. 7. Owners shall notify the appropriate authorities in the event of any spill or leakage of oil, gasoline or other flammable liquid into the waters of the marina. This notice shall include immediate notification of the Anchorage Marina Committee. 8 P a g e

9 8. Engine or generator operation, for the purpose of maintenance or performance checks, will be limited to 10 minutes per day between the hours of 9:00 a.m. and 4:00 pm. Upon re-entering its slip a vessel's engines will be shut down as promptly as practical to minimize exhaust fumes. 9. Monitoring and regulating the amount and volume of noise associated with boat activities is of paramount concern in a marina that is directly adjacent to living areas. The Anchorage Marina is a private facility and permits tenants to perform only routine maintenance, repair and upkeep of their vessels and gear between the hours of 9:00 am and 4:00 pm, October through May and 8:00 am and 5:00 pm June through September. Such work includes the normally required servicing, repair and maintenance of hulls, wood trim and bright work, engines and power train components, air conditioning and refrigeration systems, electrical and electronic systems, waste disposal and fresh water systems. The ONLY exception to this rule is an emergency situation in which the vessel is in imminent danger, when maintenance and upkeep requires the use of power tools these shall not be operated except during the approved hours and are limited to small power tools. Operators of power tools are expected to use discretion in minimizing the noise they produce. At no time shall maintenance and upkeep activities result in any damage or defacing of adjoining vessels or marina property. At no time shall a Boat Owner permit overloud partying or use of its boat and/or slip. If, in the discretion of the Dock Committee, a Boat Owner has violated this policy, the Boat Owner shall be given a written warning. If the Boat Owner violates this policy again after a written warning the Boat Owner shall be subject to such penalties and fines as the Dock Committee imposes including but not limited to the forfeiture of the security deposit and the requirement to replenish the same or the termination of the Bailment Agreement. 10. More extensive repairs involving major rebuilding or reconstruction of any of the systems described above are not permitted in the Anchorage Marina at any time. 11. Advertising or soliciting shall not be permitted on any boat within the marina. Neither the boat nor Marina address or phone numbers shall be used for business purposes. 12. Swimming or diving shall not be permitted from the docks, finger piers or boats. 13. Boat owners shall not store supplies, materials, accessories, or debris on piers or walkways and shall not construct or install thereon any lockers, chests, cabinets or similar structures except with the written approval of the Association. Painting, scraping or repairing of gear shall not be permitted on the docks or finger piers. Extent of repairs and maintenances shall be at the discretion of the association. 14. Boat owners shall not install satellite antennas, telecommunication or radio antennas, nor any other television or radio reception devices on any piling, pier or dock. 15. Fish will not be cleaned on the docks or finger piers except for the fish cleaning station located next to Slips P a g e

10 16. Subleasing wet storage spaces and transfer of boats from the assigned space to another space shall not be allowed. Owner agrees that in case of emergency, the Association may move the boat from the particular space assigned to any other mooring 17. Laundry shall not be hung on boats, docks, or finger piers in the Marina, nor shall "for sale" signs be put on boats. 18. Violation of the above rules and regulations, disorder, depredation, or indecorous conduct by a tenant, their crew or guests, that might injure a person or cause damage to property of the marina shall be cause for immediate removal from the marina of the boat in question, the forfeiture of any security deposit and last month s rent, the imposition of fines for all of the above. 19. Leasing policy a. All parties utilizing the docks must be 1) residents of Jonathan's Landing, or 2) sponsored by a resident of Jonathan s Landing, or 3) invited guests of the above. b. The appropriate Marina Committee official and/or the Management Company must be notified on the docking of any vessel not currently allocated to a specific dock. Prompt compliance with this policy will avoid unnecessary concern on the part of security patrol. c. Transient dockage is available only to Anchorage residents or their invited guests on an availability basis. A daily transient leasing fee will be established by the Marina Committee. All transient tenants are required to register their vessel with the Association and to comply with the marina Rules and Regulations. c. A non-resident tenant will not use Association facilities other than their leased dock space, the designated marina parking areas, and the docks and connecting paths thereto. d. Any tenant, to remain eligible, must own 50% or greater share in the vessel involved unless approved by the Association. I, the Owner, represent that the vessel is in compliance with current Federal and State of Florida registration laws. (Out of state vessels must register in Florida at the end of 90 days.) I, the Owner, represent that the vessel is currently insured to cover damages to Association property, other vessels, and Owner s family and/or guests, employees, and agents. Proof of ownership and proof of insurance are required to be attached to this completed Bailment Agreement. I, the Owner, have read and fully understand the attached conditions, including Marina Rules and Regulations, and agree to abide by each and every one of them, and do hereby voluntarily enter into this Bailment Agreement with the Association, as of this day of, 20 Owner: Signature Print Name 10 P a g e

11 PLEASE NOTE: THIS IS A SAMPLE TEMPLATE DISCLOSURE/AUTHORIZATION PROCESS ONLY, AND IT SHOULD NOT BE CONSTRUED AS LEGAL ADVICE. ALL CLIENTS SHOULD CONSULT WITH COUNSEL TO CONFIRM THAT THEIR DISCLOSURE AND AUTHORIZATION PROCESS COMPLIES WITH APPLICABLE FEDERAL, STATE, AND LOCAL LAWS. DISCLOSURE REGARDING BACKGROUND INVESTIGATION The Anchorage at Jonathan s Landing Condominium Association, Inc. ( the Company ) may obtain information about you from a consumer reporting agency for tenant screening purposes. Thus, you may be the subject of a consumer report and/or an investigative consumer report which may include information about your character, general reputation, personal characteristics, and/or mode of living, and which can involve personal interviews with sources such as your neighbors, friends or associates. These reports may contain information regarding your criminal history, credit history, motor vehicle records ( driving records ), verification of your education or employment history or other background checks. You have the right, upon written request made within a reasonable time after receipt of this notice, to request disclosure of the nature and scope of any investigative consumer report. Please be advised that the nature and scope of the most common form of investigative consumer report obtained with regard to applicants for residency is an investigation into your education and/or employment history conducted by Scott- Roberts and Associates, LLC, Ave. N., Lake Worth, Florida 33461, (888) , ( Agency ), or another outside organization. One person per application. You should carefully consider whether to exercise your right to request disclosure of the nature and scope of any investigative consumer report. By signing this document you agree you have read and understand this disclosure. Sign Here Consumer s Signature ACKNOWLEDGMENT AND AUTHORIZATION Print Consumer s Name I acknowledge receipt of the DISCLOSURE REGARDING BACKGROUND INVESTIGATION and A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT and certify that I have read and understand both of those documents. I hereby authorize the obtaining of consumer reports and/or investigative consumer reports by the Company at any time after receipt of this authorization and throughout my tenancy, if applicable. To this end, I hereby authorize, without reservation, any law enforcement agency, administrator, state or federal agency, institution, school or university (public or private), information service bureau, employer, insurance company, or other party to furnish any and all background information requested by Scott- Roberts and Associates, LLC, Ave. N., Lake Worth, Florida 33461, (888) , another outside organization acting on behalf of The Anchorage at Jonathan s Landing Condominium Association, Inc., and/or The Anchorage at Jonathan s Landing Condominium Association, Inc. itself. I agree that a facsimile ( fax ) or electronic or photographic copy of this Authorization shall be as valid as the original. State of Washington applicants and/or residents only: You have the right to receive a complete and accurate disclosure of the nature and scope of any investigative consumer report as well as a written summary of your rights and remedies under Washington law. New York applicants and/or residents only: You have the right to inspect and receive a copy of any investigative consumer report requested by the Company by contacting the consumer reporting agency identified above directly. California applicants and/or residents only: By signing below, you also acknowledge receipt of the NOTICE REGARDING BACKGROUND INVESTIGATION PURSUANT TO CALIFORNIA LAW. Please check this box if you would like to receive a copy of an investigative consumer report at no charge if one is obtained by the Company whenever you have a right to receive such a copy under California law. Sign Here Signature: 11 P a g e Date:

12 PLEASE NOTE: THIS IS A SAMPLE TEMPLATE DISCLOSURE/AUTHORIZATION PROCESS ONLY, AND IT SHOULD NOT BE CONSTRUED AS LEGAL ADVICE. ALL CLIENTS SHOULD CONSULT WITH COUNSEL TO CONFIRM THAT THEIR DISCLOSURE AND AUTHORIZATION PROCESS COMPLIES WITH APPLICABLE FEDERAL, STATE, AND LOCAL LAWS. Last Name: First Name: Middle: Other Names Used (alias, maiden, nickname): Address: Current Address: Street/P.O. Box City State Zip Code County Dates Former Address: Street/P.O. Box City State Zip Code County Dates Former Address: Street/P.O. Box City State Zip Code County Dates Current Employer: Company Name City State Zip Code Hire Date Supervisor Name/phone # Salary Former Employer: Company Name City State Zip Code Hire Date End Date Salary Supervisor Name/phone # Education Information: Institution Name City State Highest Degree Achieved Major Date Degree Awarded Driver s License #: State: Gender Daytime Phone Social Security Number: * Date of Birth: * *This information will be used for background screening purposes only. 12 P a g e

13 PLEASE NOTE: THIS IS A SAMPLE TEMPLATE DISCLOSURE/AUTHORIZATION PROCESS ONLY, AND IT SHOULD NOT BE CONSTRUED AS LEGAL ADVICE. ALL CLIENTS SHOULD CONSULT WITH COUNSEL TO CONFIRM THAT THEIR DISCLOSURE AND AUTHORIZATION PROCESS COMPLIES WITH APPLICABLE FEDERAL, STATE, AND LOCAL LAWS. NOTICE REGARDING BACKGROUND INVESTIGATION PURSUANT TO CALIFORNIA LAW The Anchorage at Jonathan s Landing Condominium Association, Inc. ( the Company ) intends to obtain information about you from an investigative consumer reporting agency and/or a consumer credit reporting agency for tenant screening purposes. Thus, you can expect to be the subject of "investigative consumer reports" and "consumer credit reports" obtained for tenant screening purposes. Such reports may include information about your character, general reputation, personal characteristics, and mode of living. With respect to any investigative consumer report from an investigative consumer reporting agency ("ICRA"), the Company may investigate the information contained in your tenant application and other background information about you, including but not limited to, obtaining a criminal record report, verifying references, work history, your educational achievements, licensure, and certifications, obtaining your driving record and other information about you, and interviewing people who are knowledgeable about you. The results of this report may be used as a factor in making tenant application decisions. The source of any investigative consumer report (as that term is defined under California law) will be Scott-Roberts and Associates, LLC, Ave. N., Lake Worth, Florida 33461, (888) , The source of any credit report will be Scott- Roberts and Associates, LLC, Ave. N., Lake Worth, Florida 33461, (888) , Information regarding Scott-Roberts and Associates, LLC s privacy practices (including information about whether any consumer personal information will be sent outside the U.S. or its territories) may be found at The Company agrees to provide you with a copy of an investigative consumer report when required to do so under California law. Under California Civil Code section , you are entitled to find out from an ICRA what is in the ICRA s file on you with proper identification, as follows: In person, by visual inspection of your file during normal business hours and upon reasonable notice. You also may request a copy of the information in person. The ICRA may not charge you more than the actual copying costs for providing you with a copy of your file. A summary of all information contained in the ICRA s file on you which is required to be provided by the California Civil Code will be provided to you via telephone, if you have made a written request with proper identification for telephone disclosure and the toll charge, if any, for the telephone call is prepaid by or charged directly to you. By requesting a copy be sent to a specified addressee by certified mail. ICRAs complying with requests for certified mailings shall not be liable for disclosures to third parties caused by mishandling of mail after such mailings leave the ICRAs. "Proper Identification" includes documents such as a valid driver s license, social security account number, military identification card, and credit cards. Only if you cannot identify yourself with such information may the ICRA require additional information concerning your employment and personal or family history in order to verify your identity. The ICRA will provide trained personnel to explain any information furnished to you and will provide a written explanation of any coded information contained in files maintained on you. This written explanation will be provided whenever a file is provided to you for visual inspection. You may be accompanied by one other person of your choosing, who must furnish reasonable identification. An ICRA may require you to furnish a written statement granting permission to the ICRA to discuss your file in such person s presence. 13 P a g e