Bathroom Maintenance Request Form

BATHROOM MAINTENANCE REQUEST FORM

Client Name:    Service Provider Name:

WHEREAS

WHEREAS, Client Name: requests maintenance, repair, and associated services for bathroom facilities located at the Premises identified below; and

WHEREAS, Service Provider Name: represents that it has the skill and capacity to provide such maintenance and agrees to perform the requested services under the terms set forth in this form.

REQUEST DETAILS

Plumbing (toilet/supply/drain)   Fixtures (sink/faucet/valve)   Shower/Tub   Tiles/Grout   Ventilation/Exhaust

Immediate — safety or sanitary hazard   High — affects multiple users   Normal — routine maintenance

SCOPE OF WORK

The Service Provider will perform maintenance, repair, and replacement services as necessary to remedy the items described above. The scope shall include diagnostic inspection, parts replacement, labor, and cleanup, subject to the limitations and authorizations set forth in this form. Any material substitutions or additional work beyond the scope described below shall require prior written authorization by the Client.

PAYMENT TERMS

The Client agrees to compensate the Service Provider for services rendered in accordance with the following terms. Estimated cost and final invoiced amounts may differ where additional repairs or parts are required; the Provider will seek authorization where required by the limits set below.

Client authorizes Service Provider to proceed with the Scope of Work up to the Estimated Cost without further approval.

TERM AND TERMINATION

This request and any resulting service engagement commences on Start Date: and shall continue until End Date: or until the Scope of Work is completed and final payment is made, whichever occurs later. Either party may terminate the engagement for material breach if the breaching party fails to cure within Notice Period (days): after receipt of written notice.

CONFIDENTIALITY

Each party agrees that any non-public information disclosed in connection with this request and subsequent services that is identified as confidential or that reasonably should be understood to be confidential given the nature of the information and the circumstances of disclosure shall be held in confidence and used only for purposes of performing obligations under this request. Confidential information does not include information that is or becomes public through no fault of the receiving party, was rightfully in the receiving party's possession prior to disclosure, or is independently developed without the use of the disclosing party's confidential information.

GOVERNING LAW

This Request and any service agreement arising from it shall be governed by and construed in accordance with the laws of the jurisdiction in which the Premises are located. The parties submit to the exclusive venue of the courts in that jurisdiction for any disputes arising out of this Request, to the extent permitted by law.

ENTIRE AGREEMENT

This form, together with any written change orders or signed authorizations, constitutes the entire agreement between the Client and the Service Provider with respect to the requested services and supersedes all prior negotiations, representations, or agreements, whether written or oral. No amendment is effective unless in writing and signed by both parties.

CERTIFICATION

By signing below, the undersigned Client certifies that the information provided in this request is accurate to the best of their knowledge, that the Client is authorized to request maintenance at the Premises identified, and that the Client understands and accepts the payment and access terms set forth herein.

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