Chimney Inspection Report

CHIMNEY INSPECTION REPORT

Client Name:    Property Address:

Inspection Date:    Inspector Name:    Company:

License / Cert. No.:    Contact Phone:

WHEREAS

WHEREAS Client has engaged Inspector to perform a visual chimney inspection at the Property Address specified above to identify visible conditions affecting safe operation and to provide recommended corrective actions; and

WHEREAS Inspector performed a non-invasive, on-site inspection limited to the readily accessible components of the chimney and fireplace system and has prepared this Chimney Inspection Report to document observed conditions and professional recommendations; and

WHEREAS this report documents findings as of the Inspection Date and does not constitute a guarantee or warranty of future performance, nor does it certify compliance with building codes beyond the visual observations described herein.

SCOPE OF WORK

INSPECTION FINDINGS — COMPONENTS

Exterior Chimney Condition — Brick/Flashing: Satisfactory Needs Repair Not Accessible

Chimney Crown/Cap Condition: Satisfactory Needs Repair Not Accessible

Flashing / Roof Penetration: Satisfactory Needs Repair Not Accessible

Flue / Liner Visible Condition: Satisfactory Needs Repair Not Accessible

Smoke Chamber & Firebox: Satisfactory Needs Repair Not Accessible

Damper Operation: Operable Inoperable / Needs Repair Not Present

Cleanout / Ash Pit: Accessible Blocked / Needs Service

CREOSOTE & GAS MEASUREMENTS

Creosote Level Observed: None/Trace Light (Class I) Moderate (Class II) Heavy (Class III)

Combustion Gas / CO Test Performed: Yes No    CO Reading (ppm):

OBSERVATIONS & RECOMMENDATIONS

Immediate — Unsafe to use until repaired Recommended — Repair in near term Monitor — Observe and maintain

PAYMENT TERMS

Inspection Fee: $    Deposit (if any): $

Balance Due: Payment of the balance is due within days of invoice. Late payments shall incur a finance charge of % per month (or the maximum permitted by law), plus reasonable collection costs and attorney fees.

TERM AND TERMINATION

Term Commencement Date:    Term Expiration Date (if applicable):

Either party may terminate this engagement for material breach if the breaching party fails to cure within days after written notice. Termination will not relieve Client of obligation to pay for services rendered prior to termination.

CONFIDENTIALITY

The parties agree that the contents of this inspection report, including photographs, notes and cost estimates, are confidential and solely for the use of Client and Inspector. Neither party shall disclose the report to third parties except as required by law or to contractors for purposes of repair, provided that such contractors are advised of the confidential nature of the information.

LIMITATION OF LIABILITY & CERTIFICATION

Inspector certifies that the inspection was conducted in a professional manner and that findings set forth in this report are true and accurate to the best of Inspector's knowledge at the time of inspection. This report is limited to a visual, non-invasive inspection of accessible components and does not include destructive testing, dismantling, laboratory analysis or a warranty against latent defects.

Client acknowledges and agrees that Inspector's liability for claims arising from this engagement shall be limited to the amount of fees actually paid by Client for the inspection, and Inspector shall not be liable for consequential, incidental or punitive damages. Client further agrees to indemnify and hold Inspector harmless from claims arising from conditions not observed during the inspection or from recommended repairs performed by third parties.

GOVERNING LAW; ENTIRE AGREEMENT

This Inspection Report and any related engagement terms shall be governed by the laws of the State of without regard to choice-of-law principles.

This document constitutes the entire agreement between the parties with respect to the inspection and supersedes all prior representations and agreements, whether written or oral, except for any separate written service contract signed by the parties.

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