Fill and Sign the Compensation Builder Statement Form

Compensation for Change Orders and Builder Allowance Overages Agreement made on the ________________ (date) , between ___________________ (Name of Owner) of ___________________________________________________________ _________________ (street address, city, county, state, zip code) , referred to herein as Owner , and ___________________________ (Name of Builder) , a corporation organized and existing under the laws of the state of _________________, with its principal office located at ____________________________________________________________________________ (street address, city, county, state, zip code) , referred to herein as Builder . Whereas, pursuant to the Agreement, dated ___________________ (date) , by and between Owner and Builder for the building and remodeling of the premises located at ____________________________________________________________________________ (street address, city, county, state, zip code) , hereinafter call the Work , Owner and Builder agreed to a price term of $___________ for the Work subject to certain specifications by Owner and subject to certain allowances provided by Builder; and Whereas, Owner is requesting changes to the specifications previously provided to Builder which Builder utilized to determine the Work cost; and Whereas, Builder has agreed to Owner 's modifications of the specifications for the Work ; Now, therefore, for and in consideration of the mutual covenants contained in this agreement, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties agree as follows: 1. Owner will be requesting and will Builder be (installing or constructing) ______________ ______________________________________ (description of Work that will be performed) at an allowance of $____________ that was not included in the building price. The price term for the Work shall reflect an increase of $__________. 2. Builder and Owner will agree on a schedule that reflects the amounts incurred under the allowances provided by Builder attached as Exhibit A attached hereto and made a part hereof. The overages will adjust the price terms for the Work . 3. As of the date of this Agreement, the price term shall reflect an increase of $_________. The price terms shall reflect an adjustment in the price terms as reflected on an ongoing basis as reflected in Exhibit A . 4. Severability The invalidity of any portion of this Agreement will not and shall not be deemed to affect the validity of any other provision. If any provision of this Agreement is held to be invalid, the parties agree that the remaining provisions shall be deemed to be in full force and effect as if they had been executed by both parties subsequent to the expungement of the invalid provision. 5. No Waiver The failure of either party to this Agreement to insist upon the performance of any of the terms and conditions of this Agreement, or the waiver of any breach of any of the terms and conditions of this Agreement, shall not be construed as subsequently waiving any such terms and conditions, but the same shall continue and remain in full force and effect as if no such forbearance or waiver had occurred. 6. Governing Law This Agreement shall be governed by, construed, and enforced in accordance with the laws of the State of _____________. 7. Notices Any notice provided for or concerning this Agreement shall be in writing and shall be deemed sufficiently given when sent by certified or registered mail if sent to the respective address of each party as set forth at the beginning of this Agreement. 8 . Mandatory Arbitration Any dispute under this Agreement shall be required to be resolved by binding arbitration of the parties hereto. If the parties cannot agree on an arbitrator, each party shall select one arbitrator and both arbitrators shall then select a third. The third arbitrator so selected shall arbitrate said dispute. The arbitration shall be governed by the rules of the American Arbitration Association then in force and effect. 9. Entire Agreement This Agreement shall constitute the entire agreement between the parties and any prior understanding or representation of any kind preceding the date of this Agreement shall not be binding upon either party except to the extent incorporated in this Agreement. 10. Modification of Agreement Any modification of this Agreement or additional obligation assumed by either party in connection with this Agreement shall be binding only if placed in writing and signed by each party or an authorized representative of each party. 11. Assignment of Rights The rights of each party under this Agreement are personal to that party and may not be assigned or transferred to any other person, firm, corporation, or other entity without the prior, express, and written consent of the other party. 12. In this contract, any reference to a party includes that party's heirs, executors, administrators, successors and assigns, singular includes plural and masculine includes feminine. WITNESS our signatures as of the day and date first above stated. ______________________________ (Name of Builder) ________________________ By:_________________________ (P rinted name) _________________________ ________________________ (P rinted name & Office in Corporation) (Signature of Owner) _________________________ (Signature of Officer) Attach Exhibit A