Light Out Repair Request Form

LIGHT OUT REPAIR REQUEST AND SERVICE AGREEMENT

Client Name:    Service Provider:

Work Order Number:    Effective Date:

WHEREAS

WHEREAS, Client reports one or more exterior or interior lights that are not functioning at the property or location identified in this request and requires timely repair or replacement to restore illumination for safety and code compliance; and

WHEREAS, Service Provider represents that it has the experience, personnel, equipment, and authorization necessary to perform inspection, repair, replacement, and related electrical or fixture work subject to the terms and conditions set forth herein; and

WHEREAS, the parties desire to set forth the scope, compensation, timing, and other terms governing Service Provider's performance for this reported light outage under a short-form service agreement and repair request authorization.

REQUESTOR / LOCATION DETAILS

Nearest Cross Street / Landmark:    Observed Outage Date:    Observed Time:

Safety / Hazard    Fully Dark    Flickering/Intermittent    Circuit Tripped    Other (describe below)

SCOPE OF WORK

Service Provider shall inspect the reported fixture(s), diagnose cause of outage, and perform repair or replacement necessary to restore functional light output. Work may include, but is not limited to, lamp replacement, ballast or driver replacement, photocell replacement, wiring repair, mounting hardware, and limited pole-top access work required to complete repair consistent with applicable electrical code and safety practices.

Estimated Completion Date (if provided):    Access Required: On-site access by Service Provider    Permission granted by Client

PAYMENT TERMS

Base Repair Fee: $    Payment Due:

Payment Schedule and Invoicing: Service Provider shall submit an itemized invoice upon completion of the authorized work or as otherwise agreed in writing. Client shall pay undisputed amounts within the number of days specified above. Disputed items must be raised in writing within seven (7) days of receipt of the invoice.

Late Fee: applied to past-due amounts. Client shall also reimburse reasonable collection costs, including attorneys' fees, for amounts not timely paid.

TERM AND TERMINATION

Term Start Date:    Term End Date:

Either party may terminate this repair authorization for convenience upon prior written notice. Either party may terminate immediately for material breach that remains uncured after ten (10) days' written notice specifying the breach.

CONFIDENTIALITY

Each party agrees that any non-public, proprietary, or otherwise confidential information disclosed in connection with this repair request and related work (including site plans, security procedures, and pricing) shall be held in confidence and not disclosed to third parties without prior written consent, except as mandated by law. Confidential information does not include information that is publicly available or independently developed without use of the other's confidential information.

Service Provider shall take commercially reasonable measures to safeguard any Client access codes, keys, or security information provided for performance of the work and shall return or destroy such information upon completion or termination of services.

INSURANCE AND COMPLIANCE

Service Provider shall maintain, at its expense, insurance customary for electrical and field service operations, including general liability and workers' compensation where required by law. Service Provider shall comply with all applicable laws, codes, and regulations while performing work and shall obtain any permits required for the repair or replacement.

GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the State of without regard to its conflict of laws principles.

ENTIRE AGREEMENT; AMENDMENT

This document, including any referenced scope and work order, constitutes the entire agreement between the parties regarding this light outage repair request and supersedes all prior proposals, representations, or communications, whether written or oral. Any modification or amendment must be in writing and signed by authorized representatives of both parties.

LIMITATION OF LIABILITY

Except for liabilities arising from gross negligence or willful misconduct, each party's total liability for claims arising out of this Agreement shall be limited to direct damages not to exceed the total amount paid or payable under this specific repair authorization.

ACKNOWLEDGMENT

By executing below, the parties authorize Service Provider to proceed with the described inspection and repairs in accordance with the terms above. Client certifies authority to request and approve the work at the identified location.

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