Room Upgrade Request Form

ROOM UPGRADE REQUEST FORM

WHEREAS

WHEREAS, Resident Name: occupies and rents the premises described herein under an existing occupancy agreement; and

WHEREAS, Resident requests an upgrade to a different room classification or accommodations and Facility is able to evaluate and conditionally grant such upgrade subject to the terms set forth in this form;

WHEREAS, the parties agree the upgrade and any associated changes to fees, schedule, and responsibilities shall be governed by the terms below once approved in writing by Facility.

REQUEST INFORMATION

Resident Name:    Contact Phone:

Email:

Current Room Number:    Current Room Type:

Requested Room Type / Number (if known):

Desired Effective Date:    Anticipated Length of Occupancy in Upgraded Room:

SCOPE OF WORK

Describe requested upgrade, alterations, furnishings or services to be provided as part of the upgrade. Include whether the upgrade requires relocation assistance, maintenance, or structural changes.

PAYMENT TERMS

Upgrade Fee Amount: $

One-time payment due upon approval    Installments (specify below)

Late Fee:    Interest on overdue amounts accrues at the rate specified above and Facility may suspend upgrade work or deny occupancy of the upgraded room until account is current.

TERM AND TERMINATION

Upgrade Commencement Date:    Expected Completion or End Date:

Termination by either party requires written notice delivered at least days prior to the intended termination date. Facility may terminate or suspend the upgrade if Resident fails to pay fees or violates material terms.

CONFIDENTIALITY

All pricing, technical descriptions of modifications, and personal information exchanged in connection with this request are confidential. Neither party shall disclose Confidential Information to third parties without prior written consent, except as required by law. Confidential Information excludes information that is or becomes publicly available through no fault of the receiving party.

APPROVAL (FACILITY USE)

Decision: Approve    Decline

GOVERNING LAW

This Request and any resulting amendment to residency or service agreements shall be governed by the laws of the State of without regard to conflict-of-law principles.

ENTIRE AGREEMENT

This Request, together with any written approval and any executed amendment to the existing occupancy or service agreement, constitutes the entire understanding between the parties with respect to the subject matter and supersedes all prior negotiations, representations, or agreements, whether written or oral. Any modification must be in writing and signed by both parties.

ACKNOWLEDGMENT

By signing below, Resident requests the upgrade specified above, acknowledges the Payment Terms, Scope of Work, Term and Termination provisions, and agrees to be bound by the terms once Facility provides written approval. Facility's signature below constitutes approval and an agreement to perform or provide the upgrade as described, subject to payment and scheduling terms.

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