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Customer Copy City of New Brighton Cleanup Agreement Residential Sanitary Sewer Backup Cleanup Assistance THIS CLEANUP AGREEMENT, effective as of the dates of signatures below, is entered into by and between the City of New Brighton and _______________________________________________, “Property Owner”, pursuant to the Residential Sanitary Sewer Backup Cleanup Assistance Policy. GENERALIZED SCOPE OF SERVICE Under the Residential Sanitary Sewer Backup Cleanup Assistance Policy, the City of New Brighton agrees to assist Property Owners in paying an approved contractor up to $5,000 per occurrence, per housing unit for services mentioned below. Any costs exceeding $5,000 will be invoiced to the property owner. If the balance due is not paid within 90 days, any remaining amount will be assessed to the property taxes. Any payments will be made only in strict accordance with the Policy. In general, the City of New Brighton will call an authorized contractor to perform prompt cleanup assistance under the Residential Sanitary Sewer Backup Cleanup Assistance Policy. The cleanup assistance is limited to wet extraction, sanitizing, deodorizing, removal and disposal of damaged housing materials. The Property Owner is responsible for replacement of any damaged property. The entire Policy will be available at www.cityofNew Brighton.com. REQUIRED INFORMATION Property Owner’s home address: ________________________________________________________ Property Owner’s telephone number: ____________________________________________________ Service address (if different from Property Owner’s home address): ___________________________________ By way of signature below, the Property Owner certifies that he/she has read and understands the City of New Brighton Residential Sanitary Sewer Backup Cleanup Assistance Policy. The Property Owner hereby authorizes the City to proceed with services as contained in said Policy. The Property Owner further understands and agrees that the City in no way admits or accepts liability by entering into this Agreement or by offering the benefits of this Policy. This Agreement is not intended, however, to prohibit or prevent pursuit of any other lawful remedies available to Property Owner. Date: ______________ Property Owner: __________________________________________________________ Date: ______________ Authorized City Representative: _____________________________________________ Decline Assistance I have been offered cleanup assistance as outlined in the City of New Brighton’s Sanitary Sewer Backup Cleanup Assistance Policy. I decline to accept the cleanup assistance offered by the City. Date: ________________ Property Owner: _______________________________________________________