AGREEMENT BETWEEN HOMEOWNER AND ST. JOHN'S UCC:
By initialing below, I/We understand and acknowledge that this application does
not guarantee requested repairs may be completed. A representative of St.
John's UCC will conduct a site visit and conduct a face-to-face interview to
determine repair needs. St. John's UCC will prioritize repairs to be completed.
I/We hereby acknowledge and permit the use of information
contained in this application to be used to determine eligibility for
participation in the Home Repair program.
I/We hereby authorize St. John's UCC, and its
representatives, to verify present income and related employment records, and
property ownership documents to determine eligibility for the Home Repair
Program.
I/We hereby agree to provide any documentation needed to
assist in determining eligibility.
I/We hereby certify that I/we are the owner(s) of the
property described in this Application and certify that the residence described
in this Application is my/our principal place of residence
I/We agree to allow representatives from St. John's UCC (or
its partner agencies) to visit and look at my property with or without prior
notice, and give them permission to take pictures and/or videos of my home for
planning purposes. I also understand the labor for these repairs will be
provided by volunteer teenagers and adults supervised by a construction
coordinator. When possible, we ask you to be present as repairs are being made
on your home.
Applying for this home repair does not in any way guarantee
acceptance into our program. Due to financial, time, and personnel restraints,
St. John's UCC is unable to fulfill all requests for home repairs.
Should this application be approved, we agree to the
following:
1) I agree to hold harmless St. John's UCC, its officers,
agents, employees, servants, or designees from any and all liability for death
or injury to any person resulting from the rehabilitation of my property.
2) No warranties regarding materials or workmanship are
expressed or implied. All services are performed as-is. Requests for additional
repairs or reworking of repairs must be submitted in writing to St. John's UCC.
3) I agree to allow St. John's UCC, and its representatives
to use photographs, videos, and audio of my property, home, and the residents
listed on this form for archives, and publicity and promotional use.
