Emergency Authorization Form

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UNDERSIGNED INFORMATION:

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Address
Homeowner” executes this Work Order, granting HLA Tree Service, a Louisiana company located at 123 C Church Rd, Hessmer, LA, USA the authority to perform the Scope of Work at the property known as Address (the “Work site”) (_________) upon the terms and conditions set forth herein. This is a contract to perform Priority Deployment Tree Work and Related Services (the “Work”). This “Contract”, all Price Charts, Scopes of Work, sketches and drawings, authorizations, special remarks, and amendments to this Contract shall become a part of this Contract at the time that you initial or execute them and constitute the entire agreement among the parties. The undersigned is the homeowner or agent acting under the express authority of homeowner, has received and read and understands and agrees to the scope of work, and requests that HLA Tree Service commence the Work. Initial: (_________) We charge 25% of the job total for debris removal, if applicable. We also charge the rates listed below for equipment operators, mobilization and demobilization, and back-office support for communications with insurance providers and adjusters. Initials: (_______)
Debris Removal-/ The line item for debris removal from the premises commences after the debris has been loaded onto the designated vehicle. The cost of labor and equipment for moving and loading debris is not included in the 20% debris removal line item charge.
Furthermore, if the debris removal vehicle is also utilized for transport of tools and laborers, the costs for debris removal remain distinct and separate, not encompassed within other line item service fees.
Administrative Rates: HLA Tree Service shall charge you an Administrative Fee of $150 per hour for additional evidence and/or documentation to and negotiations with your insurance carrier(s) outside of the standard photographs and invoices reflecting Work performed. Initials: ( )
Concealed Contingencies: Homeowner is responsible for delivering the Property to HLA Tree Service in workable condition and shall use its best efforts to facilitate HLA Tree Service performance of the Work. Homeowner is responsible for any and all expense and cost incurred by HLA Tree Service due to unusual or unanticipated conditions, environmental hazards, concealed damage, and/or existing defects (specifically including, but not limited to, rock, debris, etc.) on or at the Property (the “Defects”), which HLA Tree Service discovers during the course of the Work. HLA Tree Service is neither liable nor responsible for repairing any Defects. Homeowner acknowledges and understands that HLA Tree Service uses heavy machinery, and that such machinery may cause underlying damage to paved and other prepared surfaces. HLA Tree Service shall not be liable for any weight-related damage caused to any driveways, landscaping, and other above or below ground structures. You agree to pay HLA Tree Service on a time and materials basis for any unanticipated contingencies resulting in a modification to the Work occasioned by concrete, foreign matter, stinging insects, nests, rock, pipe, and electrical encountered in the course of the Work not otherwise specified to the contrary in this Contract as a special remark and initialed by both you and an agent of HLA Tree Service.
Terms of Payment: All accounts are net payable upon receipt of invoice. You shall pay a service charge of the lesser of 5% or the greatest amount allowed by law on all accounts not paid in full by the 30th day following the invoice date. Deposits and down payments are non-refundable and are deemed earned in full upon receipt. You acknowledge, agree, and understand that you are responsible for and shall pay in a timely manner any portion of the invoice not covered by insurance. You expressly consent to be contacted by electronic mail, voice, and SMS/MMS for business or payment purposes. Returned checks are subject to a $50 service fee for the administrative costs incurred. To the extent permitted by applicable law (a) reversed charges, contested charges, and stopped payments shall be considered to be a breach of this Contract, for which HLA Tree Service shall automatically be entitled to liquidated damages in the amount of the reversed charge, contested charge, and/or stopped payment plus attorney’s fees and expenses arising out of such breach; and (b) your deposit, retention, or refusal to surrender or remit to HLA Tree Service proceeds or payment received from your insurance carrier(s) for the Work may amount to insurance fraud and shall be a breach of this Contract for which HLA Tree Service shall automatically be entitled to liquidated damages in the amount of such proceeds or payment plus attorney’s fees and expenses incurred arising out of such breach.
Direct Pay Authorization: By execution of this Contract, you expressly authorize HLA Tree Service to be paid directly from your insurance company for services rendered without further acknowledgement, consent, or signature from you. To the extent permitted by applicable law, you agree that any attempt to divert or receive directly any such payment contrary to the terms of this Contract shall automatically be a breach of this Contract, for which HLA Tree Service shall be entitled to liquidated damages in the amount of the payment so diverted or redirected plus attorney’s fees and expenses arising out of such breach. AUTHORIZATIONS (Privacy, Information Release, and Payment Direction) In consideration of HLA Tree Service agreement to perform the Work under this Contract and to forgo payment in full until completion of the Work (except as otherwise provided in this Contract), by executing this Contract you: (1) Authorize HLA Tree Service (and its representatives/agents) to communicate directly with any insurance company(ies) providing coverage related to the event(s) giving rise to the Work, for the limited purposes of confirming coverage applicable to the Work; requesting and receiving claim/coverage information, payment status, estimates, and related documents; and coordinating inspection, estimating, and documentation related to the Work. (2) Waive and release any privacy rights (including, where applicable, privacy protections under state and federal law) to the extent necessary for the insurer(s) to disclose to HLA Tree Service information and documents reasonably requested and reasonably related to the loss/event(s) giving rise to the Work; the applicable insurance policy(ies) and claim file(s); and the scope, documentation, and valuation of the Work, and you direct the insurer(s) to provide such information to HLA Tree Service upon request. (3) Authorize and instruct the insurer(s), to include HLA Tree Service as a payee on any insurance proceeds issued for the Work, and/or to issue payment directly to HLA Tree Service for the portion of proceeds attributable to the Work. (4) You agree to reasonably cooperate with HLA Tree Service in connection with claim administration related to the Work, including signing insurer forms that may be required to release claim information; permit discussions regarding scope and pricing of the Work; and request that payments for covered Work be made payable to HLA Tree Service (or jointly payable), as allowed. Initials: ( ) WORKMANSHIP The Work will be performed in a professional manner by experienced personnel outfitted with appropriate tools and equipment necessary to complete the Work properly and safely. A typical priority deployment tree removal operation will involve use of a crane, multiple personnel, and a wheel loader, among other equipment, so that debris may be lifted and removed in a manner that minimizes the potential for additional damage to all structures. Further, to minimize hazards to workers, HLA Tree Service uses light towers to illuminate the Work site and chip trucks and chippers to clear the hazard zones. HLA Tree Service may place temporary tarps on structures damaged from trees and debris when the Work is complete. HLA Tree Service reserves the right, in its sole and absolute judgment, to determine what equipment, labor, and materials will be used to safely perform the Work. PERFORMANCE BY HLA Tree Service Work crews arrive at the Work site unannounced unless otherwise designated in this Contract as a special remark and initialed by both you and an agent of HLA Tree Service. HLA Tree Service shall attempt to meet all scheduled or estimated performance dates but shall not be liable for damages due to delays arising from inclement weather or other causes beyond its control. You are not relieved of your responsibilities under this Contract because of delays. INSURANCE HLA Tree Service is insured for liability resulting from injury to persons and property and maintains Workers Compensation Insurance. STUMP GRINDING If stump grinding is deemed necessary in order to repair modified structures on the property such as uplifted fences, underground utilities, sprinkler systems, or disheveled driveways etc, HLA Tree Service will arrange for stump grinding. The cost of stump grinding is $200 per linear foot as measured from outside root tip to outside root tip. Stump grinding, if included, is generally completed several days after the tree is removed. ***Stump shaving from stump grindings will not be considered debris and thus will not be hauled off of property. ACCESS TO WORK You shall use your best efforts to facilitate HLA Tree Service performance of the Work and shall provide free access to work areas for HLA Tree Service and its employees and agents and their vehicles. You agree to keep driveways clear and available for movement and parking of trucks and equipment to be used during normal work hours or as otherwise requested as necessary to perform the Work. HLA Tree Service shall not be liable for damage to driveways and/or sidewalks due to excessive weight of equipment. HLA Tree Service employees shall not be expected to keep gates closed to animals or children. PROPERTY LINES & RESTRICTIONS You shall indicate to HLA Tree Service the boundaries of the property upon which the Work site rests, Homeowner is responsible for the accuracy of markers. You agree to provide HLA Tree Service with a copy of any restrictions, easements, or rights of way upon request. HLA Tree Service may refuse to commence the Work until all such documentation is duly provided. OWNERSHIP You warrant and represent that (a) you own, or (b) you have express permission from the owner of, all trees, vegetation, and property upon which the Work is to be performed to authorize and guarantee payment for the Work. You hereby expressly agree to and shall hold HLA Tree Service harmless from all claims for damages resulting from your failure to obtain proper consents. PERMITS You are responsible for and shall obtain and pay for all required permits. INHERENT HAZARDS AND RISKS Trees inherently pose a certain degree of hazard and risk from breakage, failure, and other causes and conditions. Recommendations made by HLA Tree Service are intended to minimize or reduce hazardous conditions that may be associated with trees. While such recommendations should reduce the risk of tree failure, they cannot eliminate such risk, especially in the event of a storm or any other act of God. Therefore, there is and can be no guarantee that efforts to mitigate against unsafe conditions will prevent breakage or failure of a tree. Additionally, some hazardous conditions in landscapes are apparent, while others require detailed inspection and evaluation. While a detailed inspection and evaluation should and normally does result in the detection of potentially hazardous conditions, there can be no guarantee or certainty that all hazardous conditions will be detected. INDEMNIFICATION AND WAIVER Trees: Trees inherently pose a certain degree of hazard and risk from breakage, failure, and other causes and conditions. Recommendations made by HLA Tree Service are intended to minimize or reduce hazardous conditions that may be associated with trees. While such recommendations should reduce the risk of tree failure, they cannot eliminate such risk, especially in the event of a storm or any other act of God. Therefore, there is and can be no guarantee that efforts to mitigate against unsafe conditions will prevent breakage or failure of a tree. Latent Hazards & Unanticipated Conditions: Some hazardous conditions in landscapes are apparent, while others require detailed inspection and evaluation. While a detailed inspection and evaluation should and normally does result in the detection of potentially hazardous conditions, there can be no guarantee or certainty that all hazardous conditions will be detected. You are responsible for any and all expense and cost incurred by HLA Tree Service due to unusual or unanticipated conditions, environmental hazards, concealed damage, and/or existing defects (specifically including, but not limited to, rock, debris, etc.) on or at the Work site (the “Defects”), discovered during the course of the Work. HLA Tree Service is neither liable nor responsible for repairing any Defects. Concealed Utility Lines & Irrigations Systems: HLA Tree Service shall not be liable nor responsible for any damage to any underground object, specifically including, but not limited to, irrigation systems, gas lines, waterlines, or electrical or telephone wires or conduit. When possible, you should contact the “Call Before You Dig” at 811 to have utility lines marked. One call will notify cable, power, phone, gas, etc. Tarps: HLA Tree Service may tarp a structure or other item to protect it prior to, during, and after Work. HLA Tree Service cannot guarantee that a tarp will protect a structure during all weather conditions or events or remain intact or in place. You acknowledge, understand, and agree that a tarp may dislodge and cause damage to other items of personal and property and that HLA Tree Service shall not be liable for any damage arising therefrom or relating thereto. Damage to Property: HLA Tree Service shall not be liable for any damage trees, vegetation, and property upon which the Work is to be performed. Further, you acknowledge that HLA Tree Service uses heavy machinery, that such machinery may cause underlying damage to paved and other prepared surfaces and non-prepared surfaces and will not be liable for any damage to lawns/landscaping, driveways, sidewalks, any other hard surfaces, invisible fences, buried lines, and/or buried objects.
Indemnification: By execution of this Contract, you expressly indemnify and agree to hold harmless HLA Tree Service from and against any and all damages, losses, claims, and actions of any person, whatsoever, arising out of any damage caused to any person or property arising in the course of the Work, unless occasioned by an improper intentional act or failure to act of HLA Tree Service. Limitation of Recovery: In the event of damage, loss, claim or action for which you have the right of recovery, you expressly agree that in no event shall you seek or have the right to recover damages greater than the amounts actually remitted to HLA Tree Service for the Work.
WAIVER You declare that you are currently experiencing an emergency in the form of a fallen tree that requires immediate attention and expeditious action to remove the fallen tree. The Work to be completed by HLA Tree Service is necessary to safeguard the health, safety, and welfare of you and your property and to prevent any further damage to your property. HLA Tree Service is engaged in the foregoing emergency work efforts and agrees to immediately begin to perform the outlined scope of work. You acknowledge that you may have a right under state statute to cancel this service contract, and, as soon as HLA Tree Service commences the Work by providing emergency mobilization, you hereby expressly and knowingly waive such right, because you acknowledge HLA Tree Service ability to commence the Work without delay, because of an emergency. Initials: ( ) ACT OF GOD You understand, acknowledge, and agree that Work may be postponed, in whole or in part, due to exigencies beyond HLA Tree Service control, including, but not limited to, declarations of governmental bodies, hazardous or impenetrable road conditions, weather, strike, war, insurrection, supply chain restrictions, etc., and that your obligations under this Contract are not relieved due to any such delay. ELECTRONIC COMMUNICATIONS You agree to execute and exchange records and documents in electronic ("E") form. You shall promptly notify HLA Tree Service via telephone of any change to your telephone number and electronic mail address. You may withdraw consent to E-communications at any time by notifying HLA Tree Service via email at least 24 hours prior to such withdrawal. BREACH AND TERMINATION OF CONTRACT If either party commits a non-financial breach of this Contract, then the claiming party shall provide the breaching party with written notice of the default and ten (10) days opportunity to cure, or, in the event of a default which, cannot by its nature be cured within said ten (10) days, commence and diligently pursue cure. If either party commits a financial breach of this Contract, then the claiming party shall provide the breaching party with written notice of the default and two (2) days opportunity to cure. If the breaching party fails to cure, as required herein, then the claiming party shall have all remedies available in law, in equity, and under this Contract. If you fail to timely cure a financial breach under this Contract, then HLA Tree Service shall have the immediate right to recover all legal fees, costs, and expenses incurred in collections. The prevailing party in any legal action shall have the right to recover all legal fees, costs, and expenses actually incurred. The remedies provided herein are cumulative and shall not preclude the assertion by any party hereto of any other rights or the seeking of any other remedies against the other party hereto. HLA Tree Service reserves the right to terminate this Contract at any time with or without cause. GOVERNING LAW By execution of this Contract, you agree that this Contract shall be construed and interpreted in accordance with the laws of the State of Louisiana and to submit to the exclusive jurisdiction of the Courts located in Avoyelles Parish in connection with any litigation arising out of this Contract. You agree to submit to the jurisdiction of these courts and waive all objections to this forum, including without limitation forum non conveniens. SEVERABILITY AND INTERPRETATION If any provision of this Contract is held illegal or unenforceable in a judicial proceeding, such provision shall be severed and shall be inoperative, and the remainder of this Contract shall remain operative and binding upon the parties. This Contract shall not be construed with reference to the party that caused it or any part of it to be prepared, and the doctrine of contra proferentem shall not be applied in any action arising out of or relating to this Contract.
PAYMENT TERMS By signing this Contract, you agree, acknowledge, and understand that this is a binding contract and that you are responsible for prompt payment for Work performed, regardless of whether such Work, or any portion of it, is covered by insurance. *We bill in hourly time increments as described in our Price Chart below. *Hourly rate to be calculated from port to port to and from 123 C Church Rd, Hessmer, LA 71341 or calculated port to port to and from remote operations base when deployed and operating out of town. On jobs where trees have hit multiple structures AND the main dwelling, travel time will be exclusively apportioned toward removal of trees from the main dwelling. *Our minimum charges are described in our Price Chart below. *Charges for Work include all time required to render the services, including travel time to and from the Work site. Because all priority deployment tree work is unique and because HLA Tree Service may not be able to inspect the Work site before performing the Work, HLA Tree Service cannot provide you with a detailed written price estimate of the Work to be performed and does not and will not guarantee in advance or prior to the completion of the Work the total charges for Work to be performed. Initials: ( ) COUNTERPARTS, ELECTRONIC SIGNATURES, FACSIMILE, PDF This Contract and all future documents may be executed in any number of identical counterparts, all of which, when taken together, shall constitute the same instrument. The parties acknowledge and consent to be bound by electronic signatures, including signatures of any required witness. A facsimile, .pdf copy, and other electronically executed versions of documents executed by the parties shall be deemed an original for all relevant purposes. The undersigned is the homeowner or agent acting under the express authority of homeowner, has received and read and understands and agrees to this Contract and requests that HLA Tree Service commence the Work. The undersigned has read this Contract, including all ancillary documents which make up a part of this Contract and agrees to be bound by all of the provisions so written.
I agree to the hourly pricing and minimums as stated above and below as reasonable:
Resources and pricing Name Rate per hrs/sq.ft. Min. 111 Ton And Bigger (Tree-Mek) $1,100 USD 8 Hrs Tarp Per Sq Ft $8 USD 150 Sq. st. Equip. Operator $300 USD 6 Hrs. 15-35 Ton Stick Crane $900 USD 8 Hrs. 30-59 Ton (Tree-Mek) $750 USD 8 Hrs. 36-75 Ton Stick Crane $1020 USD 8 Hrs. 60-110 Ton (Tree-Mek) $900 USD 8 Hrs 76 Ton or Larger Stick Crane $1500 USD 8 Hrs Bucket Truck $300 USD 8 Hrs Chainsaw $45 USD 8 Hrs Chipper $350 USD 8 Hrs Chipper Truck $300 USD 8 Hrs Climber $300 USD 6 Hrs Crane Cribbing $100 USD 8 Hrs Emergency Lights/Generator $300 USD 8 Hrs Equipment Operator $230 USD 8 Hrs Equipment Trailer $185 USD 8 Hrs Class A CDL Driver $250 USD 8 Hrs Hand Tools $30 USD 4 Hrs Leaf Blower $40 USD 6 Hrs Mek Grapple Saw Head $210 USD 8 Hrs Merlo Roto $1020 USD 8 Hrs Mini Bucket/Root Grapple $180 USD 6 Hrs Mini Dangle Grapple $150 USD 6 Hrs Mini Skid Steer $270 USD 6 Hrs Sennabogin $1400 USD 8 Hrs Skid Steer $400 USD 8 Hrs
Resources and Pricing
Name Rate per hrs/sq.ft. Min.
111 Ton And Bigger (Tree-Mek)$1,100 USD8 Hrs
Tarp Per Sq Ft$8 USD150 Sq. ft.
Equip. Operator$300 USD6 Hrs.
15-35 Ton Stick Crane$900 USD8 Hrs.
30-59 Ton (Tree-Mek)$750 USD8 Hrs.
36-75 Ton Stick Crane$1020 USD8 Hrs.
60-110 Ton (Tree-Mek)$900 USD8 Hrs
76 Ton or Larger Stick Crane$1500 USD8 Hrs
Bucket Truck$300 USD8 Hrs
Chainsaw$45 USD8 Hrs
Chipper$350 USD8 Hrs
Chipper Truck$300 USD8 Hrs
Climber$300 USD6 Hrs
Crane Cribbing$100 USD8 Hrs
Emergency Lights/Generator$300 USD8 Hrs
Equipment Operator$230 USD8 Hrs
Equipment Trailer$185 USD8 Hrs
Class A CDL Driver$250 USD8 Hrs
Hand Tools$30 USD4 Hrs
Leaf Blower$40 USD6 Hrs
Mek Grapple Saw Head$210 USD8 Hrs
Merlo Roto$1020 USD8 Hrs
Mini Bucket/Root Grapple$180 USD6 Hrs
Mini Dangle Grapple$150 USD6 Hrs
Mini Skid Steer$270 USD6 Hrs
Sennabogin$1400 USD8 Hrs
Skid Steer$400 USD8 Hrs
Skid Steer Bucket/Root Grapple$240 USD6 Hrs
Skid Steer Dangle Grapple$300 USD6 Hrs
Spider/Man Lift$450 USD8 Hrs
Support Truck (Semi)$300 USD8 Hrs
Support Truck (Straight Truck)$300 USD8 Hrs
Traffic Cones & Signage$60 USD6 Hrs
Traffic Control$174 USD4 Hrs
Turf Matts (per 5)$100 USD6 Hrs
Log Truck$540 USD4 Hrs
Stump Grinder$200 USD/Linear Ft.4 Hrs
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