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Store # Space # <br />Owner Name: <br />Last <br />Start Oate - <br />LACncr.54., <br />SERV. _S AGREEMENT. <br />coataussalrg. <br />Billing Address: 5 /3:S.-e1/5720K4=5- z, <br />Street Address <br /> <br />Apartment/Unit # <br />ZIP Code <br /> <br />d <br />State <br /> <br />City <br /> <br />Mobile Phone: (.2c') Home Phone: (2cY) <br /> <br />E-mail Address: <br /> <br />Truck and Driver Information <br /> <br />License Plate #: <br />Driver #1: <br />Driver #2: <br />Insurance Co.: <br /> Reseller #: <br /> Cell Phone #: <br /> Cell Phone #: <br /> Policy #: <br />Full Service (space, electric, ice, waste) 1 Barrel of ice per day IA barrel more if available: <br />No Electricity — one (1) receptacle per truck/trailer = two extension cords allowed. <br />Waste Only — Only business related waste allowed in LAC dumpsters. <br />0 Other—Keep your parking space clean and free of debris. <br />Monti* Total $ <br />By signing your acknowledgement below, Owner agrees to pay for the Services listed above at the rates quoted <br />and beginning as of the Start Date shown above. Service Fees are due in advance and payable on the 1st day of <br />each calendar month; a $25 late fee shall be owed if payment is not received by the 10th day of each month due. <br />La Comercial is not responsible for any damage caused to your vehicle by other parking tenants or for any lost or <br />stolen property. Owner is responsible for maintaining proper insurance at all times for your vehicle and operating <br />personnel. Owner agrees to reimburse La Comercial for all damage done to the La Comercial facilities by you, your <br />vehicle and personnel. Either La Comercial or Owner may terminate this agreement with 30 days written notice, or <br />immediately in the case of breach of this agreement by either party. <br />Accepted and Agreed to as of S -1 -1 : <br />-Owner: La Comercial Corp, <br />IlAR6/ A