West Lot South Lot Garage Reserved Garage Tandem

Effective Date

Name for Reserved Sign

Group billing authorized by

Applicant

Name

Home Address

City State Zip

Tel. No. (Home)

Employment

Employer

Address

City State Zip

Tel. No.

Vehicle Description

Vehicle Make Model

Color

Tag No.

Registered To

PAYMENT IS DUE BY THE 10TH OF THE MONTH. PAST DUE PAYMENTS ARE SUBJECT TO LATE FEES. I understand that I am responsible for payment of parking fees as billed until my usage of the parking space is terminated by me or Gate. If I terminate, I will immediately notify Gate Riverplace Company ("Gate") and arrange to surrender my parking decal or access card. THERE WILL BE A $25.00 FEE FOR RETURNED CHECKS. Any parking cards, decals or related materials supplied by Gate to me shall remain the property of Gate and upon termination or revocation of parking privileges, such will be promptly returned to Gate. I also understand that Gate is not responsible for damages to person or property in case of fire or theft or acts of God, the elements, riots, civil disorder, or other events beyond the reasonable control of Gate or for damage or injury inflicted by other than an employee of Gate. Gate is not responsible for any vehicles left on lot/in garage or the contents of same. Your license and privilege is only to park your vehicle in the space provided and to access the space in accordance with any signs or rules or regulations of Gate or requirements of applicable law. Gate may terminate this license and privilege at any time by verbal or written notice to you. You are to use reasonable care in your driving, parking, access and egress and to be careful and cautious for your person, vehicle and possessions and hold Gate harmless from claims, damages or liabilities arising from your use or occupancy. The space provided and access to same is furnished in its "as is" condition and configuration which may be changed or reconfigured by Gate. Should you find a defect or failure of the condition or configuration, you are to promptly notify Gate. Gate reserves the right to interrupt or suspend the license and privilege due to accidents, repairs, replacements, law requirements, act of God or other causes beyond Gate's reasonable control. Gate will only be responsible for Gate's negligence or willful misconduct or that of its employees and not be responsible for other parkers, users, trespasser or any other persons whatsoever. Gate shall not be liable or responsible for preventing an unauthorized third party from violating or interfering with your parking license and privilege or for enforcing your licenses and privilege against such third party.

By submitting this application you agree to the above terms and agreements