10.6.11

HOME ACCESSIBILITY MODIFICATION PROGRAM

AGING WAIVER or OPTIONS PROGRAM

OFFICE OF HUMAN SERVICES, INC.

Accessibility Modification Agreement

OHS-Owner/Landlord-Tenant

AND NOW, WITNESS, this day of , 20 an Agreement is entered between,

(hereinafter called “Owner”), and (hereinafter called “Tenant” and the Office of Human Services, Inc/Aging Waiver or Options Program, (hereinafter called “OHS”).

WHEREAS, Owner is the proprietor of a building located at:

(Address of the applicant property)

WHEREAS, Tenant has requested accessibility modifications and applied for said modifications to the Owner’s property.

WHEREAS, Owner has consented to have accessibility modifications made to his building by OHS/Waiver for the benefit of the Tenant and as improvements to his property.

WHEREAS, Tenant is presently paying rent of the dwelling,

AND WHEREAS, the accessibility improvements shall be made by qualified Contractors under a legal binding Agreement with OHS.

NOW THEREFORE, it is agreed by the parties as follows:

1. The Owner hereby agrees to permit OHS and its contractors to install certain accessible improvements to his/her building located at the address set forth above. The said improvements shall be in accordance with local and Commonwealth Regulations.

2. The Owner agrees that the Tenant shall not be evicted or removed from the dwelling that he/she occupies, so long as the Tenant complies with all ongoing obligations and responsibilities due the Owner under the lease or as provided by the Landlord/Tenant Act (68P.s.250 101 et seq.) if there is no lease.

3. The agreed upon rent for the premises shall continue to be $ monthly.

4. (I) The Owner agrees not to raise the rent because of the increased value of the dwelling due to the accessibility modification improvements provided.

(II) The owner may raise the rent if he/she makes additional improvements to the property and/or incurs additional expenses such as; higher taxes, utility rates, etc. The Owner must provide to OHS documentation of such increases and/or improvements.

5. Owner does hereby state that the Tenant is presently current in payment of all rents and obligations due by the Tenant to Owner and further that this statement is made by the Owner to induce OHS, on which OHS will rely, to implement accessibility improvements to Owner’s property.

6. The Owner hereby agrees to retain ownership of the premises situated at ______for a period of five (5) years from the date of completion of construction. If the Owner sells or otherwise transfers title to the premises, the owner will be required to return the project funds to OHS in the following amounts:

More Than-Less Than

0 – 1 year………………………………………100% of project costs

1 – 2 years……………………………………..80%

2 – 3 years……………………………………..60%

3 – 4 years……………………………………..40%

4 – 5 years………………………………...... 20%

Over 5 years from the

Date of project completion………No repayment.

A progressive lien will be placed on the property by OHS to ensure compliance with the terms hereof.

7. In the event that the Ownerinitiates a transfer of title and ownership of the property and

premises to another after executing this Agreement, this Agreement shall remain in full force and effect, shall be binding upon the subsequent owner and shall require that the transfer of ownership shall be subject to the execution by the subsequent owner of the OHS-Owner/Landlord- Tenant Agreement.

8. The Office of Human Services, Inc., its subcontractors, and agents shall have the right to enter the premises at any reasonable time and with prior notice within five (5) years/sixty (60) months from the date of final inspection/project completion for the purpose of examining the accessibility modification.

9. OWNER’S PROPERTY INSURANCE:

The Owner shall purchase and maintain property insurance upon entire work at the site

tothe full insurable value thereof. This insurance shall include the interests of the Owner,the Tenant, and theContractor and his sub-contractors in the work and shall insureagainst the perils of Fire, Extended Coverage, Vandalism and Malicious Mischief.

A. Any insured loss is to be adjusted with the Owner and made payable to the Owner as trustee for the insured’s, as their interests may appear, subject to the requirements of any mortgage clause.

B. The Owner shall file a copy of all insurance policies and insurance

certificates with OHS prior to thecommencement of the work..

C.The Owner shall waive all rights against OHS, the Elk County Planning

Officeand the County of Elk for damages caused by fire or other perils to the extent covered by insuranceprovided under this paragraph.

10. OWNER'S LIABILITY INSURANCE: (limits?)

The Owner shall be responsible for purchasing and maintaining his own liability insurance and, at hisoption, may maintain such insurance as will protect him against claims which may arise from operations under the contract.

A. Any insured loss is to be adjusted with the Owner and made payable to the Owner as trustee for the insured’s, as their interests may appear, subject to the requirements of any mortgage clause.

B. The Owner shall file a copy of all insurance policies and insurance

certificates with OHS prior to thecommencement of the work..

C.The Owner shall waive all rights against OHS, the Elk County Planning

Officeand the County of Elk for damages caused by fire or other perils to the extent covered by insuranceprovided under this paragraph.

11. The Ownerunderstands that the cost of repairs to items damaged or malfunctioning due to causes other than defects in workmanship or due to manufacturer defects in parts and/or materials will be the sole responsibility of the Owner. No claims for payment and or reimbursement of these expenses will be made against Contractor’sresponsible for, or performing work, nor will the same be made against OHS, the County of Elk and/or party (s) responsible for payment to the Contractor for completion of the Work.

Intending to be legally bound, the parties hereto set their hands and seals on the day and year first above written.

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Owner (Print)

Signature Date

Tenant (Print)

SignatureDate

Office of Human Services, Inc.(Print)

SignatureDate