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R13-081 11 1 RESOLUTION NO. R13 -081 2 'i 3 A RESOLUTION OF THE CITY OF BOYNTON BEACH, 4 ' FLORIDA, AUTHORIZING AND DIRECTING 5 EXECUTION OF AN AGREEMENT FOR WATER 6 { SERVICE OUTSIDE THE CITY LIMITS AND 7 ` COVENANT FOR ANNEXATION BETWEEN THE CITY 8 OF BOYNTON BEACH AND ANN CARLIN; 9 PROVIDING AN EFFECTIVE DATE. 10 11 12 WHEREAS, the subject property is located outside of the City limits, but within our 13 water and sewer service area, at 1148 Highview Road, Lantana, Florida (PCN: 00- 43- 45 -09- 14 09 -000 - 1740); and 15 WHEREAS, the parcel covered by this agreement includes a single - family home 16 located in unincorporated Palm Beach County portion of the City's utility service area; and 17 WHEREAS, the property historically receives water from a well and the owner now 18 requests that the City provide potable water in the future; and 19 WHEREAS, no additional construction will be required by the City to serve this 20 property. 21 NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF 22 THE CITY OF BOYNTON BEACH, FLORIDA, THAT: 23 Section 1. The foregoing "Whereas" clauses are hereby ratified and confirmed as 24 being true and correct and are hereby made a specific part of this Resolution upon adoption 25 i hereof. 26 1 Section 2. The City Commission hereby authorizes and directs the City Manager 27 to execute a Water Service Agreement between the City of Boynton Beach, Florida and Ann 28 Carlin, a copy of said Agreement is attached hereto as Exhibit "A ". 29 Section 3. This Resolution shall become effective immediately upon passage. \ \apps3 city cbb \auto\Data\ 183\ Items\ 175\2537 \3325\Reso_- Carim_Water Service_Agreement doc II I 20 1 ' PASSED AND ADOPTED this 20 day of August, 2013. 2 3 4 CITY OF BOYNTON BEACH, FLORIDA 5 6 / 8 �a r Jerry a y o r, 9 10 �'i — /�4IiW/ 1 1 Vice Mayor — Woodrow L. Hay 12 13 14 Commissioner — D :vid T. Merker 15 — 16 � :i I 171 Cf,mmiss er— :chael M. Fit' r' k 18 19 1L.... —. . _ 20 • — Joe Casello 21 ATTEST: 22 23 24 ,,�, Si:- '• / I l • PA.,„:„±„, 25 ar M. Prainito, MMC 26 ity Clerk 27 28 29 ,-, X- 1, 30 u 31 'boat a i ili . x ! I I \ \apps3 city cbb \auto\Data \183 \Items \175\2537 \3325 \Reso - Carhn_Water_Service Agreement doc oop'(F) ZT -ZZ - s (TEnPTATPuI) KSM \squawaGaby a °TnzaS .zaTeM \Smod \suorquTag .z9wo1sn0 \:S S Jo T aba . 3pom alp fiutpinoid Jo slsoo p nlar atp Xrd X.zrssaoau ag 'rut sr spuns Iruo!1rppr Lions /CID atp of aournpr 09r Iltm (s) oum0 agr `pouuo ad *tom gons srg atp Juana atp u1. goan14 slsoo pawtuijsa IIr 3ournpr ui /Cud !pm (s).taum0 atp asro !palm ui pauuojtad *tom atp anrq Xrui Xl!D (q) .to 31100 iC.Lrssau 31.11. uuoj.Md .toporuuoo pasuaoil r asn (spawn() ay (r) Ouumbal Jau4ta jo uoijdo alp anrq Ilrgs aqj, •L •s.taauOu3 !Iij 044 'q uouoadsui o4 pafgns pur sopgilfl.Io aoloanu ay. 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Any water main extension made under the Agreement shall be used only for Property of the Owner(s), unless written permission is granted by the City of Boynton Beach for other party or parties to connect pursuant to the Code of Ordinances and regulations of Boynton Beach. 9. Ownership and title to all mains, extensions, and other facilities extended from the City Water Distribution System to and including the metered service to Owner(s) shall be vested in the City exclusively unless otherwise conveyed or abandoned to the property owner. 10. The Owner(s) agrees to pay all charges, deposits, and rates for service and equipment in connection with water service outside the City limits applicable under City Code of Ordinances and rate schedules which are now applicable or as may be changed from time to tune. 11. Owner(s) shall pay a twenty -five percent (25 %) surcharge on all base facility and water use charges to the Property. 12. Any rights -of -way or easements needed by the City to provide water to the Property shall be provided by the Owner(s) and at the Owner(s)'s expense. 13. It is understood by the Owner(s), and shall be binding upon the Owner(s), his or her transferees, grantees, heirs, successors, and assigns, that all water to be furnished, supplied, and sold under this Agreement is made available from surplus. If the surplus does not exist at the time of Owner(s)'s actual request for commencement of service, as determined by the City's Director of Utilities, then this CITY, without liability, may refuse to initiate service to the subject Property. 14. The Owner(s) further agrees in consideration of the privilege of receiving water service from said City, that the execution of this Agreement is considered to be a voluntary Petition for Annexation pursuant to Section 171.044 of the Florida Statutes or any successor or amendment thereto. Furthermore, should any other general law, special act, or local law be enacted which provides for voluntary or consensual annexation, this Agreement shall also be considered a request by the Owner(s) for annexation under such other laws. The Property shall be subject to annexation at the option of the City at any time eligible under any one or more of the above - referenced laws concerning annexation. Owner(s) will inform any and all purchasers of this property of this voluntary Petition for Annexation and its applicabilities to such purchasers. 15. The Owner(s) acknowledges that this Agreement is intended to be and is hereby made a covenant running with the land described in paragraph 1 above. This Agreement is to be recorded in the Public Records of Palm Beach County, Florida, and the Owner(s) and all subsequent transferees, grantees, heirs, or assigns of Owner(s) shall be bound by this Agreement. 16. It is agreed that the City shall have no liability in the event there is a reduction, impairment, or termination in water service to be provided under this Agreement due to any prohibitions, restrictions, limitations, or requirements of local, regional, state, or federal agencies or other agencies having jurisdiction over such matters. Also, the City shall have no liability in Page 2 of 5 S: \Customer Relations \FORMS \Water Service Agreements \WSA (Individual) 8 -22 -12 (3).doc the event there is a reduction, impairment or termination of water service due to acts of God, accidents, strikes, boycotts, blackouts, fire, earthquakes, other casualties, or other circumstances beyond the City's reasonable control. AGREEMENT FOR WATER SERVICE OUTSIDE THE CITY LIMITS AND COVENANT FOR ANNEXATION (Individuals) 17. The Owner(s) hereby agrees to indemnify, defend and hold harmless the City of Boynton Beach, its Mayor, Members of the City Commission, officers, employees, and agents (both in their individual and official capacities) from and against all claims, damages, law suits and expenses including reasonable attorneys' fees (whether or not incurred on appeal or in connection with post judgment collection) and costs rising out of or resulting from the Owner(s)'s obligation under or performance pursuant to this Agreement, including disputes for breach of warranty of title. 18. No prior or present agreements or representations shall be binding on any of the parties hereto unless incorporated in this Agreement. No modifications or change in this Agreement shall be valid upon the parties unless in writing executed by the parties to be bound thereby. 19. The Owner(s) warrants to the City that the Owner(s) holds legal and beneficial title to the Property which is the subject of this Agreement. 20. In the event of a sale of the Property by Owner(s), Owner(s) agrees to provide written notice of the existence of this Agreement to the buyer of the Property prior to or in conjunction with the closing of the sale transaction. (REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK) TWO (2) SIGNATURE PAGES FOLLOW Page 3 of 5 S: \Customer Relations \FORMS \Water Service Agreements \WSA (Individual) 8 -22 -12 (3).doc AGREEMENT FOR WATER SERVICE OUTSIDE THE CITY LIMITS AND COVENANT FOR ANNEXATION (Individuals) IN WITNESS WHEREOF, the parties hereto have set their hands and seals this day of \ 3 , 20 . Sealed and delivered in the presence of: TWO WITNESSES as to each Owner: INDIVIDUAL(S) AS OWNER(S): First Witness Sig ture Owner Signature 1� x m w, u _ A �' . ANN CARLIN Printed Witness Name Printed Owner Name fcond Witness Si: /ure � D / T - A. / Printed Witness Name First Witness Signature Owner Signature Printed Witness Name Printed Owner Name Second Witness Signature Printed Witness Name FOR OWNER(S) NOTARIZATION. STATE OF FLORIDA ) ss COUNTY OF PALM BEACH ) I HEREBY CERTIFY that on this day, before me, an officer duly authonzed i the State of Florida and in the County of Palm Beach to take acknowledgments, personally appeared to me Ann t I v .1 0 as the Owner(s) named in the foregoing Agreement and that he/shs acknowledged executing the same in the presence of two subscnbing witnesses freely and voluntarily and that the individual was personally known to me or provided the following proof of identification: FL, t) L - WITNESS my hand and official seal in the County and State last aforesaid this .9-3 da y of All k( ,20_1 J (Notary Seal) o•'� ",° B� CATHERINE CHER *Y.GUEERMAN r 4 1 A ^ ) ;ark � MY COMMISSION 1 EE 207630 o ta ry b Public Signature ture . i,�a„ C� EXPIRES, - -i irw �� __/ _. , b.e►'i�D r --reo, no�Jr Bonded TMu Budget Notary Servals �_ �CIL Pr inted Name of Notary Public My Commission Expires. SO 0 I , (:)! L Commission Number: Page 4 of 5 S: \Customer Relations \FORMS \Water Service Agreements \WSA (Individual) 8 -22 -12 (3).doc AGREEMENT FOR WATER SERVICE OUTSIDE THE CITY LIMITS AND COVENANT FOR ANNEXATION (Individuals) pl, ° CITY OF BOYNTON BEACH, FLORIDA "~ ,. A Florida municipal corporation Y 111 ‘ BY: ,??,„,....„.. ,Zee 145K-7-- ? . r = r i LaVerriere, City Manager 7 ATTEST: • ity C le e, Approved as to Form: City torney ti STATE OF FLORIDA ) ) ss COUNTY OF PALM BEACH ) I HEREBY CERTIFY that on this day, before me, an officer duly authonzed in the State of Florida and in the County of Palm Beach, to take acknowledgments, personally appeared Lori LaVerriere, Interim City Manager and Janet Prainito, City Clerk, respectively, of the City named in the foregoing Agreement and that they severally acknowledged executing same and voluntarily under authority duly vested in them by said City and that the City seal affixed thereto is the true corporate seal of said City �-fl WITNESS my hand and official seal in the County and State last aforesaid thiPC day of rI,ECauf> , 201 3 (Notary Seal) O_CLI—biliN i, L . Notary Public Signature x ' ' �) �" l f - , :t — ma r) Printed Notary Public Name My Commission Expires ,Ttd P`)'F i 9 , c V I t,41 Commission No. Cc (90 7e 3t-' os' Y•:." < CATHERINE CHERRY•GUBERIAAN * 1 i) < * MY COMMISSION # EE 207630 T~ EXPIRES: June 12, 2016 n ' + rf of FHge Bonded Thru Budget Notary Seances Page 5 of 5 S: \Customer Relations \FORMS \Water Service Agreements \WSA (Individual) 8 -22 -12 (3).doc i1' 7 ,, P , s ss" \ o i IRREVOCABLE SPECIAL POWER OF ATTORNEY ' `' ' (Individuals) STATE OF FLORIDA COUNTY OF PALM BEACH UWe, ANN CARLIN , hereinafter "Grantee ", hereby make, constitute, and appoint THE CITY OF BOYNTON BEACH, FLORIDA, true and lawful attorney in fact for Grantee and in Grantee's name, place and stead, for the sole purpose of executing on behalf of Grantee the power to initiate, maintain, and complete a voluntary petition for annexation of the real property described herein into the CITY OF BOYNTON BEACH. This power shall extend to the CITY OF BOYNTON BEACH full and complete authority to act on Grantee's behalf to accomplish annexation by any available means. The real property which is the subject of this power is described as follows: PCN No.: 00- 43- 45 -09 -09 -000 -1740 The powers and authority of my attorney, THE CITY OF BOYNTON BEACH, FLORIDA, shall commence and be in full force and effect on the day of , 20 and the powers and authority shall be irrevocable by Grantee. (REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK) SIGNATURE PAGE FOLLOWS Page 1 of 2 S• \Customer Relations\FORMS\Water Service Agreement~vPower of Attorney (Individual) 8 -22 -12 (3) doc IRREVOCABLE SPECIAL POWER OF ATTORNEY (Individuals) IN WITNESS WHEREOF, we have hereunto set our hands and seals this ) .D\ v ' d day of kAA , in the year 20 3 Sealed and delivered in the presence of TWO WITNESSES as too each Owner: INDIVIDUAL(S) AS OWNER(S): . evy 3(.61 first Witness S gnature Owner Signature ,n. ', r �,�� ANN CARLIN Printed WitneA Name Printed Owner Name ` ALL /ond Witness Sig -Cure o /r/+ /c ,7 Printed Witness Name First Witness Signature Owner Signature Printed Witness Name Printed Owner Name Second Witness Signature Printed Witness Name STATE OF FLORIDA ) SS COUNTY OF PALM BEACH ) THE FOREGOING INS RUMENT was acknowledged before me and executed the same this _ day of 39 31 -0 20 13, by 14 1) i1 (,.Y li fl and who are known to me or who have produced the following as proof of identification FC D• (Notary Seal) dq 1 , Pue� CATHERINE GiERRY GU9ERYAN 61 6LA�l/�(k OA/ ViANCtil * MYCOMMISSION Notary Public Signature V EXPIRES: June 12, 2016 (, 1 Bonded Thru Budget Notary Services �� `1 V l r� ( ( u �r�'Y { n u f r Printed Notary Public Name My Commission Expires d U1)1 ( , ,-1.)1(r) Commission No Page 2 of 2 S• \Customer Relations \FORMS \Water Service Agreements \Power of Attorney (Individual) 8 -22 -12 (3) doc Jop•(E) ZI -ZZ -8 (I flpTATpuI) KSM \squawaa.1Si aaznzaS -I qPM \SN Od \suoTgpTa zawogsnO \:S S 30 t abed �aom atp Ouipinoad Jo slsoo Tpnlar p of alp /Cud Xaussaoau aq 'Cray sr spun) Iruo lions 'C1D ath 01 a°urnpr oslr rum (s)Joum0 atp `patuaojaad �rortn lions suq i4i3 044 Juana 0114 ul 30 3.1 0111 S4SO0 pa4ruri4sa Ile a°urnpr ui /Cud HIM (s)aaum0 aq4 asro q°Igm lit pauuojaad )I.1om 044 anrq /Cm J4ID alp (q) ao )'aom £rrssaaau aq4 uuojaad of aolarawoo pasuaoq y asn o4 (s)iaum0 044 (r) Ouuinbaa aag4ta Jo uoijdo alp anrq Mugs J4i3 041 •L •sraauOug X113 aq; Xq uoi4aadsut 04 4°afgns pup sau!ipn Jo iopoalm 0144 Xq pa/middy aq Jsatg Ilrgs sour' Bons T'y pup Xuadozd s,(s)1aum0 atp uodn sour' a°Tnaas IIy Jo suoi4rin5az pur `salru `sapoo alquoliddr IIr gpim aouruuojuoo pur uonri uisut aoj a'gisuodsai aq Ibis (s)aaum0 au -9 •Xpadoad s,(s)aaum0 044 aatn.1as apinoad apo j /coup alp Xq paainbaa sr saulliarj atp Jo uouoadsui puy `uot4uIIr4sui `aogrl `Ipualruz `2UUaaur2ua Jo s4so° 'Ir iCrd o4 saaJOy (s).iaum0 au 'S •(s)uorpauuo3 Irt4uapisa14ualynmbg (iaquznu Xli °ads) g'I saainbai Xpadoad 041 t •uarag uo4uXog Jo /CIDD aq4' q pawra2 sr uorssruuad ua44um ssa'un `anogr ' gdrr5r.zpd ur paquasap Xlradoad 044 urg4 aag4o Xa.radord /Cur Jgauaq 10 a°tnaas 01 JTij 041 uzo.1J S°Aiaaaa 1i aa4um Xiddns .zo asn 4ou Hulls (s).1aum0 •Xpadoad aq1 a°IAJOS 01 krrssaaau sy X'uo 11104sllS J01yM J1i0 044 Wag SaalAJOS .134rm u4im (s)aaum0 apinoad 01 S0015u X113 au •Z Of7L 1 (NDd) aaqumN loaluo j Xlaadoid s,aasivaddy Xpadoad X4unoD :rasp OOTAJOS .131rm34srm pur aa4ym s J au4 ui 4nq `X4JD auk Jo salmpunoq 044 apis4no pa4u°ol (Xpadoad,, iauruiaiaq) Xpadord Iran paquasap 2uimollo3 044 sumo 11 4ygl s4uruano° puu s4uasaadaa (s)aaum0 • :smo'loj sr 0012r `su5Issr pur sJossaaans `saran aq4 `(s)aaum0 au4 pur q °rag uo4uXog Jo 'C4TJ aq1 `uiaaaq passaadxa s4uruano° Tull alp pur ura4sJCS Ja4yM i41T aq4 uzo.0 °°moos aa4ym 01.11AI000a JO a2a'inud alp JO uopriapisuoo ui `(s)aaum0 alp puu 44!3 alp `H.LlSSgNZIM „ au4 paliva aa43uuraaaq `rpuold Jo awls alp Jo uopraod.roa Irdioiunur r `1-13d3g NO.LNXOS dO AlI3 gH.L pup „`(s)aaum0„ 044 pally° a34Jruia1314 NI72IvJ NNV :uaampq puu /Cq -VOZ `k 3o /Cup -- Or sup uo apruu `4uauzaaa2y stu.l, (sienpinipLI) oe A MOIIVXINNIV NO3 INVN3AOD UNV S LIL�iI'I A.LID 3H1 3OISlflO 1DIAN3S 2I3IVM 110,4 1N13LSIIDDI9V ( :.OLT - 969T sbd 83 11O8LdW00 7 A8370'1309 '8 uoJeyc eptaoTd '44uno3 y3ea8 WTed 9T�8T.i CTOZ/60/60 a3a8O038 969 E3d oTC93 Z:10 ssaiPPV S E'REE'0E' Tot Nd3 GWEN INIENHIMMNEIHII (adoienue pedwe ;s pesseJppe -;has asopua) of uJnlaa A. Settlement Statement U.S. Department of Housing OMB No 2502 -0265 and Urban Development B. Type of Loan I ❑ FHA 2 ❑ FmHA 6 File Number 7 Loan Number 8 Mortgage Ins Case Number 3 ❑ Cony Grans 4 ❑ VA 175 - 6 5 ❑ Cony Ins 6 ❑ Seller Finance 7 II Cash Sale C. Note: This form is furnished to give you a statement of actual settlement costs Amounts paid to and by the settlement agent are shown Items marked "(p 0 c )" were paid outside the closing, they are shown here for mformauonal purposes and are not Included in the totals 13 Name & Address of Borrower E Name & Address of Seller F Name & Address of Lender Ann Carlin TOB Property Solutions LLC, a Florida Limited Liability Company 514 SE 20th Court, Boynton Beach, FL 33435 12790 Timber Pine Trail, Wellington, FL 33414 G Property Location H Settlement Agent Name Universal Land Title, LLC Ridge Grove Add No 1,Lot 174 Palm Beach County 1555 Palm Beach Lakes Blvd , Suite 500 1148Ilighvrew Road West Palm Beach, FL 33401 Tax ID. 26- 4805964 Lantana, FL 33462 Place of Settlement I Settlement Date Universal Land Title, LLC 7/12/2013 12160 South Shore Blvd., #104 Fund Wellington, FL 33414 J. Summary of Borrower's Transaction K. Summary of Seller's Transaction 100. Gross Amount Due from Borrower 400. Gross Amount Due to Seller 101 Contract Sales Price 540,900 00 401 Contract Sales Price 540,900 00 102 Personal Property 402 Personal Property 103 Settlement Charges to borrower 519.10 403 104 404 105 405 Adjustments for items paid by seller in advance Adjustments for Items paid by seller m advance 106 City property taxes 406 City property taxes 107 County property taxes 407 County property taxes 108 Non Ad Valorem Taxes 07/12/13 to 09/30/13 $66 68 408 Non Ad Valorem Taxes 07/12/13 to 09/30/13 566.68 109 School taxes 409 School taxes 110 Other taxes 410 Other taxes 111 411 112 412 113 413 114 414 115 415 116 416 120. Gross Amount Due From Borrower 540,985.78 420. Gross Amount Due to Seller 540,966.68 200. Amounts Paid By Or m Behalf Of Borrower 500. Reductions in Amount Due to Seller 201 Deposit or earnest money 510,000.00 501 Excess Deposit 202 Principal amount of new loan(s) 502 Settlement Charges to Seller (Ime 1400) 52,432.63 203 Existing loan(s) taken subject to 503 Existing Loan(s) Taken Subject to 204 Loan Amount for 2nd Lien 504 Payoff of first mortgage loan 205 505 Payoff of second mortgage loan 206 Seller credit for water meter 52,000.00 506 Seller credit for water meter 52,000 00 207 507 208 508 209 509 Adjustments for items unpaid by seller Adjustments for items unpaid by seller 210 City property taxes 510 City property tares 211 County property taxes 01/01/13 to 07112/13 5149.50 511 County property taxes 01/01;13 to 07112113 5149.50 212 Non Ad Valorem Taxes 512 Non Ad Valorem Taxes 213 School taxes 513 School taxes 214 Other taxes 514 Other taxes 215 515 216 516 217 517 218 518 219 519 220. Total Paid By /For Borrower _ $12,149.50 520. Total Reduction Amount Due Seller _ $4,582 13 300. Cash At Settlement From/To Borrower 600. Cash At Settlement To /From Seller 301 Gross Amount due from borrower (line 120) 540,985.78 601 Gross Amount due to seller (line 420) 540,966 68 302 Less amounts paid by /for borrower (line 220) 512,149.50 602 Less reductions m amt due seller (line 520) $4,582.13 303 Cash From Borrower $28,836.28 603. Cash To Seller $36,384.55 Swum 5 of the Real •state •ettlenwnt Procedures Au (RLSPA) rogmres the following • HUD Section 4(a) of RFSPA mandate, that HUD develop and pleuritic this standard Corm to he used at must desclop a Speual Inlormation Booklet to help persons borrowing mono to Imam .e the the time of loam settlement to pros tde full disclosure of all charges rmpo%d upon the borrower and prat of residential real estate to better understand Is nature and costs of real a oatc senlcmemt ssdler 1hsse are thud party disclosures that are &,grind to pro,tdt the ith pertinsnl mturmaron during the settlement prohLss m order to be a hater shopper s l so Icnder must prooide the booklet to all epplwsul Rom whom it rx or for /whom a the Pubis. Reporting Braden for this callwtson 01 tmormatton 0 sOimaced to ascrage , s hose prep Jr, a wntmn appltcauon to borrow money to finance the purchase 01 iestdennal real 1,1310 per n,gion,c, including the tam for re ng instructions ,earthing existing data sn 1 Lenders must prepare and distribute with the Booklet a Good Faith Estimate of the settlement costs gathering and mamtammg the data needed wi and completing and re. towing the collection of that the hrnrowsr is hkoh to incur to ...non with the settlsmwt 1 hese dtulosure, are mforrnatin mandator, flit, agent may not collect this information and von are, not rlgutrui to eomplus [his torn unless it dtspla} s a current], valid OMB control number mformanon tequo,ted does not lend itself to oonfaihrm dm Previous Editions are Obsolete Page 1 form HUD-1 (3/86) Printed 07/11/2013 09 :52 AM Handbook 4305 2 L. Settlement Charges 700. Total Sales/Broker's Commission based on price $40,900.00 @3 % = $1,227 00 Paid From Paid From Division of Commission (line 700) as follows Borrowers Sellers 701. $000 to Funds at Funds at 702 $1,227.00 to Boynton Beach Realty Settlement Settlement 703 Commission Paid at Settlement $0.00 $1,227 00 704 to 705 Transaction Brokerage Fee to 800. Items Payable in Connection with Loan 801 Loan Origination Fee % to 802 Loan Discount % to 803 Appraisal Fee to 804 Credit Report to 805 Lenders Inspection Fee to 806 Mortgage Insurance Application to 807 Assumption Fee to 900. Items Required by Lender To Be Paid to Advance 901 Interest from 7/12/2013 to 8/1/2013 @ SO/day 902 Mortgage Insurance Premium for months to 903 Hazard Insurance Premium for years to 1000. Reserves Deposited With Lender 1001 Hazard insurance months @ per month 1002 Homeowners insurance months @ per month 1003 City property taxes months @ per month 1004 County property taxes months @ per month 1005 Assessment Taxes months @ per month 1006 School taxes months @ per month 1007 Other taxes months @ per month 1008 Other taxes months @ per month 1011 Aggregate Adjustment 1100. rifle Charges 1101 Settlement or closing fee to Universal Land Title, LLC 5250 00 1102 Abstract or title search to Universal Land Title, LLC 5150.00 1103 Title examination to 1104 Title insurance binder to 1105 Document preparation to 1106 Notary fees to 1107 Attorneys fees to (includes above items numbers ) Keyes I' file Services/ 1108 Title insurance to $183.73 Old Republic National Title Insurance ( includes above items numbers ) 1109 Lender's coverage $0.00/$0.00 - 1110 Owner's coverage 540,900.00 /$183.73 4-1":41,v11'11.,. , ; 1111 City Lien Search to ASAP TAX & LIEN SEARCH INC $175.00 1112 Reimbursement for Estoppel Fees to Universal Land Title, LLC 1200. Government Recording and Transfer Charges 1201 Recording Fees Deed 519.10 , Mortgage , Releases $19.10 1202 City /county tax/stamps Deed , Mortgage to 1203 State tax/stamps Deed $286.30 , Mortgage to Clerk of the Grant Court Palm Beach S286.30 County 1204 Tax certificates to 1205 Record Affidavit to Clerk of the Circuit Court Palm Beach $1060 County 1300. Additional Settlement Charges 1301 Survey to 1302 Pest Inspection to 1303 Water Utilities to 5150.00 1400. Total Settlement Charges (enter on lines 103, Section J and 502, Section KJ $1910 52,432.63 Previous Editions are Obsolete Page 2 form HUD-1 (3/86) Printed 07/11/2013 09.52 AM Handbook 4305 2 Water Service Agreements Outside the City of Boynton Beach Limits (Single Family Homes) TO: APPLICANTS FOR WATER SERVICE OUTSIDE THE CITY LIMITS (SINGLE FAMILY HOMES) FROM: CITY OF BOYNTON BEACH UTILITIES DEPARTMENT RE: WATER SERVICE AGREEMENTS 1 Please note that all blanks (other than signatures) are to be typed or legibly printed 2. Names in the blanks must match the owners' name exactly as it appears on the Deed to the Property • Correct example: John Ralph Customer and Alice D Customer • Incorrect example: John R. and Alice D. Customer • Incorrect example: John and Alice Customer 3. Sign the Agreement for Water Service Outside the City Limits and Covenant for Annexation (on Page 4) and the separate Irrevocable Special Power of Attorney 4. Have all signatures properly witnessed and notarized on both Agreements, including the full names inserted in the Notary's Certification. 5. Provide the Property Control Number below and attach a copy of the Deed to the Property and legal description (Labeled "EXHIBIT A ") 6 Provide the Owner's Information and Property Information requested below 7 Return all documents to Customer Service Office, 100 East Boynton Beach Blvd, Boynton Beach FL, 33435 Sincerely, Anthony M. Penn Customer Service Manager — Utilities Finance Department 1 OIIR OFFICE WILL NEFD AT LEAST ONE WEEK'S REVIEW TIME FOR PROCESSING THIS APPLICATION, PRIOR TO SCHEDULING IT 3 -4 WI FKS BEFORE A CFI Y COMMISSION MEETING FOR APPROVAL C'1 L Y COMMISSION MEETINGS ARE NORMAL" Y SCHEDULED ON IHE I Cr AND 3 1 UFSDAY OF EVERY MONTH THE TOTAL TIME SCHEDULE FOR APPROVAL COULD BE AT LEAST 5 -6 WEEKS FROM i IIE DATE OF SUBMITTAL TO THE DATE OF COMMISSION APPROVAL DEPENDING UPON THE COMMISSION MEETINGS DATES Owner's Information Owner's Name ANN CARLIN Mailing Address 514 SE 20 CT BOYNTON BEACH FL 33435 No & Street Citi State Zip Code Home Telephone No 561- 315 -6536 Mobile Telephone No 561- 951 -0551 Property Information A ddress 1148 HIGHVIEW RD LANTANA FL 33462 No & Street City State Zip Code County Appraiser's Office Property Control Number (PCN) 00- 43- 45 -09 -09 -000 -1740 S \Customer Relations \FORMS \Water Service Agreements \Cover Letter - Single Family Homes 8 -22 -12 (3) doc