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<p class=3DMsoTitle style=3D'margin-left:0in;text-indent:0in'>HOME / VILLA=
 STANDARD
REPORT<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span><span style=3D'font-size:10.0pt;font-weight:normal'><o:p></o:p></sp=
an></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>&nbsp;</o:p>=
</span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'>ENTRY:<span style=3D'mso-spacerun:yes'>&nbsp;&n=
bsp;
</span>SELLER / REALTOR / BUYER<span style=3D'mso-tab-count:4'>&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>DAY:
_________<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;
</span>TIME: _________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'>PICKUP KEY___________________________________<s=
pan
style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;
</span>FULL INSPECTION ___________ $_________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'>SELLER NAME FOR P/U ________________________<sp=
an
style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;
</span>PARTIAL INSPECTION ________ $________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'>PERSON AT INSPECTION _______________________<sp=
an
style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;
</span>A/C INSPECTION _____________ $________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:8'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;
</span>TERMITE INSPECTION ________ $________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:8'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;
</span>RADON <u># .</u>_____TEST _________ $________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:8'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;
</span>GUEST HOUSE _______________ $________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'>INSPECTION DATE ____________________<span
style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;
</span>DOCK / SEAWALL ____________ $________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:8'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;
</span>MOLD _______________________ $________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
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-size:
10.0pt;font-weight:normal'>TO:<span style=3D'mso-tab-count:1'>&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>______________________________=
_______________<span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;
</span>INVOICE AMOUNT<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;
</span>$________<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;
</span><o:p></o:p></span></p>

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; </span>_____________________________________________<o:p></o:p></span></=
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<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>&nbsp;</o:p>=
</span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'>RE:<span style=3D'mso-tab-count:1'>&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>HOME
INSPECTION<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
; </span>_____________________________________________<o:p></o:p></span></=
p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><span style=3D'ms=
o-tab-count:
1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp; </span>_____________________________________________<o=
:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><span style=3D'ms=
o-tab-count:
1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp; </span>SUBDIVISION
/ BLDG: ________________________<span style=3D'mso-tab-count:2'>&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp; </span>ENTRY
CODE: __________________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>&nbsp;</o:p>=
</span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><u><span style=3D'font-size:10.0pt;font-weight:normal'><o:p><span
 style=3D'text-decoration:none'>&nbsp;</span></o:p></span></u></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><u><span style=3D'font-size:10.0pt;font-weight:normal'><o:p><span
 style=3D'text-decoration:none'>&nbsp;</span></o:p></span></u></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><u><span style=3D'font-size:10.0pt;font-weight:normal'>REFRIGERATOR</=
span></u><span
style=3D'font-size:10.0pt;font-weight:normal'>:<span style=3D'mso-tab-coun=
t:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp; </span>GE
/ KA / SUBZ / HOTPT / AMANA / FRIG / WHRL / KEN / W-WEST / ROPER /
JENN-AIR<span style=3D'mso-spacerun:yes'>&nbsp; </span><span style=3D'mso-=
tab-count:
2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; =
</span><span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>M-CHEF<o:p></o:p></span>=
</p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><span style=3D'ms=
o-tab-count:
3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><o:=
p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-bottom:6.0pt;text-align:l=
eft'><span
style=3D'font-size:10.0pt;font-weight:normal'>MODEL:
_________________________________________________________________________<=
o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-bottom:6.0pt;text-align:l=
eft'><span
style=3D'font-size:10.0pt;font-weight:normal'>CAPACITY: (APPROXIMATELY)
___________________________________________________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-bottom:6.0pt;text-align:l=
eft'><span
style=3D'font-size:10.0pt;font-weight:normal'>ICE MAKER: ___WORKING / NOT =
WORKING
/ NONE / NOT IN SVC / NOT VERIFIED / UN<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-bottom:6.0pt;text-align:l=
eft'><span
style=3D'font-size:10.0pt;font-weight:normal'>ICE DISPENSER: _____________=
____________________________________________________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-bottom:6.0pt;text-align:l=
eft'><span
style=3D'font-size:10.0pt;font-weight:normal'>ICE CRUSHER:
__________________________________________________________________<o:p></o=
:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-bottom:6.0pt;text-align:l=
eft'><span
style=3D'font-size:10.0pt;font-weight:normal'>WATER DISPENSER:
_____________________________________________________________<o:p></o:p></=
span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-bottom:6.0pt;text-align:l=
eft'><span
style=3D'font-size:10.0pt;font-weight:normal'>NICHE LIGHT:
________________________________ NONE<span style=3D'mso-spacerun:yes'>&nbs=
p;
</span>/<span style=3D'mso-spacerun:yes'>&nbsp; </span>WORKING<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>NOT WORKING<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-bottom:6.0pt;text-align:l=
eft'><span
style=3D'font-size:10.0pt;font-weight:normal'>BOX LIGHT:
______________________________________ WORKING / NOT WORKING<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>UN<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-bottom:6.0pt;text-align:l=
eft'><span
style=3D'font-size:10.0pt;font-weight:normal'>BOX GASKET: ________________=
___
GC<span style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>FAIR<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>OLD<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>WORN<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>TORN<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>NFA<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-bottom:6.0pt;text-align:l=
eft'><span
style=3D'font-size:10.0pt;font-weight:normal'>BOX CASE: ________________ G=
C<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>FAIR<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>POOR <span
style=3D'mso-spacerun:yes'>&nbsp;</span>/<span style=3D'mso-spacerun:yes'>=
&nbsp;
</span>RUSTY<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>WORN<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>NFA /<span
style=3D'mso-spacerun:yes'>&nbsp; </span>NSW<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-bottom:6.0pt;text-align:l=
eft'><span
style=3D'font-size:10.0pt;font-weight:normal'>COOLING COILS: _____GOOD<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>FAIR CONDITION<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>DIRTY-DUSTY<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>NEED CLEANING<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-bottom:6.0pt;text-align:l=
eft'><span
style=3D'font-size:10.0pt;font-weight:normal'>UNIT WORKING AT TIME OF
INSPECTION..<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-bottom:6.0pt;text-align:l=
eft'><span
style=3D'font-size:10.0pt;font-weight:normal'>EQUIPMENT IS _______________
OLD<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>ORIGINAL<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>RATHER NEW<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>REPLACEMENT<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'>EQUIP=
MENT
COULD REQUIRE REPAIRS / REPLACEMENT AT ANYTIME DUE TO AGE / CONDITION.<o:p=
></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>=
&nbsp;</o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'text-align:left'><st1:City w:st=
=3D"on"><st1:place
 w:st=3D"on"><span style=3D'font-size:10.0pt;font-weight:normal'>NORMAL</s=
pan></st1:place></st1:City><span
style=3D'font-size:10.0pt;font-weight:normal'> FOR AGE ________________<sp=
an
style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp; </span>UNSATISFACTORY
____________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'text-align:left'><span style=3D'=
font-size:
10.0pt;font-weight:normal'>ROUTINE MAINTENANCE _______________<span
style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>NOT
OPERATING ______________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><u><span style=3D'font-size:10.0pt;font-weight:normal'><o:p><span
 style=3D'text-decoration:none'>&nbsp;</span></o:p></span></u></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><u><span style=3D'font-size:10.0pt;font-weight:normal'><o:p><span
 style=3D'text-decoration:none'>&nbsp;</span></o:p></span></u></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><u><span style=3D'font-size:10.0pt;font-weight:normal'>REFRIGERATOR<o=
:p></o:p></span></u></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><u><span
style=3D'font-size:10.0pt;font-weight:normal'>UNDERCOUNTER</span></u><span
style=3D'font-size:10.0pt;font-weight:normal'>:<span style=3D'mso-tab-coun=
t:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp; </span>GE<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/ KA<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>SUBZ<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>WHIRL<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>KENMORE<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>MARVEL /<span
style=3D'mso-spacerun:yes'>&nbsp; </span>SANYO /<span
style=3D'mso-spacerun:yes'>&nbsp; </span>SCOTSMAN<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/ U-LINE<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>MODEL:
_________________________________________________________________________<=
o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-bottom:6.0pt;text-align:l=
eft'><span
style=3D'font-size:10.0pt;font-weight:normal'>ICE MAKER: ___WORKING / NOT =
WORKING
/ NONE / NOT IN SVC / NOT VERIFIED / UN<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>GASKET:
_______________________________ GC<span style=3D'mso-spacerun:yes'>&nbsp;&=
nbsp;
</span>/<span style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>FAIR<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>WORN<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>TORN<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>NFA<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>CASE:
________________ GC<span style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<=
span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>FAIR<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>OLD<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>WORN<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>RUSTY<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>NFA<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>NSW<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:.1in;text-align:left;text-indent:.05in'><span
style=3D'font-size:10.0pt;font-weight:normal'><span style=3D'mso-tab-count=
:3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>EQUIPMENT
WORKING AT TIME OF INSPECTION.<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:.1in;text-align:left;text-indent:.05in'><span
style=3D'font-size:10.0pt;font-weight:normal'><span style=3D'mso-tab-count=
:3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>EQUIPMENT
IS _________________OLD<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<sp=
an
style=3D'mso-spacerun:yes'>&nbsp; </span>ORIGINAL<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>RATHER NEW<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>REPLACEMENT<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'>EQUIP=
MENT
COULD REQUIRE REPAIRS / REPLACEMENT AT ANYTIME DUE TO AGE / CONDITION. <o:=
p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><span style=3D'ms=
o-tab-count:
3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><o:=
p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:348.0pt'><span style=3D'font-size:10.0pt;font-weight:normal'><=
span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;
</span>Pg. 2<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:348.0pt'><span style=3D'font-size:10.0pt;font-weight:normal'><=
o:p>&nbsp;</o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><st1:City w:st=3D"on"><st1:place w:st=3D"on"><span
  style=3D'font-size:10.0pt;font-weight:normal'>NORMAL</span></st1:place><=
/st1:City><span
style=3D'font-size:10.0pt;font-weight:normal'> FOR AGE ________________<sp=
an
style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp; </span>UNSATISFACTORY
____________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'text-align:left'><span style=3D'=
font-size:
10.0pt;font-weight:normal'>ROUTINE MAINTENANCE _______________<span
style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>NOT
OPERATING ______________<span style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </sp=
an><o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>&nbsp;</o:p>=
</span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>&nbsp;</o:p>=
</span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><u><span style=3D'font-size:10.0pt;font-weight:normal'>REFRIGERATOR<o=
:p></o:p></span></u></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><u><span
style=3D'font-size:10.0pt;font-weight:normal'>UNDERCOUNTER</span></u><span
style=3D'font-size:10.0pt;font-weight:normal'>:<span style=3D'mso-tab-coun=
t:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp; </span>GE<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/ KA<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>SUBZ<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>WHIRL<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>KENMORE<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>MARVEL /<span
style=3D'mso-spacerun:yes'>&nbsp; </span>SANYO /<span
style=3D'mso-spacerun:yes'>&nbsp; </span>SCOTSMAN<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/ U-LINE<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>MODEL:
_________________________________________________________________________<=
o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>ICE
MAKER: ___WORKING / NOT WORKING / NONE / NOT IN SVC / NOT VERIFIED / UN<o:=
p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>GASKET:
________________________________ GC<span style=3D'mso-spacerun:yes'>&nbsp;=
&nbsp;
</span>/<span style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>FAIR<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>WORN<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>TORN<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>NFA<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>CASE:
________________ GC<span style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<=
span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>FAIR<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>OLD<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>WORN<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>RUSTY<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>NFA<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>NSW<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>EQUIPMENT
WORKING AT TIME OF INSPECTION.<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>EQUIPMENT
IS _________________OLD<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<sp=
an
style=3D'mso-spacerun:yes'>&nbsp; </span>ORIGINAL<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>RATHER NEW<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>REPLACEMENT<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'>EQUIP=
MENT
COULD REQUIRE REPAIRS / REPLACEMENT AT ANYTIME DUE TO AGE / CONDITION.<o:p=
></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'><span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><st1:City w:st=3D"on"><st1:place w:st=3D"on"><span
  style=3D'font-size:10.0pt;font-weight:normal'>NORMAL</span></st1:place><=
/st1:City><span
style=3D'font-size:10.0pt;font-weight:normal'> FOR AGE ________________<sp=
an
style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp; </span>UNSATISFACTORY
____________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'>ROUTI=
NE
MAINTENANCE _______________<span style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>NOT
OPERATING ______________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>=
&nbsp;</o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>=
&nbsp;</o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><u><span
style=3D'font-size:10.0pt;font-weight:normal'>COMPACTOR</span></u><span
style=3D'font-size:10.0pt;font-weight:normal'>:<span style=3D'mso-tab-coun=
t:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>GE<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>KA<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>WHIRLPOOL<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span><st1:place w:st=3D"on=
">KENMORE</st1:place><o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>MODEL:
_________________________________________________________________________<=
o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>EQUIPMENT
WORKING AT TIME OF INSPECTION.<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>EQUIPMENT
IS _________________OLD<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<sp=
an
style=3D'mso-spacerun:yes'>&nbsp; </span>ORIGINAL<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>RATHER NEW<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>REPLACEMENT<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'>EQUIP=
MENT
COULD REQUIRE REPAIRS / REPLACEMENT AT ANYTIME DUE TO AGE / CONDITION.<o:p=
></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'><span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><st1:City w:st=3D"on"><st1:place w:st=3D"on"><span
  style=3D'font-size:10.0pt;font-weight:normal'>NORMAL</span></st1:place><=
/st1:City><span
style=3D'font-size:10.0pt;font-weight:normal'> FOR AGE ________________<sp=
an
style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp; </span>UNSATISFACTORY
____________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'>ROUTI=
NE
MAINTENANCE _______________<span style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>NOT
OPERATING ______________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>=
&nbsp;</o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>=
&nbsp;</o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><u><span
style=3D'font-size:10.0pt;font-weight:normal'>ICE MAKER</span></u><span
style=3D'font-size:10.0pt;font-weight:normal'>:<span style=3D'mso-tab-coun=
t:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </sp=
an>GE<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>SUBZ<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>/ <span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;</span>WHIRLPOOL<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span><st1:place w:st=3D"on=
">KENMORE</st1:place><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>SCOTSMAN<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>U-LINE<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>MODEL:
_________________________________________________________________________<=
o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>GASKET:
___________________________ GC<span style=3D'mso-spacerun:yes'>&nbsp;
</span>/<span style=3D'mso-spacerun:yes'>&nbsp; </span>FAIR<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>POOR<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>WORN<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>TORN<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>NFA<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>CASE:
________________ GC<span style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<=
span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>FAIR<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>OLD<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>WORN<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>RUSTY<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>NFA<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>NSW<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>EQUIPMENT
WORKING AT TIME OF INSPECTION.<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>EQUIPMENT
IS _________________OLD<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<sp=
an
style=3D'mso-spacerun:yes'>&nbsp; </span>ORIGINAL<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>RATHER NEW<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>REPLACEMENT<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'>EQUIP=
MENT
COULD REQUIRE REPAIRS / REPLACEMENT AT ANYTIME DUE TO AGE / CONDITIION.<o:=
p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'><span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><st1:City w:st=3D"on"><st1:place w:st=3D"on"><span
  style=3D'font-size:10.0pt;font-weight:normal'>NORMAL</span></st1:place><=
/st1:City><span
style=3D'font-size:10.0pt;font-weight:normal'> FOR AGE ________________<sp=
an
style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp; </span>UNSATISFACTORY
____________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'>ROUTI=
NE
MAINTENANCE _______________<span style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>NOT
OPERATING ______________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>=
&nbsp;</o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>=
&nbsp;</o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><u><span
style=3D'font-size:10.0pt;font-weight:normal'>ICE MAKER</span></u><span
style=3D'font-size:10.0pt;font-weight:normal'>:<span style=3D'mso-tab-coun=
t:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </sp=
an>GE<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>SUBZ<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>WHIRLPOOL<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span><st1:place w:st=3D"on=
">KENMORE</st1:place><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>SCOTSMAN<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>U-LINE<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>MODEL:
_________________________________________________________________________<=
o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>GASKET:
___________________________<span style=3D'mso-spacerun:yes'>&nbsp; </span>=
GC<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>FAIR<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>POOR<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>WORN<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>TORN<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>NFA<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>CASE:
________________<span style=3D'mso-spacerun:yes'>&nbsp; </span>GC<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>FAIR<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>OLD<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>WORN<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>RUSTY<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>NFA<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>NSW<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>EQUIPMENT
WORKING AT TIME OF INSPECTION.<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>EQUIPMENT
IS _________________OLD<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<sp=
an
style=3D'mso-spacerun:yes'>&nbsp; </span>ORIGINAL<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>RATHER NEW<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>REPLACEMENT<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'>EQUIP=
MENT
COULD REQUIRE REPAIRS / REPLACEMENT AT ANYTIME DUE TO AGE / CONDITIION.<o:=
p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'><span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><st1:City w:st=3D"on"><st1:place w:st=3D"on"><span
  style=3D'font-size:10.0pt;font-weight:normal'>NORMAL</span></st1:place><=
/st1:City><span
style=3D'font-size:10.0pt;font-weight:normal'> FOR AGE ________________<sp=
an
style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp; </span>UNSATISFACTORY
____________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'text-align:left'><span style=3D'=
font-size:
10.0pt;font-weight:normal'>ROUTINE MAINTENANCE _______________<span
style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>NOT
OPERATING ______________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span><o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>&nbsp;</o:p>=
</span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:-1.5in'><u><span style=3D'font-size:10.0pt;font-weight:normal'=
>RANGE/</span></u><span
style=3D'font-size:10.0pt;font-weight:normal'><span style=3D'mso-tab-count=
:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>GE
/ KA / HOTPT / AMANA<span style=3D'mso-spacerun:yes'>&nbsp; </span>/ FRIG =
/ WHIRL
/ <st1:place w:st=3D"on">KENMORE</st1:place><span style=3D'mso-spacerun:ye=
s'>&nbsp;
</span>/ W-WEST / ROPER / JENN-AIR<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:-1.5in'><u><span style=3D'font-size:10.0pt;font-weight:normal'=
>WALL
OVEN:</span></u><span style=3D'font-size:10.0pt;font-weight:normal'><span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp; </span>ASKO
/ MIELE / DACOR / GAGGENAU / TAPPAN / THERM / UNKNOWN<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp; </span><o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;</span>Pg.
3<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-bottom:6.0pt;text-align:l=
eft'><span
style=3D'font-size:10.0pt;font-weight:normal'>MODEL:
_________________________________________________________________________<=
o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-bottom:6.0pt;text-align:l=
eft'><span
style=3D'font-size:10.0pt;font-weight:normal'>SURFACE ELEMENTS / BURNERS (=
4)<span
style=3D'mso-spacerun:yes'>&nbsp; </span>(5)<span style=3D'mso-spacerun:ye=
s'>&nbsp;
</span>(6): _______________________________________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>UPPER
BROIL ELEMENT: _________________________________________________________<o=
:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>UPPER
BAKE ELEMENT: __________________________________________________________<o=
:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>UPPER
OVEN LIGHT: ____________________ NONE<span style=3D'mso-spacerun:yes'>&nbs=
p;
</span>/<span style=3D'mso-spacerun:yes'>&nbsp; </span>WORKING<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>NOT WORKING<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>UN<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>UPPER
OVEN GASKET: _______________ GC<span style=3D'mso-spacerun:yes'>&nbsp;
</span>/<span style=3D'mso-spacerun:yes'>&nbsp; </span>FAIR<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>POOR<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>WORN<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>TORN<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>NFA<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>UPPER
OVEN CASE: _________ GC<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<sp=
an
style=3D'mso-spacerun:yes'>&nbsp; </span>FAIR<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>POOR<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>WORN<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>RUSTY<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>NFA<span style=3D'mso-spacerun:ye=
s'>&nbsp;
</span>/<span style=3D'mso-spacerun:yes'>&nbsp; </span>NSW<o:p></o:p></spa=
n></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>LOWER
BROIL ELEMENT: ________________________________________________________<o:=
p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>LOWER
BAKE ELEMENT: _________________________________________________________<o:=
p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>LOWER
OVEN LIGHT: ___________________ NONE<span style=3D'mso-spacerun:yes'>&nbsp;
</span>/<span style=3D'mso-spacerun:yes'>&nbsp; </span>WORKING<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>NOT WORKING<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>UN<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>LOWER
OVEN GASKET: _______ GC<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<sp=
an
style=3D'mso-spacerun:yes'>&nbsp; </span>FAIR<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>WORN<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>POOR<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>TORN<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>NFA<span style=3D'mso-spacerun:ye=
s'>&nbsp;
</span>/<span style=3D'mso-spacerun:yes'>&nbsp; </span>NSW<o:p></o:p></spa=
n></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>LOWER
OVEN CASE: ________ GC<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>FAIR<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>POOR<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>WORN<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>RUSTY<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>NFA<span style=3D'mso-spacerun:ye=
s'>&nbsp;
</span>/<span style=3D'mso-spacerun:yes'>&nbsp; </span>NSW<o:p></o:p></spa=
n></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>SURFACE
LIGHT: ____________________ NONE<span style=3D'mso-spacerun:yes'>&nbsp;&nb=
sp;
</span>/<span style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>WORKING<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>NOT WORKING<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>UN<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>CLOCK:
_________________________________________________________________________<=
o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>TIMER:
__________________________________________________________________________=
<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>EXHAUST
FAN:<span style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>(1,<span
style=3D'mso-spacerun:yes'>&nbsp; </span>2,<span style=3D'mso-spacerun:yes=
'>&nbsp;
</span>V SPEED);<span style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>WORKI=
NG AT
INSPECTION ______________________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-bottom:6.0pt;text-align:l=
eft'><span
style=3D'font-size:10.0pt;font-weight:normal'>TYPE:<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>RECIRCULATING / EXTERIOR VE=
NTING /
DUCT NEEDS SEALING<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>UNIT
WORKING AT TIME OF INSPECTION.<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>EQUIPMENT
IS _________________OLD<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<sp=
an
style=3D'mso-spacerun:yes'>&nbsp; </span>ORIGINAL<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>RATHER NEW<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>REPLACEMENT<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'>EQUIP=
MENT
COULD REQUIRE REPAIRS / REPLACEMENT AT ANYTIME DUE TO AGE / CONDITION.<o:p=
></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><span style=3D'ms=
o-tab-count:
3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><o:=
p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><st1:City w:st=3D"on"><st1:place w:st=3D"on"><span
  style=3D'font-size:10.0pt;font-weight:normal'>NORMAL</span></st1:place><=
/st1:City><span
style=3D'font-size:10.0pt;font-weight:normal'> FOR AGE ________________<sp=
an
style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp; </span>UNSATISFACTORY
____________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'>ROUTI=
NE
MAINTENANCE _______________<span style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>NOT
OPERATING ______________<span style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><o:p></o:p><=
/span></p>

<p class=3DMsoTitle align=3Dleft style=3D'text-align:left'><span style=3D'=
font-size:
10.0pt;font-weight:normal'><o:p>&nbsp;</o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'>SELF-=
CLEAN
OVEN:<span style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>HOME CHECK SYSTE=
MS,
INC. DOES NOT VERIFY THIS FEATURE.<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>=
&nbsp;</o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>=
&nbsp;</o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:-1.5in'><u><span style=3D'font-size:10.0pt;font-weight:normal'=
>COOK
TOP:</span></u><span style=3D'font-size:10.0pt;font-weight:normal'><span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>GE<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>KA<span style=3D'mso-spacerun:yes'>&nbsp; </span>/ HOTPT /<span
style=3D'mso-spacerun:yes'>&nbsp; </span>WHIRL /<span
style=3D'mso-spacerun:yes'>&nbsp; </span><st1:place w:st=3D"on">KENMORE</s=
t1:place>
/<span style=3D'mso-spacerun:yes'>&nbsp; </span>JENN-AIR /<span
style=3D'mso-spacerun:yes'>&nbsp; </span>MIELE /<span
style=3D'mso-spacerun:yes'>&nbsp; </span>DACOR / GAGGENAU /<span
style=3D'mso-spacerun:yes'>&nbsp; </span>THERM<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>MODEL:
________________________________________________________________________<o=
:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>SURFACE
ELEMENT<span style=3D'mso-spacerun:yes'>&nbsp; </span>(2)<span
style=3D'mso-spacerun:yes'>&nbsp; </span>(4)<span style=3D'mso-spacerun:ye=
s'>&nbsp;
</span>(5)<span style=3D'mso-spacerun:yes'>&nbsp; </span>(6):
_______________________________________________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>GRILL
ELEMENT<span style=3D'mso-spacerun:yes'>&nbsp; </span>(1)<span
style=3D'mso-spacerun:yes'>&nbsp; </span>(2):
_________________________________________________________<o:p></o:p></span=
></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>EXHAUST
FAN:<span style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>(1,<span
style=3D'mso-spacerun:yes'>&nbsp; </span>2,<span style=3D'mso-spacerun:yes=
'>&nbsp;
</span>3,<span style=3D'mso-spacerun:yes'>&nbsp; </span>V SPEED);<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>WORKING AT INSPECTION
___________________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>EXHAUST
DUCT:<span style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp; </span>GC<s=
pan
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>NEEDS RESEALING
____________________________________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>UNIT
WORKING AT TIME OF INSPECTION.<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>EQUIPMENT
IS _________________OLD<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<sp=
an
style=3D'mso-spacerun:yes'>&nbsp; </span>ORIGINAL<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>RATHER NEW<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>REPLACEMENT<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'>EQUIP=
MENT
COULD REQUIRE REPAIRS / REPLACEMENT AT ANYTIME DUE TO AGE / CONDITION.<o:p=
></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><span style=3D'ms=
o-tab-count:
3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><o:=
p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><st1:City w:st=3D"on"><st1:place w:st=3D"on"><span
  style=3D'font-size:10.0pt;font-weight:normal'>NORMAL</span></st1:place><=
/st1:City><span
style=3D'font-size:10.0pt;font-weight:normal'> FOR AGE ________________<sp=
an
style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp; </span>UNSATISFACTORY
____________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'>ROUTI=
NE
MAINTENANCE _______________<span style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>NOT
OPERATING ______________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>&nbsp;</o:p>=
</span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><u><span style=3D'font-size:10.0pt;font-weight:normal'><o:p><span
 style=3D'text-decoration:none'>&nbsp;</span></o:p></span></u></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:1.5in;text-align:left;text-indent:-1.5in'><u><span
style=3D'font-size:10.0pt;font-weight:normal'>COOK TOP:</span></u><span
style=3D'font-size:10.0pt;font-weight:normal'><span style=3D'mso-tab-count=
:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp; </span>GE<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>KA<span style=3D'mso-spacerun:yes'>&nbsp; </span>/ HOTPT /<span
style=3D'mso-spacerun:yes'>&nbsp; </span>WHIRL /<span
style=3D'mso-spacerun:yes'>&nbsp; </span><st1:place w:st=3D"on">KENMORE</s=
t1:place>
/<span style=3D'mso-spacerun:yes'>&nbsp; </span>JENN-AIR /<span
style=3D'mso-spacerun:yes'>&nbsp; </span>MIELE /<span
style=3D'mso-spacerun:yes'>&nbsp; </span>DACOR / GAGGENAU /<span
style=3D'mso-spacerun:yes'>&nbsp; </span>THERM<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>MODEL:
________________________________________________________________________<o=
:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>SURFACE
ELEMENT<span style=3D'mso-spacerun:yes'>&nbsp; </span>(2)<span
style=3D'mso-spacerun:yes'>&nbsp; </span>(4)<span style=3D'mso-spacerun:ye=
s'>&nbsp;
</span>(5)<span style=3D'mso-spacerun:yes'>&nbsp; </span>(6):
_______________________________________________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>GRILL
ELEMENT<span style=3D'mso-spacerun:yes'>&nbsp; </span>(1)<span
style=3D'mso-spacerun:yes'>&nbsp; </span>(2):
_________________________________________________________<o:p></o:p></span=
></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>EXHAUST
FAN:<span style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>(1,<span
style=3D'mso-spacerun:yes'>&nbsp; </span>2,<span style=3D'mso-spacerun:yes=
'>&nbsp;
</span>3,<span style=3D'mso-spacerun:yes'>&nbsp; </span>V SPEED);<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>WORKING AT INSPECTION
___________________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>EXHAUST
DUCT:<span style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp; </span>GC<s=
pan
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>NEEDS RESEALING
____________________________________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>UNIT
WORKING AT TIME OF INSPECTION.<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>EQUIPMENT
IS _________________OLD<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<sp=
an
style=3D'mso-spacerun:yes'>&nbsp; </span>ORIGINAL<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>RATHER NEW<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>REPLACEMENT<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span>Pg. 4<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'>EQUIP=
MENT
COULD REQUIRE REPAIRS / REPLACEMENT AT ANYTIME DUE TO AGE / CONDITION.<o:p=
></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><span style=3D'ms=
o-tab-count:
3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><sp=
an
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;</span><o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><st1:City w:st=3D"on"><st1:place w:st=3D"on"><span
  style=3D'font-size:10.0pt;font-weight:normal'>NORMAL</span></st1:place><=
/st1:City><span
style=3D'font-size:10.0pt;font-weight:normal'> FOR AGE ________________<sp=
an
style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp; </span>UNSATISFACTORY
____________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'text-align:left'><span style=3D'=
font-size:
10.0pt;font-weight:normal'>ROUTINE MAINTENANCE _______________<span
style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>NOT
OPERATING ______________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>&nbsp;</o:p>=
</span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>&nbsp;</o:p>=
</span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><u><span style=3D'font-size:10.0pt;font-weight:normal'>HOOD:</span></=
u><span
style=3D'font-size:10.0pt;font-weight:normal'><span style=3D'mso-tab-count=
:3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>GE<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>WHIRL<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>KENMORE<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>MIELE<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>DACOR<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>GAGGENAU<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>THERM<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>BEST<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span><o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>BROAN<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>NUTONE<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>RANGAIR<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>VENT-A-HOOD<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>UNKNOWN<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>MODEL:
_________________________________________________________________________<=
o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>FAN:<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>(1,<span
style=3D'mso-spacerun:yes'>&nbsp; </span>2,<span style=3D'mso-spacerun:yes=
'>&nbsp;
</span>3,<span style=3D'mso-spacerun:yes'>&nbsp; </span>V SPEED);<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>WORKING AT INSPECTION
_____________________________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>LIGHT:
____________________________ NONE<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>WORKING<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>NOT WORKING<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>UN<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-bottom:6.0pt;text-align:l=
eft'><span
style=3D'font-size:10.0pt;font-weight:normal'>TYPE:<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span>RECIRCULATING<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>EXTERNAL VENTING<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>NEEDS SEALING<o:p></o:p></s=
pan></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-bottom:6.0pt;text-align:l=
eft'><span
style=3D'font-size:10.0pt;font-weight:normal'>UNIT WORKING PROPERLY AT TIM=
E OF
INSPECTION.<span style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp; </span><o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><span style=3D'ms=
o-tab-count:
3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>WOR=
N<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>NOISY BEARINGS.<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>=
&nbsp;</o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>EQUIPMENT
IS _________________OLD<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<sp=
an
style=3D'mso-spacerun:yes'>&nbsp; </span>ORIGINAL<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>RATHER NEW<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>REPLACEMENT<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:1.5in;text-align:lef=
t;
text-indent:0in'><span style=3D'font-size:10.0pt;font-weight:normal'>EQUIP=
MENT
COULD REQUIRE REPAIRS / REPLACEMENT AT ANYTIME DUE TO AGE / CONDITION.<o:p=
></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'text-align:left'><span style=3D'=
font-size:
10.0pt;font-weight:normal'><o:p>&nbsp;</o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'text-align:left'><st1:City w:st=
=3D"on"><st1:place
 w:st=3D"on"><span style=3D'font-size:10.0pt;font-weight:normal'>NORMAL</s=
pan></st1:place></st1:City><span
style=3D'font-size:10.0pt;font-weight:normal'> FOR AGE ________________<sp=
an
style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp; </span>UNSATISFACTORY
____________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'text-align:left'><span style=3D'=
font-size:
10.0pt;font-weight:normal'>ROUTINE MAINTENANCE _______________<span
style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>NOT
OPERATING ______________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>&nbsp;</o:p>=
</span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>&nbsp;</o:p>=
</span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:1.5in;text-align:left;text-indent:-1.5in'><u><span
style=3D'font-size:10.0pt;font-weight:normal'>EXHAUST FAN:</span></u><span
style=3D'font-size:10.0pt;font-weight:normal'><span style=3D'mso-tab-count=
:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>GE<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>WHIRL<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>KENMORE<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>MIELE<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>DACOR<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>GAGGENAU<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>THERM<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>BEST<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>BROAN<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>NUTONE<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>RANGAIR<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>VENT-A-HOOD<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>UNKNOWN<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>MODEL:
_________________________________________________________________________<=
o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>FAN:<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>(1,<span
style=3D'mso-spacerun:yes'>&nbsp; </span>2,<span style=3D'mso-spacerun:yes=
'>&nbsp;
</span>3,<span style=3D'mso-spacerun:yes'>&nbsp; </span>V SPEED);<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>WORKING AT INSPECTION
_____________________________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>LIGHT:
___________________________ NONE<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>WORKING<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>NOT WORKING<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>UN<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-bottom:6.0pt;text-align:l=
eft'><span
style=3D'font-size:10.0pt;font-weight:normal'>TYPE:<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span>RECIRCULATING<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>EXTERNAL VENTING<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>NEEDS SEALING<o:p></o:p></s=
pan></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-bottom:6.0pt;text-align:l=
eft'><span
style=3D'font-size:10.0pt;font-weight:normal'>UNIT WORKING PROPERLY AT TIM=
E OF
INSPECTION.<span style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp; </span><o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>WORN<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>NOISY BEARINGS.<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>EQUIPMENT
IS _________________OLD<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<sp=
an
style=3D'mso-spacerun:yes'>&nbsp; </span>ORIGINAL<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>RATHER NEW<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>REPLACEMENT<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:1.5in;text-align:left;text-indent:0in'><span
style=3D'font-size:10.0pt;font-weight:normal'>EQUIPMENT COULD REQUIRE REPA=
IRS /
REPLACEMENT AT ANYTIME DUE TO AGE / CONDITION.<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'text-align:left'><st1:City w:st=
=3D"on"><st1:place
 w:st=3D"on"><span style=3D'font-size:10.0pt;font-weight:normal'>NORMAL</s=
pan></st1:place></st1:City><span
style=3D'font-size:10.0pt;font-weight:normal'> FOR AGE &#8211; (<u>UNIT ON=
LY</u>)___<span
style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>UNSATISFACTORY
____________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><span style=3D'ms=
o-tab-count:
3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>ROU=
TINE
MAINTENANCE ______________<span style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <=
/span>NOT
OPERATING ______________<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>&nbsp;</o:p>=
</span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-left:0in;text-align:left;=
text-indent:
0in'><span style=3D'font-size:10.0pt;font-weight:normal'><o:p>&nbsp;</o:p>=
</span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:1.5in;text-align:left;text-indent:-1.5in'><u><span
style=3D'font-size:10.0pt;font-weight:normal'>MICROWAVE:</span></u><span
style=3D'font-size:10.0pt;font-weight:normal'><span style=3D'mso-tab-count=
:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>GE<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>KA<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>HOTPT<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>FRIG<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>WHIRL<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>KENMORE<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>JENN-AIR<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>PANAS<span style=3D'mso-spacerun:yes'>&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp; </span>QUASAR / SANYO<span
style=3D'mso-spacerun:yes'>&nbsp; </span>/<span style=3D'mso-spacerun:yes'=
>&nbsp;
</span>SHARP<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>MODEL:
________________________________________________________________________<o=
:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>TIMER:
_________________________________________________________________________<=
o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>CASE:
________________ GC<span style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<=
span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>FAIR<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>OLD<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>WORN<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>POOR<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>NFA<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>/<span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>NSW<o:p></o:p></span></p>

<p class=3DMsoTitle align=3Dleft style=3D'margin-top:0in;margin-right:0in;=
margin-bottom:
6.0pt;margin-left:0in;text-align:left;text-indent:0in'><span style=3D'font=
-size:
10.0pt;font-weight:normal'><span style=3D'mso-tab-count:3'>&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&