# Transmitta l o f

Omah aLea dSite Pain t Stabilizatio n Fil e Folde r Said #^'^ty i Date : (S?-<^^-f 7 Address : .giaJ-^

- m i ^, ^ t Si ~ Contractor ; CityofOmah a Year : ^ ^ ^ / 

# Pain t Stabilizatio n Propert y Fil e Folde r Document s iXWor k Writ e U p _ly^gne dAcces s Agreemen t fo r

subjec t propert y Pre-Renovation for msigne db y Propert y Owne r Pre-Renovation For mfo r

Occupant/Tenant , ifapplicabl e LX^aintin g Agreement/Cit y o f

Omah aPurchas e Orde r Settlemen t documents (i.e. , fo r

damage o r

t

o replac e plants , etc. ) Renovation Recordkeepin g Checklis t signe db y Certifie dRenovato r Propert y informatio n fromDougla s Count y Assessor' s Offic e Othe r

(describe) : rko^ S ' ._ 

## 3-7r-j c T^h"*' ^ Cit y of Omah aRepresejjtative Signatur e Dat e 

# 3773^01 X EP A Representativ e Signatur e )at e 3026250 5 

### Superfun d

# CIT Y O F OMAH A PURCHASIN G - ROO M 100 3 

### Purchas e Orde r

181 9 FARNA M STREE T PURCIMS E ORDE R NO
. OMAHA
. N E 68183-10.0 3 117442 4

FAX # 402-444-542 3 SHIPTO : CITYOFOMAH A HOUSIN G A COM M DE V R M #111 1 181 9 FARNA M STREE T OMAHA,N E 6818 3 G&MPAINTINGCOIN C -< VENOOR : > . BIL L TO : 1370 7 CUMIN G ST ClT Y O F OMALI A FINANC E OMAHA , N E 6815 4 DISBURSEMENT S ROO M #1007 181 9 FAftNA M STREE T OMAHA,N E 6818 3 ORIGINA L PURCHAS E ORDE R • VENDOR' S COP Y (SE E INSTRUCTION S BELOW ) CUSTOME R ACCOUN T NO
. VENDO R NO
. DAT E O F ORDER/BUYE R REVISE D DATE//BUYE R 9129 8 11.MAY-1 1 HHUR T PAYMENTTERM S SHI P VI A F.O.B
. DESTINATIO N FREIGHTTERM S REQUESTOR/DELIVE R T O CONFIR M T O / TELEPHON E MARTINEZ , MARGARE T P > • < ITE M PAR T NUMBER/DESCRIPTIO N • DELIVERYDAT E QUANTITY UNI T UNITPRIC E EXTENSIO N Al l price s an d amount s o n thi s orde r ar e expres s i d i n : U S Del ! a r NEEDED : 1,640.0 0 N MAY-11 , EP APAIN T STABILIZATION/ 1 PROGRA M GR P # 19 5 ­ 312 3 LAFAYETT E AV E O SHI P TO : Addres s at .to p o f pag e 1,835.0 0 N NEEDED : 

# I 07-MAy-l l EP APAIN T STABILIZATIO N PROGRA M GR P #19 5 - 202 5 MIAM I S T •io SHI P TO : i Addres s at to p o f pa^ e NEEDED : 1,950.0 0 N 07-MAY-l l EP APAIN T STABILIZATIO N PROGRA M GR P #19 5 - 312 P CAS S S T i o SHI P TO : i Addres s at to p o f pag e

SHIPTO : /Addres s show n above
. I f shipmen t I s delaye d o ran y Item s no t available , advis e at once . Purchas e orde rnumbe rmus t appea ro n al l Invoices , packages , packin g lists , bil l of lading , an d correspondence , SHIPPIN G CHARGE S T O B E PREPAID
. I F APPLICABL E AN D ADDE D T O INVOICED , cop y l o b e fijrnlshe d wil h Invoice
. 

### Tota l (
. 5'6^S.00 )

TA X EXEMPTION : .Th e Cit y of Omah a I s exemp t fro m Federa l Excis e Taxe s an d th e Nebrask a an d Cit y of Omah a Sale s Taxes
. Federa l I.D
. 476006304 ; STAT E I.D
. 01-0316768 ; Fue l Dealer s Uc
. 91-0316768
. Cll y Purchaiin g Agen l \fxnt rPlannin g Departmen t Inspector : To mRoz aOmaha/DougbsCivicCcntc r r>ofo
. / ) I on n 1.819 FaMi mStreet , Sui K

no o Date : 4-1-201 1 Omnha,Ncb;asl
. 6818 3 (402)444-515 0 

## Name : Shaw n Bas s TM=.,<402)*« « o^oroTM.
. Address : 202 5 Miam i S t n.E.c.:^.^.„,K^,s^ E Ji mSutue , Mayor 

## OMAH A EXTERIO RPAIN T STABILIZATIO N PROGRA M FO RTH E EP A OMAH A LEA D SIT E Th e Contrac t bi d document s consis t of th e followin g sections : •Genera l Responsibilitie s fo r th e Contracto r an dOccupant
. •Lea dHazardContro l Plan , Interi mContro l o f Lea dBase dPain t Hazards
. 

## : Th e Contracto r Shall : •Contracto r an d al l subcontractor(s ) shal l complet e an d submi t a"Citizenshi p Attestation" 7 "Emplove e Classification " for mt o th e Plannin g Department ; pe r Stat e requirements , befor e final paymen t can b e issued
. • Compl y wit h HUD' s "Guideline s fo r th e Evaluatio n an d Controlo f Lead-BasedPain t Hazard s i n Housing. " (Copie s ar e availabl e at th e Plannin g Department. ) •Compl y wit h Standard s calle dfo r i

n th e "Constructio n an d Rehabilitatio n Specifications , Housin g and Communit y Development Division , Cit y o f Oniaha , Nebraska. " (Copiesar e availabi e at th e Plannin g Department. ) • Compl y wit h th e Stat e ofNebrask aHealt h an d Huma n Service s Regulatio n an d Licensure , Titl e 17 8 Chapte r 2 3 Lea dBas e Paint Regulations
. • ' Coordinat e dail y constructio n schedul e wit h th e occupant . •Submit informatio n cut sheet s fo r all substitution s o r approvedequal s prior to written approva l o f th e Constructio n Specialist
. • Repai r o

r replac e al l item s damage dor disturbe ddurin g pain t stabilizatio n activities
. •Kee p wor k

sit e and surroundin g are afre e fro maccumulation s o f wast e material s o r . rubbis h cause dby th e wor k

a

t al

l times
. • Upo n dail y completio n o f work : clea n u p all rubbish , exces s material , equipment , an d etc. ; tha t i s connecte dwit h th e work , an d leav e al l part s ofth e wor k

area s i n aneat , sanitary , lea dsaf e an d presentabl e condition
. •Complet e thi s projec t withi n 3 0 calenda r days
. Th e Occupant/Owne r Shal l Remov e an d stor e awa y any person'al'propFrty'w'itFinTwiJntyXZO)'fee f o remediated
. P.rovid e acces s t o electricit y an dwate r throughou t the pain t stabilizatio n process . Remov e voluntee r tree s an d vegetatio n fro mth e dri p line o f ith e roof , an d cu t bac k shrub s an d bushe s a t leas t t>v o fee t fro mth e house
. Ensure tha t al l houisehol dmember s sta y a t leas t te n fee t awa y fro mall wor k

area s an d als o kee p al l pet s a t leas t ten fee t awa y a t al

l time s until thewor k

ha s bee n complete d an d th e are aha s passe davisua l inspection
. Initial s J D

## • Exterio r Lead-base dPain t Stabilizatio n ProgramManage db y th e City , o f Omah afo r

EP A Regio n 7 Omah aLea dSit e Th e purpos e of thi s progra mi s t o prevent yard s where lead-contaminate dsoil i s cleane d u

p fro mbecomin g re-contaminate db y deterioratin g exterio r lead-base dpaint
. Thi s i s not ahom e repai r program . Whic h Home s Ar e Eligible ? •Home s wher e soi l clean-up ha s been o r wil l b e don e an da n EP A contractor ha s identifie ddeterioratin g exterio r lead-base dpaint
. • . Home s are eligibl e onl y by referra l fro mth e EPA
. Wha t wor k

wil l b e done ? •Loos e an dflakin g lead-base dpain t will b e remove dsafel y fro mfascia , eaives , siding , .trim , windo w trim , door tri man dfoundation
. •Surface s wil l b e prime dan dpainte dto matc h existin g pain t color a

s closely a s possible
. Wha t wil l no t b e done ? •Surface s which hav e no paint wil l no t b e treated
. • . Window s o r door s will no t b e included
. •Rotte n woo dwil l no t b e replaced
. •N p housin g repair will b e done
.

. Who willperformth e work ? o

EP A contractor s will tes t paint on exterio r hous e surface s an dgiv e the result s t o th e Cit y o f Omah aPaint Stabilizatio n Program
. • . Cit y ConstructionSp'ecialist s wil l prepare awor k

pla n an dcontac t the propert y owne r fo r permissio n t o proceed
. •Wor k

will b e competitivel y bi dby approved , trainedcontractors
. When wil l th e wor k

b e done ? •Thi s progra mbega n i n 200 7 an dwil l continu e fo r severa l years . • 

### Th e Cit y staf f will prioritiz e home s base don th e presenc e ofchildre n unde r ag e si x ifknow n an dthe severit y ofth e problem
. .._._. _; Paint Stabilizatio n i s voluntai y an dwil l b e don e onl y wit h permissio n ofth e owner . 

## Initial s < i ft

### Address : 202 5 MIAMI S T' Consent fo r Acces s t o Propert y (Pag e 2 ) 3
.Plannin g an dimplementin g th e respons e actio n o n the Grantor' s propert}'
. Thi s will includ e 1 ) remova l o f loos e o r flaking pain t identifie db y EP A usin g lead-saf e method s in compliance with HUD/EP A regulation s and2 ) repaintin g accordin g t o th e attachedspecifications : TER M • Thi s acces s agreemen t shall b e operabl e fo r the perio do f tim e i t take s t o complete th e environmenta l respons e activities
. Upor i completio n o f the respons e actions , all right s an d privilege s give n b y th e Grantor shal l ceas e o n that date , unles s extende db y asubsequen t agreement . AGREEMEN T NO T T O INTERFERE
. Granto r agree s no t t o interfer e wit h an y o f th e activitie s undertaken b y Grante e a t the Property , tamper wt h an y of Grantee' s property , or tak e an y action s regarding tlie us e ofth e Propert y whic h wil l endange r huma n healt h o r welfar e o r the environment , or allow other s to us e th e Propert y i n suc h manne r durin g th e ter mo f thi s consent . Grantor.agree s t o provide notic e an dacop y o f this agreement to prospectiv e purchasers , lessees , assigns , o r grantee s of th e propert y o r an y portio n o f it
. Granto r agree s t o provid e 30-da y notic e t o EP A prior to an y transfe r o f ownership right s t o th e property . SAMPLING RESULT S • Grante e agree s t o provid e Granto r wit h tli e result s o f an y an dall sampling and/or analysi s resulting fro mGrantee' s respons e activitie s o n th e property . PRIO RCONDITION S AGREEMEN T Th e granto r agree s t o th e conditio n ofth e propert y prior to remediatio n an dindicate s o n Pag e 3 an y item s to b e removedb y the Grantor befor e activitie s commence . RESTORATION O F PROPERTY Excep t fo r the abov e stated.paint stabilization , the Grantee agrees_that_sai_ dpropert y will b e restored a s nearly as possibl e to it s origina l state an dconditio n a s foun dimmediately precedin g th e beginnin g of activities , authorize db y thi s Agreement, • following completio n of the response activities
.

(2 )2/12/200 7

### Dougla s Count y Accoun t Information Pag e 1 of 3
Dougla s County , Nebrask a Propert y Recor d - R021230000 0 Prin t Repor t Vie w Interactiv e GI S Ma p Informatio n i s vali d a s o f 2012-2-2 8 Treasurer' s Ta x Repor t Ne w Featur e -•-»- > Subdivisio n Saie s Searc h Owne r BAS S SHAW N R 202 5 MIAM I S T OMAH A N E 68110-000 0 Propert y Informatio n Ke y Numlier : 123 0 000 0 0 2 Accoun t Type : Residentia l ParcelNumbe r 021230000 0 Parce l Address : 202 5 MIAM I S T OMAH A N E 68110-000 0 Lega l Description : LAND S SEC-TWN-RG E 10-15-1 3 SU B 8 SU B 3 L T 5 5 4 0 X 12 2 Valu e Informatio n
201 1 201 0 200 9 200 8 200 7 200 6 Lan d $4,300.0 0 $4,300.0 0 $4,300.0 0 $4,300.0 0 $4,300.0 0 $4,300.0 0 Improvemen t $19,400.0 0 $19,400.0 0 $19,400.0 0 $19,400.0 0 $25,300.0 0 $25,300.0 0 Tota l $23,700.0 0 $23,700.0 0 $23,700.0 0 $23,700.0 0 $29,600.0 0 $29,600.0 0 Lan d Informatio n Acre s 0.1 1 S F 4880. 0 U nlt a 1. 0 Dept h 122. 0 Widt h 40. 0 Vacan t 

### N o Improvemen t Informatio n Buildin g 1



### http://douglasne.mapping-onIine.com/DouglasCoNe/static/accountinfo.jsp?accountno=R02..
. 3/14/201 2

### Dougla s County Accoun t Informatio n Pag e 2 o f 3

l» » Q ) »• ! 202 5 Miann i

Fmtfhc i tO«0 0 Sq
. F l 1 1/ 2 Stor y Unfi n SlaMtkclll l K»l»3 4 I I

CLIC KT O ENLARG E IMAG E Squar e Footage : 1060. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Fai r Uni t Type : Condition : Averag e

Buil t As : 1 1/ 2 Stor y Unfi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 5. 0 Exterior : Fram e Sidin g Units : 1. 0 interior : Drywal l Baths : 1. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 2. 0

Roo f Type : Gabl e Stories : 1. 5 Floorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 Yea rBuil t Yea r Remodele d Percen t Remodele d Adjuste d Yea r Buil t Physica l Ag e 191 0 198 9 0 % 191 0 10 0 Detai l Typ e Detai l Descriptio n Unlt a Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 700. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Porc h Enc I Scree n 126. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R02.
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### Dougla s Count y Accoun t Informatio n Pag e 3 o f 3

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### n»JB»^ t I O Wil i o rv^'a^gi201 2 Googl e Th e abov e ma p i s powere d b y Google , an d i s intende d t o provid e a genera l ide a o f a property' s location
. I f yo u requir e a mor e exact propert y location , yo u ma y us e th e Interactiv e GI S Map s tha t ar e maintaine d b y ou r office
.



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R02.
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