Covenant Home Warranty Application P. O Box 4141  Tulsa, OK. 74159 PH:  918-745-1181 TOLL FREE:  877-745-1181 For Service Call

Pricing Options Plan Definitions Option Price Selected Option Pricing 12-month Extended Warranty purchased at or prior to closing or possession of property   $465.00 12-month Extended Warranty purchased after closing but prior to the expiration of the 30-Day Warranty   $695.00 Optional Seller’s Coverage during listing but limited to 180 day $ 60.00   Additional HVAC system after the 1st $ 65.00   Additional Hot Water Heater after the 1st $ 40.00   Swimming Pool Equipment $145.00   Lawn Irrigation (sprinkler) system $110.00   Septic Tank Pumping $ 25.00   Electronic Air Filter and/or Humidifier $ 75.00     Deductible per occurrence for  the individual warranted  items and systems is $55.00  except for structure is $450.00.         Total Amount Due $ ____________

Confirmation Number: ______________________ Listing Date: __________Closing Date: __________ Seller’s Information ___________________________________________ Seller’s Name Phone # ___________________________________________ Property Address ___________________________________________ City                State                Zip Code ___________________________________________ Real Estate Company ___________________________________________ Realtor’s Name ___________________________________________ Realtor’s Phone Number Buyer’s Information ___________________________________________ Home Buyer’s Name Phone # ___________________________________________ Home Buyer’s Mailing Address (If Different) ___________________________________________ City                State                Zip Code By signing below all parties acknowledge that they have read the Warranty Agreement and accept the terms and conditions of this contract. ______________________________________________ Seller(s) Signature Date ______________________________________________ Buyer(s) Signature Date After being made aware of this Home Warranty Contract and upon due consideration, all parties acknowledge that they do not want to initiate the program on this property in conjunction with the purchase of the subject property. ______________________________________________ Seller(s) Signature Date ______________________________________________ Buyer(s) Signature Date