670 N. Commercial Street Manchester, NH 03101
Phone: 603-622-6223 Fax: 603-622-7342
O:\...\PROPERTIES\1000 Elm Street\Parking Garage\ _Master Automatic Payment Form (7.2.18).pdf Revised: 7.2.18
Canal Street Parking Garage Form
Date:
Name:
Employer:
Credit Card Type:
Visa
Mastercard
Credit Card #:
Exp:
CIV:
Customer Address:
Daytime Phone:
Email:
New Card Request
Update Profile on Record
Additional Card(s) Requested
Deactive Card - reason
Stolen
Lost
Other:
Vehicle Info:
Make:
Model:
License Plate#:
I have read and agreed to the terms set forth in and signed the attached contract concerning parking privileges at the Canal Street Garage. I
have included a payment for my 1
st
month's permit fee and a $50.00 (non-refundable processing fee) for the access card. I understand that I will
not receive monthly statements of the balance owed. I will send payment to Brady Sullivan Properties on or before the 1
st
of each month. If
payment is not received by the 5
th
of each month, the parking garage pass will be deactivated automatically, and a $50.00 non- refundable
reactivation fee will be accessed.
Signature of Cardholder:
Date:
I hereby agree to and wish to have the above credit card charged automatically on the first day of every month in the amount equal to one
month’s parking fee.
Signature of Cardholder:
Date:
PLEASE SEND ALL PAYMENTS, APPLICATIONS, AND SETUP FEES TO:
Brady Sullivan Properties
Attn: Scott Barry (sbarry@bradysullivan.com)
670 N. Commercial Street, Suite 303
Manchester, NH 03101
FOR BRADY SULLIVAN PROPERTIES MANAGEMENT USE ONLY
Account:
Start Date:
Fee Amount:
PM Initials:
The undersigned is hereby granted permission to use a parking space in the specified Brady Sullivan garage referenced above located in
Manchester, New Hampshire. Permit shall continue from the FIRST to the LAST DAY of each month with fees being due and payable on or
before the FIRST of each month.
The foregoing permit fee may be changed by Brady Sullivan Properties as of the first day of any month by giving not less than 7 days written
notice posted on the premise or to permittee at the address set forth herein. In the event fees are not paid when due, management may cancel
this license and take immediate possession of the space without liability to permittee. Either party shall have the privilege of terminating this
agreement by giving the other party one week’s WRITTEN notice prior to the end of any month. Permittee agrees to accept responsibility for
legal costs or outstanding fees owned by Permittee at time of termination.
ASSUMPTION OF RISK: The Permittee, having permission to park in the facility, assumes all risk of Loss or Damage to Property, contents, and all
risk of Personal Injury, including death, which is attributable to the negligence of unlawful conduct of the Third Party or natural causes beyond
the control of Brady Sullivan Plaza, LLC.
Permit does not include valet service and is for parking only. Lost or damaged cards will have a replacement fee of $50.
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