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<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN">
<html>
	<head>
		<title>Grand Marc at the Corner - Inventory and condition form</title>
		<meta http-equiv=content-type content="text/html; charset=windows-1252">
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			body,p,td,input,textarea{
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	<div style=width:6.5in;height:9in; >

		<form
			name=frm_jpi_studentliving_inventoryandconditionform
			method=post
			action="http://property.onesite.realpage.com/system/onlineforms/jpi_studentliving_inventoryandconditionform.asp?w=grandmarcatthecorner&n=1&q=95201075900&reason=post"
		>
			<table border=0 cellpadding=0 cellspacing=0 width=100% >
				<tr>
					<td align=left valign=top>
						<b>Grand Marc at the Corner</b>
						<br>301 15th St NW&nbsp;
						<br>Charlottesville&nbsp;VA&nbsp;22903-2700
						<br>(434) 293-5787
					</td>
					<td align=right valign=top style="text-align:right;vertical-align:top;">
						<img src="http://property.onesite.realpage.com:80/grandmarcatthecorner/images/logos/0125lg01.gif" border=0>
					</td>
				</tr>
			</table>
			<hr>

			<input type=hidden name=inp_now value="9/5/2010 7:59:01 PM" >
			<p align=center style="text-align:center;">
				<b>INVENTORY AND CONDITION FORM</b>
				<br>9/5/2010 7:59:01 PM
			</p>
			<table border=0 width=100%>
				<tr>
					<td width=50%>
						<table border=0 width=100%>
							<tr>
								<td nowrap>Name *</td>
								<td nowrap>

									<input type=text name=inp_name value="" tabindex=1>
	
								</td>
							</tr>
							<tr>
								<td nowrap>E-mail address *</td>
								<td nowrap>

									<input type=text name=inp_email size=30 value="">
	
								</td>
							</tr>
							<tr>
								<td nowrap>Apartment number *</td>
								<td nowrap>

									<input type=text name=inp_apartmentnumber size=4 value="">

									bedroom *

									<input type=text name=inp_bedroom size=4 value="">
	
								</td>
							</tr>
						</table>
					</td>
					<td width=50%>
						<table border=0 width=100%>
							<tr>
								<td nowrap>Last 4 digits of SSN *</td>
								<td nowrap>

									<input type=text name=inp_last4 size=4 maxlength=4 value="">
	
								</td>
							</tr>
							<tr>
								<td nowrap>Home phone *</td>
								<td nowrap>

									<input type=text name=inp_phonehome size=14 maxlength=14 value="">
	
								</td>
							</tr>
							<tr>
								<td nowrap>Work phone</td>
								<td nowrap>

									<input type=text name=inp_phonework size=14 maxlength=14 value="">

									extension

									<input type=text name=inp_phoneworkextension size=5 maxlength=5 value="">
	
								</td>
							</tr>
						</table>
					</td>
				</tr>
			</table>
			* required
			<p>
				This form protects you (the resident) and us (the owner).
				We'll use it in determining what should and should not be considered your responsibility at move-out.
				Please note any items that are missing.
				All items listed below will be assumed to be in good condition unless otherwise noted on this form.
				<b>NOTE: NOT EVERY UNIT CONTAINS ALL OF THE FURNITURE LISTED BELOW.</b>
			</p>
			<table width=100%><tr><td nowrap><b>Living room</td><td width=100%><hr></td></tr></table>
			<table border=0 width=100%>
				<tr>
					<td width=50%>
						<table border=0 width=100%>
							<tr><td nowrap width=50%>Entertainment center	</td><td width=50%><input type="text" name="livingroom_entertainmentcenter" value=""></td></tr>
							<tr><td nowrap width=50%>Sofa			</td><td width=50%><input type="text" name="livingroom_sofa" value=""></td></tr>
							<tr><td nowrap width=50%>Chair			</td><td width=50%><input type="text" name="livingroom_chair" value=""></td></tr>
							<tr><td nowrap width=50%>Coffee table		</td><td width=50%><input type="text" name="livingroom_coffeetable" value=""></td></tr>
							<tr><td nowrap width=50%>End table		</td><td width=50%><input type="text" name="livingroom_endtable" value=""></td></tr>
							<tr><td nowrap width=50%>Walls			</td><td width=50%><input type="text" name="livingroom_walls" value=""></td></tr>
							<tr><td nowrap width=50%>Plugs, covers, A/C vents	</td><td width=50%><input type="text" name="livingroom_plugscoversacvents" value=""></td></tr>
							<tr><td nowrap width=50%>Woodwork/baseboards	</td><td width=50%><input type="text" name="livingroom_woodworkbaseboards" value=""></td></tr>
						</table>
					</td>
					<td width=50%>
						<table border=0 width=100%>
							<tr><td nowrap width=50%>Ceiling			</td><td width=50%><input type="text" name="livingroom_ceiling" value=""></td></tr>
							<tr><td nowrap width=50%>Light fixtures, bulbs	</td><td width=50%><input type="text" name="livingroom_lightfixturesbulbs" value=""></td></tr>
							<tr><td nowrap width=50%>Floor/carpet		</td><td width=50%><input type="text" name="livingroom_floorcarpet" value=""></td></tr>
							<tr><td nowrap width=50%>Doors, stops, locks	</td><td width=50%><input type="text" name="livingroom_doorsstopslocks" value=""></td></tr>
							<tr><td nowrap width=50%>Windows, latches, screens	</td><td width=50%><input type="text" name="livingroom_windowslatchesscreens" value=""></td></tr>
							<tr><td nowrap width=50%>Window coverings		</td><td width=50%><input type="text" name="livingroom_windowcoverings" value=""></td></tr>
							<tr><td nowrap width=50%>Closets, rods, shelves	</td><td width=50%><input type="text" name="livingroom_closetsrodsshelves" value=""></td></tr>
							<tr><td nowrap width=50%>Other			</td><td width=50%><textarea name="livingroom_other"></textarea></td></tr>
						</table>
					</td>
				</tr>
			</table>
			<table width=100%><tr><td nowrap><b>Kitchen</td><td width=100%><hr></td></tr></table>
			<table border=0 width=100%>
				<tr>
					<td width=50%>
						<table border=0 width=100%>
							<tr><td nowrap width=50%>Walls			</td><td width=50%><input type="text" name="kitchen_walls" value=""></td></tr>
							<tr><td nowrap width=50%>Plugs, covers, A/C vents	</td><td width=50%><input type="text" name="kitchen_plugscoversacvents" value=""></td></tr>
							<tr><td nowrap width=50%>Woodwork/baseboards	</td><td width=50%><input type="text" name="kitchen_woodworkbaseboards" value=""></td></tr>
							<tr><td nowrap width=50%>Ceiling			</td><td width=50%><input type="text" name="kitchen_ceiling" value=""></td></tr>
							<tr><td nowrap width=50%>Light fixtures, bulbs	</td><td width=50%><input type="text" name="kitchen_lightfixturesbulbs" value=""></td></tr>
							<tr><td nowrap width=50%>Floor/carpet		</td><td width=50%><input type="text" name="kitchen_floorcarpet" value=""></td></tr>
							<tr><td nowrap width=50%>Doors, stops, locks	</td><td width=50%><input type="text" name="kitchen_doorsstopslocks" value=""></td></tr>
							<tr><td nowrap width=50%>Windows, latches, screens	</td><td width=50%><input type="text" name="kitchen_windowslatchesscreens" value=""></td></tr>
							<tr><td nowrap width=50%>Blinds			</td><td width=50%><input type="text" name="kitchen_blinds" value=""></td></tr>
						</table>
					</td>
					<td width=50%>
						<table border=0 width=100%>
							<tr><td nowrap width=50%>Cabinets, drawers, handles	</td><td width=50%><input type="text" name="kitchen_cabinetsdrawershandles" value=""></td></tr>
							<tr><td nowrap width=50%>Countertops		</td><td width=50%><input type="text" name="kitchen_countertops" value=""></td></tr>
							<tr><td nowrap width=50%>Stove/oven		</td><td width=50%><input type="text" name="kitchen_stoveoven" value=""></td></tr>
							<tr><td nowrap width=50%>Vent hood		</td><td width=50%><input type="text" name="kitchen_venthood" value=""></td></tr>
							<tr><td nowrap width=50%>Refrigerator		</td><td width=50%><input type="text" name="kitchen_refrigerator" value=""></td></tr>
							<tr><td nowrap width=50%>Dishwasher		</td><td width=50%><input type="text" name="kitchen_dishwasher" value=""></td></tr>
							<tr><td nowrap width=50%>Sink/disposal		</td><td width=50%><input type="text" name="kitchen_sinkdisposal" value=""></td></tr>
							<tr><td nowrap width=50%>Microwave		</td><td width=50%><input type="text" name="kitchen_microwave" value=""></td></tr>
							<tr><td nowrap width=50%>Other			</td><td width=50%><textarea name="kitchen_other"></textarea></td></tr>
						</table>
					</td>
				</tr>
			</table>
			<table width=100%><tr><td nowrap><b>General items</td><td width=100%><hr></td></tr></table>
			<table border=0 width=100%>
				<tr>
					<td width=50%>
						<table border=0 width=100%>
							<tr><td nowrap width=50%>Thermostat</td>		<td width=50%><input type="text" name="general_thermostat" value=""></td></tr>
							<tr><td nowrap width=50%>Cable tv</td>		<td width=50%><input type="text" name="general_cabletv" value=""></td></tr>
							<tr><td nowrap width=50%>A/C filter</td>		<td width=50%><input type="text" name="general_acfilter" value=""></td></tr>
						</table>
					</td>
					<td width=50%>
						<table border=0 width=100%>
							<tr><td nowrap width=50%>Washer/dryer</td>	<td width=50%><input type="text" name="general_washerdryer" value=""></td></tr>
							<tr><td nowrap width=50%>Other</td>		<td width=50%><textarea name="general_other"></textarea></td></tr>
						</table>
					</td>
				</tr>
			</table>
			<table width=100%><tr><td nowrap><b>Dining room</td><td width=100%><hr></td></tr></table>
			<table border=0 width=100%>
				<tr>
					<td width=50%>
						<table border=0 width=100%>
							<tr><td nowrap width=50%>Dining table		</td><td width=50%><input type="text" name="diningroom_diningtable" value=""></td></tr>
							<tr><td nowrap width=50%>Dining chairs		</td><td width=50%><input type="text" name="diningroom_diningchairs" value=""></td></tr>
							<tr><td nowrap width=50%>Plugs, covers, A/C vents	</td><td width=50%><input type="text" name="diningroom_plugscoversacvents" value=""></td></tr>
							<tr><td nowrap width=50%>Woodwork/baseboards	</td><td width=50%><input type="text" name="diningroom_woodworkbaseboards" value=""></td></tr>
							<tr><td nowrap width=50%>Ceiling			</td><td width=50%><input type="text" name="diningroom_ceiling" value=""></td></tr>
							<tr><td nowrap width=50%>Light fixtures, bulbs	</td><td width=50%><input type="text" name="diningroom_lightfixturesbulbs" value=""></td></tr>
						</table>
					</td>
					<td width=50%>
						<table border=0 width=100%>
							<tr><td nowrap width=50%>Floor/carpet		</td><td width=50%><input type="text" name="diningroom_floorcarpet" value=""></td></tr>
							<tr><td nowrap width=50%>Doors, stops, locks	</td><td width=50%><input type="text" name="diningroom_doorsstopslocks" value=""></td></tr>
							<tr><td nowrap width=50%>Windows, latches, screens	</td><td width=50%><input type="text" name="diningroom_windowslatchesscreens" value=""></td></tr>
							<tr><td nowrap width=50%>Blinds			</td><td width=50%><input type="text" name="diningroom_blinds" value=""></td></tr>
							<tr><td nowrap width=50%>Other			</td><td width=50%><textarea name="diningroom_other"></textarea></td></tr>
						</table>
					</td>
				</tr>
			</table>
			<table width=100%><tr><td nowrap><b>Halls</td><td width=100%><hr></td></tr></table>
			<table border=0 width=100%>
				<tr>
					<td width=50%>
						<table border=0 width=100%>
							<tr><td nowrap width=50%>Walls			</td><td width=50%><input type="text" name="halls_walls" value=""></td></tr>
							<tr><td nowrap width=50%>Ceiling			</td><td width=50%><input type="text" name="halls_ceiling" value=""></td></tr>
							<tr><td nowrap width=50%>Light fixtures, bulbs	</td><td width=50%><input type="text" name="halls_lightfixturesbulbs" value=""></td></tr>
							<tr><td nowrap width=50%>Floor/carpet		</td><td width=50%><input type="text" name="halls_floorcarpet" value=""></td></tr>
						</table>
					</td>
					<td width=50%>
						<table border=0 width=100%>
							<tr><td nowrap width=50%>Doors, stops, locks	</td><td width=50%><input type="text" name="halls_doorsstopslocks" value=""></td></tr>
							<tr><td nowrap width=50%>Closet, rods, shelves	</td><td width=50%><input type="text" name="halls_closetrodsshelves" value=""></td></tr>
							<tr><td nowrap width=50%>Other			</td><td width=50%><textarea name="halls_other"></textarea></td></tr>
						</table>
					</td>
				</tr>
			</table>
			<table width=100%><tr><td nowrap><b>Bedroom</td><td width=100%><hr></td></tr></table>
			<table border=0 width=100%>
				<tr>
					<td width=50%>
						<table border=0 width=100%>
							<tr><td nowrap width=50%>Bed			</td><td width=50%><input type="text" name="bedroom_bed" value=""></td></tr>
							<tr><td nowrap width=50%>Desk			</td><td width=50%><input type="text" name="bedroom_desk" value=""></td></tr>
							<tr><td nowrap width=50%>Desk chair		</td><td width=50%><input type="text" name="bedroom_deskchair" value=""></td></tr>
							<tr><td nowrap width=50%>Dresser			</td><td width=50%><input type="text" name="bedroom_dresser" value=""></td></tr>
							<tr><td nowrap width=50%>Walls			</td><td width=50%><input type="text" name="bedroom_walls" value=""></td></tr>
							<tr><td nowrap width=50%>Plugs, covers, A/C vents	</td><td width=50%><input type="text" name="bedroom_plugscoversacvents" value=""></td></tr>
							<tr><td nowrap width=50%>Woodwork/baseboards	</td><td width=50%><input type="text" name="bedroom_woodworkbaseboards" value=""></td></tr>
							<tr><td nowrap width=50%>Ceiling			</td><td width=50%><input type="text" name="bedroom_ceiling" value=""></td></tr>
						</table>
					</td>
					<td width=50%>
						<table border=0 width=100%>
							<tr><td nowrap width=50%>Light fixtures, bulbs	</td><td width=50%><input type="text" name="bedroom_lightfixturesbulbs" value=""></td></tr>
							<tr><td nowrap width=50%>Floor/carpet		</td><td width=50%><input type="text" name="bedroom_floorcarpet" value=""></td></tr>
							<tr><td nowrap width=50%>Doors, stops, locks	</td><td width=50%><input type="text" name="bedroom_doorsstopslocks" value=""></td></tr>
							<tr><td nowrap width=50%>Windows, latches, screens	</td><td width=50%><input type="text" name="bedroom_windowslatchesscreens" value=""></td></tr>
							<tr><td nowrap width=50%>Blinds			</td><td width=50%><input type="text" name="bedroom_blinds" value=""></td></tr>
							<tr><td nowrap width=50%>Closet, rods, shelves	</td><td width=50%><input type="text" name="bedroom_closetrodsshelves" value=""></td></tr>
							<tr><td nowrap width=50%>Other			</td><td width=50%><textarea name="bedroom_other"></textarea></td></tr>
						</table>
					</td>
				</tr>
			</table>
			<table width=100%><tr><td nowrap><b>Bath</td><td width=100%><hr></td></tr></table>
			<table border=0 width=100%>
				<tr>
					<td width=50%>
						<table border=0 width=100%>
							<tr><td nowrap width=50%>Walls			</td><td width=50%><input type="text" name="bathroom_walls" value=""></td></tr>
							<tr><td nowrap width=50%>Plugs, covers, A/C vents	</td><td width=50%><input type="text" name="bathroom_plugscoversacvents" value=""></td></tr>
							<tr><td nowrap width=50%>Woodwork/baseboards	</td><td width=50%><input type="text" name="bathroom_woodworkbaseboards" value=""></td></tr>
							<tr><td nowrap width=50%>Ceiling			</td><td width=50%><input type="text" name="bathroom_ceiling" value=""></td></tr>
							<tr><td nowrap width=50%>Light fixtures, bulbs	</td><td width=50%><input type="text" name="bathroom_lightfixturesbulbs" value=""></td></tr>
							<tr><td nowrap width=50%>Exhaust fan		</td><td width=50%><input type="text" name="bathroom_exhaustfan" value=""></td></tr>
							<tr><td nowrap width=50%>Floor/carpet		</td><td width=50%><input type="text" name="bathroom_floorcarpet" value=""></td></tr>
							<tr><td nowrap width=50%>Doors, stops, locks	</td><td width=50%><input type="text" name="bathroom_doorsstopslocks" value=""></td></tr>
							<tr><td nowrap width=50%>Windows, latches, screens	</td><td width=50%><input type="text" name="bathroom_windowslatchesscreens" value=""></td></tr>
						</table>
					</td>
					<td width=50%>
						<table border=0 width=100%>
							<tr><td nowrap width=50%>Blinds			</td><td width=50%><input type="text" name="bathroom_blinds" value=""></td></tr>
							<tr><td nowrap width=50%>Sink, handles, stopper	</td><td width=50%><input type="text" name="bathroom_sinkhandlesstopper" value=""></td></tr>
							<tr><td nowrap width=50%>Countertops		</td><td width=50%><input type="text" name="bathroom_countertops" value=""></td></tr>
							<tr><td nowrap width=50%>Mirror			</td><td width=50%><input type="text" name="bathroom_mirror" value=""></td></tr>
							<tr><td nowrap width=50%>Cabinets, drawers, handles	</td><td width=50%><input type="text" name="bathroom_cabinetsdrawershandles" value=""></td></tr>
							<tr><td nowrap width=50%>Toilet			</td><td width=50%><input type="text" name="bathroom_toilet" value=""></td></tr>
							<tr><td nowrap width=50%>Shower, doors, rods, stopper	</td><td width=50%><input type="text" name="bathroom_showerdoorsrodsstopper" value=""></td></tr>
							<tr><td nowrap width=50%>Tile			</td><td width=50%><input type="text" name="bathroom_tile" value=""></td></tr>
							<tr><td nowrap width=50%>Other			</td><td width=50%><textarea name="bathroom_other"></textarea></td></tr>
						</table>
					</td>
				</tr>
			</table>
			<table width=100%><tr><td nowrap><b>Safety-related items</td><td width=100%><hr></td></tr></table>
			<table border=0 width=100%>
				<tr>
					<td width=50%>
						<table border=0 width=100%>
							<tr><td nowrap width=50%>Door handle locks		</td><td width=50%><input type="text" name="safety_doorhandlelocks" value=""></td></tr>
							<tr><td nowrap width=50%>Keyed deadbolt locks	</td><td width=50%><input type="text" name="safety_keyeddeadboltlocks" value=""></td></tr>
							<tr><td nowrap width=50%>Keyless deadbolt locks	</td><td width=50%><input type="text" name="safety_keylessdeadboltlocks" value=""></td></tr>
							<tr><td nowrap width=50%>Sliding door pinlocks	</td><td width=50%><input type="text" name="safety_slidingdoorpinlocks" value=""></td></tr>
							<tr><td nowrap width=50%>Doorviewers		</td><td width=50%><input type="text" name="safety_doorviewers" value=""></td></tr>
						</table>
					</td>
					<td width=50%>
						<table border=0 width=100%>
							<tr><td nowrap width=50%>Porch and patio lights	</td><td width=50%><input type="text" name="safety_porchandpatiolights" value=""></td></tr>
							<tr><td nowrap width=50%>Smoke detectors		</td><td width=50%><input type="text" name="safety_smokedetectors" value=""></td></tr>
							<tr><td nowrap width=50%>Alarm system		</td><td width=50%><input type="text" name="safety_alarmsystem" value=""></td></tr>
							<tr><td nowrap width=50%>Fire extinguishers (don't test)	</td><td width=50%><input type="text" name="safety_fireextinguishers" value=""></td></tr>
							<tr><td nowrap width=50%>Other			</td><td width=50%><textarea name="safety_other"></textarea></td></tr>
						</table>
					</td>
				</tr>
			</table>
			<table width=100%><tr><td nowrap><b>Acknowledgement</td><td width=100%><hr></td></tr></table>
			<p>
				You acknowledge that you have inspected and tested all of the safety-related items (if in dwelling) and that they are working, except as noted above.
				You acknowledge receiving written operating instructions on the alarm system and gate access entry systems (if there are any).
			</p>

			<p>
				By selecting "I Agree" below, you accept this inventory as part of the Lease and agree that it accurately reflects the condition of the Premises for purpose of determining any refund due to you when you move out.
			</p>
			<p align=center style="text-align:center;">
				<input type=submit value="I Agree" name=Submit style="text-align:center;">
				<input type=reset value=Reset name=Reset style="text-align:center;">
			</p>

		</form>
	</body>
</html>
