LAKE POWELL RESORTS & MARINAS P.O. BOX 1926 PAGE, AZ 86040 FAX: (928) 645-6186 MOORAGE APPLICATION (Complete Sections B, D, E, F, G) Marina Use Only: Marina Space Number MOORAGE TRANSFER or (Complete Sections A, B, C, D, E, F, G) Change of Ownership (including shares) BOAT TRANSFER (Complete Sections A, C, D, E, F, G) Change of Vessel ADMINISTRATIVE FEE and MOORAGE FEES: $300 & 1% of Total Sale Price Fee Please attach a Check or Money Order for the amount of the administrative fee, payable to ARAMARK. For Moorage/Boat Transfers All moorage fees must be current prior to the review of the Application for transfer. FORM INSTRUCTIONS: Moorage Type Moorage Width x Length THIS FORM MUST BE COMPLETED AND RETURNED ALONG WITH COPIES OF THE FOLLOWING DOCUMENTS (as applicable): 1. Registration or Documentation 2. Current Owners List: names, addresses, contact information PARTNERSHIPS, CORPORATIONS & LIMITED LIABILITY CORPORATIONS 3. Partnership, Corporation or LLC Agreement (Moorage Transfer and Applications Only) 4. Articles of Incorporation (Moorage Transfer and Applications Only) 5. By-Laws (Moorage Transfer and Applications Only) 6. Operating Agreement (Moorage Transfer and Applications Only) 7. Documents of Formation (Moorage Transfer and Applications Only) 8. Certificate of Officers, Directors, Managers, Authorized representatives of Owner, certificate Of Signer s authority. (Moorage Transfer and Applications Only) 9. Copy of Bill of Sale for vessel or share being transferred. BOAT TRANSFER REQUEST A 10 % guideline will be used when placing new boats into slips. This policy states that approved length of the boat shall be no larger than 10% of the length of the slip and no smaller than 10% of the length of the slip. PLEASE PROVIDE INFORMATION ON YOUR INTENTIONS FOR THE MOORAGE Do you plan on replacing the existing boat with a new boat? If yes, when do you plan on replacing the existing boat? Version Date: 2-24-04 Page 1 of 6
Do you plan on selling any additional shares or adding partners in the boat? If yes, then how many? When do you plan on adding to the current ownership? CURRENT TENANT or SELLER SIGNATURE DATE BUYER SIGNATURE DATE or APPLICANT SIGNATURE The Marina Manager, Director of Marina Operations, and the National Park Service must approve all transfers in writing before a Moorage Agreement will be considered. Current Tenant Information: SECTION A CURRENT TENANT NAME (SELLER) CORPORATION or ENTITY NAME (IF APPLICABLE) ADDRESS CITY STATE ZIP HOME PHONE ( ) WORK PHONE ( ) E-mail Moorage Applicant: SECTION B NEW TENANT NAME CORPORATION or ENTITY NAME (IF APPLICABLE) ADDRESS CITY STATE ZIP HOME PHONE ( ) WORK PHONE ( ) E-mail I / we accept the rights and responsibilities addressed in the Boat Storage License and the Moorage Policies and Procedures. I also agree to comply with all NPS policies and regulations. It is necessary to provide current vessel insurance, ownership records, schedules, and current vessel registration to the Slip & Buoy Office on an annual basis with the Moorage Agreement and annually thereafter by no later than May 1. BOAT LISTED UNDER CONTRACT: SECTION C Boat Make Boat Name Boat Model Boat Year Length Beam Height Registration Number Hull ID Number Marina Buoy Number Slip Number Dry Storage Version Date: 2-24-04 Page 2 of 6
BOAT CURRENTLY OCCUPYING MOORAGE: Is the boat listed above currently occupying the moorage space? If not, what boat is occupying the moorage? If no boat is currently occupying the moorage what date was the boat removed? This moorage shall not be used for any commercial purposes. No money or any other form of consideration can be attached or become a part of the transfer of this moorage. The purchase price paid may be only for the value of the boat with no consideration paid for the moorage. SECTION D Number of Ownerships Available on This Boat: Number of Ownerships Currently Sold on This Boat: Purchase Price of Boat/Ownership(if only partial ownership is currently being sold): NPS Authorized Broker Used: All ownership or memberships of the entity in which the boat is held must be sold before the transfer will be considered. No ownerships may be sold for profit within the Glen Canyon Recreation Area.The NPS authorized broker must be involved in any sale of vessels or ownership in vessels as stated in the Glen Canyon National Recreation Area Policy for Boat Brokering. Any additional ownerships to be sold above the number listed above under Available Ownerships will have to be approved in advance and in writing by the concessioner. Once the transfer is approved any boats purchased will remain in the slip for a minimum of 24 months before a request to install a new boat into the slip will be considered. SECTION E BOAT TO BE LISTED UNDER AGREEMENT: Boat Make Boat Name Boat Model Boat Year Length Beam Height Registration Number Hull ID Number Applicants that have ownership in any other boats must list what boats they involved at Lake Powell. Applicant Boat Owned Location Version Date: 2-24-04 Page 3 of 6
Applicant Boat Owned Location Applicant Boat Owned Location Applicant Boat Owned Location SECTION F Name Name Address Address PO Box PO Box City State Zip City State Zip Home Phone Home Phone Work Phone Work Phone E-mail Address E-mail Address Shares Owned Total Price Paid Shares Owned Total Price Paid Name Name Address Address PO Box PO Box City State Zip City State Zip Home Phone Home Phone Work Phone Work Phone E-mail Address E-mail Address Shares Owned Total Price Paid Shares Owned Total Price Paid Name Name Address Address PO Box PO Box City State Zip City State Zip Home Phone Home Phone Work Phone Work Phone Version Date: 2-24-04 Page 4 of 6
E-mail Address E-mail Address Shares Owned Total Price Paid Shares Owned Total Price Paid IF THERE ARE ADDITION OWNERS PROVIDE THEIR INFORMATION SECTION G CURRENT TENANT or SELLER SIGNATURE DATE BUYERS SIGNATURE DATE MOORAGE APPLICANT SIGNATURE DATE Applicants who provide false information above will be removed from all moorage waitlists managed by Lake Powell Resorts & Marinas. Please note that the information provided above is provided to Glen Canyon National Recreation Area, National Park Service, an agency of the Federal Government. Therefore, this information is subject to Title18 U.S.C., Part I, Chapter 47, Section 1001 and the National Park Service may take enforcement action under this statute which provides that any person who knowingly and willfully falsifies, conceals or covers up a material fact or makes any materially false, fictitious, or fraudulent statement or representation or makes or uses any false writing or document knowing the same to contain any materially false, fictitious, fraudulent statement or entry shall be fined or imprisoned not more than 5 years, or both. Q:\Concessions\Houseboats\slip contract 1001 language.doc APPROVED MARINA MANAGER DATE DIRECTOR OF MARINA OPERATIONS DATE NPS DATE DENIED MARINA MANAGER DATE DIRECTOR OF MARINA OPERATIONS DATE NPS DATE COMMENTS: Version Date: 2-24-04 Page 5 of 6
Version Date: 2-24-04 Page 6 of 6