HomeMy WebLinkAboutTermite Treatmentr / q (.( 11-� MD/
APPT. DATE I 01 l� TIME
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INSPECTOR TECH/
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DATE TAKEN: BY:
Services, LLC
Martin 772.287.8486 • St. Lucie 772429.7716
Indian River 772-567-7392 • Palm Beach 561-746-7364
4001 Virginia Avenue, Suite Fort Pierce, Florida 34981
F—JRECEIVED
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AN 17 /p.^',y
FOR FAST, PROFESSIONAL SERVICE CALL
cie County, Permitting
COMER INFORMATION Acct. IIII Q41
t` 705-e 55 I
SERVICE REQUESTED
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ZIP CODE/GRID
SOURCE
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CONTRACTS:
2 Li a -160
HOME TEL0 WORKTELN
DIRECTIONS
PAYMENT/CREDIT CARD ATION
SVC AMT CARD TYPE CHEC # / CARD # / EXP DATE AMT
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AUTHORIZATION
CODE DATE TIME
2.
3.
4.
TOTAL DUE
TOTALAUTH.
DEFERRED DATE
CARDHOLDER NAME (If different from above)
I AGREE TO PAYABOVE TOTALAMOUNT ACCORDING TO CARD ISSUER AGREEMENT (Visa/MasterCard Customer Inquiries Call 1-800-920-1079).
SIGNATURE:
DATE:
VALUED CUSTOMER COMMENTS:
SALES TECH COMMENTS- n.
PEST CONTROL / FLEAS / OTS
TERMITE / FUME
MATERIAL
TREATMENT SITES TREATED Name (%) & Amt INSPECTED
SITES
Evidence Treated MATERIAL
(V!N) (YIN) Name (%) & Amaunt
Mulch/Flowerbeds
Foundation
Woodpile/Garbage Area a
r'e/ Crawl Space
Doors/Windows/Eaves
Interior Walls
Attic/Crawl Space
Door Frames
Underneath Appliances
Window Frames
Wall Voids/False Bottoms
Bath Traps
Cracks/Crevices
Attic
Drawers/Cabinets/Closets
Other
Other
TARGET PESTS QrP4✓p
Time/Beg: 12, ?�
Comp: I; TOT: f0,, ,
End rsement hereon acknowledges receipt of and satisfaction for services rendered. I certify t above to be true and an accurate record of my operations.
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CUSTOMERS SIGNATURE
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DATE WIPEOUT TECHNICIAN