HomeMy WebLinkAboutTreatment of Termites TERMITE PRETREAT SPECIALISTS €437d3 86 PRE_TREA1'
1 -800-DILIGENT
FAX 800-837-0311
TermitePretreat.com
State License 150612
Notice of Preventative Treatment for Termites
(as required by Florida Building Code(FBC)104.2.6 and Broward County Chapter FBC 105.2.2)
PEST PREVENTION I LAWN&ORNAMENTAL CARE I TERMITE SERVICES I MOSQUITO ABATEMENT I RODENT EXCLUSION&REMOVAL
SERVICE ORDER NUMBER SERVICE DATE y TIME r 3 0 WEATHER CONDITIONS
DEVELOPMENT NAME(PROJECT) CONTRACTOR'S ME / CONTACT PERSON
STRUCTURE ADDRESS(LOT/BLOCK CITY,STATE, IP CODE COUNTY
0 24 fit/ I 7-4 ,T t, Z,'
C NTACT PHONE NUMBER TES
TREATMENT TYPEIAREA
LOATING ❑MONOLITHIC ❑PATIO ❑GARAGE ❑DRIVEWAY ❑STEM WALL ❑ADDITION
❑CUTOUTS ❑FOOTERS ❑FRONT ENTRY ❑EXTERIOR PERIMETER FOR RENEWAL ❑OTHER
TREATMENT TYPE
❑TAMP&TREAT �j TREAT ONLY -1�INAL ❑RETREAT ❑BORA CARE TREATMENT ❑BAIT STATION
PRODUCT
BASELINE ❑PROBUILD TC ❑DRAGNET ❑DEMON TC ❑TERMIDOR TC ❑BORACARE ❑OTHER y
ACTIVE INGREDIENT
CONCENTRATION
X06% ❑.12% ❑.25% ❑.5% ❑.23% ❑OTHER GALLONS APPLIED i PND PFS+�,••
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SQUARE FOOTAGE LINEAR FOOTAGE SO " O �!
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SQUARE FOOTAGE VERIFIED • •
DYES ❑NO ❑MEASURED OR VERIFIED PER PLANS
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JOB READY CONDITIONS MET •. i
;AES ❑NO DETAILS ••'��•'.••�•••
SAFETY CONDITIONS
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ds:per 104.2.E FBC-If soil chemical barrier method for termite prevention is used.Final exterior treatment shall be completed prior to in p a'
Certificate of Compliance:The building has received a complete treatment for the prevention of subterranean termites.Treatment is in a johncf with rules and
laws established by the Florida Department of Agriculture and Consumer Services.(Per theFlorida Building Code.) JJ(� S 2008
If this notice is for the final exterior treatment,initial and date this line C>7 ^ /" CJ PQb)(c WOrk
�at•,Lucde Coyn
FINAL STICKER
/ELECTRICAL PANEL ❑WATER HEATER OTHER
Payment Terms: Customer's payment in full is due at time of initial service.Customer agrees that a finance charge in the amount of 18%per annum will
be assessed on all unpaid balances that are not satisfied by the due date. In the event a collection process becomes necessary to recover an unpaid .
balance the following fees will be assessed including but not limited to: collection service fee,attorney's fee,finance charges and non-sufficient funds
payment fee. Customer will be responsi for paying all costs associated with any collection process.
Date Applicato (Diligent Lawn and Pest Control,Inc.)
Date Customer(Property Owner or Agent)
^ �" 1-800-DILIGENT
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80001 ligent.com
Corporate 3100 NW Boca Raton Blvd. I Suite 106 1 Boca Raton,Florida 33431 1 800.487.8190 '
Building Photographs,,,
See Instructions for Item A6.
For Insurance Company Use:,;.
Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Policy Number
5024 WATERSONG WAY
City State ZIP Code Company NAIL Number•
FORT PIERCE FLORIDA 34949
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the
instructions for Item A6. Identify all photographs with: date taken; "Front View"and "Rear View"; and, if required, "Right Side
View"and "Left Side View". If submitting more photographs than will fit on this page, use the Continuation Page,following.
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Front View Rear View
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Left Side View Right Side View
Building Photographs"
Continuation Page
For Insurance:Company Use
Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Policy'Num-ber
5024 WATERSONG WAY
City State ZIP Code Com Dan yNAlCNiunber;=
FORT PIERCE FLORIDA 34949
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the
instructions for Item A6. Identify all photographs with: date taken; "Front View"and"Rear View"; and, if required, "Right Side
View"and"Left Side View". If submitting more photographs than will fit on this page, use the Continuation Page, following.
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North Flood Vent South Flood Vents