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HomeMy WebLinkAboutSubterranean Termite Repair AgreementIt : ` ! THIS AGREEMENT PROVIDES FOR Ho RETREATMENT OF A STRUCTURE 'M AND THE REPAIR OF DAMAGES d a+: CAUSED BY WOOD DESTROYING ORGANISMS WITHIN THE LIMITS Account No.: 3405434 STATED IN THIS AGREEMENT. SUBTERRANEAN TERMITE REPAIR AGREEMENT Section L GENERAL INFORMATION. Name: Adams Homes illing Address: 751 SE Port St Lucie Blvd Service .address: 5420 Lugo St ty; Port Saint Lucie City: Fort Pierce JHme te: FL Zip Code: 34984-5211 State: FL Zip Code: 34951-4457 Phone: 772-905-8394rk Phone: Section Il. INSPECTION FINDINGS. The condition of the readily accessible areas of the structure(s) located at the Service Add ss on the date of the inspection only is listed below: a. No Visible evidence of previous or current subterranean termite infestation as observed. b. ❑ Visible evidence of a subterranean termite infestation was observed as folio : ❑ Live subterranean termites (description and location indicated on the.atta bed graph) ❑ Termite parts, exit holes or shelter tubes (description and location indicat d on the attached graph) ❑ Damage from subterranean termites was noted in the following area(s): Any damage noted above should be considered only as evidence of cuffenl or p vious infestation of subterranean termites. Ifany of the boxes in subsection b. above are checked, some degree of damage, including bidden damage, I+I'a'y be present. The inspectors training and experience do not qualify the inspector in damage evaluation or any other building construction technology an or repair. Any visible evidence observed above appears: ❑ Active; ❑ Inactive; ❑ Activity cannot be determined without fur her investigation. Reason: /n many cases, based upon visible signs ofinfestation by subterranean fermi! it is not possible to ascertain whether an infestation is active or inactive without benefit ofsubsequent inspections and evaluations over a period, . ❑ It appears that the structure(s) or a portion of the structure(s) may have been reviously treated. Evidence of previous treatment: Section III. OBSTRUCTIONS AND INACCESSIBLE AREAS. The following areas of the structure(s) inspected were obstructed or inaccessible (see Section 171.1 under General Terms and Conditions): ❑ Basement ❑ Exterior ❑ Crawl Space ❑ Porch ❑ Main evel ❑ Addition ❑ Attic ❑ Garage ❑ Other Comments: Section 1V. ADDITIONAL COMMENTS. Section V. TYPE OF TREATMENT. OB IGATIONS: ❑ Post Construction Corrective Treatment (Se reverse side for a description of floe Company's obligation to retreat and to repair damage causer/ by subterranean termites.) ❑ Post Construction Preventative Treatment * Pre -Construction Treatment Loc tion of Treatment Sticker: Panel ❑ Other: Treatment is provided against the attack of subterranean temrites (Reticulitermes spp., Iiet rotermes spp. and Coptotermes spp. (Formosan)), but does not protect against any other pests, plant, animal or organism other than subterranean termites. Duri the term of this Agreement, HomeTeam Pest Defense, Inc. (the "Company") will provide re -inspections to the structure when deemed necessary by th Company or annually if requested by the Customer, subject to the General Terms and Conditions on the reverse side. Customer agrees to make the treate structure(s) available for re -inspection. The Company will retreat the treated structure(s) only upon (a) visual evidence of a live termite infestation or (b) dislurban a of the soil surrounding the treated structure(s). The Company has not inspected or treated the structure(s) for health -related molds or fungi. By law, the Company is of qualified, authorized or licensed to inspect for stealth -related molds or fungi. Actual Treatment Date: 11/29/2021 PAYMENT METHOD: Initial Treatment Date: T'sobligations. Check ❑ Credit Card Down Payment: $ 0.00 Balance Due: $ 0 5. credit card or recurring debit from your bank account, please Annual Renewal: S 275.00 e attached Authorization for Pre -Arranged Payments. This Agreement contains certain limitations, conditions and exclusions on the Coigations. Please read the entire Agreement before signing. In consideration for the Company performing the services specified above and subject nd conditions of this Agreement, Customer agrees to make the payments indicated above. Customer acknowledges receipt of a signed copy of this Ags Agreement is not binding on the Company until signed by an authorized manager or executive officer of the Company. CUSTOMER: HOMETEAM PEST DEFENSE. INC. Printed Printed N Effective RIGHT TO CANCEL: YOU, THE CUSTOMER, MAY CANCEL THIS TRANSACTIONAT OAT TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAYAFTERTHE DATEOFTHIS TRANSACTION.SEE THE ATTACHEDNOTICE O CANCELLATION FOR AN EXPLANA TION OF THIS RIGHT. a0 HomeTeam Pest De&nse, Inc. 2017 1 09/17- (53314 5YR) Section VI. OBLIGATIONS. A. The Customer agrees to be solely responsible for maintaining the Treated P rums Conducive," see below for explanation). The Customer agrees to be solely responsr le far exclusively with the Customer, not with the Company. Failure of the Company to ale Cost under this Section. In addition, the existence of any Conditions Conducive that was n t time the time of the execution of this Agreement, will permit the Company, at its sole Idiscre additional treatment required as a result of the Conditions Conducive. Customer agrees to agrees to maintain the area(s) baited free from such Conditions Conducive. Otter specific it CONDITIONS CONDUCIVE: Conditions Conducive include, but are not limited to roof or around the structure; inherent structural problems, including, but not limited to, woad t insulation, stucco construction, expanded polystyrene or styrofoam molded founds on s ground; and firewood, trash, lumber, wood, mulch, shrubs, vines, and other protective un B. ADDITIONS, ALTERATIONS, AND OTHER CHANGES. This Agreement co ers t Customer will immediately notify the Company in writing (1) prior to the Struc[ur (s) b termiticide being applied on or close to the location of any Station, (3) if soil is rem ved baiting equipment or supplies occurs. Failure to notify the Company in writing of any even addition, alteration or other such event maybe provided by the Company at Customer' expo C. REPAIR AND RETREATMENT OBLIGATION. Customer initials Sub of subterranean termites occurs in the treated structure(s) during the term of is Agreement addition, subject to the general terms and conditions of this Agreement, the Company Comppany's total liability will not exceed in any one calendar year the lesser of (1) 200 $1,000,000 in the aggregate over the term of the Agreement, including extensions and ne consequential damages relating to the existence of Subterranean termites or Subt can diminution of value, or any "stigma" damage due to the presence of Subterranean t rmit Company is performing a service and except for termite damage repairs set forth abov and its services, Customer waives any claim for property damage, and agrees that under o ci amount aid by the Customer to Company for the termite service to be performed. es free from any condition conducive to termite infestation ("Conditions identifying and correcting Conditions Conducive. The responsibility rests omer to any of the above conditions does not alter Customers responsibility ly corrected, including any Conditions Conducive existing but not visible at tion, to terminate the Agreement or to require Customer to purchase any fully cooperate with the Company during the term of this Agreement, and ems maybe noted in "Additional Comments" (Section M. leaks, improper ventilation, faulty plumbing, and water leaks or intrusion in o ground contact, masonry failures, and settlement of the foundation, foam ystems, siding (including vinyl, wood and metal) if within 6 inches of the d covering that restricts visual inspection or treatment of the structure. he Structure(s) identified in Section I as of the date of the initial installation. eing structurally modified, altered or otherwise changed, (2) prior to any or added around the foundation of the Structures or (4) any tampering of t listed above may void the Agreement. Additio services required by any rise, and may require an adjustment in the renewal fee. ject to the general terms and conditions of this Agreement, if an infestation the Company will retreat the area of infestation at no additional charge. In will repair, at its cost, new termite damage to the treated structure(s). The ,000 and (ii) the fair market value of the treated structure(s), nor exceed Is. Customer expressly waives any claim for economic, compensatory, or termite damage, or for increased costs, loss of use, business interruption, es or Subterranean termite damage. The Customer acknowledges that the any damage to the structure caused by the Company in the performance of rcumstances shall Company be held liable for any amount greater than the 1. The Company is not responsible for the cost of repairs of subterranean termite damage caused by or related to structural conditions or Conditions Conducive. 2. Due to subterranean termite habits, termite activity may continue to be present In a structure for a period of time following treatment. The Company is not responsible for (i) repairs of subterranean termite damage to the treated structu e(s) or the contents thereof that occurred prior to a treatment date or that occurs within six months following a treatment date or (fl) any costs or expenses infurred by Customer as a result of any such damage. 3. If new damage, as evidenced by the presence of live termites, occurs while this Agre antis in force, following written notification from Customer and an inspection by the Company, the Company agrees, at its discretion, to either (i) repair the damaget the Company's cost or (ii) reimburse Customer for the reasonable cost of the repairs, but only to the extent that, in either case, the total reasonable cost of such rep ai is less than $200,000 in any one calendar year. 4. Subject to the remaining provisions of this Section VI.A.4, if the Company chooses of to repair the damage itself, Customer will be entitled to select the contractor who will perform the needed repairs to the treated structure(s). Prior to entering into a c ntract with a contractor, Customer agrees to provide the Company a copy of the proposed contract or written bid If the Company detemtines the bid to be excessivg, Customer agrees to writ access to the treated structures) to a contractor designated by the Company for [he purpose of obtaining a second bid for the work. In chses where there are multiple bids for repair work, Customer acknowledges that the Company reserves the tight ro select the contractor to perform the repairs. t{li 5. The Company is not responsible for the repair of either visible damage (noted on a attached inspection graph) or hidden damage existing as of the date of this Agreement. The Company does not guarantee that the damage disclosed on the attach d inspection graph represents all of the existing damage as of the date of this Agreement. Customer waives all claims for damage to the property or people that may r�sul[ directly or indirectly from services provided by the Company, with the sole exception of claims for damages due to the gross negligence of the Company and/or its eppmployees. D. PRETREATMENT LIMITED WARRANTY RENEWAL. The following applieif the Company previously provided a pretreatment for subterranean termite protection on the treated stmcture(s). The pretreatment included an obligation for the ompany to retreat the structure(s), at its cost, if live termites are found at the structure(s) during the one (1) year following the pretreatment. The Company hereby �ansfers the retreatment obliggation to you, subject to the remaining terms and conditions of this Section VI.B. You have the option to renew this obligation annually` after the expiration of the fust tens for four (4) additional one year periods provided that at the time of each renewal the annual renewal fee shown on the front pag of this Agreement (subject to adjustment as provided in Section VB.2 below) is paid and a previous one year renewal was purchased. The Company's repair liability is invited as described in Section VI.A above. Section VH. GENERAL TERMS AND CONDITIONS. 1. INSPECTION. The inspection provided for in this Agreement was conducted in th re visible evidence of the infestation by subterranean termites is reported, some degree of dhrn the readily accessible areas of the structure(s) inspected, including attics and crawlspaces t that were obstructed or inaccessible at the time of this inspection. All structure(s) that m%er were obstructed and/or inaccessible for physical access, nor did the Company inspect Are object including, but not limited to: molding, floor coverings, wall coverings, siding, ceili 2. TERM. Unless otherwise specifically provided herein, the parties agree that the automatically renewed on an annual basis, for a maximum of four (4) additional one () annual renewal fee shown on the front page of this Agreement (subject to adjustment p party written notice at least thirty (30) days prior to the end of the then current term. Th C may be terminated by Customer by providing written notice to the Company within thirty'(3 3. CONDITIONS. Customer agrees to repair and correct, at Customer's sole expense, aa{piy notice by the Company, including, but not limited to, any and all conditions that are condor treatments, inspections or the effectiveness of the treatments. If the condition is not corner discretion, terminate this Agreement with no liability. Customer further agrees to main i including, but not limited to, roof leaks, improper ventilation, faulty plumbing, and water including, but not limited to, wood to ground contact, masonry failures, and settlement of styrofoam molded foundation systems, siding (including vinyl, wood and metal) if withi 6 firewood, trash, lumber, wood, mulch, shrubs, vines, and other protective ground covering th 4. NOTICE OF CLAIMS, ACCESS TO TREATED STRUCTURE. Any claim under The Company is obligated to perform under this Agreement only if Customer allows the C this Agreement, including, but not limited to re -inspection, whether the inspection has be 5. ASSIGNABHdTY. This Agreement is transferable to a new owner of the structures) I transfer fee, adjust the annual renewal rate, and change the terms of the repair and retie continued'coversge within thirty (30) days of the closing of the sale of the structures) or d obligations under this Agreement will immediately and automatically terminate effective a 6. PAYMENT. Unless Customer prepays annually, the Company will invoice Customer o the invoice is due and payable upon receipt. Invoices that are not paid within thirty (30) do to the lesser of 1.5 % per month (18 % per year) or the maximum rate allowed bylaw. If the Company will be entitled to recover from Customer all costs of collection, including reasons 7. MODIFICATION OF STRUCTURE(S). This Agreement covers the treated structures structurally modified, altered or otherwise changed, or before any soil is removed or structure(s), Customer will immediately notify the Company for proper instructions and/or Customer fails to do so, this Agreement will immediately and automatically terminate. In annual renewal rate. 8. CHEMICAL SENSITIVITY OR SPECIAL HEALTH CONDITIONS. If Customer (A) be sensitive to pesticides/tertiticides or their odors or (B) have other health conditio recommends that you not have an initial or a subsequent service performed at your pre Company will provide information about the chemicals to be used in treating the premises. all claims against the Company in connection with such sensitivity or condition. At your re in treating the premises. 9. ARBITRATION. ANY CONTROVERSY OR CLAIM ARISING OUT OF OR RF� BETWEEN THE PARTIES, INCLUDING BUT NOT LIMITED TO ANY TORT INJURY OR PROPERTY DAMAGE, SHALL BE SETTLED BY BINDING ARB ARBITRATION SHALL BE ADMINISTERED UNDER THE COMMERCNI. R OR, IF APPLICABLE, IT SHALL BE DETERMINED UNDER THE AAA PROC EXPRESSLY AGREE THAT THE ARBITRATOR SHALL FOLLOW THE SUBST THIS AGREEMENT, AND THAT ANY ARBITRATION PROCEEDING UNDER WITH ANY ACTION OR LEGAL PROCEEDING UNDER ANY OTHER AGREE PROCEED AS A CLASS ACTION, PRIVATE ATTORNEY GENERAL ACTION THE RIGHT TO REQUIRE A PANEL OF THREE (3) ARBITRATORS, AND THE OF THE ADDITIONAL ARBITRATORS. EITHER PARTY MAY REQUEST AT ACCOMPANIED BY A REASONED OPINION. THE AWARD RENDERED BY T PARTIES, EXCEPT THAT EITHER PARTY MAY WITHIN 30 DAYS OF THE ORI MEMBER APPEAL TRIBUNAL. THE APPEALING PARTY SHALL BE RESPONS THE APPEAL TRIBUNAL SHALL REVIEW ALL QUESTIONS OF LAW AND FA OF THE APPEAL TRIBUNAL SHALL BE FINAL AND BINDING. JUDGMENT JURISDICTION THEREOF. CUSTOMER AND COMPANY ACKNOWLEDGE PURSUANT TO A TRANSACTION INVOLVING INTERSTATE COMMERCE ACT. 10. ENTIRE AGREEMENT AND SEVERABH,ITY. This Agreement; the attach expressly warrants and represents that, in entering this Agreement, Customer is not relying expressly and fully set forth in this Agreement. If any part of this Agreement is held to be of this Agreement will remain in full force and effect. The terms of the Agreement stated h signed by a Corporate Officer of Company. No other employees or agents of Company have that as to the paragraph on ARBITRATION, if the sentence precluding the arbitrator from attorney general action is found to be invalid or unenforceable then the entirety of the ARB adily accessible areas of the structure(s) located at the Service Address. If age, including hidden damage, maybe present. The inspection covered only hat permitted entry during inspection. This inspection did not include areas e inspected are specifically noted. The Company did not inspect areas that etieves that Customer or other occupants of the treated structure are or may ns that may be affected by pesticides/temdticides or their odors, Company it es until you have consulted with your family physician. At your request, y permitting the treatment, Customer assumes the risk and waives any and uest, the Company will provide information about the chemicals to be used LATING TO THIS AGREEMENT OR ANY OTHER AGREEMENT AND STATUTORY CLAIMS, AND ANY CLAIMS FOR PERSONAL RATION. UNLESS THE PARTIES AGREE OTHERWISE, THE S OF THE AMERICAN ARBITRATION ASSOCIATION ("AAA") DUKES FOR CONSUMER -RELATED DISPUTES. THE PARTIES IVE LAW, INCLUDING THE TERMS AND CONDITIONS OF HIS AGREEMENT WILL NOT BE CONSOLIDATED OR JOINED NT OR INVOLVING ANY OTHER PREMISES, AND WELL NOT R SIMILAR REPRESENTATIVE ACTION. EITHER PARTY HAS RI EQUESTING PARTY SHALL BE RESPONSIBLE FOR THE COST TIME PRIOR TO THE HEARING THAT THE AWARD BE HE ARBITRATOR(S) SHALL BE FINAL AND BINDING ON ALL OVAL AWARD REQUEST AN ARBITRAL APPEAL TO A THREE HILE FOR ALL APPELLATE ARBTTRATOR(s) FEES AND COSTS. �'T UNDER A CLEARLY ERRONEOUS STANDARD. THE AWARD MAY BE ENTERED ON THE AWARD IN ANY COURT HAVING ND AGREE THAT THIS ARBITRATION PROVISION IS MADE SHALL BE GOVERNED BY THE FEDERAL ARBITRATION d graph constitute the entire agreement between the parties. Customer o any promise, agreement or statement, whether oral or written, that is not and or unenforceable for any reason, the remaining terms and conditions erelin may not be amended or altered unless a written change is approved and authority to amend or alter any part of this Agreement. Provided, however, m �onducfing an arbitration proceeding as a class, representative or private 1 'RATION paragraph shall be deemed to be deleted from this Agreement. 0 HomeTeam Pest Defense, Inc. 2017 1 09/17 - (53314 5YR) Subterranean Termite Protection Builder's Guarantee This form is completed by the builder. OMB Approval No. 2502-0525 (exp. 09/30/2022) Public reporting burden for this collection of information is estimated to average 5 minutes per res onse, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This nformation is required to obtain benefits. HUD may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number. Sectio 24 CFR 200.926d(b)(3) requires that the sites for HUD insured structures must be free of termite hazards. This information collection requires a licensed Pest Control company to provide the builder a record of specific treatment information in those cases when if any method other than use of pressure treated lumber is used for prevention of subterranean termite infestation. When applicable, form HUD-NPMA-99-B must accompany the form HUD-NPMA-99-A. Builders, pest control companies, mortgage lenders, homebuyers, and HUD as a record of lreatme! tt for specific homes will use the information collected. The information is not considered confidential, therefore no assurance of confidentiality is provided. HUD is committed to protecting tpe privacy of individuals' information stored electronically or in paper form, in accordance with federal privacy laws, guidance, and best practices. HUD expects its third -party business partners, who collect, use, maintain, or disseminate HUD information to protect the privacy of This form is submitted for proposed (new) construction cases when prevention of architect, FHA or VA. This form is to be completed by the builder. This guarantee is issued by the builder to the or remedies that the buyer may have against the builder. FHAIVA Case No.: Location of Structure(s) (Street Address, or Legal Description, City, State and Zip): Buyer's Name: Builder is to check and complete either box 1 or box 2. 1. x❑ Pest Control Company Applied Treatment (See HUD-NPMA 99B for treatment informati termite infestation is specified by the builder or required by the lender, the This guarantee is not to be considered as a waiver of, or in place of, any legal rights The undersigned builder hereby certifies that a State licensed or otherwise authorized pest control company (where required by State law) was contracted to treat the property at the location referenced above to prevent subterranean termites. The builder further certifies that the contract with the pest control company required the treatment materials and methods used to be in conformance with all applicable State anllld Federal requirements. All work required by the contract has been completed unless noted on HUD-NPMA 99B. Where not prohibited by applicable State requirements, the buyer, for an additional fee payable to the pest control company, may extend the protection against subterranean termites. Contact the pest control company I sted on the attachment for further information. The builder hereby guarantees that, if subterranean termite infestation should occur witt otherwise State authorized pest control company will treat as necessary to control infest If permitted by State law, the buyer may contract directly, at the buyer's expense, with a EPA registered products to control any infestation. The builder will not be responsible fo damage by subterranean termites within the one-year builder's warranty period. This guw which affects the original structure or treatment. Examples include, but are not limited tc new subterranean termite hazards, or interfere with the control measures. If within the g claim will be investigated by an unbiased expert mutually agreeable to the buyer and bu the case. The non -prevailing party will pay the cost of any inspections made to investiga regulatory agency. All service must be in compliance with the International Resider Type of Service% ❑ Termite Bait System ❑x Field Applied Wood Treatn 2. ❑ Builder Installed Subterranean Termite Prevention using Pressure Treated Lumber The builder certifies that subterranean termite prevention was installed using pressure to compliance with applicable building codes and HUD requirements specified in FHA pressure treated sills as a sole method of termite prevention is NOT acceptable at Initial of Builder Date Builder's Company Name: Builder's one year from the date of closing, the builder will ensure that a licensed or ons in the structure. This further treatment will be without cost to the buyer. est control company to inspect the property on a periodic basis and use luaranteeing such contracted work. The builder further agrees to repair all antee does not apply to additions or alterations that are made by the buyer, andscape and mulch alterations, which disturb the treated area and create rrantee period the builder questions the validity of a claim by the buyer, the let. The report of the expert will be accepted as the basis for disposition of the claim. For further information, contact your State structural pest control at Code. ❑ Soil Treatment ❑ Installed Physical Barrier System lumber only and certifies that use of the pressure treated lumber is in e Family Housing Policy Handbook 4000.1 (4000.1). Note: Using violates the requirements of the 4000.1. Phone No: 772-905-8394 Date: Consumer Maintenance Advisory regarding Integrated Pest Management for Prevention o Wood Destroying insects. Information regarding prevention of wood destroying insect infestation is helpful to any property owner interested in protecting the structure from inias ation. Any structure can be attacked by wood destroying insects.Pedodic mainte trance should include measures to minimize possibilities of infestation in and around a structure. tentilation, actors which may lead to infestation from wood destroying insects include foam insulation at foundation, earth -wood contact, faulty grade, firewood against structure, insufficient moisture. wood debris in crawl space, wood mulch, tree branches touching structures, landscape timbers, and wood rot. Should these or other such conditions exist, corrective measure should be taken by the owner in order to reduce the chances of infestations by wood destroying insects, and the need for treatment. An original and one copy of this guarantee are to be prepared by the builder and sent to the lender The lender provides one copy to the buyer at closing and includes a copy in the VA loan package or HUD insurance case binder. The builder sends one copy to the licensed pest I ntrol company which performed the treatment. Attached is a copy of the state authorized pest control company's New Construction Subterranean I ermite Service Record, HUD-NPMA-99-13. Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or ?ivil penalties. (18 U.S.C. 1001. 1010, 1012:31 U.S.C. 3729.3802) form HUD-NPMA-99-A (8/2008) New Construction Subterranean Termite OMB Approval No. 2502-0525 Service Record (exp.09/30/2022) This form is completed by the licensed Pest Control Company Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, an completing and reviewing the collection of information. This information its required to obtain benefits. HUD may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number. Section 24 CFR 200.926d(b)(3) requires that the sites for HUD insured structure must be free of termite hazards. This information collection requires the builder to certify that an authorized Pest Control company performed all required treatment for termites, and that the builder guarantees the treated area against infestation for one year. Builders, pest control companies, mortgage lenders, use the information collected. The information is not considered confidential, th0efore, homebuyers, and HUD as a record of treatment for specific homes will no assurance of confidentiality is provided. This report is submitted for informational purposes to the builder on proposed (n w) construction cases when treatment for prevention of subterranean termite infestation is specified by the builder, architect, or required by the lender, archite.1t, FHA, or VA. All contracts for services are between the Pest Control company and builder, unl ss stated otherwise. Section 1: General Information (Pest Control Company Information) Company Name: Home'ream Pest Defense Inc. Company Address 4341 Fortune Place Cit West Melbourne State FL Zip 32904-1532 Company Business License No. JB165929 Company Phone No. 321-409-8489 FHA/VA Case No. (if any) Section 2: Builder Information Company Name Adams Homes South Phone No. 772-905-8394 Section 3: Property Information 5420 Lugo St, Location of Structure (s) Treated (Street Address or Legal Description, City, State and Zip) Fort Pierce, FL, 34951-4457 Section 4: Service Information Date(s) of Service(s) 11/29/2021 Type of Construction (More than one box may be checked) ❑x Slab ❑ Basement ❑ Crawl ❑ Other Check all that apply: ❑ A. Soil Applied Liquid Termiticide Brand Name of Termiticide: EPA Registration No. Approx. Dilution (%): Approx. Total Gallons Mix Applied: Treatment completed on exterior: ❑x Yes ❑ No. Q B. Wood Applied Liquid Termiticide Brand Name of Termiticide: Bora-care EPA Registration No. 64405-1-AA Approx. Dilution (%): .23 Approx. Total Gallons Mix Applied: 2 5 ❑ C. Bait system Installed Name of System EPA Registration No. Number of Stations installed ❑ D. Physical Barrier System Installed Name of System Attach installation informati n (required) Service Agreement Available? x❑ Yes ❑ No Note: Some state laws require service agreements to be issued. This form does not preempt state law. Attachments (List) Comments Name ofApplicator(s) cosmo Flachmeier Certification No. (if required by State law) JE133994 The applicator has used a product in accordance with the product label and state r quirements. All materials and methods used comply with state and federal regulations. Authorized Signature late 04/26/22 Warning: HUD will prosecute false aims and statements. Conviction may result in criminal a 'd/or civil penalties. (18 U.S.C. 1001, 1010. 1012; 31 U.S.C. 3729, 3802) form HUD-NPMA-99-B (08/2008)