Authorization for Anti-Pest Service

Customer Name*

First Last

Service Address*

Street Address City State ZIP Code

Pests Covered in This Agreement: German Roaches, American Roaches, Oriental Roaches, Smokey Brown Roaches Fire Ants inside or within 50 feet of the home, Argentine Ants, Carpenter Ants, Pharaoh Ants, Rover Ants, Scorpions, Non Poisonous Spiders, Ground Beetles, Centipedes, Millipedes, Earwigs, Sow bugs, Pill bugs, Crickets, Norway Rats, Roof Rats and Mice.

Only the pests listed above shall be controlled for the price quoted in this agreement. Other pests can be treated by Anti-Pest for an additional charge. THIS AGREEMENT DOES NOT COVER: Termites or other Wood Destroying Insects, Fleas, Ticks, Fabric Pests, Bedbugs, Pantry Pests, Birds, Wildlife, Lawn/Landscape Pests or any Flying Insects.

Service Subscription Plan: Includes 6 scheduled INTERCEPT services per year (for Every Other Month service) or 4 scheduled services per year (for Quarterly service). Anti-Pest will continue to service on the scheduled service day unless you notify our office that you wish to discontinue service.

On the SCHEDULED SERVICE DAY, the technician will service the outside perimeter of the home and leave a service ticket attached to the door.
Fire Ant mounds within 50’ of the home will be treated at no additional charge.
If a problem with any of the pests covered in this agreement arises between scheduled services, no additional charge will be incurred for a return visit; even if an inside treatment is necessary.

I, the customer, certify I have read and fully understand the terms of this Agreement. I understand any unpaid balance over 90 days may be turned over to an outside Collection Agency, which would incur additional fees at a maximum of 25% of the total balance owed. I understand if I cancel this subscription prior to one year from the start of this agreement, I will be charged a $100 cancellation fee or the remaining balance on the agreement (whichever is less)**

Date*

Customer Authorization

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