Representative:___________________________________________________________
THERMAL REMEDIATION BED BUG SERVICE AGREEMENT
BILLING INFORMATION
SERVICE ADDRESS
Client Name______________________________________Name_________________________________________________
Contact__________________________________________Contact_______________________________________________
Billing Address____________________________________ Service Address________________________________________
City_____________________ST:_________Zip__________City_____________________ST:____________Zip____________
Primary Phone #__________________________________ Secondary Phone #______________________________________
Client Email Address:_____________________________________________________________________________________
SITE DESCRIPTION (check one) Apartment_______ Hotel Room_______ Single Family Home_______ Other_____________
SPECIFIC AREA(S) TO BE TREATED: (Unit #, Room #, Number of bedrooms, special areas to be treated, etc)
_____________________________________________________________________________________________________________________________
CONDITIONS:
Is there anyone at this service location who is allergic or sensitive to pesticides?
YES____
NO____
Initials______________
Is there anyone at this service location who is asthmatic or has respiratory ailments? YES____
NO____
Initials______________
I have received the Thermal Remediation Pre-Treatment Checklist
NO____
Initials______________
YES____
SERVICE AGREEMENT:
This Service Agreement for the treatment of Bed Bugs, entered into by and between the Client named above and Rose Pest Solutions, provides for the treatment and control of
Bed Bugs (Cimex Lectularius Linnaeus) by Rose Pest Solutions as defined and under the terms set forth below. This Agreement does not provide protection against any other
pests, including household pests, etc. The Client agrees that Rose Pest Solutions is not responsible for any injury, disease or illness caused, or allegedly caused, by bites or
contamination of or due to Bed Bugs or any other insects.
CLIENT PREPARATION REQUIREMENTS:
The Client must ensure that the area(s) to be treated are prepared for service in accordance with the THERMAL REMEDIATION PRE-TREATMENT CHECKLIST given to the
Client at the time this Agreement is executed. By signing this agreement, the Client acknowledges receipt of the checklist and agrees to ensure compliance with the requirements
on the checklist prior to Rose Pest Solutions arrival. The Client must provide the signed copy of the checklist to Rose Pest Solutions either prior to the scheduled treatment
appointment or at the time of the appointment.
In the event that the Client fails to provide the signed checklist or Rose Pest Solutions discovers that the items on the checklist have not been completed, no service will be
rendered and a $125.00 trip charge will be assessed to the Client.
24 HOUR NOTICE OF CANCELLATION – Client may cancel or reschedule treatment 24 hours prior to treatment date without penalty. Cancellation or rescheduling
treatment on day of scheduled service will result in a cancellation/rescheduling fee of $125.00.
SCOPE OF SERVICE:
This Bed Bug treatment will be applied only to those areas specified above, and will be completed using Rose Pest Solutions HEAT TREATMENT methods, including thermal
remediation, a chemical application, or a combination of both. This service will also include the use of various Bed Bug Detection monitors. It is recommended that after treatment
is completed the Client purchase Bed Bug Proof mattress encasements which are available for purchase through Rose Pest Solutions or through local vendors.
SERVICE FEE:
The price for the work as described above is as follows: (Price guaranteed for 30 days from proposal date)
Thermal Remediation DATE SCHEDULED______________________________
1st Follow up inspection DATE SCHEDULED______________________________
2nd Follow up Inspection DATE SCHEDULED______________________________
Price $__________ ______
Price $
125.00
Price $
125.00
Encasements
King Mat_____ Queen Mat_____ Queen Box_____ Full Mat_____ Full Box_____ Twin Mat_____ Twin Box_____ Crib_____
($65.00 ea)
($55.00 ea)
($45.00 ea) ($45.00 ea) ($40.00 ea)
($35.00 ea)
($30.00 ea) ($30.00 ea) Price $ _________________
Total Treatment Price
Less Deposit (Minimum 25%)
Total due on date of completion
$__________________
-$__________________
$__________________
By signing this Agreement, I, the Client, certify that I have read and fully understand the provisions on all pages of this agreement (specifically
including the additional provisions contained on page 2) with all its terms and conditions without limitation, and it being specifically understood
that Rose Pest Solutions, and the undersigned are bound only by the terms and conditions of this Agreement and not by any other representations
oral or otherwise.
Authorized Signature:___________________________________________________________ Date:_________________
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ADDITIONAL PROVISIONS:
1.
2.
3.
4.
5.
6.
7.
CHANGE IN LAW: This Agreement shall be interpreted, regulated and adjudicated in accordance with applicable federal, state and
local laws and regulations as they exist at the time this Agreement is executed. Should any federal, state or local law or regulation be
changed regarding Rose Pest Solutions services or treatment, Rose Pest Solutions may take whatever steps are necessary to
comply with such laws.
LIMITATION OF LIABILITY: Limits of Liability to the fullest extent permitted by law, Rose Pest Solutions will not be liable for personal
injury, death, property damage, loss of use, loss of income or any other damages whatsoever, including consequential and incidental
damages, arising from the service agreement or otherwise. Rose Pest Solutions specifically disclaims any warranty, express or
implied of merchantability or of fitness for a particular purpose or otherwise. Rose Pest Solutions will not be liable for any
consequential, incidental, indirect, exemplary, punitive, special damages, including without limitation any lost profits or labor costs and
will not be liable for non-economic damages, diminution of goodwill or loss to reputation arising from the performance of this
agreement, from any breach of this agreement, or from any other cause whatsoever. The exclusive remedy of the buyer for any and
all losses, injuries or damages whether in contract, warranty, tort, negligence, strict liability or otherwise shall not exceed the purchase
price paid or at Rose Pest Solutions election the labor and products necessary to help reduce Bed Bug population. The limitations set
forth in this Agreement regarding Rose Pest Solutions liability shall be valid and enforceable notwithstanding a failure of essential
purpose of the limited remedies specified above. By way of example, and not limitation, Rose Pest Solutions will not be liable for
injury, illness, or damage (1) resulting from moisture conditions, including but not limited to fungus or mold, whether visible or not, (2)
resulting from any wood destroying organisms, (3) relating to the replacement of linen, upholstery, furniture, mattresses, the soiling of
those items or any related costs, (4) relating to medical evaluation or treatment for bites associated with Bed Bugs, (5) relating to an
infestation of Bed Bugs or otherwise, (6) relating to persons, property, birds, animals, or vegetation, (7) relating to bites, stings or
contamination of or due to Bed Bugs or other insects, spiders, rodents or beetles. No agents of Rose Pest Solutions are authorized to
make any warranties beyond those contained herein or to modify the warranties contained herein. Except as to those limitations of
liability, no persons other than the contracting party shall be deemed to be third party beneficiaries of this agreement. Note that some
jurisdictions may not allow exclusions of implied warranty so some of the exclusions may not apply to you.
NONPAYMENT: The Client will pay Rose Pest Solutions all invoices upon receipt. Rose Pest Solutions may terminate this Agreement
if payment is not received within thirty (30) days of the date of invoice. In the event legal action is necessary to collect any amount
due, Rose Pet Solutions shall be entitled to receive from Client all reasonable costs of collection, including reasonable attorney’s fees
and expenses, in addition to any outstanding amount due Rose Pest Solutions. In addition, interest at the rate of 1.5% per month,
being 18% annually or the highest rate allowed by applicable law will be assessed on any past due amounts owed by Client until paid.
This Agreement and any extension of its term will be effective only upon payment of the charges as provided herein.
TERMINATION: Rose Pest Solutions’ liability under this Agreement will terminate and Rose Pest Solutions will be excused from the performance of
any obligations under this Agreement, including any and all guarantees of its service, should 1) Client allows another pest control operator and/or
person to treat the subject structure(s) during the term hereof, 2) Client utilizes any home remedy products, do it yourself products, over the counter
products or, any chemicals to eradicate Bed Bugs, Termites, Insects, Spiders, Beetles or Rodents that could cause a negative resolution or chemical
reaction, or 3) Rose Pest Solutions be prevented or delayed from fulfilling its responsibilities under the terms of this Agreement by reasons or
circumstances reasonably beyond Rose Pest Solutions’ control, including but not limited to acts of war, whether declared or undeclared, acts of any
duly constituted government authority, strikes, acts of god, or refusal of Client to allow Rose Pest Solutions access to the structure(s) for the purpose
of treatment or carrying out he terms and conditions of this Agreement.
NOTICE OF CLAIMS, ACCESS TO PROPERTY: Any claim under the terms of the agreement must be made immediately in writing to Rose Pest
Solutions. Rose Pest Solutions is only obligated to perform the services under this agreement if the Client allows Rose Pest Solutions access to the
identified structure(s) for the purpose contemplated by the agreement, including but not limited to re-inspection, whether the inspection was
requested or considered necessary by the Client or required by the agreement and requested or considered necessary by Rose Pest Solutions.
CHEMICAL SENSITIVITY: If Client or other occupants of the structure(s) or adjacent buildings believe they are or may be sensitive to pesticides or
their odors or if Client or other occupants have consulted with a medical doctor, or other healthcare provider regarding such sensitivity, Client must
notify Rose Pest Solutions in writing in advance of treatment of the structure(s), Rose Pest Solutions reserves the right, upon receipt of such
notification to deny or terminate service. Failure to provide such notification represents Client’s assumption of risk and waiver of any claims against
Rose Pest Solutions in connection with such sensitivity.
THERMAL REMEDIATION: The Client is hereby advised that thermal remediation techniques used by Rose Pest Solutions will reach
temperatures in excess of 120F.
ARBITRATION: In the event a dispute shall arise between the parties to this Agreement, it is hereby agreed that the dispute shall be
referred to arbitration and that the arbitrator's decision shall be final and legally binding and judgment may be entered thereon.
9. ENTIRE AGREEMENT: This Agreement, together with any attachment(s), if any, signed by Rose Pet Solutions and the Client
constitutes the entire Agreement between the parties and no other representation or statements whether oral or written will be binding
upon the parties.
10. WARRANTY: Due to the many ways in which Bed Bugs can be re-introduced into a treated area, Rose Pest Solutions does not
guarantee that the treated areas will not be re-infested following treatment. However, Rose Pest Solutions warranties that the service
described above will be done in a careful and workmanlike manner. If live Bed Bugs are noticed in the treated area(s) during any of
the follow up inspections or within the 30 day period after the initial treatment, a follow-up treatment will be scheduled and completed
using the most effective remediation method(s) at no additional cost to the Client. Continuing discoveries of active Bed Bugs in a
treated area does not mean failure of the treatment, and is usually the result of re-introduction of Bed Bugs from a source outside the
treated areas, such as used furniture and clothing, or the wiring and piping in the premises. Accordingly, Rose Pest Solutions’
warranty is specifically limited to the 30 day period following treatment with payment in full. In the event that the Client does not allow
for any of the mandatory follow up inspections to be completed on the date in which they are scheduled, any and all warranties will be
null and void.
8.
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Thermal Remediation Pre-Treatment Checklist
Rose Pest Solutions has completed an inspection of your home and has found that bed bugs are present or there is evidence of activity. Our service
Technician needs your full cooperation in order to control these pests. For a successful bed bug treatment, you must follow and complete the tasks set forth
below, and initial next to each item to affirm that the task has been completed. A completed and signed checklist must be provided to Rose’s Technician prior
to treatment. In the event that the Client fails to provide the sign checklist or Rose’s Technician discovers that the items on the checklist have not been
completed, no service will be rendered and a $125.00 trip charge will be assessed to the Client.
Client Name:________________________________________________________________________
Address:____________________________________________________________________________
Scheduled Treatment Date:_____________________________________________________________
CHECKLIST
_________All infested materials have been left in place in the areas specified in the Bed Bug Remediation Agreement. Except for
items specifically set forth below, Client affirms the he/she DID NOT remove infested materials from the infested areas
and has left everything in place.
__________ All pets such as cats, dogs, fish, etc, have been removed from the premises. Client affirms that everyone will leave the
premises for the entire day.
__________ All items that the Client, and any individual residing in the premises, plans on wearing or taking with him/her such as
purses, handbags, backpacks, shoes, briefcases, etc have been inspected and determined to be bed bug free.
__________ All electronic equipment (TV’s, computers, radios, clocks) have been unplugged from wall outlets.
__________ Heating/Air Conditioning systems have been turned off.
__________ All densely packed clothing has been removed and placed loosely in open-weave laundry baskets.
__________ All loose papers and plastic trash bags that would be blown about by a stiff wind have been gathered and placed in boxes.
__________ All valuable articles on shelves that might be damaged if someone brushes against them have been removed.
__________ To the extent that any waterbeds or air beds (Select Comfort) are present in the premises, they have been drained or
deflated.
__________ A path approximately the width of a door has been cleared for the movement of large equipment.
__________ All items that could hamper movement of heating equipment and treatment have been removed, reducing the amount of
“clutter” in the treatment area.
__________ Each of the following items have been placed in containers/boxes and left by the door for inspection by the Technician.
o
o
o
o
o
o
o
o
o
Compressed gases, flammable or combustible chemicals including gasoline, propane, butane, cigarette lighters,
lighter fluid/fuel, gun powder, black powder, ammunition, lamp fuel, oxygen tanks, fire extinguishers, etc.
All aerosols and pressurized cans including hairspray, spray-on deodorants, bug sprays, spray paints, asthma inhalers, any aerosol containers.
All foodstuffs including any candy that melts. These items may be placed in the refrigerator.
All medicines. These may be placed in the refrigerator.
All wax figurines, candles, fruit, etc or oil paintings or items you are unsure of that may be affected by the treatment.
All musical instruments that could be damaged by heat, such as guitars, drums, woodwinds, piano’s etc.
All indoor plants including seeds and bulbs. Fresh fruits and vegetables may be kept in the refrigerator.
Carbonated beverages or drinks under pressure such as 2 liter colas, wine bottles, canned soda and/or beer, etc
these items may be left in the refrigerator.
Any items of value that might be damaged by temperatures ranging between 120F – 150F. After treatment you will
notice clothing, mattress, blankets, sofa cushions, etc. are not the way you left them. We must move these items to
get even heat distribution.
Resident Name/Signature________________________________________
Date_________________
Rose Technician _______________________________________________
Date_________________
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