PDF Form
CUSTOMER COPY
TOVAR TERMITE AND PEST CONTROL
SERVICE CONTRACT-INVOICE
1407 Foothill Blvd., Ste #205 • La Verne, CA 91750
- ♦ Fax -
INVOICE NUMBER
TECHNICIAN
DATE OF SERVICE
CUST. NO.
TEL. NO. H.
MAP CODE
W.
CROSS ST
TYPE OF SERVICE
FREQUENCY
PROPERTY TYPE
BILIING NAME AND ADDRES
ROUTE
TIME
BILIING NAME AND ADDRES
DUE AND PAYABLE AT TIME OF SERVICE. PLEASE PAY FROM THIS INVOICE AND RETURN ONE COPY WITH YOUR REMITANCE. TERMS:
ACCOUNTS OVER 30 DAYS LATE WILL BE CHARGED A FEE OF $25.00 EACH MONTH PAST DUE. AND AN INTEREST CHARGE OF 18% PER ANNUM.
A $150.00 FEE WILL CHARGED TO ACCOUNTS WHO DO NOT FUL FILL THEIR CONTRACT AGREEMENT.
SERVICE INSTRUCTIONS:
MATERIAL USED AND LOCATION
q CON
q MFA
q MFR
q PCQ
q ONSL
q SN
q SUS
q TAL
q TRM
q UP
q OTHER
q KITCHEN q BATHROOM q LIVING ROOM
q GARAGE q EAVES
q FOUNDATION q SHED
q COBWEBS q OTHER
COMMENTS
CUSTOMER SIGNATURE _____________________________
CUSTOMER COPY
SERVICE CONTRACT-INVOICE
TOVAR TERMITE AND PEST CONTROL
INVOICE NUMBER
1407 Foothill Blvd., Ste #205 • La Verne, CA 91750
- ♦ Fax -
AFTER
DATE OF SERVICE
CUST. NO.
TEL. NO. H.
MAP CODE
W.
CROSS ST
WKFM,MV.,M.,VC.,MV.,.,M,.M,.M,.MVCBCVBMM,.,CV.,MB562
EXP. DAT
WE APPRECIATE YOUR BUSINESS
PLEASE PAY FROM THIS INVOICE FOR VISA q
MASTERCARD q
OR DISCOVER CAR q
REFLECTED IN BALANCE
NOT
PREVIOUS
BALANCE
q CASH q CHECK#____________
WE
PAYMENTS RECEIVED
PAYMENTS q
CURRENT
SERVICE
ADDED
CHARGE
WE HAVE SERVICED YOUR PROPERTY TODAY IN ACCORDANCE WITH OUR PEST CONTROL AGREEMENT. OUR COMMITMENT IS TO PROVIDE THE BEST PEST CONTROL SERVICE
AVAILABLE. PLEASE CALL US CONCERNING ANY QUESTIONS REGARDING YOUR SERVICE. THIS CONTRACT AGREEMENT IS FOR A PERIO OF 1 YEAR UNLESS OTHERWISE
AGREED UPON IN WRITING. BAKERSFIELD PEST CONTROL RESERVES THE RIGHT TO CANCEL THIS AGREEMENT WITHOUT REASON OR PRIOR NOTICE.
AMOUNT
RECEIVED
TOTALDUE
CUSTOMER SIGNATURE _____________________________
RETURN SLIP
TOVAR TERMITE AND PEST CONTROL
SERVICE CONTRACT-INVOICE
1407 Foothill Blvd., Ste #205 • La Verne, CA 91750
- ♦ Fax -
INVOICE NUMBER
TECHNICIAN
DATE OF SERVICE
CUST. NO.
TEL. NO. H.
MAP CODE
W.
CROSS ST
TYPE OF SERVICE
FREQUENCY
BILIING NAME AND ADDRES
SERVICE INSTRUCTIONS:
PROPERTY TYPE
ROUTE
TIME
BILIING NAME AND ADDRES
DUE AND PAYABLE AT TIME OF SERVICE. PLEASE PAY FROM THIS INVOICE AND RETURN ONE COPY WITH YOUR REMITANCE. TERMS:
ACCOUNTS OVER 30 DAYS LATE WILL BE CHARGED A FEE OF $25.00 EACH MONTH PAST DUE. AND AN INTEREST CHARGE OF 18% PER ANNUM.
A $150.00 FEE WILL CHARGED TO ACCOUNTS WHO DO NOT FUL FILL THEIR CONTRACT AGREEMENT.
MATERIAL USED AND LOCATION
q CON
q MFA
q MFR
q PCQ
q ONSL
q SN
q SUS
q TAL
q TRM
q UP
q OTHER
q KITCHEN q BATHROOM q LIVING ROOM
q GARAGE q EAVES
q FOUNDATION q SHED
q COBWEBS q OTHER
COMMENTS
CUSTOMER SIGNATURE _____________________________
**If within 24 hours following application, you experience symptoms similar
to common seasonal illness comparable to the flu: Contact your physician
or poison control center and your pest control operator immediately.
“State law requires that you be given the following information:
CAUTION-PESTICIDES ARE TOXIC CHEMICALS. Structural Pest
Control Companies are registered and regulated by the Structural Pest
Control Board, and apply pesticides which are registered and approved
for use by the California Department of Pesticide Regulation and the
U.S. Environmental Protection Agency. Registration is granted when
the state finds that based on existing scientific evidence, there are
no appreciable risks if proper use conditions are followed or that risks
are outweighed by the benefits. The degree of risk depends upon the
degree of exposure, so exposure should be minimized.
Bromadiolone
3-Y3-(4 Bromo)(1, 1-B1-Phenyl-4-Y1)-hydroxy-1-{Phenylprool-4
Delta Dust
(Deltamethrin)
Drione Dust 1%
(Pyrethrins)
Max Force Bail Gel
(Fipronil)
Suspend SC
(Deltamethrin)
Avitrol
(Amino Pyridine)
Talstar
(Bifenthrin)
Termidor Sc
(Fiprinol)
Cy-Kick
(Cyfiuthrim)
Cirkil
Cold Pressed Neem Oil
Onlsaught
(S)-Cyano(3-Phenoxyphenyl)methy-(s)-4chloro-alpha(1-methlethy) Benzene-Acetate)
ULD BP-100
Pyrenthrins, Piperonyl butoxide, Technical
Up-Cyde Pro 2.0 E.C. Cypermethrin
Demon Max
Cypermethrin Technicial
Phantom
Chlorfenapyr:4-bromo-2(4-chlorophenyl)-1-(ethoxymethyl)
-5-(trifluuromethyl)-1H-pyrrole-3 carbonitrile
NyGuard IGR
Pyriproxyfen (Nylar) [2-1(1-Methyl-2-(4-phenoxyphenoxy)
ethoxy] pyridine
Zoecon Gentrol IGR Isoprenoid (S)-Hydroprene:
(Ethy1(2E,4E,7S)-3,7,11-trimethyl-2,4-dodecadienoate
Fumitoxin Tablets
Aluminum Phosphide EPA Registration No. 72959-1
Fumitoxin Pellets
Aluminum Phosphide EPA Registration No. 72959-2
Vendetta Bait Gel
Abamectin
Suspend Polyzone
(Deltamethrin)
Strychnine Alkaloid
Strychnine Alkaloid EPA Registration No-
P.C.Q. Rodentcide-CA Diphacinone
We will use the following pesticides:
Dear Customer,
Thank you for selecting A Tovar Pest Control to perform your pesticide
application requirements. In accordance with the laws and regulations
of the State of California, we we are required to provide you with the
following information prior to application of chemicals to your property.
Please take a few moments to read and become familiar with the
content.
**If within 24 hours following application, you experience symptoms similar
to common seasonal illness comparable to the flu: Contact your physician
or poison control center and your pest control operator immediately.
“State law requires that you be given the following information:
CAUTION-PESTICIDES ARE TOXIC CHEMICALS. Structural Pest
Control Companies are registered and regulated by the Structural Pest
Control Board, and apply pesticides which are registered and approved
for use by the California Department of Pesticide Regulation and the
U.S. Environmental Protection Agency. Registration is granted when
the state finds that based on existing scientific evidence, there are
no appreciable risks if proper use conditions are followed or that risks
are outweighed by the benefits. The degree of risk depends upon the
degree of exposure, so exposure should be minimized.
Bromadiolone
3-Y3-(4 Bromo)(1, 1-B1-Phenyl-4-Y1)-hydroxy-1-{Phenylprool-4
Delta Dust
(Deltamethrin)
Drione Dust 1%
(Pyrethrins)
Max Force Bail Gel
(Fipronil)
Suspend SC
(Deltamethrin)
Avitrol
(Amino Pyridine)
Talstar
(Bifenthrin)
Termidor Sc
(Fiprinol)
Cy-Kick
(Cyfiuthrim)
Cirkil
Cold Pressed Neem Oil
Onlsaught
(S)-Cyano(3-Phenoxyphenyl)methy-(s)-4chloro-alpha(1-methlethy) Benzene-Acetate)
ULD BP-100
Pyrenthrins, Piperonyl butoxide, Technical
Up-Cyde Pro 2.0 E.C. Cypermethrin
Demon Max
Cypermethrin Technicial
Phantom
Chlorfenapyr:4-bromo-2(4-chlorophenyl)-1-(ethoxymethyl)
-5-(trifluuromethyl)-1H-pyrrole-3 carbonitrile
NyGuard IGR
Pyriproxyfen (Nylar) [2-1(1-Methyl-2-(4-phenoxyphenoxy)
ethoxy] pyridine
Zoecon Gentrol IGR Isoprenoid (S)-Hydroprene:
(Ethy1(2E,4E,7S)-3,7,11-trimethyl-2,4-dodecadienoate
Fumitoxin Tablets
Aluminum Phosphide EPA Registration No. 72959-1
Fumitoxin Pellets
Aluminum Phosphide EPA Registration No. 72959-2
Vendetta Bait Gel
Abamectin
Suspend Polyzone
(Deltamethrin)
Strychnine Alkaloid
Strychnine Alkaloid EPA Registration No-
P.C.Q. Rodentcide-CA Diphacinone
We will use the following pesticides:
Dear Customer,
Thank you for selecting A Tovar Pest Control to perform your pesticide
application requirements. In accordance with the laws and regulations
of the State of California, we we are required to provide you with the
following information prior to application of chemicals to your property.
Please take a few moments to read and become familiar with the
content.
County Health Department (Health Questions)
Los Angeles - - - - - - - - - - - - - - -
San Bernardino - - - - - - - - - - - - -
Riverside County - - - - - - - - - - - -
Orange - - - - - - - - - - - - - - - - -
A Tovar Pest Control - - - - - - - - - - - -
Poison Control - - - - - - - - - - - - - -
County Agriculture Commission (Applicator Information)
Los Angeles - - - - - - - - - - - - - - -
San Bernardino - - - - - - - - - - - - -
Orange - - - - - - - - - - - - - - - - -
Riverside - - - - - - - - - - - - - - - -
County Health Department (Health Questions)
Los Angeles - - - - - - - - - - - - - - -
San Bernardino - - - - - - - - - - - - -
Riverside County - - - - - - - - - - - -
Orange - - - - - - - - - - - - - - - - -
A Tovar Pest Control - - - - - - - - - - - -
Poison Control - - - - - - - - - - - - - -
For further information contact any of the following:
County Agriculture Commission (Applicator Information)
Los Angeles - - - - - - - - - - - - - - -
San Bernardino - - - - - - - - - - - - -
Orange - - - - - - - - - - - - - - - - -
Riverside - - - - - - - - - - - - - - - -
Structural Pest Control Board - - - - - - - Evergreen Stree, Suite 1500 - - - - - -
Sacramento, CA-
For further information contact any of the following:
Structural Pest Control Board - - - - - - - Evergreen Stree, Suite 1500 - - - - - -
Sacramento, CA-