Name

First Last

Email*

Phone

Address

Street Address Address Line 2 City State ZIP Code

Square footage*

A1. Initial Charge

Price: $199.00

This is the cost of the first visit.

A2. Initial Charge

Price: $99.00

This is the cost of the first visit.

A3. Initial Charge

Price: $99.00

This is the cost of the first visit.

B1. Initial Charge

Price: $199.00

This is the cost of the first visit.

B2. Initial Charge

Price: $99.00

This is the cost of the first visit.

B3. Initial Charge

Price: $99.00

This is the cost of the first visit.

C1. Initial Charge

Price: $199.00

This is the cost of the first visit.

C2. Initial Charge

Price: $99.00

This is the cost of the first visit.

C3. Initial Charge

Price: $99.00

This is the cost of the first visit.

Get $100 off your Initial treatment when you sign up for a 1 year agreement. Your first Monthly, Bi-Monthly or Quarterly treatment will be scheduled 30-40 days after your Initial treatment.

Yes! Let's Do It!
No, not right now.

Would you like an additional $6 off your regular service by putting a credit card on file for payment?

Yes
No

A1. Regular Service Charge*

Monthly: $50.00
Bi-Monthly: $80.00
Quarterly: $105.00

A10. Service Charge*

12 Monthly Treatments/Year $44.00
6 Bi-Monthly Treatments/Year $74.00
4 Quarterly Treatments/Year $99.00

B1. Service Charge*

Monthly: $56.00
Bi-Monthly: $83.00
Quarterly: $110.00

B10. Service Charge*

12 Monthly Treatments/Year $50.00
6 Bi-Monthly Treatments/Year $77.00
4 Quarterly Treatments/Year $104.00

C1. Service Charge*

Monthly: $62.00
Bi-Monthly: $89.00
Quarterly: $120.00

C10. Service Charge*

12 Monthly Treatments/Year $56.00
6 Bi-Monthly Treatments/Year $83.00
4 Quarterly Treatments/Year $114.00

Total Quote For First Visit

$0.00

D1. Initial Charge

Contact Us for A Quote

Total Quote For First Visit

Contact Us for A Quote

D1. Initial Charge

Total Quote For First Visit

Preferred Service Date

Preferred Service Time

Additional Notes

Agreement:

This service agreement shall be continued for a minimum of 12 months. After the initial one-year period, service will continue until canceled with a 30 day written notice. Stampede Pest Control will provide continuous service under the terms and conditions indicated in the agreement. This service does not include control and or prevention of wood destroying pests such as termites, or any other wood destroying organisms. Stampede Pest Control shall not be held liable for any claim for personal loss, property loss, or structural damage. Virtually all pesticides have some odor that may be present for a short time after application. If you or any member of your household is sensitive to chemical odor of chemicals, Stampede Pest Control recommends you to consult your family physician prior to treatment. A finance fee of 1% per month (12% per year) will be charged on past due accounts (45 days after service date) and a service fee of $25.00 on all returned checks.

The first service performed on a home under 2000 square feet has a minimum cost of $199.00. An initial treatment costing less than $199.00 is based on a minimum (12) twelve-month service agreement. If service is canceled prior to fulfilling the (12) twelve-month agreement the customer agrees to pay the difference between $199.00 and the discounted initial price.

Stampede Pest Control will service the interior and the exterior of the home during the initial treatment. Stampede Pest Control will service the exterior of the home for all future treatments, however, the interior and the exterior of the home are always under warranty. If the customer would like the inside or the outside treated, once notified, STAMPEDE PEST CONTROL will treat the interior and the exterior of the home at no extra charge to the customer.

1. I am entitled to an exact copy of this service agreement

2. I may cancel this transaction at any time prior to midnight of the third business day after the date of the signing of this agreement.

3. It is important that I thoroughly read this agreement before I sign it, and I will keep my copy to protect all of my legal rights.

I Acknowledge receipt of a signed copy of this agreement, together with an oral explanation of my right to cancel this sale.

Accept*

I Accept the Terms of Agreement

Signature*

Name

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