1835 Atl Beach Dr Termite HomeTeam
sur ereexsr
New Construction Subterranean Termite Treatment
This repo0 is submitted M iniormabon purposes W me wode r on(rew)oonstmdion cases where treatment Wr prevention of
subtensnean uamnde infestation Is required by Me Floods Budding Code,Section 1 W.2.e.
All Writuicts for ice am between the Pest COMMI Operator d builder, k fated otherwise
Section 1: Hometeam Pest Defense
Compare,Address:6594 Columbia Park Drive Cd,Jacksonville State:FL
Zip: 3225& Compare,Phone No.:904-730.2522 Business License No.: 1MO370M
2409
Section 2: Builder Information
Compare,Name:TON BmMem Inc
Phone No.:
Section 3: Property Information
Building Permit No.:
LocaWn of Strudure(a)Treated:1835 Atlantic Beach Dr Atlanfic
Type of Construction: ®Slab ❑Baseman ❑Creel El alms
Approximate Dep81 of Foobag: Outside: Insdd: Type Fill:
Section 4:Treatment Information
Debate)of Treatment(s):V16/18 EPA RepisVaSon No.:64401
Brent Name of Piodudus)used:BoreCare
Final MV SduWn:23 TreaVrontArea Sq.Ft.:2750
Linear Ft.219 Linear Ft.or Maeooy Voids:_
jyJ@i f Calkins of Tenadsitle Applied: 4
Service Agreement Availadei ®Yes ONo FFI-d.
g has receivedacomplete treatment for be
Liquid treatment ❑Ves ®No dsubtenanedntermitec.Treatment6 in
Liquid Final exteoortresMent ❑Yes ®No with the rules and laws established by Ne
Barak treatment ®Yes ❑No paNnenlot Apoultural and onsumerBasin lau of Pumeat ❑Yes ®No inieel
Note-.Some Stale Wes require service agreements to be issued. This roam mann not preempt State low.
Atladtments(List)
Commen
Name of Applicdor(s):REID SMITHCeMOoaWn NO.: JE252234
Au oorized Sigmdure Sa�Am 1t-)C�A'� Date 0211&18
RNNi&ll5
L.1 F�TRXATMENT
AGREEMBNTPROVIDFS FOR
�) OFA SFRUCNRBHomeTeam THE REPAIR OF DAMAGES
SED BY WOOD DESTROYING
vrsr v111.s1 ANISMS WITHIN THE LIMITS
ED IN THIS AGREEMENT.
Aumunl No.:79B S81"+
SUBTERRANEAN TERMITE REPAIR AGREEMENT
Antilles].GENBRALINFORMATION.
[•Jane; Toll Brolheie/IAC 47 ABCC Billing Adilms: 1835 Atlantic Beach or
Service Add(ess: 1835 Atlantic Beach Or City: Atlantic Beach
City:
Atlantic Beach State: FL Zip Code: 33333-7346
Suite: PL Zip Code:33233-7346 Home Phone: Foo-000-0000
Work Phone:
Mi I.wseE(CTmR Fmmncs.
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Enron ERaAi elan,
I NT�M Ct N[RL:FILL THE CLLRONER.MAY CANCEL THIS TRANSACODE ATANY TIME PRIOR TO M/ONIGNT OF THE THIRD BOSINETS
DAY AFTER THE DATE OF THLSTPANSACiIOH SEE THE ATTACHED NOTICE OF CANCELMIIOV FORAN CTPLINATION OF MaAlGHS.
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9.ARBITEATION.ANY CONTROVERSY OR CLAIM ARISING(IVT OF IIR
BE
TO THIS AGREEMENT UR ANY MHER AGREEMENT
BETWEEN TN6 PARTIPb,INCLVOING BUT XUT LIMITED 111 ANY TORT AND 8(ATUTORY CLAIMS,AND ANV CLAIMS FUP PBILSONAL
MJV0.Y OR pROPERI'V DAMAGE.SHALL BE SETRED gV HINUING All THATION,UNLESS THE PARTIES ACPRH MHERWI38,THE
ARBITGTION SHALL BE ADMINIITERED UNDER
THE
CUM1IMERCNL RVLE$OP TH8 AM80.1GN AD Ron
ASSOCIATION("AM"1
OP,Ip APPLICABLE IT MIALL B8 D8T8RMIXED UNDER TIIE AM PR(KBDUPE$POR CONSUMERiELATED DISPN'P3.THE PARTIES
AND NYLL
E%PRBSSLY AGREE THAT THE ARBRR.IiOR$HALL FOLIUW THE SUWKADWIV8 LAW.INCLUDING THE TERMS AND CONDITIONS OF
TNI6 AGREEMENT,AND THAT ANY ARBITMiIOX PROCEEDING HE VNDHR TN19 AGUS
EMEM WILL NOT B6 CNHOnONSOLIDATED OR JOINED
PROCEQDAN
VoTHYA6 AICLASS ACr1UNED LEGAL PPB VATL ATTORNBYA GENE LA
ACTION O4N11 RB IlTATI11 ACTION.IEITHCR PARTY PAS
FIRE RIGHT TO REQUIRE A PANEL OF THREE(H ARBITRATORS AND THE PEQUE6TMG PARTY SHALL P8 RESPoN6D LE FORTHB CURT
OF THE ADDITIONAL ARBITMMPS EITHER PARTY MAV REQUEST AT ANY TIME PRIOR TO THE NGW NG THAT TN8 AWARD BE
ACCOMPANIED BY A PEA60XED OPINION,THE AWARD RENDERED BV THL A0.BITGT0RI31 SHALL B8 FINAL AND BINDING ON ALL
PAPTIE5.8%CERT THAT EITHER PARTY MAY WITHIN Jn DAYS OF T.EORIGINALAWARDREQU FST AN ARBITRAL AI, ATHREE
MEMDER APPEAL TRIBUNAL.TNEAPPGLINC PAM'
BE 0.ESPoNSIBLE PoP ALLAPPELLATE ARHITRAT PER
--FRE6 AND GUSTS
THE APPEAL TRIBVNALSNALL BEVIEW ALL QUESTIONS OF LAW AND FACT UNDBR A CLEARLY ERRONEOUS 6TANDA0.4 THE AWAIfD
OF THE APPEAL TRIBUNAL SHALL BE FlNAL AND BINDING.TUDGMFNT MAV BE ENTERED ON TN8 AWARD IN ANY COURT HAVING
PV0.5UAMION IN IS MADE
TO A TMPD SACTIO NVULVING INTERSTATECOMMERCECOMMERCE AND SNALLOWLEDGE A AGREETBE GHATOVERNED BYTHIS PATNB FEDEMLTION 6ARDRMTION
ACT, genmto
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AY onto Ill.— on ARBITRATION.111M ssmel;.o ewlodlnP the oNimarfmm^mdnuetge^neLileYlon Peamlingua=Wss,tgenmluuveapnvae
LIwreY 6mme1 Ynm IvfuuMa htmado uulmnfonaIheemirttY orlhe ARBITMTION pragnpX eM1sll Et IkelotdabtdelpM fion Nn Apeunenl.
O xo.wimn onto.—la.wli ID.ODOYVO
OMB Approval No.25i12A525
Subterranean Termite Protection Builder's Guarantee (exp.OSl30120m)
This form is completed by the builder.
Public reporting burden lor this collection of information is estimated to average 5 minutes Per response,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
information is required to obtain benefits.HUD may not wiled this information,and you are not required to complete this form,unless 8 diwlays a
currently valid OMB control number.Section 24 CFR 200.92Bd(b)(3)requires that the sites for HUD insured structures must be free of termite
haeards.This information collection requires a licensed Pool Control company to provide the builder a record of specific treatment information in those
cases when it any method]other than use of pressure treated lumber is used for prevention of subterranean lamas infestation.When applicable,form
HUD-NPMA-99-13 must accompany the form HUD-NPMA-99-A.Builders,pest control companies,mortgage lenders,homebuyers,and HUD as a
record of treatment for specific homes will use the information collected].The information is not considered]confidential,therefore no assurance of
confidentiality is provided.
This form is Submitted for proposed(new)construction cases when prevention of subterranean termite infestation is specified by the builder or required by the
lender,the architect.FHA or VA.
Tax form Is to be complated by the builder.TNs guarantee is issued]by Me builder to Me buyer.This guarantee is not to be considered as a waiver of or in ounce of,
any legal rights a remudles that the buyer may have against the buirder.
FRAIVA Case No
Lmalion of Sbuclure(s)(Sheet Address.or Legal Description,Cly,state and Zip).
1835 Atlantic Beach Dr,Atlantic Beach FL,32233-7346
BuyefS Name'
Builder Is to check and complete either box 1 or box 2.
1. Pest Control Company Applied Treatment(See HUD-NPMA 9913 br treatment information)
The undersigned builder hereby certifies that a Stela licensed or otherwise authonied past control company hanare required by State law)was con0ectad to
treat the propeM at the location referenced above to prevent subtaranean termifoo The builder further combos that the contract we the peat control
company required]the treatment materials and methods used to be in conformance with all applicede State and Federal requirement,All work required by
the contract hes been comptated unless noted]on HUD-NPMA 998.Where not prohibited by applicable state requirements,IM buyer for an adtli4onal fee
Payable to the pest control company,may extend]the protection against subterranean termites.Contact the pest control company listed]on the attachment
for further Information.
The Wilder hereby gueramees that,if subterammn termite infestation should]occur within one year from the date of dosing,the Wilder will ensure Met a
licensed]or otherwise State authorized pest control company will treat as necessary to control infestations in the struclum.This further treatment will he
without cost to the buyer.If permitted by State law,Me buyer may contract directly,at Me buyers expense,with a pest control company to inspect the
property on a periodic basis and use EPA registered]products b control any infestation.The builder will not be responsible for guaranteeing sudh contracted]
work.The builder further agrees to repair all damage by subterranean termites within Me one-year builders warranty pend This guarentea does not apply
to additions or alterations that ere made by the buyer which affects,the original stmcom or treatment Examples include,but are not limited]to,landscape
and much alterations,which disturb the treated area and create new subaraman termite hazards,a intedere with the contra measures.If within the
guarantee period the wilder questions the validity of a claim by the buyer,the claim will be investigated by an unbiased expert mutually agreeable to Me
buyer and builder.The.,it of Me expect will Ixt accepted]as Me basis for diswsltion of the case.The non-proveilirp party will pay Me mit of any
inspections made to investigate Ma claim.For further information,ranted your State structural pest control regulatory agency.All service must be In
compliance with Ne International Residential Code.
typo of Service: ❑ Termite Bail System ® Field Applied Wood Treatment Q Soil Treatment ❑ Installed Physical Better 5 stem
2. ,-f Builder Installed Subterranean Termite Prevention using Pressure Treated Lumber
The builder codifies that subterrsceen tatmits prevention was installed]using pressure treated lumber only and certifies that use of the pressure treated
lumber is In compliance with appliceble building codes ark HUD requirements including Mortgagee Lettar 2001-04.Note:Using pressure treated antis as
a sole method of birm0e prevention is NOT acceptable and violates the requirements of Mortgagee Letter 2001-04.
Initial of Builder Data
Attachments'
guilders Compary Name: TOLL BROTHERS Phare No..
Builders Signature: Date:
Consumer MaiMenence Advisory regarding Integrated Peat Management for Prevention a Wood]Destroying insects.Information regarding prevention of
wood destroying insect Infestation is helpful to any property owner Interested In protecting the structure hon infestalmn.Any structure con be atlecketl by wood
assuming insectoPerbdic mainte nonce should Include measures to minimize pcesilasslas of infestation in and around a structure Factors which may lead to
infestation from wood]destroying insects include from insulann M foundation.ean-wood contact,faulty grade,firewood against structure,InsuMcient ventilation,
moisture.wand debit In Crawl Specs,wand mukh,tree Drenches roudlin9 slmcNres,lentlscepo timbers,and wood rot.Snultl Mese or oth ....h conditions,
Most comedlve measure should be taken by Me owner in order M reduce the chances of mu stelions by won tlesiroying insects,and has need for treatment.
An original ark one copy of this guarantee are to be prepared by the Wilder and sent to the lender.The lender provides one copy M the buyer at dosing and
Includes a copy in the VA ban package or HUD insurance case binder.The builder sends one copy to the licensed]pest control wintery which petfametl Me
treatment.
Atlechatl is a copy of the state authorized]pest control wmeanyS New Construction Subterranean Temhita Service Record.HUD-NPMA-99-13,
Warring:HUD will prosecute[also claims and statements.Conviction may result in Criminal andlor civil penanes.(10 U.S.C.1001.1010,1012:31 U.S.C.3729 3002)
form HUD41PMrlAB-A(fl/2008)
New Construction Subterranean Termite OMB App oval No
(exp.o.2502-0525
05)32-019)
Service Record
This form is completed by fhe licensed Pest Control Company
Public reporfing burden for this wllectmn of m(ormatan is estimated to average 15 minutes per response,inctudng the time for revrewmg
instructions,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information.
This information 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.
Section 24 CFR 200.926d(b)(3)requires that the sites for HUD insured structures must be free of termite hazards.This information collection requires
the builder to certify that an aulhoraed 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,homebuyers,and HUD as a record of treatment for
p if h will thek C II ted Th f C I tl tl fit til thet assuranceofconfdenlial8yisprovided.
This report is submitted for informational puryoses to the boder on proposed(new)wi—ruction rases when treatment for prevention of subterranean
termite infestation is specified by the builder,architect,or required by the tender,architect,FHA,or VA.
All contracts for services are between the Pest Control company,and builder,unless stated otherwise.
Section 1:General Information(Pest Control Company Information)
Company Name HomeTeam Pest Defense Inc.
Company Add." 6694 Columbia Park Drive City Jacksonville Slate FL Zip 32258-2409
Company Business License No. 16/0370000 Company Phone No. 904-730-2522
FHANA Case No.(if any)
Section 2:Builder Information
Company Name Tall Brothers Inc Phone No. 904-217-0739
Section 3:Property Information
Location of Strudum(s)Treated(Street Address or Legal Description,City,State and Zip) 1835 Atlantic Beach Or,Atlantic Beach,
FL,32233-7346
Section 4:Treatment Information
Dates)of Service(s) 2116118
Type of Construction(More than one box may be checked) ®Slob r Basement r Crawl 1]Other
Check all that appy:
F—v A.Soil Applied Liquid Termitk:ide
Brand Name of EPA Registration No.
Termiticide:
Approx.Dilution I%): Approx.Total Gallons Mix Applied: Treatment completed on exterior:Eyes R No
® B.Wood Applied Liquid Termiticide
Brand Name ofEPA Registration
Termiticide:
BoreCare No 64405-1-AA
Approx.Dilution(%): 23 Approx.Total Gallons Mix Applied: 4
C.Bait system Installed
EPA Registration Number of Stations
Name of System: No installed
D.Physical Barrier System Installed
Name of System: Attach installation information(required)
ServiceAgreement Available? ®yea LINO
Note:Some stale laws require service agreements to be issued.This form does not preempt state law.
Attachments(List)
Comments
Name of Applicator(s) REID SMITH Cerification No.(if required by State law) JE252234
The applicator has used a product in accordance with the product label and slate requirements. All materials and methods used comply with state
and federal regulations. ,/} s)
Authorized Signature 4y�`e�'• Dale 02116/18
w.rmme�Ruo car Pm.asmersdsa n.rns eaa sralemems. C.vd.may mina m mmned ansa crvn Walls.oa u.s.c.lwl.mm.1o12;31u.s.c.372a,3902)
form HUD-NPMA-99-B(08-008)