1738 ATLANTIC BEACH DR - FINAL TERMITE p7 ITIS AGREEMENT PROVIDES FOR
RETREATMENT OF A STRUCTURE
HomeTeam AND THE REPAIR OF DAMAGES
PEST 0 E r E n s E CAUSED BY WOOD DESTROYING
ORGANISMS WITHIN THE LIMITS
STATED IN THIS AGREEMENT.
Account No.:2 8 5313 4
SUBTERRANEAN TERMITE REPAIR AGREEMENT
Section I.GENERAL INFORMATION.
Name: Toll Brothers/Lot 75 ABCC Billing Address: 1738 Atlantic Beach Drive
Service Address: 1738 Atlantic Beach Drive City: Atlantic Beach
City: Atlantic Beach State: FL Zip Code: 32233
State: FL Zip Code: 32233 Home Phone: 904-000-0000
Work Phone:
Section II.INSPECTION FINDINGS.
The condition of the readily accessible areas of the structure(s)located at the Service Address on the date of the Inspection only is listed below:
a. el No Visible evidence of previous or current subterranean termite infestation was observed.
b. 0 Visible evidence of a subterranean termite infestation was observed as follows:
0 Live subterranean termites(description and location indicated on the attached graph)
Cl Termite parts,exit holes or shelter tubes(description and location indicated on the attached graph)
❑Damage from subterranean termites was noted in the following area(s):
Any damage noted above should be considered only as evidence acumen'or previous infestation of subterranean termites.If any of the boxes in subsection
b.above are checked,some degree of damage,including hidden damage,may be present.The inspector's training and experience do not qualify the
inspector in damage evaluation or any other building constmction technology and/or repair.Any visible evidence observed above appears:
0 Active; 0 Inactive; U Activity cannot be determined without further investigation.Reason:
In many cases,based upon visible signs of infestation by subterranean termites,it is not possible to ascertain whether an infestation is active or inactive
without benefit of subsequent inspections and evaluations over a period of time.
0 It appears that the structure(s)or a portion of the structure(s)may have been previously treated.Evidence of previous treatment:
Section III.OBSTRUCTIONS AND INACCESSIBLE AREAS.
The following areas of the structure(s)inspected were obstructed or inaccessible(see Section VII.f under General Terms and Conditions):
U Basement U Exterior U Crawl Space 0 Porch 0 Main Level U Addition U Attic 0 Garage 0 Other
Continents: _
Section IV.ADDITIONAL COMMENTS.
Section V.TYPE OF TREATMENT.
0 Post Construction Corrective Treatment (See reverse side for a description of the Company'sobligation to retreat
and to repair damage caused by subterranean termines.)
0 Post Construction Preventative Treatment
Location of Treatment Sticker:_
Pre-Construction Treatment
❑Other.
Treatment is provided against the attack of subterranean termites(Reticulitermes spp.,Heteroternes spp.and Coptotermes spp.(Formosan)),but does not protect
against any other pests,plant,animal or organism other than subterranean termites.During the term of this Agreement,HomeTeam Pest Defense,Inc.(the"Company")
will re-inspect the treated structure(s)annually or at more frequent intervals as the Company deems necessary upon Customer's request,subject to the General Terms
and Conditions on the reverse side.Customer agrees to make the treated structure(s)available for re-inspection.The Company will retreat the treated structure(s)only
upon(a)visual evidence of a live termite infestation or(b)disturbance of the soil surrounding the treated structure(s).The Company has not inspected or treated the
structure(s)for health-related molds or fungi.By law,the Company is not qualified,authorized or licensed to inspect for health-related molds or fungi.
Actual Treatment Dale: 07/23/2018 PAYMENT METHOD:
Initial Treatment Date: 07/23/2018
Down Payment: f 0.00 0 Cash 0 Check U Credit Card
Balance Due: f 0.00
Annual Renewal: # 300-00 If paying by credit card or recurring debit from your bank account,please
complete the attached Authorization for Pre-Arranged Payments.
This Agreetnent contains certain limitations,conditions and exclusions on the Company's obligations.Please read the entire Agreement before signing.
In consideration for the Company performing the services specified above and subject to the terms and conditions of this Agreement,Customer agrees to make the
payments indicated above.Customer acknowledges receipt of a signed copy of this Agreement.This Agreement is not binding on the Company until signed by an
authorized manager or executive officer of the Company.
CUSTOMER: HOMETEAM PEST DEFENSE,INC.
Signature: Signature: ,4$f#/EVS'TEE7LEV
Printed Name: Printed Name: agxr.RV CTRRfit.RV
Email: Effective Date: 07/23/2018
RIGHT TO CANCEL:YOU,THE CUSTOMER,MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS
DAY AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FOR AN EXPLANATION OF THIS RIGHT.
0 tlomeTam Pest Defense.Inc.2012 2112•(53314 SYR)
PDF processed with CutePDF evaluation edition www.CutePDF.com
Section VI.OBLIGATIONS.
A.The Customer agrees to be solely responsible for maintaining the Treated Premises free from any condition conducive to termite infestation("Conditions
Conducive,"see below for explanation).The Customer agrees to be solely responsible for identifying and correcting Conditions Conducive.The responsibility rests
exclusively with the Customer,not with the Company.Failure of the Company to alert Customer to any of the above conditions does not alter Customer's responsibility
under this Section.In addition,the existence of any Conditions Conducive that was not timely corrected,including any Conditions Conducive existing but not visible at
the time of the execution of this Agreement,will permit the Company,at its sole discretion,to terminate the Agreement or to require Customer to purchase any
additional treatment required as a result of the Conditions Conducive.Customer agrees to fully cooperate with the Company during the term of this Agreement,and
agrees to maintain the area(s)baited free from such Conditions Conducive.Other specific items may be noted below in"Additional Comments"(Section XV).
CONDITIONS CONDUCIVE:Conditions Conducive include,but are not limited to,roof leaks,improper ventilation,faulty plumbing,and water leaks or intrusion in
or around the structure;inherent structural problems,including,but not limited to,wood to ground contact,masonry failures,and settlement of the foundation,foam
insulation,stucco construction,expanded polystyrene or styrofoam molded foundation systems,siding(including vinyl,wood and metal)if within 6 inches of the
ground;mulch or other protective ground covering;and firewood,trash,lumber,wood,mulch,shrubs,vines,and other protective ground covering if within 6 inches of
contact with structure.
B.ADDITIONS,ALTERATIONS,AND OTHER CHANGES.This Agreement covers the Structure(s)identified in Section I as of the date of the initial installation.
Customer will immediately notify the Company in writing(I)prior to the Structure(s)being structurally modified,altered or otherwise changed,(2)prior to any
termiticide being applied on or close to the location of any Station,(3)if soil is removed or added around the foundation of the Structure(s)or(4)any tampering of
baiting equipment or supplies occurs.Failure to notify the Company in writing of any event listed above may void the Agreement.Additional services required by any
addition,alteration or other such event maybe provided by the Company at Customer's expense,and may require an adjustment in the renewal fee.
C.Repair and Retreatment Obligation.Customer initials .Subject to the general terms and conditions of this Agreement,if an infestation of subterranean
termites occurs in the treated structure(s)during the tern of this Agreement,the Company will retreat the area of infestation at no additional charge.In addition,subject
to the general terms and conditions of this Agreement,the Company will repair,at its cost,new termite damage to the treated structure(s).The Company's total liability
will not exceed in any one calendar year the lesser of(i)$200,000 and(ii)the fair market value of the treated structure(s),nor exceed$1,000,000 in the aggregate over
the term of the Agreement,including extensions and renewals.Customer expressly waives any claim for economic,compensatory,or consequential damages relating to
the existence of Subterranean termites or Subterranean termite damage,or for increased costs,loss of use,business interruption,diminution of value,or any"stigma"
damage due to the presence of Subterranean termites or Subterranean termite damage.The Customer acknowledges that the Company is performing a service and
except for termite damage repairs set forth above and any damage to the structure caused by the Company in the performance of its services,Customer waives any
claim for property damage,and agrees that under no circumstances shall Company be held liable for any amount greater than the amount paid by the Customer to
Company for the termite service to be performed.
I.The Company is not responsible for the cost of repairs of subterranean termite damage caused by or related to structural conditions or Conditions Conducive.
2.Due to subterranean termite habits,termite activity may continue to be present in a structure for a period of time following treatment.The Company is not
responsible for(i)repairs of subterranean termite damage to the treated structure(s)or the contents thereof that occurred prior to a treatment date or that
occurs within six months following a treatment date or(ii)any costs or expenses incurred by Customer as a result of any such damage.
3.If new damage,as evidenced by the presence of live termites,occurs while this Agreement is in force,following written notification from Customer and an inspection
by the Company,the Company agrees,at its discretion,to either(i)repair the damage at the Company's cost or(ii)reimburse Customer for the reasonable cost of the
repairs,but only to the extent that,in either case,the total reasonable cost of such repairs is less than$200,000 in any one calendar year.
4.Subject to the remaining provisions of this Section VI.A.4,if the Company chooses not to repair the damage itself,Customer will be entitled to select the contractor
who will perform the needed repairs to the treated structure(s).Prior to entering into a contract with a contractor,Customer agrees to provide the Company a copy of the
proposed contract or written bid.If the Company detennines the bid to be excessive,Customer agrees to grant access to the treated structure(s)to a contractor
designated by the Company for the purpose of obtaining a second bid for the work.In cases where there are multiple bids for repair work,Customer acknowledges that
the Company reserves the right to select the contractor to perform the repairs.
5.Thc Company is not responsible for the repair of either visible damage(noted on the attached inspection graph)or hidden damage existing as of the date of this
Agreement.The Company does not guarantee that the damage disclosed on the attached inspection graph represents all of the existing damage as of the date of this
Agreement.Customer waives all claims for damage to the property or people that may result directly or indirectly from services provided by the Company,with the sole
exception of claims for damages due to the gross negligence of the Company and/or its employees.
D.Pretreatment Limited Warranty Renewal.The following applies if the Company previously provided a pretreatment for subterranean termite protection on the treated
structure(s).The pretrcannent included an obligation for the Company to retreat the structure(s),at its cost,if live termites are found at the structure(s)during the one
(I)year following the pretreatment.The Company hereby transfers the retreatment obligation to you,subject to the remaining terms and conditions of this Section VI.B.
You have the option to renew this obligation annually after the expiration of the first term for four(4)additional one year periods provided that at the time of each
renewal the annual renewal fee shown on the front page of this Agreement(subject to adjustment as provided in Section VII.2 below)is paid and a previous one year
renewal was purchased.The Company's repair liability is limited as described in Section VI.A above.
Section VII.GENERAL TERMS AND CONDITIONS.
I.INSPECTION.The inspection provided for in this Agreement was conducted in the readily accessible areas of the structure(s)located at the Service Address.If
visible evidence of the infestation by subterranean termites is reported,some degree of damage,including hidden damage,may be present.The inspection covered only
the readily accessible areas of the structure(s)inspected,including attics and crawispaces that permitted entry during inspection.This inspection did not include areas
that were obstructed or inaccessible at the time of this inspection.All structure(s)that were inspected are specifically noted.The Company did not inspect areas that
were obstructed and/or inaccessible for physical access,nor did the Company inspect areas that required the breaking apart or into,dismantling,or removal of any
object including,but not limited to:molding,floor coverings,wall coverings,siding,ceilings,insulation,floors,furniture,appliances and/or personal possessions.
2.TERM.Unless otherwise specifically provided herein,the parties agree that the initial term of this Agreement will be for twelve(12)months and will be
automatically renewed on an annual basis,for a maximum of four(4)additional one(I)year periods,following the initial term,upon payment by Customer of the
annual renewal fee shown on the front page of this Agreement(subject to adjustment as provided in this subsection),unless either party cancels by giving the other
party written notice at least thirty(30)days prior to the end of the then current term.The Company reserves the right to increase the price of service.This Agreement
may be terminated by Customer by providing written notice to the Company within thirty(30)days following Customer's receipt of the notice of increase.
3.CONDITIONS.Customer agrees to repair and correct,at Customer's sole expense,any condition of which Customer has been notified or otherwise placed on notice
by the Company,including,but not limited to any and all conditions that are conducive to infestations of subterranean termites or that prevent or negate proper
treatments,inspections or the effectiveness of the treatments.If the condition is not corrected within sixty(60)days following notification,the Company may,in its
discretion,terminate this Agreement with no liability.Customer further agrees to maintain the treated structures)free from any factors contributing to infestation,such
as wood,trash,lumber,direct wood-soil contact or standing water under pier-foundation structures.
4.NOTICE OF CLAIMS,ACCESS TO TREATED STRUCf URE.Any claim under this Agreement must be made immediately in writing to the Company office.
The Company is obligated to perfonn under this Agreement only if Customer allows the Company access to the treated strocture(s)for any purpose contemplated by
this Agreement,including,but not limited to re-inspection,whether the inspection has been requested by Customer or is considered necessary by the Company.
5.ASSIGNABILITY.This Agreement is transferable to a new owner of the structure(s)located at the Service Address.The Company reserves the right to charge a
transfer fee,adjust the annual renewal rate,and change the terms of the repair and retreatment obligation upon any such transfer.If the new owner fails to request
continued coverage within thirty(30)days of the closing of the sale of the structure(s)or does not agree to pay the annual renewal fee or transfer fee,the Company's
obligations under this Agreement will immediately and automatically terminate effective as of the date of the closing of the sale of the structure(s).
6.PAYMENT.Unless Customer prepays annually,the Company will invoice Customer on a monthly basis for services rendered in este prior month.The full amount of
the invoice is due and payable upon receipt.Invoices that are not paid within thirty(30)days of the invoice date will accrue interest on the unpaid balance at a rate equal
to the lesser of 1.5%per month(18%per year)or the maximum rate allowed by law.If the Company must take legal action to collect any amount due the Company,the
Company will be entitled to recover frau Customer all costs of collection,including reasonable anomeys'fees,in addition to all outstanding amounts due the Company.
7.MODIFICATION OF STRUCTURE(S).This Agreement covers the treated structure(s)as existing as of the date of the initial treatment.If any treated structure is
structurally modified,altered or otherwise changed,or before any soil is removed or added around the foundation,or before any soil is removed from under the
structure(s),Customer will immediately notify the Company for proper instructions and/or any additional treatment,at Customer's expense,required by the changes.If
Customer fails to do so,this Agreement will immediately and automatically terminate.In the event of structure additions,the Company reserves the right to adjust the
annual renewal rate.
8.CHEMICAL SENSITIVITY OR SPECIAL HEALTH CONDITIONS.If Customer believes that Customer or other occupants of the treated structure are or may
(A)be sensitive to pesticides/termiticides or their odors or(B)have other health conditions that may be affected by pesticides/tenniticides or their odors,Company
recommends that you not have an initial or a subsequent service performed at your premises until you have consulted with your family physician.At your request,
Company will provide information about the chemicals to be used in treating the premises.By permitting the treatment,Customer assumes the risk and waives any and
all claims against the Company in connection with such sensitivity or condition.At your request,the Company will provide in formation about the chemicals to be used
in treating the premises.
9.ARBITRATION.ANY CONTROVERSY OR CLAIM ARISING OUT OF OR RELATING TO THIS AGREEMENT OR ANY OTHER AGREEMENT
BETWEEN THE PARTIES,INCLUDING BUT NOT LIMITED TO ANY TORT AND STATUTORY CLAIMS,AND ANY CLAIMS FOR PERSONAL
INJURY OR PROPERTY DAMAGE,SHALL BE SETTLED BY BINDING ARBITRATION.UNLESS THE PARTIES AGREE OTHERWISE,THE
ARBITRATION SHALL BE ADMINISTERED UNDER THE COMMERCIAL RULES OF THE AMERICAN ARBITRATION ASSOCIATION("AAA")
OR,IF APPLICABLE,IT SHALL BE DETERMINED UNDER THE AAA PROCEDURES FOR CONSUMER-RELATED DISPUTES.THE PARTIES
EXPRESSLY AGREE THAT TIIE ARBITRATOR SHALL FOLLOW THE SUBSTANTIVE LAW,INCLUDING TIIE TERMS AND CONDITIONS OF
THIS AGREEMENT,AND TIIAT ANY ARBITRATION PROCEEDING UNDER THIS AGREEMENT WILL NOT BE CONSOLIDATED OR JOINED
WITH ANY ACTION OR LEGAL PROCEEDING UNDER ANY OTHER AGREEMENT OR INVOLVING ANY OTHER PREMISES,AND WILL NOT
PROCEED AS A CLASS ACTION,PRIVATE ATTORNEY GENERAL ACTION OR SIMILAR REPRESENTATIVE ACTION.EITHER PARTY HAS
THE RIGHT TO REQUIRE A PANEL OF THREE(3)ARBITRATORS,AND TIIE REQUESTING PARTY SHALL BE RESPONSIBLE FOR THE COST
OF THE ADDITIONAL ARBITRATORS.EITHER PARTY MAY REQUEST AT ANY TIME PRIOR TO THE HEARING THAT TIIE AWARD BE
ACCOMPANIED BY A REASONED OPINION.TIIE AWARD RENDERED BY THE ARBITRATOR(S)SHALL BE FINAL AND BINDING ON ALL
PARTIES,EXCEPT THAT EITHER PARTY MAY WITHIN 30 DAYS OF THE ORIGINAL AWARD REQUEST AN ARBITRAL APPEAL TO A THREE
MEMBER APPEAL TRIBUNAL.TIIE APPEALING PARTY SHALL BE RESPONSIBLE FOR ALL APPELLATE ARBITRATOR(S)FEES AND COSTS.
THE APPEAL TRIBUNAL SHALL REVIEW ALL QUESTIONS OF LAW AND FACT UNDER A CLEARLY ERRONEOUS STANDARD.THE AWARD
OF THE APPEAL TRIBUNAL SHALL BE FINAL AND BINDING.JUDGMENT MAY BE ENTERED ON THE AWARD IN ANY COURT HAVING
JURISDICTION THEREOF. CUSTOMER AND ORKIN ACKNOWLEDGE AND AGREE THAT THIS ARBITRATION PROVISION IS MADE
PURSUANT TO A TRANSACTION INVOLVING INTERSTATE COMMERCE AND SHALL BE GOVERNED BY THE FEDERAL ARBITRATION
ACT.
10.ENTIRE AGREEMENT AND SEVERABILITY.This Agreement and the attached graph constitute the entire agreement between the parties. Customer
expressly warrants and represents that,in entering this Agreement,Customer is not relying on any promise,agreement or statement,whether oral or written,that is not
expressly and fully set forth in this Agreement.If any part of this Agreement is held to be invalid or unenforceable for any reason,time remaining terns and conditions
of this Agreement will remain in full force and effect.The terms of the Agreement stated herein may not be amended or altered unless a written change is approved and
signed by a Corporate Officer of Company.No other employees or agents of Company have authonty to amend or alter any par of this Agreement.Provided,however.
that as to the paragraph on ARBITRATION,if the sentence precluding the arbitrator from conducting an arbitration proceeding as a class,representative or private
anorney general action is found lobe invalid or unenforceable then the entirety of the ARBITRATION paragraph shall be deemed to be deleted from this Agreement.
G HomeTeam Pest Defense,Inc.2012 2/12-03314 5YR)
Subterranean Termite Protection Builder's Guarantee OMB Approval No.2502-0525
(exp.05/30/2018)
This form is completed by the builder.
Public reporting burden for 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 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 a licensed Pest Control company to provide the builder a record of specific treatment information in those
cases when if any method other than use of pressure treated lumber is used for prevention of subterranean termite infestation.When applicable,form
HUD-NPMA-99-B 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.
This form is to be completed by the builder.This guarantee is issued by the builder to the buyer.This guarantee is not to be considered as a waiver of,or in place of,
any legal rights or remedies that the buyer may have against the builder.
FHANA Case No.:
Location of Structure(s)(Street Address,or Legal Description,City,State and Zip):
1738 Atlantic Beach Drive,Atlantic Beach,FL,32233
Buyer's Name:
Builder is to check and complete either box 1 or box 2.
1.d Pest Control Company Applied Treatment(See HUD-NPMA 99B for treatment information)
The undersigned builder hereby certifies that a State licensed or otherwise authorized pest control company(where required by State law)was contracted to
treat the property at the location referenced above to prevent subterranean termites.The builder further certifies that the contract with the pest control
company required the treatment materials and methods used to be in conformance with all applicable State and Federal requirements.All work required by
the contract has been completed unless noted on HUD-NPMA 99B.Where not prohibited by applicable State requirements,the buyer,for an additional 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 builder hereby guarantees that,if subterranean termite infestation should occur within one year from the date of closing,the builder will ensure that a
licensed or otherwise State authorized pest control company will treat as necessary to control infestations in the structure.This further treatment will be
without cost to the buyer.If permitted by State law,the buyer may contract directly,at the buyer's expense,with a pest control company to inspect the
property on a periodic basis and use EPA registered products to control any infestation.The builder will not be responsible for guaranteeing such contracted
work.The builder further agrees to repair all damage by subterranean termites within the one-year builder's warranty period.This guarantee does not apply
to additions or alterations that are made by the buyer,which affects the original structure or treatment.Examples include,but are not limited to,landscape
and mulch alterations,which disturb the treated area and create new subterranean termite hazards,or interfere with the control measures.If within the
guarantee period the builder questions the validity of a claim by the buyer,the claim will be investigated by an unbiased expert mutually agreeable to the
buyer and builder.The report of the expert will be accepted as the basis for disposition of the case.The non-prevailing party will pay the cost of any
inspections made to investigate the claim.For further information,contact your State structural pest control regulatory agency.All service must be in
compliance with the International Residential Code.
Type of Service: E Termite Bait System ® Field Applied Wood Treatment [-. Soil Treatment r Installed Physical Barrier System
2.F. Builder Installed Subterranean Termite Prevention using Pressure Treated Lumber
The builder certifies that subterranean termite prevention was installed using pressure treated lumber only and certifies that use of the pressure treated
lumber is in compliance with applicable building codes and HUD requirements including Mortgagee Letter 2001-04.Note:Using pressure treated sills as
a sole method of termite prevention is NOT acceptable and violates the requirements of Mortgagee Letter 2001-04.
Initial of Builder Date
Attachments:
Builder's Company Name: TOLL BROTHERS Phone No.:
Builder's Signature: Date: 07/23/2018
Consumer Maintenance Advisory regarding integrated Pest Management for Prevention of Wood Destroying insects.Information regarding prevention of
wood destroying insect infestation is helpful to any property owner interested in protecting the structure from infestation.Any structure can be attacked by wood
destroying insects.Periodic mainte nance should include measures to minimize possibilities of infestation in and around a structure.Factors which may lead to
infestation from wood destroying insects include foam insulation at foundation,earth-wood contact,faulty grade,firewood against structure,insufficient ventilation,
moisture.wood debris in crawl space,wood mulch,tree branches touching structures,landscape timbers,and wood rot.Should these or other such conditions
exist,corrective measure should be taken by the owner in order to reduce the chances of infestations by wood destroying insects,and the need for treatment.
An original and one copy of this guarantee are to be prepared by the builder and sent to the lender.The lender provides one copy to the buyer at closing and
includes a copy in the VA loan package or HUD insurance case binder.The builder sends one copy to the licensed pest control company which performed the
treatment.
Attached is a copy of the state authorized pest control company's New Construction Subterranean Termite Service Record,HUD-NPMA-99-B.
Warning:HUD will prosecute false claims and statements.Conviction may result in criminal and/or civil penalties.(18 U.S.C. 1001.1010,1012:31 U.S.C.3729.3802)
form HUD-NPMA-99-A(8/2008)
New Construction Subterranean Termite OMB Approval No.2502-0525
(exp.05/30/2018)
Service Record
This form is completed by the licensed Pest Control Company
Public reporting burden for this collection of information is estimated to average 15 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 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 authorized 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
specific homes will use the information collected.The information is not considered confidential,therefore no assurance of confidentiality is provided.
This report is submitted for informational purposes to the builder on proposed(new)construction cases when treatment for prevention of subterranean
termite infestation is specified by the builder,architect,or required by the lender,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 Address 6694 Columbia Park Drive City Jacksonville State FL Zip 32258-2409
Company Business License No. 1640370000 Company Phone No. 904-730-2522
FHANA Case No.(if any)
Section 2:Builder Information
Company Name Toll Brothers Inc Phone No. 904-217-0739
Section 3:Property Information
Location of Structure(s)Treated(Street Address or Legal Description,City,State and Zip) 1738 Atlantic Beach Drive,Atlantic Beach,
FL,32233
Section 4:Treatment Information
Date(s)of Service(s) 07/23/2018
Type of Construction(More than one box may be checked) El Slab F.Basement E.Crawl E.Other
Check all that apply:
(- A.Soil Applied Liquid Termiticide
Brand Name of EPA Registration No.
Termiticide:
Approx.Dilution(%): Approx.Total Gallons Mix Applied: Treatment completed on exterior:®Yes E No
® B.Wood Applied Liquid Termiticide
Brand Name of Bora-Care EPA Registration 64405-1-AA
Termiticide: No.
Approx.Dilution(%): 23 Approx.Total Gallons Mix Applied: 4
7 C.Bait system Installed
Name of System: EPA Registration Number of Stations
No. installed
7 D.Physical Barrier System Installed
Name of System: Attach installation information(required)
Service Agreement Available? b Yes L,No
Note:Some state laws require service agreements to be issued.This form does not preempt state law.
Attachments(List)
Comments
Name of Applicator(s) HARRY CRUZ Certification No.(if required by State law) JE252234
The applicator has used a product in accordance with the product label and state requirements. All materials and methods used comply with state
and federal regulations. ��Q
Authorized Signature K•,(� 'F""'7 ‘41.1„, Date 07/23/18
Warning:HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties.(18 U.S.C.1001,1010.1012;31 U.S.C.3729,3802)
form HUD-NPMA-99-B(08/2008)
144g)'
HomeTeam
PEST DEFENSE'
New Construction Subterranean Termite Treatment
This report is submitted for information purposes to the builder on(new)construction cases where treatment for prevention of
subterranean termite infestation is required by the Florida Building Code,Section 104.2.6.
All contracts for services are between the Pest Control Operator and builder, unless stated otherwise.
Section 1: Hometeam Pest Defense
Company Address:6694 Columbia Park Drive City:Jacksonville State:FL
Zip:24409 258- Company Phone No.:904-730-2522 Business License No.: 1640370000
Section 2: Builder Information
Company Name:Toll Brothers Inc
Phone No.:
Section 3: Property Information
Building Permit No.:
Location of Structure(s)Treated:1738 Atlantic Beach Drive,Atlantic
Type of Construction: N Slab ❑Basement Li Crawl Cl Other
Approximate Depth of Footing: Outside: Inside: Type Fill:
Section 4: Treatment Information
Date(s)of Treatment(s):07/23/2018 EPA Registration No.:64405-1-AA
Brand Name of Product(s)Used:Bora-Care
Final Mix Solution:23 Treatment Area Sq.Ft.:2863
Linear Ft.215 Linear Ft.of Masonry Voids:
Total Gallons of Termiticide Applied:
Service Agreement Available? ®Yes 0 No This building has received a complete treatment for the
Liquid treatment: ❑Yes Ll No prevention of subterranean termites.Treatment is in
Liquid Final exterior treatment: ❑Yes ®No accordance with the rules and laws established by the
Borate treatment: ®Yes 0 No Florida Department of Agricultural and Consumer
Bait in lieu of Pretreat: ❑Yes 1 No Services. Initial ,rQ
Note:Some State laws require service agreements to be issued. This form does not preempt State law.
Attachments(List)
Comments
Name of Applicator(s):HARRY CRUZ/ �—rE Certification No.: JE252234
Authorized Signature AtEl- LEY c)I DL EY1/ Date 07/23/18
RH-NT9/05
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