Pest Control Bed Bug Preparation Form

Pest Control Bed Bug Preparation Form and Service Agreement

Parties and Service Location

Service Provider:

Client Name:

Recitals

WHEREAS, Service Provider is duly licensed and experienced in inspection and treatment for bed bug infestations and maintains the necessary equipment, personnel, and materials to provide such services; and

WHEREAS, Client requests that Service Provider perform inspection and treatment services at the Service Address and agrees to perform the preparatory and post-treatment duties described in this form; and

WHEREAS, the parties desire to set forth the Scope of Work, Payment Terms, Preparation Requirements, and other contractual provisions governing the provision of services.

Scope of Work

Service Provider shall perform the following services at the Service Address: inspection, localized and/or whole-unit treatment for bed bugs using EPA-registered products and approved treatment methods, follow-up visits as required, and technician recommendations documented below. Specific methods selected (check all that apply):

Chemical treatment (residual insecticide)
Heat treatment
Steam treatment for furniture and baseboards
Mattress and box spring encasement installation

Payment Terms

Total Contract Price: $

Deposit Required: $ due at scheduling. Remaining balance due: $ payable within days after final treatment.

Late fee or interest on past due balances: . Client agrees to pay reasonable collection costs, including attorney fees, if applicable.

Term and Termination

Service commencement date:

Agreement end date (if applicable): . Otherwise, this Agreement continues until final completion of agreed services.

Termination: Either party may terminate for material breach if the other party fails to cure the breach within days of written notice. Client remains responsible for payment for services performed and for costs incurred through termination.

Client Preparation Requirements (Checklist)

The following actions must be completed by Client prior to arrival of technician. Failure to complete required preparations may result in additional fees or rescheduling.

Launder and dry all bedding, linens, curtains, and clothing at high heat; place laundered items in sealed bags or containers.
Remove clutter from floors and under beds; store items in sealed plastic bins where possible.
Move furniture away from walls and clear area to allow technician access to baseboards and behind furniture.
Thoroughly vacuum mattresses, box springs, upholstery, carpets, and cracks; dispose of vacuum bag immediately in sealed trash.
If encasements are selected, provide access to mattresses and box springs or authorize Service Provider to install.
Remove people, pets, and fish tanks from premises during treatment and follow re-entry times provided by technician.
Provide unobstructed access to electrical outlets, baseboards, and furniture legs; ensure electricity is available for equipment.
Notify Service Provider of any occupants with respiratory issues, mobility limitations, or infants; provide special access instructions if necessary.

Confidentiality

Both parties acknowledge that certain information exchanged in connection with inspection and treatment, including treatment methods, pricing, and client contact information, constitutes confidential business information. Service Provider shall not disclose Client-specific treatment records or Client contact information to third parties except: (a) as required by law, (b) to perform the services (including subcontractors under Service Provider control), or (c) with Client's written consent. Client shall not disclose proprietary treatment protocols disclosed by Service Provider without prior written consent.

Liability and Warranties

Service Provider warrants that services will be performed in a professional manner consistent with industry standards. Except as expressly set forth herein, Service Provider disclaims all other warranties, express or implied. Service Provider's liability for any claim arising from services provided is limited to direct damages not to exceed the total amounts paid by Client under this Agreement for the specific services at issue. Service Provider is not responsible for reinfestation caused by events outside of its control or Client's failure to comply with preparation or re‑entry instructions.

Technician Recommendations / Follow-up

Governing Law and Entire Agreement

Governing Law: This Agreement shall be governed by and construed in accordance with the laws of the state of without regard to conflict of law principles.

Entire Agreement: This document, together with any written attachments or technician notes executed contemporaneously, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements and understandings, whether written or oral. No modification of this Agreement is effective unless in writing and signed by both parties.

Client Certification

By initialing and signing below, Client certifies that the preparatory actions required above have been completed as indicated and that Client understands the risks, re-entry instructions, and limitations of treatment. Client acknowledges receipt of any pre-treatment instructions and consents to the methods checked in the Scope of Work.

Client Initials:

Sign Now