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Form preview Pest control quotation format... Streetscene Housing Environmental Protection Flint Street Fartown Huddersfield HD1 6LG Tel 01484 226891 Fax 01484 226490 PCD C 28 Ref No A/c No PEST CONTROL SERVICE AGREEMENT/ REQUEST FOR SERVICE COMMERCIAL Date Received Taken by Account Address. Name Address Post Code Pest Type LOCATION STATUS ORDER NO/COST CODE APPOINTMENT Allocated to CURRENT CHARGES excluding VAT Rats/Mice indoors only 90. 00 VAT for first hour or part thereof then 45. 00 VAT per hour Cockroaches/Bedbugs Pharaoh Ants By quotation Fleas All other insects including Ants except Pharaoh Ants Bees etc Call-out charge 35. Streetscene Housing Environmental Protection Flint Street Fartown Huddersfield HD1 6LG Tel 01484 226891 Fax 01484 226490 PCD C 28 Ref No A/c No PEST CONTROL SERVICE AGREEMENT/ REQUEST FOR SERVICE COMMERCIAL Date Received Taken by Account Address. Name Address Post Code Pest Type LOCATION STATUS ORDER NO/COST CODE APPOINTMENT Allocated to CURRENT CHARGES excluding VAT Rats/Mice indoors only 90. 00 VAT for first hour or part thereof then 45. 00 VAT per hour Cockroaches/Bedbugs Pharaoh Ants By quotation Fleas All other insects including Ants except Pharaoh Ants Bees etc Call-out charge 35. 00 VAT Survey Work Wasps Nest 48. 00 VAT plus additional 20. 00 VAT for each extra nest treated in one visit PEST CONTROL AGREEMENT Note - Technicians will not accept payment. An invoice will be sent at a later date. I/We print full name owner s occupier s of the premises named above request and authorise Public Protection Services to carry out a treatment/survey to attempt to eradicate the infestation highlighted above at my/our premises. The treatment carried out on my/our premises has been fully explained to me/us an Environmental Risk Assessment has been carried out and a poison safety sheet together with a survey checklist detailing the number and positions of any bait points being used has been left with me/us by the Pest Control Technician* I/We undertake to pay on demand the appropriate charges for the service. DATE SIGNED POSITION HELD For Health and Safety reasons no baits will be left at the end of the treatment ARRIVE DEPART REVISIT DATE/TIME IF REQUESTED INT DATE COMPLETED FEE DUE VAT TOTAL FEE DUE. Streetscene Housing Environmental Protection Flint Street Fartown Huddersfield HD1 6LG Tel 01484 226891 Fax 01484 226490 PCD C 28 Ref No A/c No PEST CONTROL SERVICE AGREEMENT/ REQUEST FOR SERVICE COMMERCIAL Date Received Taken by Account Address. Name Address Post Code Pest Type LOCATION STATUS ORDER NO/COST CODE APPOINTMENT Allocated to CURRENT CHARGES excluding VAT Rats/Mice indoors only 90. Name Address Post Code Pest Type LOCATION STATUS ORDER NO/COST CODE APPOINTMENT Allocated to CURRENT CHARGES excluding VAT Rats/Mice indoors only 90. 00 VAT for first hour or part thereof then 45. 00 VAT per hour Cockroaches/Bedbugs Pharaoh Ants By quotation Fleas All other insects including Ants except Pharaoh Ants Bees etc Call-out charge 35. 00 VAT for first hour or part thereof then 45. 00 VAT per hour Cockroaches/Bedbugs Pharaoh Ants By quotation Fleas All other insects including Ants except Pharaoh Ants Bees etc Call-out charge 35. 00 VAT Survey Work Wasps Nest 48. 00 VAT plus additional 20. 00 VAT for each extra nest treated in one visit PEST CONTROL AGREEMENT Note - Technicians will not accept payment.
Form preview Quotation evaluation report sa... Req ID University of Vermont Procurement Services Quotation Evaluation Form This form must be completed for all purchases greater than 25 000 but less than 50 000. A minimum of three quotes should be obtained and attached to this form* If this purchase is determined by your department to be a Sole or Single Source please complete a Single/Sole Source Justification Form instead* This form can be found on the Procurement Services website. Prepared by Department Phone Purchase Description Required Delivery Date Company 1. 2. 3. Total Price After evaluating all of the above please make your supplier recommendation below. If the decision is based on anything other than price please describe the reasoning and value for the selection* Recommended Supplier Basis for Recommendation The information provided above is accurate and represents a fair and impartial evaluation of quotations received* Name/Title Date Signature Phone Please scan and attach to your requisition in PeopleSoft or fax to 656-8684 referencing your requisition ID. Procurement Services Review Date QE0410 PROCUREMENT SERVICES 19 Roosevelt Highway Ste 120 Colchester VT 05446 Phone 802 656-4192 Fax 802 656-8684 Federal law requires that we have on file a W-9 form with the Employer ID number or Social Security number and signature for each person to whom the University makes payment. Please complete this form and FAX it to the Procurement office at 802 656-8684. We require either the individual s name/Social Security number or the company s name/Federal Employer ID number as they appear on your income tax return* PLEASE PRINT LEGIBLY VF1109 COMPANY NAME DBA NAME Federal EIN OR Social Security Address to send QUOTE ORDER PAYMENTS PHONE NUMBER E-mail address PO Box Street Address City State Zip Website NAME Contact Person for ORDERS Does your company accept MasterCard Please circle YES or NO What are your standard invoicing terms Net days / Discount percent / Discount Days Other Business Description Please circle CORPORATION or NOT-FOR-PROFIT or PARTNERSHIP or SOLE PROPRIETORSHIP Business Classification Please circle LARGE SMALL If Small Business please circle if 51 or more of your company is owned by WOMEN or MINORITY or DISADVANTAGED Certification Under penalties of perjury I certify that 1 The number shown above is my correct taxpayer identification number 2 I am not subject to backup withholding because a I am exempt from backup withholding or b I have not been notified by the IRS that I am subject to backup withholding and 3 I am a U*S* person including a U*S* resident alien. SIGNATURE DATE Name Title FEDERAL LAW REQUIRES THAT YOU PROVIDE US WITH AN ACCURATE REPLY The IRS may impose a penalty of up to 500 for non-compliance or for supplying false information* ACH VENDOR PAYMENT ENROLLMENT FORM This form is used for Automated Clearing House ACH vendor payments. Please provide us with the information below to accept the Automated Clearing House ACH electronic funds transfer. BANK NAME Bank Address Routing Number Account Name Check One Checking Account Savings Account I authorize the University of Vermont s Procurement Services to electronically transfer my vendor payment via ACH to the financial institution designated above.

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