Customer Contract

Customer Contract Form

AIPM Agriclinic & Integrated Pest Management Private Limited

Address: SF 04, Second Floor, Jaiwant Complex, Sonarpeth, Bicholim, North Goa - 403504

Name

Phone/Mobile

Contract Date

Address

Billing Addres

City

State

Pin Code

With the reference to the discussion with your representative , we area pleased to place our Customer -Service-Contract on you for Integrated Management Service/s as per following particulars and on the terms and condition mentioned overleaf.

SERVICE DETAILS

Type of Service

	Tick
Integrated Cockroach Management (ICM)
Integrated Ants Management (IAM)
Integrated Lizard Management (ILM)
Integrated Bed Bugs Management (IBM)
Integrated Rodent Management(IRM)
Integrated Fly Management (IFM)
Integrated Termite Management (ITM Pre Construction))
Integrated Termite Management (ITM Post Construction)
Integrated Mosquito Management (IMM))
Integrated Snake Management (ISM)
Other

Term & Frequency Of Service

Date of Service

Time of Service

ADDITIONAL INFROMATION

Contact Person Name

Contact Person Phone

PAYMENT & CONTRACT TERMS

Terms Of Payment

Contract Period Start Date

Contract Period End Date

GSTIN No.

Remarks

Amount To be Paid

Declaration , I/We hereby declare to pay the charges of amount mentioned above and GST applicable , for this contract prior to commencement of the premises from their presence. I have read & understood your contract terms , requirements for the treatment and I agree to the terms and conditions printed overleaf.

Authorization & Signature

Customer Signature

Sign above

Company Stamp