DRAFT SAMPLE COMMERCIAL LAWN APPLICATION CONTRACT PREPARED BY THE ADMINISTRATION OF THE NASSAU/SUFFOLK LANDSCAPE GARDNER’S ASSOCIATION NOTE: This model contract is available from green industry associations in New York State. The Department has reviewed the specific provisions of the model contract that are required by 6 NYCRR Section 325.40 and found the specific provisions to be consistent with Section 325.40. PLEASE ALSO NOTE: Nothing in this sample contract beyond the specific provisions mentioned above has been reviewed and/or accepted by the NYSDEC. LANGUAGE BELOW THIS LINE (ON NEXT PAGE) IS THE SAMPLE CONTRACT COMMERCIAL LAWN APPLICATION CONTRACT Pesticide Business Name, Address and Telephone Number1 Consumer Affairs # (if applicable):_______________________________________________ NYSDEC Pesticide Business Registration number1: _____________________________________ NYSDEC Pesticide Applicator Certification ID number1:___________________________ Name of Property Owner (or Agent)1 ________________________________________________ Address of Property to be Treated1:__________________________________________________ City _______________ State _________ Zip Code __________ Phone_____________________ Date(s) of application and alternate date(s) for each pesticide to be applied: Target Pest Pesticide and Approximate Date(s) Alternate Date(s) of Application, including the EPA Product of Application, including day(s), month(s) & year(s) Registration the day(s), month(s) & Number2 year(s)1 Alternate date(s) of application are not required to be Insert an approximate date included in the contract. If alternate date(s) are in the that is as specific as contract, insert alternate date(s) that is as specific as possible and which does possible and which does not exceed a period of three not exceed a period of consecutive calendar weeks or include a specific date, if three consecutive calendar requested by property owner. If alternate date is not weeks or include a specific included in contract, oral or written notice of an date, if requested by alternate date, which does not exceed a period of three property owner. consecutive calendar weeks, must be provided to the property owner and acceptance obtained. NOTE: The property owner or owner’s agent may request the specific date or dates of the application(s) to be provided and, if so requested, the pesticide applicator or business must inform of the specific dates and include that date or dates in the contract.1 Total number of commercial lawn applications1: __________ Cost per application: $_______________ Total cost of commercial lawn applications1: $____________ Included with this contract is a list of the pesticides to be applied (including brand names and generic names of active ingredients) AND any label warnings of the pesticides to be applied that are pertinent to the protection of humans, animals or the environment 1. NOTE: If this is a multi-year contract, state each year covered by the contract. By signing this contract, I understand I am agreeing to all the terms and conditions listed above. Property owner or owner’s agent signature1_________________________________________________ Date _____________________ (Date, Month & Year) Pesticide Applicator or Business Signature1 and Title______________________________________ contrctsmpl1231.wpd 1 This item is required to be contained in the contract by New York State regulation 6 NYCRR Section 325.40. 2 The product registration number can be provided in the contract or before leaving the premises at which commercial lawn applications have been made.
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