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) &
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, Month & Year)
Pesticide Applicator or Business Signature1 and Title______________________________________
This item is required to be contained in the contract by New York State regulation
6 NYCRR Section 325.40.
The product registration number can be provided in the contract or before leaving the
premises at which commercial lawn applications have been made.