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Service Agreement Order Form

Property To Be Covered
Residential Plan I...............$225.00
  Only available for new construction or newly modeled homes & condos.
Residential Plan II...............$299.00
  Available for all single family homes & condos includes preventive service in specific areas prone to moisture.
I hereby elect the option during the first six months of coverage to transfer and extend coverage for twelve months to purchaser with no transfer fee. After six months the service agreement may be
transferred for the remaining months and subject to annual renewal at the option of the purchaser.

Notice
Business Relationship Disclosure

From Prudential Gardner Realtors and ServiceAccess, Inc. to potential customer of service agreement. This is to give you notice that GBS Properties, LLC d/b/a Prudential Gardner Realtors has a business relationship with ServiceAccess, Inc. and may receive a marketing fee or other benefit from the purchase of this agreement. There are frequently other service providers available with similar services and you may shop around to determine you are receiving the best rate for this service. You are NOT obligated or required to purchase this service agreement as a condition of sale or purchase of the property.

Property To Be Covered:
City:
State:
Zip:
Name:
AC/Phone:
Email:
Broker & Agent
Company:
Agent Name:
Agent Phone:
Agent Email:
Effective Date:
Acknowledgement
I/we have read the above Business Relationship Disclosure notice and Terms and Conditions of this service agreement, and by clicking the box to the left elect to purchase the termite/mold service agreement.