rayspest.pestportals.com
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34.200.132.22
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Submitted URL: https://u15096333.ct.sendgrid.net/ls/click?upn=oE8lMArfVIyWDxalF-2FnYdRinOsUqZPqE4PmlKB4rHiyoKfVPRaOePVV3Za-2FDFOYf2I8RpYM6jGMbvaX...
Effective URL: https://rayspest.pestportals.com/signAgreement?code=13580&cID=4646&codex=313236313737303232&lID=6673cb44179d41489c037033b24af6dd
Submission: On June 13 via manual from IN — Scanned from DE
Effective URL: https://rayspest.pestportals.com/signAgreement?code=13580&cID=4646&codex=313236313737303232&lID=6673cb44179d41489c037033b24af6dd
Submission: On June 13 via manual from IN — Scanned from DE
Form analysis
2 forms found in the DOM<form id="paymentProfileForm" class="billingForm" style="display: none;">
<input name="newACHGateway" type="hidden" value="">
<input name="newCCGateway" type="hidden" value="brain">
<input class="id" name="id" value="0" type="hidden">
<input name="paymentMethod" type="hidden" value="">
<input name="gateway" type="hidden" value="">
<input name="vault" value="" type="hidden">
<input name="profileID" type="hidden" value="">
<input name="paymentProfileID" type="hidden" value="">
<input name="customerID" value="39981" type="hidden">
<p class="bold">Billing Address</p>
<div class="row form-group-sm">
<div class="col-md-6">
<label for="billingFName">First Name</label>
<input type="text" name="billingFName" id="billingFName" value="Brenda" placeholder="First Name">
</div>
<div class="col-md-6">
<label for="billingLName">Last Name</label>
<input type="text" name="billingLName" id="billingLName" value="Sigmon" placeholder="Last Name">
</div>
</div>
<div class="row form-group-sm">
<div class="col-md-12">
<label for="billingAddress1">Billing Address</label>
<input type="text" name="billingAddress1" id="billingAddress1" value="3866 N Patterson Ave." placeholder="Billing Address">
</div>
</div>
<div class="row form-group-sm">
<div class="col-md-8">
<label for="billingCity">City</label>
<input type="text" name="billingCity" id="billingCity" value="Winston-Salem" placeholder="City">
</div>
<div class="col-md-4">
<label for="billingState">State</label>
<select name="billingState" id="billingState" statehelper="">
<option value="AA" countryid="US">AA</option>
<option value="AE" countryid="US">AE</option>
<option value="AK" countryid="US">AK</option>
<option value="AL" countryid="US">AL</option>
<option value="AP" countryid="US">AP</option>
<option value="AR" countryid="US">AR</option>
<option value="AZ" countryid="US">AZ</option>
<option value="CA" countryid="US">CA</option>
<option value="CO" countryid="US">CO</option>
<option value="CT" countryid="US">CT</option>
<option value="DC" countryid="US">DC</option>
<option value="DE" countryid="US">DE</option>
<option value="FL" countryid="US">FL</option>
<option value="GA" countryid="US">GA</option>
<option value="HI" countryid="US">HI</option>
<option value="IA" countryid="US">IA</option>
<option value="ID" countryid="US">ID</option>
<option value="IL" countryid="US">IL</option>
<option value="IN" countryid="US">IN</option>
<option value="KS" countryid="US">KS</option>
<option value="KY" countryid="US">KY</option>
<option value="LA" countryid="US">LA</option>
<option value="MA" countryid="US">MA</option>
<option value="MD" countryid="US">MD</option>
<option value="ME" countryid="US">ME</option>
<option value="MI" countryid="US">MI</option>
<option value="MN" countryid="US">MN</option>
<option value="MO" countryid="US">MO</option>
<option value="MS" countryid="US">MS</option>
<option value="MT" countryid="US">MT</option>
<option value="NC" selected="SELECTED" countryid="US">NC</option>
<option value="ND" countryid="US">ND</option>
<option value="NE" countryid="US">NE</option>
<option value="NH" countryid="US">NH</option>
<option value="NJ" countryid="US">NJ</option>
<option value="NM" countryid="US">NM</option>
<option value="NV" countryid="US">NV</option>
<option value="NY" countryid="US">NY</option>
<option value="OH" countryid="US">OH</option>
<option value="OK" countryid="US">OK</option>
<option value="OR" countryid="US">OR</option>
<option value="PA" countryid="US">PA</option>
<option value="PR" countryid="US">PR</option>
<option value="RI" countryid="US">RI</option>
<option value="SC" countryid="US">SC</option>
<option value="SD" countryid="US">SD</option>
<option value="TN" countryid="US">TN</option>
<option value="TX" countryid="US">TX</option>
<option value="UT" countryid="US">UT</option>
<option value="VA" countryid="US">VA</option>
<option value="VT" countryid="US">VT</option>
<option value="WA" countryid="US">WA</option>
<option value="WI" countryid="US">WI</option>
<option value="WV" countryid="US">WV</option>
<option value="WY" countryid="US">WY</option>
</select>
</div>
</div>
<div class="row form-group-sm">
<div class="col-md-6">
<label for="billingZip">Zip</label>
<input type="text" name="billingZip" id="billingZip" size="7" value="27105" placeholder="Zip">
</div>
<div class="col-md-6">
<label for="billingCountryID">Country</label>
<select name="billingCountryID" id="billingCountryID">
<option value="BR">Brazil</option>
<option value="CA">Canada</option>
<option value="DE">Germany</option>
<option value="GU">Guam</option>
<option value="UK">United Kingdom</option>
<option value="US" selected="SELECTED">United States</option>
<option value="VI">Virgin Islands</option>
</select>
</div>
</div>
<div class="text-center form-group" id="paymentType">
<div class="btn-group btn-group-md" role="group" aria-label="achMethod">
<button type="button" class="btn showCCForm">Credit Card</button>
</div>
</div>
<div class="cardLogoGroup">
<img src="/resources/img/card-logos/visa.svg" class="card-logo" style="margin-left:26%">
<img src="/resources/img/card-logos/mastercard.svg" class="card-logo" style="margin-left:6%">
<img src="/resources/img/card-logos/discover.svg" class="card-logo" style="margin-left:6%">
<img src="/resources/img/card-logos/amex.svg" class="card-logo" style="margin-left:6%">
</div>
<div class="clr"><br></div>
<div id="form_cc" class="row cc-related">
<div class="col-md-12">
<p class="bold">Secure Credit Card Form</p>
</div>
<div class="col-sm-6">
<label for="card-number">Card Number</label>
<div id="card-number"></div>
</div>
<div class="col-sm-2 p-0">
<label for="expiration-month">Exp. MM</label>
<div id="expiration-month"></div>
</div>
<div class="col-sm-4">
<label for="expiration-year">Exp. YYYY</label>
<div id="expiration-year"></div>
</div>
<script>
var brain_initialized;
let cvv_selector = false;
//
function brainTreeSetup() {
if (!brain_initialized) {
Vault_Braintree.init({
paymentMethod: "cc",
selectors: {
cardNumber: "#card-number",
expirationMonth: "#expiration-month",
expirationYear: "#expiration-year",
cvv: cvv_selector,
saveButton: "#paymentFormSubmit"
},
callbacks: {
beforeTokenize: function() {
$(Vault_Braintree.config.selectors.saveButton).text('processing').attr('disabled', 'disabled');
},
afterTokenize: function(payload) {
if ($('#enableAPay:checked').length && $('#autopayInitials').val() == '') {
alert('Please enter your initials to proceed!');
$(Vault_Braintree.config.selectors.saveButton).text('Save').removeAttr('disabled');
return false;
} else {
let container = $("#paymentProfileForm"),
params = container.serializeFormJSON();
params.action = "saveBrainCC";
params.paymentNonce = payload.nonce;
params.nonceObj = payload;
params.enableAPay = $('#enableAPay:checked').length;
$.post(vaultEndPoint, params, function(response) {
saveBillingProfileCallback(response);
}, "json");
}
}
}
});
brain_initialized = true;
}
}
</script>
</div>
<div class="row form-group">
<div class="customerAutoPayInput col-md-6 checkbox">
<label for="enableAPay">
<input type="checkbox" name="enableAPay" id="enableAPay" value="1"> Default AutoPay </label>
</div>
</div>
<div class="row form-group autoPayInitialsWrapper">
<div class="col-md-12">
<input type="text" name="autopayInitials" id="autopayInitials" maxlength="2">
<label for="autopayInitials" name="autopayInitials" style="display: inline;color: inherit;">I authorize Ray's Pest Control, together with its affiliates, designees, and other service providers, to electronically debit or charge my payment
method for the applicable amount as services are provided. I agree that no prior notification may be provided. I understand that this preauthorized electronic transfer is to remain in effect until I contact Ray's Pest Control and remove my
authorization.</label>
</div>
</div>
</form>
<form>
<div class="aLeft">
<label for="agreeConsent"><input type="checkbox" name="Accept" id="agreeConsent"> I have read the terms of this <a href="#" class="eca link-color">Electronic Consent Agreement</a> and agree to receive the Contract Documents
electronically.</label>
<input type="hidden" name="action" value="signElectronicConsent">
<input type="hidden" name="linkID" id="linkID" value="">
</div>
</form>
Text Content
Welcome Clayton Homes of Winston Salem Thank you for choosing Ray's Pest Control! CONGRATULATIONS ON CHOOSING THE BEST PEST SERVICE!! Please review the following agreement and then sign. You will receive a copy via email for your records. Thanks! Ray's Pest Control 895 Peters Creek Pkwy 203 WinstonSalem, NC 27103 (336) 722-1307 | contact@raypestcontrol.com License #: 2006PW COMMERCIAL QUARTERLY PEST CONTROL SERVICE AGREEMENT SERVICE ADDRESS Clayton Homes of Winston Salem 3866 N Patterson Ave. Winston-Salem, NC 27105 CUSTOMER INFORMATION brenda.sigmon@claytonhomes.com (704) 873-2547 | Notes: INCLUDED INSECTS German Roaches American Roaches Oriental Roaches Brown Banded Roaches Smokey Brown Roaches Silverfish Ants (except Carenter & Fire) Crickets Millipedes Sow Bugs Earwigs Spiders Centipedes Firebrats Ground Beetles Pill Bugs This agreement includes callbacks for the described pests above as needed, only if account balances are current. It will include inside service if needed or requested. ADDITIONAL PESTS Mice/Rats Fleas Wasps/Hornets Carpenter Ants Box Elders Pest Elimination Service is available at an extra charge for Flying Insects, Stored Product Pest, Parasitic Insects like Bed Bugs, Fleas, and Mosquitoes, Wood Destroying Insects & Rodents. TERMS You (the purchaser) agree: A. To pay the initial quote of $80.00for the Pest Elimination Service. $80.00 for each of the recurring pest elimination services. $320.00 total agreement cost for the 1st year. b. To render payment for each of the Pest Elimination Services named above within 30 days of billing., c. To accept without undue delay each of the Pest Elimination Services. d. To make the interior of the structure readily available for each of the pest elimination services. e. To comply with all requests from Ray Pest Co. to correct structural conditions or other conditions, if any, that may cause or lead to pest infestations. f. To allow Ray Pest Control to perform pest elimination service(s) in the month(s) that they are due with or without purchasers response to Ray Pest Control's notice(s) of services to be performed. It is the purchasers responsibility to inform Ray Pest Control of any contact changes. 3. Ray Pest Control will not be responsible for: a. Costs of any repairs or compensation for any kind of damage - whether past present, or future - done to the structure of its contents by insects, pests or rodents. b. Elimination of any insects, pests or rodents on or around the exterior of the structure. (Exterior service under this agreement is limited to providing servicing concerning the entrance of insects, pests or rodents to the interior. Elimination of insects, pests and/or rodents on or around the exterior of the structure is available for a reasonable additional charge through a separate agreement.) c. The elimination of any of the above named pests if the purchaser fails to correct, or have corrected, conditions contributing to or causing these pests infestations. 4. Ray Pest Control and you (the purchaser) agree: a. That this agreement shall remain in full force and effect for a period of one (1) year from the date of the initial service. This agreement shall automatically be renewed for an additional one (1) year period after the first year of service, provided, however, that either party may terminate the Agreement at any time following the first year of service by providing written notice to the other party ninety (90) days prior to termination of the Agreement. b. The balances over sixty days old will be charged an interest rate of one and one half percent per month. This is an annual rate of eighteen percent. c. It is further agreed that keys will be available to all units needing service at all times and without delay. There will be an additional charge should extra trips be necessary to complete service, or if service is prolonged due to the non-availability of keys. d. Should there be a confirmed service appointment and that appointment is refused upon our arrival, there will be a fifty percent (25%) service charge. e. There is a $80.00 charge for early termination of this service agreement. Initially you may see a slight increase in pest activity as pest populations are disrupted. Within a few weeks you should see this activity drastically decline as our products take effect. Over time, these pest levels will continually decrease as regular services are performed. Regular treatments are critical in maintaining protective barriers and preventing infestations from reoccurring. If you see more than the occasional pest around your home, please call (336) 722-1307 at any time for a complimentary retreat! COMMERCIAL QUARTERLY PEST CONTROL SERVICE SUBSCRIPTION Jun '22 (S)80.00 Jul '22 Aug '22 Sep '22 (S)80.00 Oct '22 Nov '22 Dec '22 (S)80.00 Jan '23 Feb '23 Mar '23 (S)80.00 Apr '23 May '23 INITIAL SERVICE / WARRANTIES Initial Quote: $80.00 Initial Discount: ($0.00) Sub Total: $80.00 Tax (0%): $0.00 Initial Total: $80.00 RECURRING SERVICES Service Charge: $80.00 Tax (0%): $0.00 Recurring Total: $80.00 You, the customer, may cancel this transaction anytime prior to midnight of the third business day after the date of this transaction by giving written notice of cancellation to Ray's Pest Control. If for any reason, at any time, the contract is cancelled before its completion, and the initial service has been performed, customer agrees to pay the full initial service charge. Upon completion of this agreement treatments will continue at the same frequency until cancelled by the customer. BILLING INFO 3866 N Patterson Ave. Winston-Salem, NC 27105 PAYMENT INFORMATION I authorize Ray's Pest Control to automatically bill my debit/credit card upon completion of each service. This agreement is for an initial period of 12 month(s). Sign above I have read and agree to the terms and conditions of this agreement including any additional terms and disclosures listed above. I confirm that my email address is entered correctly and agree to receive my agreement, additional disclosures, and future account notifications electronically. Clear Sign Agreement Billing Address First Name Last Name Billing Address City State AAAEAKALAPARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUTVAVTWAWIWVWY Zip Country BrazilCanadaGermanyGuamUnited KingdomUnited StatesVirgin Islands Credit Card Secure Credit Card Form Card Number Exp. MM Exp. YYYY Default AutoPay I authorize Ray's Pest Control, together with its affiliates, designees, and other service providers, to electronically debit or charge my payment method for the applicable amount as services are provided. I agree that no prior notification may be provided. I understand that this preauthorized electronic transfer is to remain in effect until I contact Ray's Pest Control and remove my authorization. Cancel Save I have read the terms of this Electronic Consent Agreement and agree to receive the Contract Documents electronically. * Powered by * * RAY'S PEST CONTROL PO Box 5957 Winston Salem, NC 27113 (336) 722-1307 https://raypestcontrol.com ×Close LINKED PROPERTIES Click on a property to load account: Thank You! ×Close PLEASE SHARE THE LOVE! We appreciate your review! We use reviews to help improve our service, train our employees, and compliment our technicians. Reviews are also a powerful tool to help us grow our business. 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