Invoice 212C-Elgin August.pdf

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Attached to
Release Competitive Sealed Bidding IL|23-416CMS-BOPM4-P-42408
Contract number
23-416CMS-BOPM4-P-42408
Issued by
Illinois

About this file

This document is a series of pest control service notifications and consolidated invoices from Chicago Pests LLC for services rendered to Elgin Mental Health Center in Elgin, Illinois, during August 2025. The services were performed under Purchase Order Number 23-416CMS-BOPM4-P-42408, with Keith Henley serving as the primary supervisor and various technicians including Duane Peake, Diego Salazar, and others conducting individual service visits.

The services consisted of multiple general and one-time pest control treatments throughout the facility, targeting areas such as kitchens, bathrooms, baseboards, and specific units like the Hartman Unit and Kilbourne Building. The treatments included applications of various EPA-registered pesticides and rodenticides such as CY-KICK CS, ADVION ANT BAIT GEL, ADVION EVOLUTION COCKROACH GEL, TALSTAR P, and RESOLV SOFT BAIT RODENTICIDE. The total consolidated invoice amount is $875.00, comprising seven separate service visits between August 6-27, 2025, with individual service costs ranging from $95.00 for general services to $165.00 for one-time services. The invoices note that payments are due at the time of service, with a $25 finance charge applied to past due accounts.

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Consolidated Invoice 750 S State

C. INVOICE NO. ACCOUNT NUMBER

212C 12488

INVOICE DATE

09/09/2025

LICENSE

051-079571

AMOUNT DUE

$875.00

Subtotals $875.00

Total Discounts

$0.00

Taxes $0.00

Invoice Total

$875.00

Amount Paid

$0.00

Amount Due

$875.00

Chicago Pests LLC 270 Main St Park Forest, IL 60466

(844) 720-2847

Attn: Maureen Zamora Elgin Mental Health Center 750 S State Elgin, IL 60123

Elgin Mental Health Center (Acct #: 12488)

CUST ID CUSTOMER PO INVOICE # INVOICE DATE SUBTOTAL TAX INVOICE TOTAL

12488 Elgin Mental Health Center One Time Service

23-416CMS-BOPM4-P-42408 32374 08/06/2025 165.00 0.00 165.00

12488 Elgin Mental Health Center General Service

23-416CMS-BOPM4-P-42408 32493 08/06/2025 95.00 0.00 95.00

12488 Elgin Mental Health Center General Service

23-416CMS-BOPM4-P-42408 32556 08/13/2025 95.00 0.00 95.00

12488 Elgin Mental Health Center One Time Service

23-416CMS-BOPM4-P-42408 32646 08/20/2025 165.00 0.00 165.00

12488 Elgin Mental Health Center General Service

23-416CMS-BOPM4-P-42408 32662 08/20/2025 95.00 0.00 95.00

12488 Elgin Mental Health Center One Time Service

23-416CMS-BOPM4-P-42408 32668 08/27/2025 165.00 0.00 165.00

12488 Elgin Mental Health Center General Service

23-416CMS-BOPM4-P-42408 32782 08/27/2025 95.00 0.00 95.00

Additional Notes

Payments are due at time of service. A finance charge of $25 will be added to all past due invoices.

National Emergency Poison Control: (800)222-1222

9/9/25, 5:21 PM Invoice https://chicagopest.pestroutes.com/resources/routers/billing.php 1/2

Invoice Date 09/09/2025 Invoice # 212C

AMOUNT DUE

$875.00

REMITTANCE

Account # 12488

LOGIN TO YOUR CUSTOMER PORTAL TO PAY YOUR BILL ONLINE.

For questions regarding this statement, please contact us at (844) 720-2847 or workorders@chicagopests.com. If you would like to setup or manage your payment online, please continue to https://chicagopest.FieldPortals.com.

PLEASE REMIT PAYMENT TO

Chicago Pests LLC 270 Main St Park Forest, IL 60466

9/9/25, 5:21 PM Invoice https://chicagopest.pestroutes.com/resources/routers/billing.php 2/2

Service Notification Chicago Pests LLC 270 Main St Park Forest, IL 60466 United States 051-079571

Customer Service

(844) 720-2847 https://Www.Chicagopests.com workorders@chicagopests.com

Customer Elgin Mental Health Center Ronald Thomas

CustomerID 12488 Account # 12488 Invoice # 32374 Address 750 S State

Elgin, IL 60123 United States

County Kane Phone: (847) 742-1040

Customer Information Tech Keith Henley License(s) # 052-084431 Supervisor Keith Henley License(s) # 052-084431 Date 08/06/2025 Service Description(s)

One Time Service Service Time 11:00 am - 12:00 pm Time In 12:32 pm Time Out 1:33 pm Wind 0 mph Temperature 0.00 ℉ Serviced Interior Yes

Service Information Location Instructions

CY-KICK CS - BASF

[Cyfluthrin 6%]

EPA REG. # 499-304

EPA Lot #

Diluted Amount: 2.000 gals Concentrated Amount: 2 flozs Dilution Rate: 0.7813000%

Application Method: B&G

Target Issues:

Target Areas: Interior Baseboards, Kitchen/Bathrooms

ADVION ANT BAIT GEL - Syngenta [Indoxacarb 0.05%]

EPA REG. # 100-1498

EPA Lot #

Diluted Amount: 5.000 units Concentrated Amount: 0 units

Application Method: Bait Gun Application Rate: 1

Target Issues:

Target Areas: Cabinets, Kitchen/Bathrooms

ADVION EVOLUTION COCKROACH GEL - Syngenta [Indoxacarb 0.6%]

EPA REG. # 100-1484

EPA Lot #

Diluted Amount: 4.000 units Concentrated Amount: 0 units Active Ingredient: 0.6%

Application Method: Bait Gun Application Rate: 1

Target Issues:

Target Areas: Cabinets, Kitchen/Bathrooms

Products Used

Equipment Summary Technician Comments:

Power house interior whole building, bathrooms, dix unit a117, Hinton unit female hallway and tables

Appointment Notes

One Time Service $165.00 Subtotal $165.00 Tax 8.500 % $0.00 Service Total: $165.00

PO Number: 23-416CMS-

BOPM4-P-42408

Invoice Items

Chicago Pests LLC is committed to the safety of our customers and our environment. All materials used by Chicago Pests LLC have been registered by the Environmental Protection Agency. Please avoid unnecessary contact with materials and comply with all instructions and recommendations from our technicians. Thanks for your patronage! National Emergency Poison Control: (800)222-1222

Tech Signature:

Customer Elgin Mental Health Center Maureen Zamora

CustomerID 12488 Account # 12488 Invoice # 32374 Address 750 S State

Elgin, IL 60123 US Phone: (847) 894-0089 Service Date 08/06/2025 Service Description

One Time Service Service Time 11:00 am - 12:00 pm

BILLING INFORMATION

Please pay online or remit payment to:

270 Main St Park Forest, IL 60466

ACCOUNT STATEMENT:

Service Total $165.00 Amount paid $0.00 Service Amount Due $165.00

Current Account Balance $875.00

Please pay from this invoice

(844) 720-2847 https://Www.Chicagopests.com workorders@chicagopests.com

051-079571 Amount Included ____________________

270 Main St Park Forest, IL 60466 United States 051-079571

Customer Service

(844) 720-2847 https://Www.Chicagopests.com workorders@chicagopests.com

Customer Elgin Mental Health Center Ronald Thomas

CustomerID 12488 Account # 12488 Invoice # 32493 Address 750 S State

Elgin, IL 60123 United States

County Kane Phone: (847) 742-1040

Customer Information Tech Duane Peake License # Supervisor Keith Henley License(s) # 052-084431 Date 08/06/2025 Service Description(s)

General Service Service Time 9:30 am - 12:00 pm Time In 11:30 am Time Out 12:30 pm Wind 0 mph Temperature 0.00 ℉ Serviced Interior Yes

Service Information Location Instructions

CY-KICK CS - BASF

[Cyfluthrin 6%]

EPA REG. # 499-304

EPA Lot #

Diluted Amount: 2.000 gals Concentrated Amount: 2 flozs Dilution Rate: 0.7813000%

Application Method: B&G

Target Issues:

Target Areas:

MOUSE HOUSE

EPA REG. # N/A

EPA Lot #

Diluted Amount: 2.000 units Concentrated Amount: 0 units

Application Method: Hand Placed

Target Issues:

Target Areas:

GLUE BOARD

EPA REG. # N/A

EPA Lot # 5

Diluted Amount: 3.000 each Concentrated Amount: 0 each

Application Method: Glue Boards

Target Issues:

Target Areas:

Products Used

Equipment Summary Technician Comments:

treated the dietary and pharmacy areas.

Appointment Notes

General Service $95.00 Subtotal $95.00 Tax 8.500 % $0.00 Service Total: $95.00

PO Number: 23-416CMS-

BOPM4-P-42408

Invoice Items

Chicago Pests LLC is committed to the safety of our customers and our environment. All materials used by Chicago Pests LLC have been registered by the Environmental Protection Agency. Please avoid unnecessary contact with materials and comply with all instructions and recommendations from our technicians. Thanks for your patronage! National Emergency Poison Control: (800)222-1222

Customer Elgin Mental Health Center Maureen Zamora

CustomerID 12488 Account # 12488 Invoice # 32493 Address 750 S State

Elgin, IL 60123 US Phone: (847) 894-0089 Service Date 08/06/2025 Service Description

General Service Service Time 9:30 am - 12:00 pm

BILLING INFORMATION

Please pay online or remit payment to:

270 Main St Park Forest, IL 60466

ACCOUNT STATEMENT:

Service Total $95.00 Amount paid $0.00 Service Amount Due $95.00

Current Account Balance $875.00

Please pay from this invoice

(844) 720-2847 https://Www.Chicagopests.com

270 Main St Park Forest, IL 60466 United States 051-079571

Customer Service

(844) 720-2847 https://Www.Chicagopests.com workorders@chicagopests.com

Customer Elgin Mental Health Center Ronald Thomas

CustomerID 12488 Account # 12488 Invoice # 32556 Address 750 S State

Elgin, IL 60123 United States

County Kane Phone: (847) 742-1040

Customer Information Tech Duane Peake License # Supervisor Keith Henley License(s) # 052-084431 Date 08/13/2025 Service Description(s)

General Service Service Time 9:30 am - 12:00 pm Time In 11:00 am Time Out 12:00 pm Wind 0 mph Temperature 0.00 ℉ Serviced Interior Yes

Service Information Location Instructions

CY-KICK CS - BASF

[Cyfluthrin 6%]

EPA REG. # 499-304

EPA Lot #

Diluted Amount: 2.000 gals Concentrated Amount: 2 flozs Dilution Rate: 0.7813000%

Application Method: B&G

Target Issues:

Target Areas:

GLUE BOARD

EPA REG. # N/A

EPA Lot # 5

Diluted Amount: 4.000 each Concentrated Amount: 0 each

Application Method: Glue Boards

Target Issues:

Target Areas:

Products Used

Equipment Summary Technician Comments:

treated kitchen and pharmacy changed glue boards and spot treated the areas as needed.

Appointment Notes

General Service $95.00 Subtotal $95.00 Tax 8.500 % $0.00 Service Total: $95.00

PO Number: 23-416CMS-

BOPM4-P-42408

Invoice Items

Chicago Pests LLC is committed to the safety of our customers and our environment. All materials used by Chicago Pests LLC have been registered by the Environmental Protection Agency. Please avoid unnecessary contact with materials and comply with all instructions and recommendations from our technicians. Thanks for your patronage! National Emergency Poison Control: (800)222-1222

Customer Elgin Mental Health Center Maureen Zamora

CustomerID 12488 Account # 12488 Invoice # 32556 Address 750 S State

Elgin, IL 60123 US Phone: (847) 894-0089 Service Date 08/13/2025 Service Description

General Service Service Time 9:30 am - 12:00 pm

BILLING INFORMATION

Please pay online or remit payment to:

270 Main St Park Forest, IL 60466

ACCOUNT STATEMENT:

Service Total $95.00 Amount paid $0.00 Service Amount Due $95.00

Current Account Balance $875.00

Please pay from this invoice

(844) 720-2847 https://Www.Chicagopests.com

270 Main St Park Forest, IL 60466 United States 051-079571

Customer Service

(844) 720-2847 https://Www.Chicagopests.com workorders@chicagopests.com

Customer Elgin Mental Health Center Ronald Thomas

CustomerID 12488 Account # 12488 Invoice # 32646 Address 750 S State

Elgin, IL 60123 United States

County Kane Phone: (847) 742-1040

Customer Information Tech Diego Salazar License # Supervisor Keith Henley License(s) # 052-084431 Date 08/20/2025 Service Description(s)

One Time Service Service Time 8:00 am - 8:00 pm Time In 11:46 am Time Out 12:19 pm Wind 0 mph Temperature 0.00 ℉ Serviced Interior Yes

Service Information Location Instructions

CY-KICK CS - BASF

[Cyfluthrin 6%]

EPA REG. # 499-304

EPA Lot #

Diluted Amount: 2.000 flozs Concentrated Amount: 0.016 flozs Dilution Rate: 0.7813000%

Application Method: B&G

Target Issues:

Target Areas: Interior Baseboards, Kitchen/Bathrooms

ADVION ANT BAIT GEL - Syngenta [Indoxacarb 0.05%]

EPA REG. # 100-1498

EPA Lot #

Diluted Amount: 2.000 grams Concentrated Amount: 0 units

Application Method: Bait Gun Application Rate: 1

Target Issues:

Target Areas: Cabinets, Kitchen/Bathrooms

Products Used

Equipment Summary Technician Comments:

Kilbourn building:

- Office N34, was treated for spiders. Spider webs were removed. Office was spot treated. All windows and area where heater radiator were treated. Most activity was located in that area.

- Office S18, was spot treated for ant activity. Windows and baseboards were spot treated.

*Kelvin, groundskeeper was my escort and he signed.

Appointment Notes

One Time Service $165.00 Subtotal $165.00 Tax 8.500 % $0.00 Service Total: $165.00

PO Number: 23-416CMS-

BOPM4-P-42408

Invoice Items

Chicago Pests LLC is committed to the safety of our customers and our environment. All materials used by Chicago Pests LLC have been registered by the Environmental Protection Agency. Please avoid unnecessary contact with materials and comply with all instructions and recommendations from our technicians. Thanks for your patronage! National Emergency Poison Control: (800)222-1222

Customer Signature:Tech Signature:

Customer Elgin Mental Health Center Maureen Zamora

CustomerID 12488 Account # 12488 Invoice # 32646 Address 750 S State

Elgin, IL 60123 US Phone: (847) 894-0089 Service Date 08/20/2025 Service Description

One Time Service Service Time 8:00 am - 8:00 pm

BILLING INFORMATION

Please pay online or remit payment to:

270 Main St Park Forest, IL 60466

ACCOUNT STATEMENT:

Service Total $165.00 Amount paid $0.00 Service Amount Due $165.00

Current Account Balance $875.00

Please pay from this invoice

(844) 720-2847 https://Www.Chicagopests.com

270 Main St Park Forest, IL 60466 United States 051-079571

Customer Service

(844) 720-2847 https://Www.Chicagopests.com workorders@chicagopests.com

Customer Elgin Mental Health Center Ronald Thomas

CustomerID 12488 Account # 12488 Invoice # 32662 Address 750 S State

Elgin, IL 60123 United States

County Kane Phone: (847) 742-1040

Customer Information Tech Diego Salazar License # Supervisor Keith Henley License(s) # 052-084431 Date 08/20/2025 Service Description(s)

General Service Service Time 9:30 am - 12:00 pm Time In 10:46 am Time Out 11:42 am Wind 0 mph Temperature 0.00 ℉ Serviced Interior Yes

Service Information Location Instructions

CY-KICK CS - BASF

[Cyfluthrin 6%]

EPA REG. # 499-304

EPA Lot #

Diluted Amount: 1.000 gals Concentrated Amount: 1 flozs Dilution Rate: 0.7813000%

Application Method: B&G

Target Issues:

Target Areas:

RESOLV SOFT BAIT RODENTICIDE - Lipatech [Bromadiolone .005%]

EPA REG. # 7173-297

EPA Lot # 7173-297

Diluted Amount: 4.000 units Concentrated Amount: 0 units

Application Method: Bait Box

Target Issues:

Target Areas:

Products Used

Equipment Summary Technician Comments:

Dietary was spot treated and dead mouse was removed and snap traps reset.

Water continues to leak in dishwasher area and it’s contributing to roach activity. Recommend that it get fix asap Pharmacy was treated for mice. Glue boards were replaced as needed and bait was placed where activity was spotted.

Appointment Notes

General Service $95.00 Subtotal $95.00 Tax 8.500 % $0.00 Service Total: $95.00

PO Number: 23-416CMS-

BOPM4-P-42408

Invoice Items

Chicago Pests LLC is committed to the safety of our customers and our environment. All materials used by Chicago Pests LLC have been registered by the Environmental Protection Agency. Please avoid unnecessary contact with materials and comply with all instructions and recommendations from our technicians. Thanks for your patronage! National Emergency Poison Control: (800)222-1222

Customer Signature:Tech Signature:

Customer Elgin Mental Health Center Maureen Zamora

CustomerID 12488 Account # 12488 Invoice # 32662 Address 750 S State

Elgin, IL 60123 US Phone: (847) 894-0089 Service Date 08/20/2025 Service Description

General Service Service Time 9:30 am - 12:00 pm

BILLING INFORMATION

Please pay online or remit payment to:

270 Main St Park Forest, IL 60466

ACCOUNT STATEMENT:

Service Total $95.00 Amount paid $0.00 Service Amount Due $95.00

Current Account Balance $875.00

Please pay from this invoice

(844) 720-2847 https://Www.Chicagopests.com

270 Main St Park Forest, IL 60466 United States 051-079571

Customer Service

(844) 720-2847 https://Www.Chicagopests.com workorders@chicagopests.com

Customer Elgin Mental Health Center Ronald Thomas

CustomerID 12488 Account # 12488 Invoice # 32668 Address 750 S State

Elgin, IL 60123 United States

County Kane Phone: (847) 742-1040

Customer Information Tech Duane Peake License # Supervisor Keith Henley License(s) # 052-084431 Date 08/27/2025 Service Description(s)

One Time Service Service Time 8:00 am - 8:00 pm Time In 12:00 pm Time Out 1:00 pm Wind 0 mph Temperature 0.00 ℉ Serviced Interior Yes

Service Information Location Instructions

ADVION EVOLUTION COCKROACH GEL - Syngenta [Indoxacarb 0.6%]

EPA REG. # 100-1484

EPA Lot #

Diluted Amount: 6.000 units Concentrated Amount: 0 units Active Ingredient: 0.6%

Application Method: Bait Gun Application Rate: 1

Target Issues:

Target Areas: Cabinets, Kitchen/Bathrooms

TALSTAR P 0.062 - FMC Professional Solutions [Bifenthrin 7.9%]

EPA REG. # 279-3206

EPA Lot #

Diluted Amount: 1.500 gals Concentrated Amount: 1.5 flozs Dilution Rate: 0.7813000%

Application Method: B&G

Target Issues:

Target Areas:

Products Used

CY-KICK CS - BASF [Cyfluthrin 6%]

EPA REG. # 499-304

EPA Lot # Target Areas: Interior Baseboards, Kitchen/Bathrooms

Diluted Amount: 0.000 gals Concentrated Amount: 0 flozs Dilution Rate: 0.7813000% Target Issues:

Application Method:

B&G

ADVION ANT BAIT GEL - Syngenta [Indoxacarb 0.05%]

EPA REG. # 100-1498

EPA Lot # Target Areas: Cabinets, Kitchen/Bathrooms

Diluted Amount: 0.000 units Concentrated Amount: 0 units Target Issues:

Application Method: Bait Gun

Application Rate: 1

RESOLV SOFT BAIT RODENTICIDE -

Lipatech [Bromadiolone .005%]

EPA REG. # 7173-297

EPA Lot # Target Areas: Basement, Cabinets, Kitchen/Bathrooms

Diluted Amount: 0.000 units Concentrated Amount: 0 units Target Issues:

Application Method: Bait Station

ADVION EVOLUTION COCKROACH

GEL - Syngenta [Indoxacarb 0.6%]

EPA REG. # 100-1484

EPA Lot # Target Areas: Cabinets, Kitchen/Bathrooms

Diluted Amount: 0.000 units Concentrated Amount: 0 units Active Ingredient: 0.6% Target Issues:

Application Method: Bait Gun

Application Rate: 1

Unit: FTP Building Hartman Unit-

CY-KICK CS - BASF [Cyfluthrin 6%]

EPA REG. # 499-304

EPA Lot # Target Areas: Interior Baseboards, Kitchen/Bathrooms

Diluted Amount: 0.000 gals Concentrated Amount: 0 flozs Dilution Rate: 0.7813000% Target Issues:

Application Method:

B&G

ADVION ANT BAIT GEL - Syngenta [Indoxacarb 0.05%]

EPA REG. # 100-1498

EPA Lot # Target Areas: Cabinets, Kitchen/Bathrooms

Diluted Amount: 0.000 units Concentrated Amount: 0 units Target Issues:

Application Method: Bait Gun

Application Rate: 1

RESOLV SOFT BAIT RODENTICIDE -

Lipatech [Bromadiolone .005%]

EPA REG. # 7173-297

EPA Lot # Target Areas: Basement, Cabinets, Kitchen/Bathrooms

Diluted Amount: 0.000 units Concentrated Amount: 0 units Target Issues:

Application Method: Bait Station

ADVION EVOLUTION COCKROACH

GEL - Syngenta [Indoxacarb 0.6%]

EPA REG. # 100-1484

EPA Lot # Target Areas: Cabinets, Kitchen/Bathrooms

Diluted Amount: 0.000 units Concentrated Amount: 0 units Active Ingredient: 0.6% Target Issues:

Application Method: Bait Gun

Application Rate: 1

Unit: FTP Building-

CY-KICK CS - BASF [Cyfluthrin 6%]

EPA REG. # 499-304

EPA Lot # Target Areas: Interior Baseboards, Kitchen/Bathrooms

Diluted Amount: 0.000 gals Concentrated Amount: 0 flozs Dilution Rate: 0.7813000% Target Issues:

Application Method:

B&G

ADVION ANT BAIT GEL - Syngenta [Indoxacarb 0.05%]

EPA REG. # 100-1498

EPA Lot # Target Areas: Cabinets, Kitchen/Bathrooms

Diluted Amount: 0.000 units Concentrated Amount: 0 units Target Issues:

Application Method: Bait Gun

Application Rate: 1

Unit: Kilbourne-

Units Treated

RESOLV SOFT BAIT RODENTICIDE -

Lipatech [Bromadiolone .005%]

EPA REG. # 7173-297

EPA Lot # Target Areas: Basement, Cabinets, Kitchen/Bathrooms

Diluted Amount: 0.000 units Concentrated Amount: 0 units Target Issues:

Application Method: Bait Station

ADVION EVOLUTION COCKROACH

GEL - Syngenta [Indoxacarb 0.6%]

EPA REG. # 100-1484

EPA Lot # Target Areas: Cabinets, Kitchen/Bathrooms

Diluted Amount: 0.000 units Concentrated Amount: 0 units Active Ingredient: 0.6% Target Issues:

Application Method: Bait Gun

Application Rate: 1

Equipment Summary Technician Comments:

treated all add ons as needed kitchens bathrooms and pr building

Appointment Notes

One Time Service $165.00 Subtotal $165.00 Tax 8.500 % $0.00 Service Total: $165.00

PO Number: 23-416CMS-

BOPM4-P-42408

Invoice Items

Chicago Pests LLC is committed to the safety of our customers and our environment. All materials used by Chicago Pests LLC have been registered by the Environmental Protection Agency. Please avoid unnecessary contact with materials and comply with all instructions and recommendations from our technicians. Thanks for your patronage! National Emergency Poison Control: (800)222-1222

Customer Elgin Mental Health Center Maureen Zamora

CustomerID 12488 Account # 12488 Invoice # 32668 Address 750 S State

Elgin, IL 60123 US Phone: (847) 894-0089 Service Date 08/27/2025 Service Description

One Time Service Service Time 8:00 am - 8:00 pm

BILLING INFORMATION

Please pay online or remit payment to:

270 Main St Park Forest, IL 60466

ACCOUNT STATEMENT:

Service Total $165.00 Amount paid $0.00 Service Amount Due $165.00

Current Account Balance $875.00

Please pay from this invoice

(844) 720-2847 https://Www.Chicagopests.com

270 Main St Park Forest, IL 60466 United States 051-079571

Customer Service

(844) 720-2847 https://Www.Chicagopests.com workorders@chicagopests.com

Customer Elgin Mental Health Center Ronald Thomas

CustomerID 12488 Account # 12488 Invoice # 32782 Address 750 S State

Elgin, IL 60123 United States

County Kane Phone: (847) 742-1040

Customer Information Tech Duane Peake License # Supervisor Keith Henley License(s) # 052-084431 Date 08/27/2025 Service Description(s)

General Service Service Time 9:30 am - 12:00 pm Time In 11:00 am Time Out 12:00 pm Wind 0 mph Temperature 0.00 ℉ Serviced Interior Yes

Service Information Location Instructions

CY-KICK CS - BASF

[Cyfluthrin 6%]

EPA REG. # 499-304

EPA Lot #

Diluted Amount: 1.000 gals Concentrated Amount: 1 flozs Dilution Rate: 0.7813000%

Application Method: B&G

Target Issues:

Target Areas:

GLUE BOARD

EPA REG. # N/A

EPA Lot #

Diluted Amount: 4.000 each Concentrated Amount: 0 each

Application Method: Glue Boards

Target Issues:

Target Areas:

Products Used

Equipment Summary Technician Comments:

treated kitchen and pharmacy changed glue boards and spot treated the areas as needed.

Appointment Notes

General Service $95.00 Subtotal $95.00 Tax 8.500 % $0.00 Service Total: $95.00

PO Number: 23-416CMS-

BOPM4-P-42408

Invoice Items

Chicago Pests LLC is committed to the safety of our customers and our environment. All materials used by Chicago Pests LLC have been registered by the Environmental Protection Agency. Please avoid unnecessary contact with materials and comply with all instructions and recommendations from our technicians. Thanks for your patronage! National Emergency Poison Control: (800)222-1222

Customer Elgin Mental Health Center Maureen Zamora

CustomerID 12488 Account # 12488 Invoice # 32782 Address 750 S State

Elgin, IL 60123 US Phone: (847) 894-0089 Service Date 08/27/2025 Service Description

General Service Service Time 9:30 am - 12:00 pm

BILLING INFORMATION

Please pay online or remit payment to:

270 Main St Park Forest, IL 60466

ACCOUNT STATEMENT:

Service Total $95.00 Amount paid $0.00 Service Amount Due $95.00

Current Account Balance $875.00

Please pay from this invoice

(844) 720-2847 https://Www.Chicagopests.com

File details come from the government source that posted it. Updated .