ROUTINE CLEANING AGREEMENT CLIENT INFORMATIONClient Name* First Last Client Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Client Email* Phone*Previously, you received an email with access to a copy of the bid which was presented and agreed upon. It is our understanding that you have chosen the following package, to be completed at the time of service:INTIAL EMPTY NEST CLEANROBIN [INITIAL CLEAN]EAGLE [INITIAL CLEAN]NOT NEEDEDSELECTED PACKAGE*ROBIN [INITIAL CLEAN]EAGLE [INITIAL CLEAN]EVERY OTHER WEEKONCE A MONTHSPRING CLEANFALL CLEANBID PRICE*To ensure the property is cleaned to the satisfaction of the client, Empty Nest Cleaning will guarantee that the final cost will not exceed the bid price listed below.The set appointment date and time for cleaning services is as follows:ROUTINE CLEAN START DATE* MM slash DD slash YYYY CLEANING START TIME* : Hours Minutes AM PM AM/PM CLEANING END TIME* : Hours Minutes AM PM AM/PM CLEANING AGREEMENTEmpty Nest Cleaning offers over 20 years of cleaning experience and provides cleaning services based on the condition of the property and what is needed to reduce stress on clients. For this reason, the proposed agreement is based on the specific needs required to do a thorough and detailed cleaning of the location during the agreed upon cleaning dates and times (not based on the typical square/foot pricing model). PROPERTY ADDRESS Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country DURATION*How much time each clean should take.2 Hours per-clean4 Hours per-clean6 hours per-clean8 hours per-cleanFREQUENCY*How often cleans are scheduledEvery WeekEvery Other WeekMonthlyFEE (PER-CLEAN)*Card on-file billed within 24hrs after each scheduled clean.ASSIGNED EMPLOYEE* First Last The following Empty Nest employee has been assigned for this routine clean. It is ideal that this same employee services your home on a regular basis; however, there may be times when that employee calls in sick, schedules time-off, or has an emergency situation that prevents them from attending work. Every effort to reschedule your cleaning appointment will be made at our earliest convenience. In rare circumstances, another employee may be temporarily assigned to cover for the absent employee assigned to your home.The following person is referred to as "THE CLIENT" within the Agreement included below:CLIENT NAME Referred to, throughout the Hold Harmless Agreement as "THE CLIENT"CLICK HERE TO READ THE HOLD HARMLESS AGREEMENT (agreement will open in a new tab/page)CLICK HERE TO READ THE ROUTINE CLEAN AGREEMENT (agreement will open in a new tab/page)CONFIRMATION* I have read, and by signing below, agree with the terms of the agreements provided above. Signature (THE CLIENT)*CREDIT CARD INFORMATIONOur website uses an encrypted Secure Socket Layer (SSL) protection to ensure that you information is secure. All data transmitted from this this website is encrypted and transferred securely at all times. Your card will not be billed until completion of the services outlined in this agreementCREDIT CARD TYPE* Visa Mastercard Discover CARD NUMBER* CARD EXPIRATION MONTH*JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberCARD EXPIRATION YEAR*201820192020202120222023202420252026SECURITY NUMBER* The security number is typically on the back of the card - 3 or 4 digits.NAME ON CARD* BILLING ADDRESS* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code BILLING APPROVAL*By checking this box I agree to allow Empty Nest Cleaning Co to process my card for the amount agreed upon in this agreement. I agree
