3‐Day ‐ $20 2‐Hour* ‐ $352‐Day ‐ $12 2‐Hour* ‐ $152‐Day ‐ $45

Next‐Day‐$130 2‐Day ‐ $110 3‐Day ‐ $65Next‐Day‐$130 2‐Day ‐ $110 3‐Day ‐ $65

Additional charges will apply for bulk roofing samples with more than 2 layers or for bulk flooring samples with more than 4 layers.

Date/Time:Received by (signature):

Relinquished by (signature):

Page __ of __

Date/Time:

Turn‐Around Time

Sample Area (Lead)

Flow Rate in L/min (Air)

Select Analysis            (one test per sample) ‐‐>

Sampling Time (Air)

Sample Description/Location

*2‐hour turn‐around time is guaranteed if received before 3:00 PM. Please make arrangements for samples submitted after 3:00 PM if needed same day.

I agree that I have read the Terms and Conditions as stated on the reverse of this form and further agree that these Terms and Conditions apply to this Project. IN WITNESS WHEREOF, the parties hereto have

executed this Agreement as of this date.

Project Number

Sample ID Asbe

stos Bulk

Asbe

stos in

 Air

Lead

 in Paint

Project Name/Description

Special Instructions/CommentsAsbestos in AirLead in PaintMold BulkMold in Air

Mold Bu

lkMold in Air

Chain of Custody

Analysis/Turn‐Around TimesAsbestos Bulk

Company Name

Collected By Email Address

Phone Number

Billing Address

Date Sampled

Terms and Conditions

4. Client acknowledges billing minimums of 2 hours as outlined below.

5. This agreement is governed by laws of the State of Idaho and is entered into the County of Ada, City of Boise.

3. In recognition of the relative risks of the Client and MTI on the project, Client agrees, to the extent permitted by law, that MTI’s liability to the Client, in any way arising out of the Agreement, shall be limited to 100% of the total fees and costs paid to MTI or $25,000, whichever is greater.

6. Client shall promptly pay and be responsible for the removal and lawful disposal of samples, cuttings, and hazardous substances, unless other arrangements are mutually agreed to in writing. Client shall take custody of all monitoring wells and probes during an investigation by MTI, and shall take any and all necessary steps for the maintenance, repair or closure of such wells or probes at Client’s expense if so requested by MTI.

7. Services of MTI under this Agreement will be performed in a manner consistent with that level of care and skill ordinarily exercised by members of the Profession currently practicing under similar conditions in the locality of the Project. No other warranty, expressed or implied, is made.

8. If any party hereto commences an action or arbitration proceeding to interpret or enforce this contract, the prevailing party shall be entitled to an award of attorney’s fees and costs in addition to all other amounts awarded by the Court of arbitrator.

9. Services provided pursuant to this Agreement are intended solely for the use and benefit of Client. No other person or entity shall be entitled to rely on the services, opinions, recommendations, plans, or specifications provided pursuant to this Agreement without the express written consent of MTI.

For revisions, deletions or additions to the above information, or questions regarding invoices, please contact the billing department within 30 days in writing. For questions about reports, please contact the Project Manager. We require 24-hour notification of our personnel. Dispatch hours are 7:00 a.m. to 5:00 p.m. Although we will try to accommodate all dispatch request, we cannot guarantee that calls after 5:00 p.m. will be received. If a day’s inspection is canceled (for any reason), please notify the dispatch office by 5:00 p.m. on the day prior to the scheduled inspection. Cancellations received on the day of inspection are subject to a 2-hour show-up charge. In addition, all charges are portal to portal. The following basis of charges will be in effect during our participation on your projects.

1. Client agrees to pay invoice within 30 days, or incur interest charges of 1% per month.

2. Client acknowledges services are rendered at the unit rates quoted herein. Total inspection hours are as necessitated by the contractor’s/client’s schedule and local, state, and federal regulation requirements, and are not the responsibility of MTI.