GreenCast

2020 H2O Pro™ Aquatic Herbicide Performance Guarantee Claim Form

*First Name
 
   
*Last Name
 
   
*E-mail
 
   
*Title
 
 
*Company Name
 
   
*Company Type
 
   
*Address 1
 
   
Address 2
 
 
*City
 
   
*State
 
   
*Zip
 
   
*Phone
 
   

 

Primary month(s) Reward is/was purchased*Number of business locations/branches
 To select multiple months, hold down the “Ctrl” key on your keyboard while clicking on each of the months you wish to select.
 
 

Primary month(s) Reward will be applied*Number of application crews
 To select multiple months, hold down the “Ctrl” key on your keyboard while clicking on each of the months you wish to select.
 
 

Where did you hear about the Reward Performance Guarantee Program?

* Number of acres treated with Reward this calendar year
  
 

* Authorized Reward Distributor, Agent

* Distributor or Agent Sales Representative’s Name
 
 
 
 
* Location of treatment(City,State) * Water body name or description of location * Air temperature
 
 
 
 
 
 
* Date of treatment * Rate of Reward used * Sky condition (sunny, cloudy, rainy, overcast, etc.)
 
 
 
 
 
 
* Time of treatment * Area treated (acres)   Wind condition
 
 
 
 
 
* Target weed * Area of treatment failure (acres)  Water Temperture
 
 
 
 
  
 Water turbidity    Water pH  Was the treatment for private or public waters?
     

 Did you use Reward in a combination? if so, with what product?

* How should we contact you to validate/verify claim (phone, email)?
   

Comments/further explaination/details
 


*Denotes a required field