PROPOSAL FOR:
Owner(s) Name:_______________________________Work Ph.___________Home Ph.___________

Property Address______________________________City______________State____Zip________

Billing Address___________________________________________Alternate Ph. No.____________

EQUIPMENT COVERED:
Brand: Model #: Serial #: Date Installed/Age: Unit Location: Filter Size:
1___________________________________________________________________________

2___________________________________________________________________________

3___________________________________________________________________________

4___________________________________________________________________________

5___________________________________________________________________________

COVERAGE PLAN:
(See Planned Service Agreement Plans webpage for Choice of Plans)
Plan A:____________________Plan B:____________________Plan C:____________________

Plan D:____________________Plan E:____________________Plan F:____________________

TERMS AND CONDITIONS:
The inspection and maintenance to be performed as part of this agreement includes _________inspections per year. Emergancy service will be available during weekends, holidays, and after regular working hours at discounted hourly rates. Only the work expressly described in this proposal will be done unless asked to do otherwise by the owner or authorized personnel. The purpose of this service is to routinely inspect your equipment and perform regular maintenance on that equipment to keep it performing at its peak efficiency and maximum life. We make no guarantee that this equipment will not fail, and we accept no responsibility for its expected life. If my system requires a filter size other than expressly provided in this contract, I authorize Hvac Services, Inc. to replace my filter)s) with like kind and bill me, as indicated by my signature on this contract.
ACCEPTANCE:
Total Amount $____________________
Anniversary Date:__________________ Approved by: __________________________________

Customer Signature:__________________________________________ Title:_______________

Company Representative Signature: _________________________________________

PAYMENT PLAN:
Check Check #____________________ Amount _______________________

Cash Amount _______________________

Credit Card Visa ____ MasterCard ____ (Daytime Phone # for processing) will be handled by office personnel

Card Number ________-______-______-______ Expiration Date: __________________