To take advantage of Hvac Services, Inc., preventative
maintenance services, print out and complete the appropriate
sections of the form below and bring it to our offices or
mail it to P.O. Box 153; Glasgow, KY 42142-0153. We will
contact you to finalize the agreement. Click
Here for a printable version of our Service Plan.
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: __________________
