1. And Thank You For Choosing Us To Serve You Address:
Quality Completion Inspection Phone:
□ Outdoor work site areas cleaned Email:
Name: www.anymechanicalcompany.com
Congratulations on the purchase your new CUSTOMER INFORMATION
Home Comfort System Name:
COPY AND PASTE YOUR LOGO HERE
Certified Installers ANY MECHANICAL COMPANY
Name:
Name: 12345 ANY STREET
Name: ANYWHERE, USA 12345
Install Helpers OFFICE: ### - ### - ####
EMAIL:
□ Operation Explained
□ Warranty Material Given To Homeowner Equipment Information
□ Maintenance records holder attached Model # Serial #
□ Indoor work site areas cleaned
□ Thermostat Programmed Equipment Location if Different
□ Heat Started/Completed Start up Sheet Address:
□ Cooling Started/Completed Start up Sheet
Payment Form
□ Down Payment
Please keep all paperwork for equipment in the holder
attached to the indoor equipment for future warranty
maintenance agreement records
□ check #
□visa □amex □mc □discover
□cash □check □credit card □debit card
Amount Received: $
signature: Install Date (s)
Start: Terms
card #
3 digit code #
3 digit code #
signature: I ______________________________ did authorize the above work and do attest
it is satisfactory completed. I agree that all material remains property of
contractor named above until final payment is received.
□ Pay In Full
□cash □check □credit card □debit card
□ Balance Due Payment End: Full payment due upon completion
□cash □check □credit card □debit card
Amount Received: $ Material, parts and equipment are warranted by manufactures written warranty
only. Any labor provided by installing contractor named above is warranted for
## year (s), unless expressed in writing.
□ check #
□visa □amex □mc □discover
card #
card # Print Print
3 digit code #
signature: Referral Offer
Amount Received: $
□ check # Customer Signature Company Representative
□visa □amex □mc □discover Sign Sign
Thank You For Your Business We Appreciate You.
Name:_________________________________________________________
Address:________________________________________________________
City:_________________State:___________________Zip:______________
______________________________ referred me to your company and with my
purchase of a new Comfort System please send
______________________________ a $100.00 gift card from
______________________________
Investment
$
Pre Paid Discount 5%
Total Due $