Service Request Form: 224 Milvan Dr. Unit C Toronto, On M9L 2A5 (647) 271-2656

You might also like

Download as pdf or txt
Download as pdf or txt
You are on page 1of 1

224 MILVAN DR.

UNIT C
TORONTO, ON M9L 2A5
universalductcleaning@hotmail.com
(647) 271-2656

SERVICE REQUEST FORM


NAME:
____________________________
DATE & TIME:
ADDRESS:
____________________________
TYPE OF HOME:
____________________________
SQ. FT.:
INTERSECTIONS: ____________________________
PHONE #:

________________________
________________________
_______________________
_______________________

PRODUCTS & SERVICES


AIR DUCT CLEANING
DRYER VENT CLEANING
H.R.V. CLEANING
FURNACE TUNE-UP/CLEANING
A/C TUNE-UP
HUMIDIFIER INSTALLATION
HOME CENTRAL VACUUM CLEANING
SANITIZING
FURNACE FILTER
HUMIDIFIER FILTER
WINDOW CLEANING
EAVESTROUGH CLEANING
CARPET CLEANING
_____ ROOMS
_____ HALLWAY
_____ STEPS
_____ AREA RUGS
PAYMENT
o CASH
o DEBIT (add 3%)
o CHEQUE
o CREDIT (add 3%)

RATE
$
$
$
$
$
$
$
$
$
$
$
$
$

SUBTOTAL $
13% HST $
TOTAL S

COMMENTS: _______________________________________________________________________________
__________________________________________________________________________________________
HOW DID YOU HEAR ABOUT US:
o GOOGLE
o YELLOW PAGES
o COMPANY WEBSITE
o TRUCK SIGN
o LAWN SIGN
o SOCIAL MEDIA (FACEBOOK, INSTAGRAM,
TWITTER, ETC.)
REQUESTORS NAME:

__________________________

o
o
o
o
o
o

FLYERS (STICKERS, ETC.)


KIJIJI/CRAIGSLIST/YOURCLASSIFIEDS
NEWSPAPER
PREVIOUS CLIENT _____________________
REFERRAL FROM ______________________
OTHER ______________________________

SIGNATURE:

________________________________

I agree that the AIR DUCTS, were cleaned to my satisfaction.

TECHNICIANS NAME: __________________________

You might also like