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�°� 3��1 �-���C� <br /> � arrell � � �AC 1817177 AHV Serviced Serviced <br /> �;,� Checked r'V Checked <br /> ��� o m e � --� � ••• . . Evap.Coil Y / N Fan Blade Y / N " <br /> ��' • Drain Pan Y / N Fan Motor Y / N <br /> S�s�V�riPis Return Supply High Low SH/SC Static Press %RH <br /> WFiEN COMFORT JUST CAN'T WAIT Insp./Clean Drain Pan Y / N Condenser Coil Y / N <br /> Before I Safety Float Switch Y / N Contactor Y / N <br /> After / Transformer Y / N Compressor Y / N <br /> INVOICE#:� �� �� : Circuit Board Y / N Defrost Board Y / N <br /> AHCJ Model S/N Blower Relay Y / N Liq.Line Drier Y / N <br /> DATE: �/ �"�' t��Time In: Time Out: Heat Sequencer Y / N Time Delay Y / N <br /> Name: �-� �J'� �l�_2,)Y�.� CU Model S/N Fan Speed Sett Y / N En.recovery Y / N <br /> j � r_� ��_� ,]�� p Heat Element Strip Y / N Reversing Valve Y / N <br /> Address: `P�� �►�1�- �� PCK Model S/N Blower Cap Y / N Accumulator Y / N <br /> ( � � I Blower Wheel Y / N Freon Charge Y / N <br /> ��-E-'-��'V � �l� 4� l L .� �" ��-_ ' � Blower Housing Y / N Amp.Rating <br /> /" � �� •a� p Horizontal Vertical Package Roof Blower Amp Y / N [ � Y / N <br /> Home Tel: t�,� �o�- l � <br /> t � G� �- Filters[size: ] Y / N CU Amp. <br /> Ce l l/Fa x: U�J..��' 3 ' � 1 S� S/C HP Tons Thermostat Y / N [ � Y / N <br /> Email: O � �: '0 DUCT SYSTEM <br /> . . . <br /> Reason for Today's Call: ' New Good Fair Poor Cover Y / N Power Sc�ub Y / N <br /> — Ducts Attic Boot Seal Y / N <br /> Good ! Fair ! Poor Y � � Duct Leaks Y / N <br /> Service Res / Comm Clean/Check Residential Estimated Age. Yrs ;4verage Life:� Yrs Airtlowfrom each sg. Y / N Sanitization Y / N <br /> Warranty Res./Comm. Maintenance Highest Electric Bill:$ Month <br /> Service Return Duct Cleaning Estimated Utility Overpayment:$ /5 Years 5��0�G �h09Ce? <br /> �_ Enroll in our Preferred Partner Program and save on this <br /> repair TODAY! (Program includes 20%Discount on <br /> (A/�-� }� ,° ° HVAC Repairs,Parts&Labor). <br /> ` � n./L�li'V y '7 _ <br /> C ' � � � . � � Subtotal $ <br /> I Your Savings Ar�: $ <br /> �l'.��� l ►� � �-�--_ '►'1^Q._ I.I.:Vti'LeK�' . $ <br /> � ` ' �'3- . Accep Offer � Decline Offer <br /> � � � � Inifials Iniflals <br /> J�U <br /> � � . �- l �� FORM OF PAYMENT <br /> _Cash _Check# <br /> Credit Card:_VISP� �MC _AmEx <br /> Name on Card: �E-�� ('A-Z.j I�L�J�K.`C' <br /> ' !hereby authorize the above work to 6e done as so ordered and outlined Card No. '�S�T-� ��� � �J�-w 0���� <br /> above. It is agreed that the seller will retain tiHe to any equipment or -7 <br /> I Tf����,� ���� matena!until final and complete payment is made.!f the settlement is not Total Amount Due � ��� Auth.Code: � 8 > Expiration � � ��� <br /> made as agreed,the seller has the right fo remove eq�ipment and material I <br /> � • and the sefler will be held harmless for any damages resulting(rom the <br /> :� removal o(equipment. Parts and Labor Warranty: � <br /> D�r�-� All parts as recorded are warranted as per manufacturer specifications.We do ; <br /> , /� not guarantee other parts than those we supply. If repairs later become , <br /> � � Signature , necessary due to other de(ecGve parts,they will be charged separately. � <br /> Te - icia 's Signatu AuthoRZed by �hereby acknow dge the satisiacrory comp�etion otrhe above descnbed worx We garantee that alI repairs are done right.If a repair fails during the season, <br /> we will repair it again absolutely free. � <br />