Service Agreement.

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Account number *

Do you have an account with us?

 
Account number *

Please insert your account number below:
 
Billing details

 
Full company name: *

 
Company registration number:

 
Contact Name: *

 
Full Company Address: *

 
Postcode: *

 
Telephone: *

 
Fax:

 
Accounts invoice/statement to be received by email:

     
 
Site Details (where work is to be carried out)

 
Are the site details where work is to be carried out the same as the billing address? *


 
Full Company Name: *

 
Full Company Address: *

 
Postcode: *

 
Opening Times

 
Company brands to be covered *


 
Service

 
Annual Service *

Please select a call out charge based on when you would like the work to be undertaken.

 
Please tick unit type for work to be carried out on. (Oct-Feb) *

If you have difficulties in identifying which unit/s you currently have on site, then please click here http://ow.ly/SEq0z

 
Please tick unit type for work to be carried out on. (Mar-Sep) *

If you have difficulties in identifying which unit/s you currently have on site, then please click here http://ow.ly/SEq0z

 
Please insert the number of units for work to be carried out on:

*

 
What controls are being used? *

 
Nordair Niche Service

Our Rates are £75.00 ex vat per hour. If the units have not been serviced by us within the last 12 months a £200.00 ex vat call out fee applies; this will cover the first 2 hours of labour/travel, thereafter you will be chardged £75.00 ex vat per hour.
 
Please insert the number of units for work to be carried out on:

*

 
What controls are being used? *

 
Please indicate the model of the unit(s) you would like us to carry out work on: *

 
Site contact name: *

 
Site contact telephone: *

 
Is access equipment required? If yes is it to be supplied by: *

**Clients must ensure that provided lifting equipment has a validated LOLER certification.

 
If client is to provide access equipment, please specify type: *

 
What is the mounting height of the unit from the floor: (m) *

 
Are the units accessible from; *


 
Is a risk assessment and method statement required? *

     
 
Site induction required? *

     
 
Induction time & location: *

 
Is adequate van parking available (if not please give details) *

 
Preferred date for the work to be carried out. *

 
Confirmation

Charges are set out as included within this agreement. An additional charge of £75.00 an hour may apply if access to the equipment is prohibited, or site delays are experienced.

We confirm the data contained within this form is accurate to the best of our knowledge. We accept that we may be liable for additional charges should the information be inaccurate.
 
Name: *

 
Date *

 
Purchase order number: *

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