Sanitary Plumbing

Word Order Request or Callout Request Form

Client/Customer Name

Contact Number

Site/Location Address

E-Mail

Area/Level Location

Apartment/Common Area

Description of Fault or Failure

Parts / Materials required to fix / resolve the fault / appliance (If known)

Other Details(Maximum of seven files with total of 8MB)

Service Agreement

I agree that if the above work request and description as outlined above does not fall within Fixit Plumbing, warranty terms & conditions as described below then I / Company shall be responsible for all labour & material costs to complete the works as described. I (Print name submitted below) as a duly appointed person, hereby authorise the above works to be performed and charged to: Company Name: (Submitted below) Signed: (Please Attach Signature or Signature proof) Date: (Date below)

Submitted Print Name

Company Name

Signature

Date

Terms & Conditions:

Provided on the quotation/ invoice/ callout details before project is completed. Payment on completion. Credit card facilities available. EFT transfers also available. Bank transfer and cash also accepted.