Service Request Form
DATE: ___________________
CUSTOMER NAME: ___________________________ ACCOUNT # _______________
VESSEL LENGTH _______________ MAKE _________________ TYPE _________________
VESSEL NAME ________________________
SERVICES PRICES
RE-BLOCK $75.00
ADJUST STANDS UNDER BOAT
$10.00
CHECK BOAT FOR STANDING WATER
N/C
PUMP WATER OUT OF BOAT $50.00 MIN
(HAZARD
WASTE DISPOSAL WILL BE ADDITIONAL)
PRESSURE WASH $2.00 PER FT =
______________
STEP MAST $75.00
FOR
EQUIPMENT +
$60.00
PER HR LABOR
RIGGING $75.00
FOR
EQUIPMENT +
$60.00
PER HR LABOR
AUTOMATIC
MONTHLY STORAGE PAYMENTS
CANCEL
AUTO PAYMENTS
CARD TYPE (CIRCLE ONE) VISA MASTER CARD DISCOVER AMEX
CARD # _____________________________________________ DAY OF MONTH TO RUN ______
EXPIRATION DATE ________________________
CARD STMT ADDRESS ___________________________________
ZIP ____________________
CUSTOMER SIGNATURE _________________________________________
* A CONFIRMATION CALL WILL BE GIVEN TO VERIFY THIS REQUEST