Customer Form | Request for Quote | Air Conditioning Service

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

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Option #1

Straight Cool
Packaged Unit
Heat Pump
Multi-System

Make

Tons

Seer

Outdoor Model#

Indoor Model#

Compressor

Single Stage
Two Stage
Dual Compressor
Variable Speed

Untitled

First Choice
Second Choice
Third Choice

Indoor Unit

Job Total $

Utility Rebate $

Manufacture Rebate $

Company Rebate $

Permit Fee $

Total Investment $

Warranty

Years Compressor

Years Parts

Years Coils

Years Labor

Notes

Option #2

Straight Cool
Packaged Unit
Heat Pump
Multi-System

Make

Tons

Seer

Outdoor Model #

Indoor Model #

Compressor

Single Stage
Two Stage
Dual Compressor
Variable Speed

Indoor Unit

Job Total $

Utility Rebate $

Manufacture Rebate $

Company Rebate $

Permit Fee $

Total Investment $

Warranty

Years Compressor

Years Parts

Years Coils

Years Labor

Notes

Option #3

Straight Cool
Packaged Unit
Heat Pump
Multi-System

Make

Tons

Seer

Outdoor Model #

Indoor Model #

Compressor

Single Stage
Two Stage
Dual Compressor
Variable Speed

Indoor Unit

Job Total $

Utility Rebate $

Manufacture Rebate $

Company Rebate $

Permit Fee $

Total Investment $

Warranty

Years Compressor

Years Parts

Years Coils

Years Labor

Notes

WE PROPOSE hereby to finish material and labor - complete in accordance with above specification, for the sum of Dollars $

Estimated Start Date

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