Customer Authorization Signature:
I, the undersigned, am owner/authorized representative/tenant of the premises listed herein. I hereby authorize you to perform the diagnosis to be a determine a solution. I hereby authorize the work
described below and agree to the terms and conditions as stated on the form. I recognize that aged and deteriorated plumbing fixtures, piping, and appurtenances may no longer be serviceable, and I
agree to hold SRL Plumbing LLC blameless for any damage or destruction to those items as a result
of these conventional repair efforts. I agree to pay for all work, goods, and services received, and
hereby further authorize SRL Plumbing LLC to bill any of my credit card(s) for the goods and/or
services being provided, and I agree to perform the obligations set forth in the applicable card holder
agreement with the credit card user. A service charge of 1-½% per month (:18% per annum) will be
charged on all balances 30 days or more past due.
Completion of Work Signature:
I knowledge satisfactory completion of the above described work, and that the premises have been
left in a satisfactory condition. I understand that if my check does not clear, I could be held liable for
three times the amount of the check, in no case more than $500, nor less than $100, plus the face
value of the check, as set forth in Arizona Civil Code. I agree that the amount set forth in the space
marked "Total", is the total flat price for the work performed.
The property owner has the right to file a written complaint with the Arizona Registrar of Contractors
for any alleged violation of section 32-1154, subsection A. 32-1154, subsection A.
SRL Plumbing LLC
PO Box 27363, Prescott Valley, Arizona 86312
Copyright © 2023 SRL Plumbing LLC - All Rights Reserved.
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