Affordable Cooling & Heating Service
Company  Name:
 POC Name:
Street Address
 2nd Street Address
City:
 State:
 Zip Code:
Business Phone:
 Fax Number:
Website Address:
 Your E-mail Address:
We are Purchasing a
Commercial Annual Preventative  Maintenance Agreement.
$299.95 for Air Conditioning Systems !
$369.95 for Heat Pump Systems !
Add $50.00 for Each Rooftop Units .
(Additional Charge, Plus Sales Tax for Refrigerant.)
Quantity of Air Conditioning Systems:
 Located on roof?:
Yes or No
Quantity of Heat Pump Systems:
 Located on roof?:
Yes or No
Please Enter Your Credit Card Information.
Credit Card Number:
 Type of Credit Card:
(VISA, Dicover or Mastercard Only)
Expiration Date:
 (example:  01/08)
 CVV2 Number:
Do You have questions or comments?
Comments: (Example:)
Request to purchase an Annual Preventative
Maintenance Agreement  for 2009.

Please Enter Your Informatiom To Purchase a
Commercial Annual Preventative Maintenance Agreement, With Your Credit Card,
Please Fill In the Information Below and Press Submit Button.
Commercial Annual Preventative Maintenance Agreement
Credit Card Purchase Entry Form
For More
Information.
About
PMA's  
Call Our
OFFICE at

(816)
468-1509
Our
Mailing
Address is
Located at
the Bottom
of This
Page.
When Mailing Payment With Your:
(Credit Card, Check or Money Order)

Press the Blue CLICK HERE Button, to Print a:
Residential Annual Preventative Maintenance Agreement Sign-Up Form





Please, Fill Out the Form:

Mail Completed Form and Payment To:

Affordable Cooling & Heating Service
P.O. Box 28856
Kansas City, MO  64118

CLICK HERE for
PMA FROM

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PMA FROM