Affordable Cooling & Heating Service
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print a
Commercial
Annual
Preventative
Maintenance
Agreement Sign
Up Form
COMMERCIAL Annual Preventative Maintenance Agreement,
Request or Sign-Up Form
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 an Annual Commercial Preventative  Maintenance Agreement.
$149.95 for Air Conditioning Systems and/or $224.95 for Heat Pump Systems.  Add $50.00 for Each Rooftop System.
Quantity of Air Conditioning Systems:
 Located on roof?:
 Yes or No
Quantity of Heat Pump Systems:
 Located on roof?:
 Yes or No
Credit Card Number:
 Type of Credit Card:
 (VISA or Mastercard Only)
Expiration Date:
 (example:  01/08)
 CVV2 Number:
Comments: (Example:)
Request to purchase an Annual Preventative
Maintenance Agreement  for 2009.
When Mailing Payment With Credit Card Information, Check or Money Order,
Please Print and Fill out a:  
Commercial Preventative Maintenance Agreement Sign-Up form.

Mail Form and Payment to:  
Affordable Cooling & Heating Service,  PO Box  28856,  Kansas City, MO  64118
(816)
468-1509
or
(816)
459-7977
To Purchase a
Commercial Annual Preventative Maintenance Agreement, With Your Credit Card,
Please Fill In Your Information Below and Press Submit Button.