Billing Name
Street Address
City/State/Zip
Phone Alt. Phone
Equipment Location
Street Address
City/State/Zip
Email
Service Description Hours Amount Due
Customer Name (Please Print) Customer Signature
Technician Signature
Date
Technician Name (Please Print)
Amount Due
Subtotal
Tax
Amount Due
Equipment Model No. Brand Serial No.
(“Agreement”) is made and entered by and between _________________ and _________________.
“Contractor” and “Customer” hereby agree as follows:
Payment: Customer shall pay for the services and/or equipment (including repair and maintenance) furnished by Contractor
in accordance with the charges on the Service Agreement, as adjusted by Contractor hereunder, within _______ business
days of the date of Contractor’s invoice. All invoices not contested in writing within _______ business days of receipt are
deemed accepted by Customer as true and accurate and are payable in full. Interest will be charged on all accounts not
paid when due at a rate of two percent per month, or, if less, the maximum rate allowed by law. In the event Customer fails
to pay Contractor all amounts which become due under the Service Agreement or fails to perform its obligations hereunder,
and Contractor refers such matter to an attorney or collection agency, Customer agrees to pay, in addition to the amounts
due, any and all costs incurred by Contractor as a result of such action, including reasonable attorneys fees. Contractor
has the right to charge a return check fee or a fee to restart Customer if shut off for poor pay history.
INVOICE
Date
CONTRACTOR CUSTOMER
Terms of Agreement
Invoice # Date
P. O. # Account #
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