Service Call Entry Page

Our 58th Year of Service

Bradford Plg. Htg. A/C Co. Inc

Marion, Indiana USA

Phone 1-765-674-6200

Fax 1-765-674-8246

Company Information

Services Offered

Contact Personnel

Product Literature

On-Line Service Call

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Welcome to Our Online Service Entry Form.
Fields with*Must be completed

First Name: *	Middle Initial: *	Last Name: *
Callers Name: *	Service Address: *
City: *	State: *	Zip: *
Billing Address: * If same type "same"	City:	State: Zip:
Daytime Phone: *	Ask for Who?: *
Evening Phone: *	Ask for Who?: *
Tenant Phone: * If none type "none"	Ask for Who?:	Best time and day for Customer / tenant to be home?:*

**Please List HVAC Equipment Information If Available, other equipment: Water Heater, Softer, Well Pump, Disposal, Fixture Brand, Faucet Brand, ect.**
Brand Name
Air Conditioner / Heat Pump	Model Number	Serial Number
Air Handler / Furnace	Model Number	Serial Number
Water Heater	Model Number	Serial Number
Water Softener	Model Number	Serial Number
Other Equipment	Model Number	Serial Number

**Choose Your Service Problem**

If Your problem is not listed Please described in Text Box Below
The more information you give us the quicker We will be able to make repairs

"Notice"

If requesting a service call or an estimate for heating and/or plumbing

Our company is located in the state of "Indiana", county of "Grant", city of "Marion".

For Service Calls and Residential (Home) estimates, Our travel distance is usually 50 miles, however there are Exceptions.

Travel for larger commercial/industrial jobs Will be based upon each Job.

Have You been a customer of Ours before?:
Please Select One:
Do You Own the Property?:
If Not Please Fill In the Landlord's Info

Landlord's Name: * If none type "none"
Landlord's Address:
Landlord's City State Zip:

Where are You Employed?: *
Your Correct E-mail Address: *

Our Regular Labor Rate for Service Calls is $65.00 the First hour. All additional hours are billable at $58.00 per hour. Afterhours Rate is $75.00 per hour: Is This Understood and do You Agree?:

Enter Your Service Call over our Web Site and receive a Labor Discount!!

We have a Minimum Diagnostic Charge Of $39.95, this means if Our mechanic is at your home for ANY TIME, the Diagnostic Charge is BILLABLE. Is This Understood and do You Agree?:

Our Company's regular hours are Monday-Friday, 8:00am - 5:00pm. Any repairs NOT made in this time frame will be billed at our afterhours rate. Our afterhours rate is NOT 50% More than the regular rate, but ONLY an additional $17.00 per hour. We know it is expensive to have a Mechanic make a call, and as it doesn't cost the company to work afterhours, We do not charge extra for the Company, HOWEVER Our mechanics MUST BE PAID OVERTIME RATES just like every other employee expects and also because Uncle Sam and the IRS mandates overtime pay.

All customers without established credit history with Our Company will be required to pay at time of service

How Will You be Paying for these repairs?:

If Other, Please Specify:

By submitting this form, it is fully understood that I have read all questions and statements and completely understand and agree with all the entries and data I have entered.

Have You been a customer of Ours before?: Please Select One:	Do You Own the Property?: If Not Please Fill In the Landlord's Info
*Landlord's Name: If none type "none"**	Landlord's Address:	Landlord's City State Zip:
Where are You Employed?: *	Your Correct E-mail Address: *

How Will You be Paying for these repairs?: If Other, Please Specify:	By submitting this form, it is fully understood that I have read all questions and statements and completely understand and agree with all the entries and data I have entered.