WINTERIZATION REQUEST FORM & APPROVAL

WINTERIZATION REQUEST FORM & APPROVAL - WEST GA BOAT CENTER
CUSTOMER NAME*

First NameLast Name
MAILING ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
EMAIL *
example@example.com
BEST PHONE NUMBER*

Area CodePhone Number
Eclipse Marine Group Service offers TEXT MESSAGING as a method of communication with our customers.

DISCLAIMER: Text communication will be used regarding your service needs only. Standard text messaging rates from your wireless carrier may apply. Any costs related with receiving a text message are the responsibility of the individual receiving it. Check with your cellphone provider for details on receiving text messages (SMS). To opt out of texting at any time, reply STOP.
Do we have your permission to communicate via TEXT MESSAGING?*

YESNO
BOAT MAKE / MODEL*
As much info as you can provide
ENGINE MAKE/MODEL/YEAR/HP*
As much information as you know
ENGINE SERIAL NUMBER *
If available (if not, type N/A)
DROP-OFF METHOD*

BY LAND (Bringing on Trailer)COME GET MY BOAT ON TRAILEROther
KEY LOCATION*
TYPE OF MOTOR*

OUTBOARDINBOARD/OUTBOARD - STERNDRIVE (Mercruiser, Volvo Penta)INBOARD - (PCM, INDMAR, etc)JET SKI / JET MOTORS
NUMBER OF OUTBOARDS

123MORE
WINTERIZATION PACKAGE CHOICE (Refer to Menu) - OUTBOARD*

OUTBOARD LEVEL 1 - 75 HP & lessOUTBOARD LEVEL 1 - 90HP+OUTBOARD LEVEL 1 - DFI/OPTI/HDPI/ETECOUTBOARD LEVEL 2 - ALL MODELSHelp me decide!
WINTERIZATION PACKAGE CHOICE (Refer to Menu) - I/O - STERNDRIVE*

LEVEL 1 - I/O / INBOARDLEVEL 2 - I/O / INBOARDLEVEL 3 - I/OLEVEL 3 - INBOARDHelp me decide!
WINTERIZATION PACKAGE CHOICE (Refer to Menu) - JET MOTORS*

LEVEL 1 - JET - SINGLE MOTOR OR JET SKILEVEL 1 - DUAL - DUAL MOTORS OR SKISLEVEL 2 - JET - SINGLE MOTOR OR JET SKILEVEL 2 - JET - DUAL MOTORS OR SKISHelp me decide!
OUTBOARD ADD-ON OPTIONS

IMPELLER CHANGEFUEL SYSTEM SERVICESPARK PLUG CHANGEOther
I/O | STERNDRIVE | INBOARD - ADD-ON OPTIONS

IMPELLER CHANGE -ALPHAIMPELLER CHANGE - BRAVO OR PENTAIMPELLER CHANGE -UNKNOWN OUTDRIVEFUEL SYSTEM SERVICESPARK PLUG CHANGEOther
JET MOTOR ADD-ON OPTIONS

FUEL SYSTEM SERVICESPARK PLUG CHANGEOther
ADDITIONAL WINTERIZATION CHOICES

WINTERIZE BALLAST SYSTEMWINTERIZE PORTA POTTI SYSTEMWINTERIZE FRESH WATER SYSTEMWINTERIZE RAW WATER WASHDOWNWINTERIZE LIVEWELLS (ALL)Other
Please list any additional services (warranty repairs, boat repairs, etc) that you would like completed while we have your boat for winterization.
SUMMARY OF ABOVE CHOICES:

{customerName} - {mailingAddress} - {email5} - {bestPhone} - {dropoffMethod} - {keyLocation} - {winterizationPackage21} - {winterizationPackage18} - {winterizationPackage22} - {outboardAddon} - {io} - {jetMotor} - {additionalWinterization}

Additional Services Requested:

{typeA39}
OPTIONAL REPAIR COST ALLOWANCE

The above listed winterization menu pricing options display pricing that in some cases includes and in others does not include parts and taxes. Therefore, once parts are added to the repair order, the due amount will increase (if not included in the flat rate as pictured). We know you're busy, so we are provided the option for "Pre-authoization" of a certain dollar amount of your choosing as an "allowance" for your winterization and other chosen services. This is completely optional, but will expedite the repair process by eliminating the step of approval of printed estimate. *If any additional suggestions or repairs are to be made, the service advisor must contact you to receive further authorization for any amount additional to your choice made below. See below for optional "Allowance."
"I HEREBY ALLOW WEST GEORGIA BOAT CENTER TO COMPLETE THE ABOVE CHOSEN SERVICES AT THE LISTED CHARGE AMOUNT."

Send me a Quote for Approval Regardless> $250> $500> $650> $1,000Other
Storage Fees: Storage fees will be added to all units not picked up and paid for within ten (10) days after notification of completed service. Any unit not picked up within ninety (90) days after notification of completion of service will be considered abandoned property and may be offered for public or private sales by West Georgia Boat Center to allow West Georgia Boat Center to recover the costs of repairs and materials.
STORAGE FEE: $15.00 PER DAY Initials*
Warning: Boats are returned with drain plug(s) removed. Customer is responsible for re-securing drain plugs, petcocks, drain valves and the attachment of trailer to vehicle hitch apparatus prior to departure (when applicable). West Georgia Boat Center MAKES NO WARRANTIES, EXPRESS OR IMPLIED IN CONNECTION WITH THE LABOR AND MATERIALS TO BE FURNISHED PURSUANT TO THIS REPAIR ORDER, INCLUDING BUT NOT LIMITED TO, THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. Any warranties are limited to those of the original product manufacturer. West Georgia Boat Center's liability for acts, errors or omissions shall be limited to the invoice amount actually paid by the customer. If any court proceedings or other legal process or proceedings arise out of this repair order, the customer agrees to pay West Georgia Boat Center reasonable attorney's fees plus all costs of court and/or associated expenses incurred by West Georgia Boat Center.
Initials*
REPAIR ORDER AUTHORIZATION

I hereby authorize the above-referenced repairs and labor (as agreed to per the allowance above) to be performed, including all necessary materials; and I agree to pay the total amount of all charges for such labor and materials at the time the unit is available for pickup and delivery. All prices are subject to all taxes applicable by law and I agree to pay all such taxes. I have read the descriptions of work I have requested and agree that they are acceptable descriptions of the conditions that require repair. I hereby
acknowledge reading an understanding all the terms and conditions of this Agreement and agree that it is an enforceable legal contract binding upon me. I authorize West Georgia Boat Center permission to operate the unit as necessary for the purpose of testing and/or inspection. I agree that West Georgia Boat Center is not responsible for any loss or damage to the unit and/or its contents in the case of fire, theft, or any other cause whatsoever. I agree that jurisdiction and venue for any legal action or proceeding arising out of this Agreement (including any claim, action or proceeding relating to any service, repair or maintenance of the unit) shall be in Troup County, GA. In all instances, West Georgia Boat Center shall not be liable for any consequential damages, or any type or nature whatsoever, to the maximum extent permitted by applicable law. An express mechanics lien is hereby acknowledged on the above-referenced unit to secure the cost of repairs.
Signature*

Clear
PRESCHEDULE DATES: When would you like to pre-schedule your winterization for? (dates are approximate & the service dept will contact you at the expected time)

Do Not Pre-schedule, Complete ASAPSeptember 15-30October 1-15October 16-31November 1-15November 16-30December 1-20January 1-15January 16-31
Should be Empty:

WINTERIZATION REQUEST FORM & APPROVAL - WEST GA BOAT CENTER