Authorisation To Proceed

Name*

First NameLast Name

Site Address*

Street Address Line 2

Email*

example@example.com

Phone Number*

Automatic Gate Solutions Branch*

Customer Brief*

What is this form for?

This form used normally for service and/or repair work is to authorise works where a costing or quote for the works cannot be determined. Once completed it will instruct the technician as to the works expected and how to progress.

How to fill in this form ?

The section above may be pre filled for you - if not please complete this section and/or make any corrections. Next please select only one of the three options below to instruct on how you would like us to proceed. Each option has an explanation attached of the charges incurred and the way in which the work will be handled. Next fill in the credit card payment section and sign to enable us to charge the pre authorisation callout fee and schedule in your job. If you wish to pay by cheque or cash directly to the technician on site at completion this will still be possible and the pre authorisation will be cancelled. Finally please sign, date and enter your name before returning the form.

What happens next ?

Once this form has been filled out, signed and returned a work order can be produced and your works scheduled. You will be notified as soon as possible of the date and time of any work.

Booking preference -*

OPTION 1 - TECHNICIAN TO ATTEND AND QUOTE ONLY - I require a technician to attend and investigate any fault and to report the fault by written quote for my consideration. I understand that this option will incur a service fee which includes attendance on site and half an hour labour to determine the fault and produce the quote. I agree to the technician removing any parts and returning them to the service centre for further inspection if required. Any parts removed will be avaialble for collection should you decide not to proceed with the quotation. This option is best if you are unsure as to whether repairs are going to be economical or a replacement is more appropriate. The technician will make an inspection and report to the manager who will provide a written quote. Cost for this option is a single service fee. On completion you will be provided with a report and receipt.OPTION 2 - TECHNICIAN TO ATTEND AND REPAIR AS NECESSARY - I require a technician to attend and make full repairs as deemed reasonable and possible and to further report any other suggested repairs by written quote for my consideration. I understand that this option will incur charges including a service fee, labour fees and parts. I agree to the technician removing any parts and returning them to the service centre for further inspection if required. I further agree to payment for these charges as indicated below. Select this option for the most economical result. The technician will attend site and will do whatever is possible and reasonable to rectify the situation. He will also if required create a "further action" report if further works are required. You will be informed of any further requirements together with an estimate of the total cost. On completion you will be provided with a report and receipt.OPTION 3 - TECHNICIAN TO ATTEND AND REPAIR WARRANTY ITEMS ONLY - I require a technician to attend and make any repairs that are deemed to be under warranty and possible at the time and to further report any other suggested works by written quote for my consideration. I agree to the technician removing any parts and returning them to the service centre for further inspection if required. I understand that this option will not incur charges for warranty repairs. I further agree that if no fault covered by warranty is found that “OPTION 1” as above will be required to proceed any further. If the payment section below has been completed I agree to proceed automatically to "OPTION 1" and to the charges associated with "OPTION 1".Select this option is you think that any work may be covered under warranty. If the technician finds any fault of product manufacture and/or installation (if performed by us) and the installation falls within specified warranty periods he will make good and/or create a "further action" report to make good the situation. This situation will not incurr any cost. If the technician does not find any repairs deemed covered by warranty he will make a report for the manager who will discuss further option with you. NOTE: Whilst it is not a prerequisite filling in the payment section below will enable the technician to proceed to "OPTION 1" and to make non-warranty repairs on site and thereby save you the cost of a second return call. This is advisable if there is any doubt.

PAYMENT SECTION - PLEASE COMPLETE CREDIT CARD DETAILS AND SIGN -
Accepted Cards - VISA and MASTERCARD

NOTE: Callout service fee will be charged to this card when your job is scheduled. Further payment will be charged to the card when the job is complete.
I authorise payment for call request as above -

Credit Card Details

Name on card

Card 16 digit Number

ExpiryCCV

Date*

Date

Signature*

Please sign approval to proceed.

Please verify that you are human*

AUTHORISATION TO PROCEED WITH WORKS