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HCA - CLOSEOUT FORM
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37
Questions
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1
Which Company did you make the sale for?
*
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Please Select
Hales AC
CCS
Abraham
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Please Select
Hales AC
CCS
Abraham
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2
HCA Name
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3
HCA Email
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example@example.com
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4
Job / Lead #
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5
Customer Name
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6
Customer Address
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7
Customer Phone #
*
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Please enter a valid phone number.
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8
Lead Source
*
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Please Select
Tech
Marketed
Costco
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Please Select
Tech
Marketed
Costco
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9
Lead Result
*
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Please Select
Sold
Not Sold
Rescheduled with Date & Time
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Please Select
Sold
Not Sold
Rescheduled with Date & Time
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10
Install Date:
*
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-
Date
Month
Day
Year
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11
System Style Sold
*
This field is required.
Split System Straight Cool
Split System Heat Pump
Package Unit
Front Feed OTWH
Pancake/Ceiling Air Handler
Water Sourced Heat Pump
Ductless/Mini Split
Other
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12
Was their existing system a Heat Pump, Straight Cool or?
*
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Heat Pump
Straight Cool
WSHP
Other
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13
Brand Sold
*
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Lennox
Trane
Bosch
First Company
Other
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14
System Level Sold
*
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Basic
Deluxe
Premier
Optimum
Other
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15
Air Handler Sold
*
This field is required.
New Lennox Basic - CBK45UHPT
New Lennox Deluxe - CBK45UHET
Lennox Premier - CBK45UHVT
Lennox Opt - CBA38MV
Lennox/ADP Front Feed
Trane Basic TEM4
Trane Premier TEM6
Trane Front Draw TMM5
First Company WSHP - Hydrotech
Bosch WSHP - Series SV
Bosch WSHP - Whisper
Lennox Basic Package Unit
Lennox Deluxe Package Unit
Old Lennox Basic - CBA25UH
Old Lennox Deluxe - CBA25UHV
Other
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16
Current Heater Bank Size in KW/H
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17
How many inches tall is the current Air Handler?
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18
How many inches wide is the current Air Handler?
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19
How Many inches deep is the Current Air Handler?
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20
CONDENSER Sold
*
This field is required.
Lennox Basic SC - ML17XC1
Lennox Basic HP - ML17XP1
Lennox Deluxe SC - EL17XC1
Lennox Deluxe HP - EL17XP1
Lennox Premier SC - EL18XCV
Lennox Premier HP - EL18XPV
Lennox Opt SC - SL28XCV
Lennox Opt HP - SL25XPV
Trane Basic SC 4TTR40
Trane Premier SC 4TTR60
NO CONDENSER - Water Sourced Heat Pump
Other
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21
What size system?
*
This field is required.
1.5 Ton / 18,000 BTU
2.0 Ton / 24,000 BTU
2.5 Ton / 30,000 BTU
3.0 Ton / 36,000 BTU
3.5 Ton / 42,000 BTU
4.0 Ton / 48,000 BTU
5.0 Ton / 60,000 BTU
Other
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22
What Thermostat?
*
This field is required.
Basic Level - Digital nonprogrammable
Deluxe Level - Honeywell T6 Wifi
Lennox Premier - iComfort E30
Lennox Opt - iComfort S40
Trane Premier - Honeywell T6 Wifi
Other
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23
What Air Filter / Cleaner?
*
This field is required.
1" Basic Level
MERV 11 - Deluxe/Premier Level
1" Electrostatic Deluxe/Premier (MERV 11 wont fit)
PureAir
Other
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24
Other Add Ons?
PureBreathe UVC Single Bulb $999.00
PureBreathe UVC Dual Bulb $1499.00
OXIPURE UVV *Must be installed with a PureBreathe $799.00
Duct Cleaning *Charge is for One System $624.00
Dryer Vent Cleaning $275.00
PureAir *Lennox Only $3499.00
Clean Effects *Trane Only $3499.00
MERV 11 Filter Upgrade on Basic Install $649.00
MERV 11 to MERV 16 Upgrade $449.00
1” Filter to 1” Electrostatic Upgrade $649.00
New Line set on Basic Install $800.00
Honeywell T6 Wi-Fi Upgrade on Basic Install $449.00
iComfort E30 Upgrade on Install $999.00
iComfort S40 Upgrade on Install $1999.00
Condensate Pump on Basic Install $289.00
AC Wall Brackets $449.00
Horizontal Install upgrade on Basic $649.00
Standard Crane Service $800.00
1 to 10 Year Extended Labor Warranty $2499.00
5 to 10 Year Extended Labor Warranty $1399.00
Whole Home Dehumidifier 90 Pints per day $4300.00
1st Years Maintenance $129.00
New Duct Work (in Attic Only) Priced Per Vent
Other
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25
Does it require a Crane?
*
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Yes
No
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26
Invoice Amount?
*
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27
How are they paying for it?
*
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Credit Card
Cash
Check
APPROVED Financing
NOT YET APPROVED Financing
Other
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28
What system did you quote? Please include Model # & Amount you Quoted it for
*
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Example: Quoted a Deluxe RA20 Lennox for $13419
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
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29
What are your next steps?
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30
Why did you reschedule?
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31
When are you going back?
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32
Upload All Photos of the Air Handler
*Multiple Photos is OK*
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Max. file size
: 10.6MB
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33
Upload All Photos of the Condenser
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: 10.6MB
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34
Upload All Photos of the Electrical Panel
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: 10.6MB
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35
Upload Photos of the Investment Agreement
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Max. file size
: 10.6MB
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36
Upload photos of the Comfort Survey Cover, Questionnaire, Heat Load & General Information.
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Max. file size
: 10.6MB
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37
Notes for the installers
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