Customer and Aircraft Service Request
CUSTOMER INFORMATION
Full Name
*
First Name
Last Name
Company
*
Phone
*
Format: (000) 000-0000.
Email
*
example@example.com
Street Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
AIRCRAFT INFORMATION
N-Number
*
Year
Category
*
Experimental, Light-Sport Aircraft, Certified
Manufacturer
*
Model
*
Serial Number
*
Engine Make/Model
*
Engine Serial Number
*
Prop Make/Model
Prop Serial Number
TACH/Flight Time
HOBBS/Engine Hours
Aircraft Location
*
REQUESTED SERVICES
Requested Services
*
Annual Inspection
100-Hour Inspection
Condition Inspection
ROTAX Inspection
Oil Change Service
AD/ASB/SB Compliance
Troubleshooting
Repair
Prebuy/Evaluation
Other
Describe requested work and/or known discrepancies
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Customer and AircraftService Request
90
15
—AVIATION SERVICES—
9015 Aviation Services LLC
SERVICE EXPECTATIONS
What you can expect from 9015 Aviation Services
Maintenance and inspections performed using applicable maintenance data
Discrepancies documented and communicated appropriately
Reasonable estimates of cost and completion time when practical
Required maintenance-record entries/documentation for work performed
Additional work outside the authorized scope will be handled according to the authorization selected below
What 9015 Aviation Services expects from the customer
Accurate aircraft and contact information
Reasonable access to the aircraft and available maintenance records
Timely authorization or denial of additional work
Payment according to the agreed terms
Disclosure of known discrepancies or concerns relevant to the requested work
RATES & ADDITIONAL WORK
STANDARD LABOR RATE: $130.00/LABOR HOUR
Labor is billed based on actual time required for authorized maintenance, inspection, research, documentation, and associated work unless agreed in advance
IF ADDITIONAL DISCREPANCIES ARE DISCOVERED:
*
Contact me before performing any additional billable work
Additional Work up to $
Additional Work based on Labor Hours
Other
Additional work up to $
Additional work up to Labor Hours
Additional work authorization does not guarantee that all identified discrepancies can be corrected within the selected dollar or labor-hour limit.
PAYMENT & ACKNOWLEDGEMENT
PAYMENT IS DUE UPON COMPLETTION OF SERVICES UNLESS PRIOR ARRANGEMENTS HAVE BEEN MADE
By signing below, I acknowledge that I have reviewed the information provided in this service request, understand the stated labor rate and service expectations, and authorize work according to the selections above. I understand that inspection findings may result in additional recommended or required maintenance beyond the originally requested scope. Submission of this request does not guarantee acceptance, price or completion date unless separately agreed upon.
Customer Name:
*
Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
2
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