Service Agreement - Protection Plan

Service Agreement - Protection Plan
Clean & Check (parts extra)
Gas Furnace
A/C
Boiler 80% eff
Boiler 90% eff
Heat Pump/Geo
*Elec. Air Cleaner
*Water Heater
*Air exchanger
*Humidifier
* To be done in conjunction with major system maintenance.
As a Protection Plan customer, you will receive priority service repairs and after hours service at special agreement prices.
Protection Plan Agreement

Customer
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Day

Area CodePhone Number
Phone Evening

Area CodePhone Number
Cell Phone

Area CodePhone Number
Email
example@example.com
Best Number to Reach For Scheduling
Maintenance Plan
Number of Service Inspections Per Year:
Start Date - This date will be a full year from your start date

MonthDayYear
Date
End Date - 12 months from start date

MonthDayYear
Date
Equipment Covered

Prices will be determined by the Service Department, please enter your equipment information and we will get back to you on your exact price.
The annual cost for your Protection Plan will be: $______________

Does not include WI sales tax.

TO BE FILLED OUT BY AN ANDERSON HEATING REPRESENTATIVE.
Purchaser Signature

Use your mouse or finger to sign.
Date

MonthDayYear
Date
Anderson Heating Representative Signature: ___________________________________

Date: ______/______/_______

TO BE FILLED OUT BY AN ANDERSON HEATING REPRESENTATIVE.
Payment Information Below
How will you pay?
If paying by credit card, please call our office: 715-549-6297 | 651-430-0685

If paying by check, send to:

Anderson Heating
1446 7th St.
Houlton, WI 54082
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Service Agreement - Protection Plan

Clean & Check (parts extra)

Protection Plan Agreement

Maintenance Plan

Equipment Covered

Payment Information Below