Service Agreement - Protection Plan

Service Agreement - Protection Plan
Clean & Check (parts extra)
Gas Furnace

Once a year Twice a year
A/C

Once a year Twice a year
Boiler 80% eff

Once a year Twice a year
Boiler 90% eff

Once a year Twice a year
Heat Pump/Geo

Once a year Twice a year
*Elec. Air Cleaner

Once a year Twice a year
*Water Heater

Once a year Twice a year
*Air exchanger

Once a year Twice a year
*Humidifier

Once a year Twice a year
* 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 Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Day

Area Code Phone Number
Phone Evening

Area Code Phone Number
Cell Phone

Area Code Phone Number
Email *
example@example.com
Best Number to Reach For Scheduling

Day Evening Cell
Maintenance Plan
Number of Service Inspections Per Year:
Start Date - This date will be a full year from your start date

Month Day Year
Date
End Date - 12 months from start date

Month Day Year
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. Clear
Date *

Month Day Year
Date
Anderson Heating Representative Signature: ___________________________________

Date: ______/______/_______

TO BE FILLED OUT BY AN ANDERSON HEATING REPRESENTATIVE.
Payment Information Below
How will you pay?

Pre-Pay Annual Amount in Full Pay at time of service ( 1 call per year) Pay 1/2 of annual cost at time of service (2 calls per year)
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
Enter the message as it's shown *
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Service Agreement - Protection Plan

Clean & Check (parts extra)

Protection Plan Agreement

Maintenance Plan

Equipment Covered

Payment Information Below