Work Order Form - Dixie Express Home Repair Services Largo St Pete Clearwater FL

Work Order Request Form

Client Name*
First
Client Address:*
Street Address City ZIP / Postal Code
Client Email:*
Client Phone:*
Date of Work Order:*
MM slash DD slash YYYY
Date(s) Work Performed:
Description of Work Needed and Performed:*
Image File Upload
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Max. file size: 256 MB, Max. files: 5.
Additional Comments:
Please Note: Hourly rates will be charged for all travel to and from the project location and for any time used to procure materials for the project. Note: Prices do not include any Engineering fees, Permitting fees or testing charges. If these Items are needed, they will be at an additional charge plus 15%. Acceptance of Work and Hourly Rates: By signing below, I agree to allow Dixie Express to preform the work described above at the rate of $115.00 per man per hour and materials at cost plus 15% and a $55.00 one time trip charge. Payment will be due at the time that services are rendered in the form of either a check or credit card payment. Bounced checks will be subject to a $50.00 fee. All credit card transactions will be charged the total plus up to 4% processing surcharge.*
I Agree to the Acceptance of Work and Hourly Rates Terms Above:
Owner Name:
Owner Signature:
Authorizing Agent Name and Title:
Date of Acceptance:
MM slash DD slash YYYY

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CERTIFIED GENERAL CONTRACTOR ( CGC 1529252 )