Request for Annual Service - Boiler Equipment

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To:	Waterloo Manufacturing Company Limited	Date:
Attention:	Bob Baker, Service Manager	Purchase Order #
From:
Company Name:
Address:
City:		Postal Code:
Phone Number:		Fax Number:
E-Mail Address:

RE: Annual Service - Boiler Equipment
We, the undersigned, hereby authorize you to carry out any required service to place our boiler in peak operating condition. We agree to purchase from you any required parts to accomplish this. We realize that you will schedule your representatives as closely as possible to our needs, but do understand that you must group a number of calls in a given area.
We prefer to have this service carried out during the month of and you will advise us in advance of your representatives’ call.

AUTHORIZED BY:
Phone Number:
Check here to have a representative call to discuss controls and system efficiency enhancements.

RE: Annual Service - Boiler Equipment