Application Form
SERVICESAFE ( GAS Appliances )

Title Mr/Mrs/Miss/Ms
Name
Tel. Number. (Daytime)
Address


  Post Code
Account Address if different to the above.


  Post Code
Appliance Details
Appliance Boiler/Fire/Water Heater Manufacturer
(If Known)		 Model Approx. Age 
(Years)		 SERVICESAFE Cost £
(See below for details)
         
Method of Payment    Cheque 
Postal Order
I enclose my cheque/postal order 
Made payable to 
HEATING MAINTENANCE SERVICES LTD		 £

I confirm that the system and/or appliance is used only for domestic purposes. Should it be found that the system/appliance is not in good condition and working order when the first inspection is carried out, I accept that the cost of bringing the equipment up to standard is NOT included in the Servicesafe Contract and that Heating Maintenance Services Ltd. reserve the right to cancel the Servicesafe Contract and refund all monies paid.  
I confirm that I have read and accepted the Terms and Conditions which apply to the Servicesafe Contract.  

Limited to domestic appliances below 44kW(150,000 Bthu) output

Signed.
Dated. 

To E-Mail the form press the Confirm Button but please remember to print off the completed form and post it with your cheque or postal order to the address shown at the bottom of this page.

Costs SERVICESAFE (GAS / OIL Appliances)
Prices Correct at January 2008

Appliance

Single Annual Payment
  GAS 
Appliances		 OIL 
Appliances
1. Central Heating Boiler/ System
Each additional Appliance
i.e. Fire, Water Heater etc		 £190.00 £233.00
£50.00 £50.00
2. If you do not have Central Heating, Water Heater
Each additional Appliance
i.e. Fire, Water Heater		 £164.00 £164.00
£50.00 £50.00
3. If you do not have Central Heating or a Water Heater, 1st Appliance
Each additional Appliance i.e. Fire		 £95.00 £95.00
£50.00 £50.00

 

For Advice and further information please contact us

Telephone : 01684 892877
Fax        : 01684 892587
E-mail  :
Address  &
Registered office 		: Heating Maintenance Services Ltd.
Cromwell Road
MALVERN
WR14 1NA