Service Authorization Form

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I ______________________________ hereby grant permission to the representatives of THE POOL COMPANY, INC., and am providing information for payment as follows:

1) I am giving permission to the technicians to be on my property.
2) I am giving permission to perform the work and repairs needed.
3) I understand and agree that my current credit card information needs to be on file at THE POOL COMPANY, INC if I want work to be performed.
4) I understand this card will be billed for the labor, parts, and taxes, within two days of the service call, unless I pay by cash or check at the time the service technicians are on the property.
5) My credit card number is ___________________________, expiration date is ___________, the security code is ______, and the billing address of the credit card is _________________________________________________.

Signature ____________________________ Date ____________

Please e-mail this to: Ron@thepoolcompany.net or Fax 540-370-0436

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Polaris Automatic Cleaners
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Hours
Mon 10:00 am 5:00 pm
Thur 10:00 am 5:00 pm
Fri 10:00 am 5:00 pm
Sat 10:00 am 2:00 pm