Service Request Form

Location Information

Contact Name*

First Last

Contact Email*

Contact Phone*

Building Name*

Suite Specific*

Yes
No

Suite Number*

Suite Name*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

System Type

Customer Type*

Building Owner/Engineer
Tenant
Contractor

Billing Information

Billing Address Same as Above

Bill To Company*

Bill To Address*

Street Address Address Line 2 City State ZIP Code

Name on Credit Card*

First Last

Card Type*

Visa
MasterCard
American Express
Discover

Credit Card Number*

CSV Code*

Purchase Order*

AP Contact*

First Last

AP Email*

AP Phone*

Reason for Service Request

Description of Probelm*

Photo of Panel/Issue*

Drop files here or

When to Schedule*

ASAP
Next Available
Next Week

Terms and Conditions

Cancellation Policy: Rescheduling or cancelling an appointment with less than 24 hours written notice will result in a three hour minimum charge per the originally scheduled time and day.

Labor: Service rates effective January 1st, 2020. Our standard service requires that you call Monday through Friday between the hours of 7:30 A.M. and 4:30 P.M. Our normal response time is the next working day. Our response time on emergency service calls is usually within 4 hours. A standard service call will require a labor minimum of three hours. BEC does not charge for travel or fuel surcharges. All work beyond the three hour minimum will be charged in half hour increments. Work performed between 6:00 A.M. and 2:30 P.M, Monday through Friday, excluding holidays shall be billable at Standard Rates. Any service performed between the hours of 2:31 P.M. and 5:01 A.M. shall be subject to After Hours Rates. Any service performed on a Sunday and the listed statutory holidays shall be subject to Sunday/Holiday Rates. Any agreement outside of this service request form shall take precedent.

Service Rates (subject to 3 hour minimum):
Standard Rate - $480.00 for first three hours, no travel sur-charges. Each additional hour, billed in half hour increments $160.00/hour.
After Hours Rate - $660.00 for first three hours, no travel sur-charges. Each additional hour, billed in half hour increments $220.00/hour.
Sunday/Holiday Rate - $780.00 for first three hours, no travel sur-charges. Each additional hour, billed in half hour increments $260.00/hour.

Holiday or Non-Scheduled Work Day	Date Observed in 2020
New Year's Day	Wednesday, January 1
Memorial Day	Monday, May 25
Independence Day	Friday, July 3
Labor Day	Monday, September 7
Veterans Day (Observed)	Wednesday, November 11
Thanksgiving Day	Thursday, November 26
Day after Thanksgiving	Friday, November 27
Christmas Day	Friday, December 25

Programming Only Rates: Available upon request. Contact service@becinc.net.

Material: List price plus all applicable taxes.

Warranty: Any issue covered under warranty will not be invoiced.

Payment: Due upon receipt. BEC accepts check, all major credit cards, and ACH.

I agree to the terms above*

First Last

Signature*