To be completed for Non Contract customers requesting a service
I authorize Alemany Building Solutions, LLC. to perform billable time and material service repairs at the below listed facility which will be charged immediately the job is completed:

Date

YYYY

Time

Hour

Minute

Second

Site of work to be performed:

Provide description of work:

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Person authorizing work:

First Name

Last Name

Position of person authorizing the job:

Phone

(###)

###

####

Email Address

By submitting below the form, I acknowledge that the job will be charge in a time and material basis, two-hour minimum labor hours as follows:

Fire Alarm technician at $120.00/hour

Building Automation technician at $140:00/hour

Billable Details: Credit Card Information

Expiration Date

YYYY

Security Pin # (Visa/MC 3 digits, AmEx 4 digits)

ZIP Code of Credit Card

Please sign here, print the form and fax/email back to our office:

(305)284-8473 payments@alemany-usa.com

Please let us know the prefered date to perform the job, or any comments/questions that you might have.

We proudly support the following organizations:

work authorization form