WORK ORDER PAGE

***ALL PROJECTS REQUIRE A WORK ORDER BEFORE SERVICES CAN BE PROVIDED***

THE PDF & DOC FILES WILL OPEN IN A NEW PAGE AND/OR WILL ALLOW YOU TO SAVE TO YOUR COMPUTER AS A REFERENCE FOR OUR HANDY ONLINE FORM BELOW!

You can Download a pdf file of our Work Order HERE.

Or you can Download a .doc file of our Work Order HERE.

Use the Online Form Below:  Email Confirmation From Us Required.

Note:  Form clears when successfully sent to us.

Please email any attachments separately to geotech.emporia@gmail.com.

Note:  We Accept Most Credit and Debit Cards!

*Required Fields

Date:*

Name(s):*

Phone(s):*

E-mail:*

Billing Address*

Address of Survey*

Record Owner

Type of Survey needed:*

Special Instructions:

Title Company:

Lender?

Estimated Fee Requested (Yes/No)*

Did we quote you a fee already? If so enter that here.

How Did You Find Out About Us? Check all that apply.*

Repeat Client

Word of Mouth

Radio Ad

Print Ad

Internet Search

Other

A finance charge of 1.5% per month, which is an annual percentage rate of 18%, shall be applied to all accounts that are not paid within 30 days of final billing. In the event of failure to pay, Client/Customer agrees to pay interest, together with any and all costs incurred in the collection of the account. Should it become necessary to place this account with an attorney for collection, Client/Customer agrees to pay all such costs of such collection, including, but not limited to court costs, and attorney fees, except that such costs of collection shall not exceed 40% of the unpaid debt after default or $250.00 whichever is greater. The Client/Customer agrees that in the event of any controversy, litigation, dispute or claim arising out of the Agreement, venue shall be exclusively in Lyon County, Kansas, notwithstanding the execution of documents in any other venue in said state. *

I agree

VERIFICATION (CLICK LETTERS TO RENEW)

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