Name *

First Name

Last Name

Service Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Billing Address *

Please make sure your preferred method of receiving mail is provided.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Bundled Service Plans Available: *

Please mark all services you would like Mtn Mist Sprinklers to provide.

Spring Start-Up Service (No Discount)

Fall winterization Service (No Discount)

Spring & Fall Bundle (5% Discount)

Spring Clean-Up (No Discount)

Fall Clean-Up (No Discount)

Clean-Up Bundle (5% Discount)

Filter Cleaning Services: (Cody Only) *

These services can vary depending on the type of system you have and water source being utilized. Please note based on your selection a professional recommendation will be made to ensure the service is necessary. Also please note filter cleanings are automatically done with every spring startup service at no additional cost.

Bi-Weekly (2 times per month)

Monthly ( 1 time per month)

NONE or N/A

Do you have pets/dogs?

Please indicate additional information regarding your pets if necessary.

YES

NO

I AGREE TO THE MARKED TERMS ABOVE: *

I request Mountain Mist Sprinklers & Landscaping to perform the services I have checked above. I understand that all invoices are due and payable within 30 days to receive the 5% discount. (or other discount amount provided and agreed to in writing with the business owner) I understand a 2% additional late fee charge will be assessed after 30 days of no payment. I accept/agree to pay 30% of all costs of collections if pursued including, but not limited to attorney fees and court costs by outside sources.

YES