Service Request Form

Client ID:

Your Name *:

Your Cellphone Number *:

Your Email Address *:

Company Name *: Autofilled from Client ID. Please confirm or edit if required. If the information is missing, enter the details manually.

Billing Address *: Autofilled from Client ID. Please confirm or edit if required. If the information is missing, enter the details manually.

Is this service call for an existing building under our management? *

Yes

No

Select Building Name:

Building Address *: Autofilled from Building Name. Please confirm or edit if required. If the information is missing, enter the details manually.

Building Contact Person Name *: Autofilled from Building Name. Please confirm or edit if required. If the information is missing, enter the details manually.

Building Contact Person Cellphone Number *: Autofilled from Building Name. Please confirm or edit if required. If the information is missing, enter the details manually.

Building Contact Person Email Address: Autofilled from Building Name. Please confirm or edit if required. If the information is missing, enter the details manually.

Service Description *:

Upload Files (Images/Videos/Documents, Max 80 MB)

Preferred Service Date *:

Please confirm there are no restrictions to the start time. If yes, kindly mention them in the service description.

Is this an emergency service call? *

Yes

No

I confirm that I am authorized to request this service on behalf of my company and that all provided information is correct. *

I have read and agree to the Terms & Conditions as outlined in the maintenance contract for the selected building. I authorize R&S United Services to charge our account based on the agreed-upon rates. If the building is not under a maintenance contract, labor rates for regular hours will be $200.00/hr., subject to change. *

Additional Notes or Instructions: