After performing the services I have authorized and requested, please leave an invoice for the job and I will send in my payment.  I recognize that payment will be due upon receipt of invoice. Late fee will be assessed after 30 days, details below.

Please perform the services I have requested for ____________ year/s.

Client signature___________________________________________ Date_________________

Name_______________________________________________________

Address______________________________________________________

City____________________________ State____________  Zip____________________

Home phone _________________ Work phone_______________ Cell ______________

We will help protect and maintain your roof with this special offer by inspecting your roof for a list of over 20 common problems including, sealing vent pipes, nail pops, tightening the ridgevents, sealing flashings, cleaning the gutters and replacing up to 5 missing shingles, or one vent pipe gasket assembly for a total price of $400! 
Sign up for bi-annual inspections for
$700 a year and save $100.00! 

Our new service will give you peice of mind knowing that these problems are repaired before they end up costing you thousands of dollars in damages!
 
Just initial next to the service your requesting and choose a month for your inspection, fill in the number of years requested, sign at the bottom and return this form to us by email, regular mail or fax.

Customer Initial_________Please perform the roof inspection services described during the month of: ___________

Customer Initial_________Please perform the roof inspection services described during the month of: ___________

___________Please automatically bill my credit card for each service.
                   (This will only be done if requested and initialed.)

Visa____ Master card ______ I will mail a check  ________

Credit card # ____________________________________________________ Exp. ____________

Signature _______________________________________________________ Date ____________

By sending in this form you authorize Henry's Housework Inc. to provide the requested work each year for the number of years that you have requested. Past Dues, or any part thereof, including prior Service Charges, are subject to a 2% per month (24% per annum) Service Charge. Service Charges are computed on an average daily balance. Collection costs and/or reasonable attorney's fees are the responsibility of the customer/client. All payments received are applied in the order of: collection costs, attorney's fees, service charges, and past due amounts. Any remaining funds are then applied to current amounts due.
Method of payment at time of service
For commercial contracts or more information, please call our office at 301-216-9675!
Henry's Housework Logo, the pressure washing, roof repair and gutter specialist in Maryland