Service Request Form

( *=required)

Type of Service

Service Category

Company Name

Person entering this Service Request

Contact Phone

Return Email Address

Purchase Order/Ref#

Drawing needs to be updated?

Yes

Enter the date the service to be started by *

(dd/mm/yyyy)

Enter the date the service to be completed by*

(dd/mm/yyyy)

Address where service is to be carried out:

Site Name:
Site Contact Name:
Site Contact Phone:
Building Name:
Street No:
Street:
Suburb:
City:

Description of work to be completed *

Other Comments to facilitate preparation of the quotation

Note: If you have not purchase services from IndeServe in the past, you must complete a Credit Application form, before the work can be scheduled. Please print the form, fill out the required information, and fax the form to IndeServe at 04916 9003 for approval.

View Standard Condition of Contract

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