Proposal Form 12 Customer InformationName First Last Proposal Date Month Day Year PhoneEmail(Required) Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code OptionsAir Conditioner / Heat PumpModelSize Add RemoveGas Furnace / Air HandlerModelSize Add RemoveComfort CoilModelSize Add RemoveRegular Price Trane Promotion PSO Instant Discount Installed Price ONG Rebate Thermostat NotesTotal Investment Monthly PaymentNumber of MonthsEfficiencySEERAFUE Add RemoveRegistered WarrantyYrs. CompressorYrs. CoilYrs. Heat ExchangerYrs. PartsYrs. Labor Add Remove You Will NeedVenting Partial All new Combustion Air Needed Inside Wiring Reconnect Electrician Needed Control Wiring Needed Thermostat Needed Gas Piping Reconnect Additional pipe needed Condensate Drain Safety Pan needed Condensate Pump Plenum or Transition Needed Pad Needed Copper Refrigerant Lines Reconnect All new Outside Electrical Reconnect Electrician needed Labor All Necessary Labor For A Professional Installation System EnhancementsTrane CleanEffects: Air Scrubber Plus: Media Air Cleaner: Whole House Humidifier Extended Warranty:Special Instructions:Acceptance of Proposal I , the customer named below, agree to the following:The prices and specification contained herein are satisfactory and accepted. Seller is authorized to complete this contract as specified and payment in full will be made upon completion. Work stoppages caused by the customer or other contractors will result in partial payment due... amount to be determined by the seller. Lien rights may be exercised if payment in full is not made by the customer upon completion. Customer SignatureDate Month Day Year Company SignatureDate Month Day Year CAPTCHA
