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Service Request & Authorisation Form - Vessel Vault
Service Request & Authorisation Form
Service Request & Authorisation
Given Name
Surname
Email Address
Please provide a valid email address.
Contact Number
Please enter a 10-digit contact number.
Manufacturer / Brand
Vessel Model
Year of Manufacture
HIN Number
Description of Service or Repairs Needed
Engine Details
+
Engine Manufacturer
Engine Model Name / Number
Engine Serial Number
Propulsion Type
Billing Details
+
Billing Street Address
City / Suburb
State / Territory
Postal Code
Payment Details
+
Name on Card
Card Number
Expiry (MM/YYYY)
Security Code
I agree to the Terms and Conditions
You must agree before submitting.
I authorise Vessel Vault to undertake the work described above and to supply any necessary labour, components, and materials. I agree that such work will be charged at Vessel Vault’s prevailing rates and prices in effect at the time the work is performed. I further authorise Vessel Vault to process payment for the completed work using the credit card details provided in a valid credit card authorisation form. Unless loss or damage is directly caused by the proven negligence of Vessel Vault or its employees, Vessel Vault accepts no liability for any loss of, or damage to, the vessel, its equipment, or its contents while berthed, stored, transported, or otherwise handled in connection with the authorised work. If the vessel is not collected within two (2) business days after written or verbal notification of completion, I acknowledge and agree that reasonable storage fees may be charged by Vessel Vault until collection is made. For security purposes, credit card details must be provided before any work is commenced. If you prefer not to submit these details in writing, please mark each credit card field with an “X”. Vessel Vault will then contact you to obtain the details verbally. Payment may be made by EFT or credit card at the time of invoicing. Cash payments are not accepted.
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