Hale Glass

Building/Park:

Company Name: *

Address: *

City: *

Cross Streets:

Job Contact: *

Job Contact Phone: *

Make appointment with tenant?

Yes     No

Is the building vacant?

Yes     No     Lockbox#

Quote first or bill later?

Quote first
Just do it and bill me later (established accounts only)

When should we contact you?

Call to schedule
Call when job is complete

Window:

Emergency board-up required

Glass replacement:   Qty:    Floor#:

Reset shifted glass

Repair hanging window gasket

Window film

Window leaks

Door:

Door slams

Door does not lock properly

Door scrapes/rubs/drags

Door handle/hardware loose

Door stays open

Door pivot broken

Door closer leaks

Door off hinges

Other:

Special
Instructions:

Bill To:

Account#:

Company Name: *

Address: *

Contact Information:

Name: *

Phone: *

Fax:

CC: