Winter Service Request Application

CUSTOMER INFORMATION

Name: ____________________________________________ Phone: _____________________ Cell: _____________________

Address: ________________________________________________________________________________________________

VESSEL INFORMATION – Section B       [   ]  Check box if you’re a returning boater & disregard Section B.

Name of Boat: _____________________________  Year: _______  Length O/A: ______  Registration No.: ________________

Make: ___________________________________  Model: ______________________________  Color: ___________________

Engine Make: ___________________________________ Year: ___________ HP: __________  Drive Type: _______________

      Please Check The Services To Be Performed On Your Vessel - Only the Checked Items Will Be Performed

                                                                                                                                                                                   Yes   No

1)      Boat Load onto Trailer ………………………………………………………………………………..                   [   ]     [   ]

Trailer Location/Requested Load Date: _____________________________________________________________

2)      Engine Winterization - Please Select Engine Type Below…………………………………….…………                   [   ]     [   ]           

      _______ I/O Single                                 _______ I/O Twin

_______ Inboard Single                  _______ Inboard Twin  

_______ Outboard 50HP & under       _______ Outboard 50HP & up        _______ Outboard Twin  

_______ Jet Ski (Sea Doo)                     _______ Jet Ski (All Other Makes)

3)      Battery Service - Please Select Service Type Below ………………………………………….…………                  [   ]     [   ]           

_______ Disconnect Only

_______ Disconnect, Remove for Owner pick-up

_______ Disconnect, Remove, Store, Charge & Re-Install at Launch    

4)      Oil Change & Filter ……………………………………………………………………………………                   [   ]     [   ]          

5)      Gear Lube Change …………………………………………………………………………………….                   [   ]     [   ]                      

6)      Bottom Power Wash …………………………………………………………………………….…….                    [   ]     [   ]                        

7)      Shrink Wrap ……………..…………………………………………………………………….………                    [   ]     [   ]          

8)      Other: (Please Explain) _______________________________________________________________________                    [   ]     [   ]

Requested Servicing Date:  _______________________________________________________________________

All boats must be available to be placed in storage no later than November 15, 2010 and will not be accessible until April 15, 2011

SPECIAL INSTRUCTIONS

1)       This form must be submitted with your winter storage reservation request.

2)       Be certain your keys are in your ignition for easy winterization of your vessel.

3)       Customer is responsible for having vessel ready and in launch area on the scheduled date of Load to Customer Trailer.

4)       After your boat is placed in storage, no service can be performed unless previously arranged with the service department.

Method of payment:    Credit Card:      Visa      MC      Check      Money Order

Credit Card #: _________________________________________________ Expiration: _____________ Code: ______________

Cardholder’s Signature: ___________________________________________________________ Date: ____________________

 By signing, customer gives Copper Kettle Marine Srvice permission to operate vessel within marina. Customer also understands that

payment is due upon receipt of invoice. If payment is not made within 14 days of receipt, a $25 late fee will be applied to the invoice.

Corporate:  5201 West Erie Avenue  Lorain,  Ohio      Office Phone: 440.282.6301      Service Phone: 440.2828.9685      Fax: 440.960.1356