Fall Removal Authorization

Use this form to authorize Manke Enterprises to remove your lift and/or dock this fall.

For Questions, please contact Ben Leistico at
608-592-4022 or
ben@manke.com

Billing Address:
Name

Street/PO Box

City

State

Zip Code


 Lake Address (if different than billing)
Street/PO Box

City

State

Zip Code
Daytime phone number:

Cell phone number:


e-mail: Required


We respect your privacy! Manke Enterprises will never sell, rent, give, or otherwise share your information with anyone. 		Are you a new customer?
Yes I am.
No, I'm a current Manke customer
I am returning to Manke after trying someone else.
Dates
Approximate date to remove equipment?
 

Alternate date?
 
We will make our best effort to perform the work on the requested dates, but circustances may not allow us to get to you on the exact date.
Additional Options:
Boat Lift(s)
Dock
Other Equipment (describe in "special instructions")
 Coupon Code
If you have a code for discounts, enter it here
Are there any repairs you need done?

 Do you have any special instructions for us?
Terms and Conditions
  1. It is the responsibity of the client to make sure that all equipment and hardware is accessible for the Manke crews.
  2. If equipment or hardware to be removed is to be stored inside a boathouse or other structure, Manke Enterprises will need access to that building.
Required I have read the Terms & Conditions of this contract. I understand that typing my name in the box to the right is a legally-binding "digital signature" which constitutes my approval and accceptance of all terms as stated. Digital Signature: Required