Job Order Form

Please enter your job requirements
First and Last Name*:
Address*:
Town/State/Zip Code*:
Telephone (Day)*:
Telephone (Evening):
Telephone (Mobile):
Fax:
Email*:
Best Time to Call:
Job(s)
1. Description*:
Budget:
Time Frame*:

2. Description:
Budget:
Time Frame:

3. Description:
Budget:
Time Frame:

Notes:
I understand and acknowledge that Reliable Referrals, LLC is a referral service and will refer contractors who have been screened consistent with the Reliable Referrals' program, to be considered by me to accomplish a job that I described to a representative of Reliable Referrals. Any arrangements made, or contracts negotiated are strictly between me and the contractor. I understand that the contractors referred are independent of Reliable Referrals. Reliable Referrals has not made any representation to me as to the work to be performed or the nature or quality of the work anticipated to be accomplished. I agree to satisfy myself that the contractor meets the standards of work I require. I hereby hold Reliable Referrals harmless from any defect in workmanship, default, damage, injury or expense arising out of the work performed by a contractor referred and hired by me.
Homeowner's Signature*:
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Reliable Referrals