SERVICE REQUEST FORM
Return Customer

Please take a moment to fill out the required fields on this page. If any of your contact or boat information has changed please fill out a New Customer Request Form.
Once your information has been submitted and received by us we will contact you with an estimated date and time that our mechanic will be able to fulfill your request.

Fields marked (*) are required.

Personal Information
*First Name
*Last Name
*Telephone (H)			(W)
Cell Phone
*Email
Boat Information
*Boat Name
*Boat Location
*Key Location
Service Requested
*Timeframe
Urgent	(overtime fees)
1 -2 weeks
Flexible
	I hereby authorize the above repair work to be done along with the necessary materials. KM Marine Solutions and your employees may operate the unit herein described on any waterways or elsewhere for purposes of testing, inspection, or delivery at my risk. An express mechanic’s lien is acknowledged on above unit to secure the amount of repairs thereto. it is also understood that you will not be held responsible for loss or damage to unit (or articles left in or with the unit) in case of fire, theft, accident, inclement weather conditions, or any other cause beyond your control. Any invoice beyond 30 days will become a collection matter all cost will be at your expense. Invoices will be subject to late fee charges of 6.5% per month after 30 days.
*Authorised By