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NON -CONTRACTUAL SERVICES <br />Do you require a Purchase Order to be listed on your invoices for work NOT <br />included in this service agreement (Check one)? (If a purchase order is <br />required for service calls to be billed, service calls will not be dispatched <br />without a PO except in the event of an entrapment) <br />o= Signature <br />Service <br />Yes No <br />PO# Value <br />If providing a blanket PO, please provide PO# and value: <br />WORK ORDER MANAGEMENT Yes No <br />Do you require enrollment in a workorder management system? <br />Please provide system name: <br />CERTIFICATE OF INSURANCE <br />Yes No <br />Do you require a certificate of insurance? <br />If yes to above, please provide the below for your certificate of insurance: <br />Certificate Holder Name: <br />Certificate Holder Address: <br />Email address for delivery of <br />certificate: <br />(If not provided, the certificate <br />will be sent out via standard <br />mail to the certificate holder <br />address) <br />Do you require upload of your certificate to a third party site? <br />If yes, please provide site name: <br />Yes No <br />Page 1 16 <br />297 <br />