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Residential Pre Auth Form [TEST]

HomeResidentialResidential Pre Auth Form [TEST]

Payment Authorization

Please complete the form to confirm your service appointment

Residential Pre Auth Form [TEST]

Customer & Service Location

Customer Name
Customer Name

Credit Card Pre-Authorization

By completing this form, you authorize Fitch Electric to place a temporary pre-authorization hold (up to the amount below) prior to dispatch, and to charge your card for the final invoice upon completion of service if another form of payment is not provided.
Credit Card
Credit Card
Billing Address
Billing Address

Service Terms & Conditions

1. Service Authorization

I authorize Fitch Electric to perform electrical diagnostic and repair services
at the service address listed above. I understand a licensed technician will diagnose the issue
and, with my approval, perform repairs as needed.

2. Pricing & Billing Terms

Minimum Service Charge:

  • There is a one-hour minimum charge of $325 required to dispatch a technician.
  • This minimum includes the trip charge, diagnostic time, and up to the first hour of labor.

Hourly Labor After First Hour:

  • Labor after the first hour is billed at $150 per hour, billed in reasonable increments.

Emergency / After-Hours Service:

  • If this visit is classified as an emergency, same-day, after-hours, weekend, or holiday service,
    labor rates and minimum charges may be higher than standard rates.
  • Emergency pricing will be communicated when reasonably possible prior to dispatch or upon arrival.

Materials:

  • Materials, parts, devices, and equipment are billed separately from labor.
  • Specialty materials or equipment rentals, if required, will be discussed with me whenever reasonably possible.

3. Credit Card Pre-Authorization & Payment

  • I authorize Fitch Electric to place a temporary pre-authorization hold on my credit card
    prior to dispatch.
  • The pre-authorization amount will vary based on the nature of the service and may be
    up to $500.
  • This pre-authorization is a temporary hold and is not an initial charge.
  • Upon completion of service, I authorize Fitch Electric to charge my card for the
    final invoice amount, including labor, materials, and applicable taxes,
    if another form of payment is not provided at the time of service.
  • If I choose to pay by check, ACH, or another method, payment is due
    immediately upon job completion, before the technician leaves the property.

4. Cancellations & Missed Appointments

  • Appointments canceled with less than 24 hours’ notice may be subject to a
    $150 cancellation fee.
  • If the technician arrives and cannot gain access to the property or is turned away,
    the $325 minimum service charge may still apply.

5. Scope, Safety & Limitations

  • All work will be performed in a safe and code-compliant manner.
  • If unsafe or hazardous conditions are discovered, work may be paused until a safe
    repair plan is agreed upon.
  • Fitch Electric is not responsible for pre-existing conditions, concealed defects,
    or failures in equipment or systems not visible or accessible at the time of service.

6. Warranty

  • Labor performed by Fitch Electric is warranted for 1 year from the date of service unless otherwise noted.
  • Materials are covered by the applicable manufacturer’s warranty, if any.

7. Acknowledgment & Authorization

By submitting this form, I confirm that I am the authorized cardholder or have permission from the cardholder.
I have read, understand, and agree to the pricing, terms, and conditions above and authorize
Fitch Electric to perform the requested work and process payment as described.