Home
Services
Service Request
Service Request Form
*
Indicates required field
Name
*
First
Last
Phone Number
*
Email
*
Requested Service Work
*
I AUTHORIZE CAPTAIN DOUG'S MARINE SERVICE TO PERFORM THE ABOVE WORK AND ANY VERBALLY APPROVED WORK WITH THE FOLLOWING LIMITATION OF LIABILITY. LIMITATION OF LIABILITY: CAPTAIN DOUG'S MARINE SERVICE LLC AND ALL AFFILIATED PARTIES SHALL NOT BE RESPONSIBLE OR LIABLE IN ANY WAY FOR: (A) ANY LOSS OF OR DAMAGE TO VESSELS; OR (B) ANY LOSS OR DAMAGE TO ANY ARTICLES, EQUIPMENT OR PERSONAL PROPERTY INCLUDING AS A RESULT OF THEFT; OR (C) PERSONAL INJURY OR DEATH OF OWNER, HIS EMPLOYEES, GUESTS, AGENTS OR REPRESENTATIVES. SERVICE REQUESTS REQUIRE THAT VESSELS ARE ADEQUATELY COVERED BY PRIVATE INSURANCE FOR ALL LOSSES. I UNDERSTAND THAT ALL INVOICES WILL BE CHARGED A SERVICE FEE OF 3.5% IF PAID BY CREDIT CARD.
*
I agree
I AUTHORIZE CAPTAIN DOUG'S MARINE SERVICE TO PERFORM THE ABOVE WORK AND ANY VERBALLY APPROVED WORK WITH THE FOLLOWING LIMITATION OF LIABILITY. LIMITATION OF LIABILITY: CAPTAIN DOUG'S MARINE SERVICE LLC SHALL NOT BE RESPONSIBLE FOR: (A) ANY LOSS OF OR DAMAGE TO VESSELS; OR (B) ANY LOSS OR DAMAGE TO ANY ARTICLES, EQUIPMENT OR PERSONAL PROPERTY; OR (C) PERSONAL INJURY OR DEATH OF OWNER, HIS EMPLOYEES, GUESTS, AGENTS OR REPRESENTATIVES.
Submit
