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Service Release Form
Please fill out the information below as completely as possible, then click "Submit" at the bottom. (*All Fields Required.)
Service Release Form
Select Your Location
Venice (VNC)
Venice Maintenance (VNC)
Sarasota (SRQ)
Sarasota Maintenance (SRQ)
Lantana (LNA)
Lantana Maintenance (LNA)
Tampa (TPF)
Tampa Maintenance (TPF)
Punta Gorda (PGD)
Punta Gorda Maintenance (PGD)
Contact Information
Customer First Name:
Customer Last Name:
Company (Optional):
Phone:
Email:
Address:
City:
State:
Postal Code:
Aircraft Information
Tail #:
Make/Model:
Date Aircraft Dropped Off:
Additional Information
Did you leave your logbooks?
Yes
No
If yes, which logbooks did you leave?
Airframe:
Powerplant
Propeller
Did you leave your aircraft keys?
Yes
No
If yes, with whom or where?
Did you leave your POH?
Yes
No
Did you leave a copy of the current weight and balance?
Yes
No
Requested Work
Comments/Squawks - Please be as detailed as possible:
Date Aircraft Requested:
*While it is not guaranteed, we will do our best to accomodate the date requested.
Quote/Sales Order # (if applicable):
Supporting Documents
Select File to Upload (Only image files will be accepted):
Shipping (if applicable)
It is our policy is to insure all shipments for full replacement value. If you choose to decline insurance on any shipments made by SAI you accept and assume full responsibility for any loss or damage to any shipment or package once it has left our facility. SAI will not be responsible for any merchandise or equipment regardless of the condition it is received in, nor for any missing merchandise or equipment that may be lost during transit.
Check the following box only if you do
NOT
want us to insure your shipments:
I have read and understand the above statements, and choose to waive insurance on shipments from Sarasota Avionics.
Pilot Authorization
I authorize Sarasota Avionics to fly the above mentioned aircraft as needed.
Yes
No
Please indicate your approval of this permission by checking the appropriate boxes:
I have reviewed the requirements of aircraft insurance on this aircraft, and confirm that Sarasota Avionics Inc.'s (SAI) pilot will meet the requirements of Owner's insurance on this aircraft.
Yes
No
I certify that the aircraft complies with state and Federal Aviation Regulations (FAR) applicable to the aircraft described in this Agreement, and specifically confirms that this aircraft is in airworthy condition. Owner understands that Owner is responsible for keeping current with all regulations while Owner's aircraft is in the possession of SAI.
Yes
No
The aircraft described in this Agreement has a current annual inspection as required by FAR. Owner understands that Owner is responsible for keeping Owner's annual inspection current during any period while Owner's aircraft is in the possession of SAI.
Yes
No
I certify that the Owner has an aviation Hull / Liability policy on the aircraft described in this Agreement. If the policy is cancelled or expires, Owner agrees to immediately notify SAI in writing of that event.
Yes
No
This Agreement applies only to the described aircraft. If there are changes in the described aircraft or Owner's pilot status, Owner agrees to submit a new Agreement to SAI.
Yes
No
An express mechanic's lien is hereby acknowledged in this aircraft to secure the amount of repairs thereto. If it becomes necessary for Sarasota Avionics ("SAI") to employ a collection agency and/or attorney to collect this account, I agree to pay all court costs plus a reasonable attorney's fee and/or collection agency fee. The fact that I may have insurance does not release me of my personal responsibility of payment. I understand it is my option to leave my personal effects in the aircraft. SAI will not be held responsible for loss or damage to the aircraft or articles left in case of fire, theft, or any cause beyond its control. Customer shall not be entitled to recover from the company any consequential damage to property, damage for loss of use, loss of time, loss of profits or income, or any other incidental damages. The balance for equipment purchased is due by check or wire transfer when aircraft arrives. Credit card payments will not be accepted for invoices totaling over $5,000. Payment in full is due prior to aircraft delivery.
By signing below I agree to the terms and authorize the work listed above to be done along with the necessary material.
Signature
Signature Date:
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