Restaurant Cleaning Proposal Form

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Cleaning Proposal
Restaurant Name: ____________________________ Contact: _______________________ Position: _________________
Address: _______________________________________________
Bill to: ____________________________________
City: _____________________ State/Prov: ______ Zip: _________ Address: ___________________________________
Phone: ___________ Fax: ___________ Estimator: _____________ City: ______________________ Zip: ___________
:
DESCRIBE WORK TO BE PERFORMED
Number of Systems to be cleaned: _____
# of Hoods (inside): __ Type: ______________________________
# of Filters: __ Type: __________________________ # of Fans: __ Type/Size: __________________________________
Work to be done in a professional manner, during non-operating hours. Precautions
COST OF FIRST CLEANING
will be taken to protect and cover cooking equipment and surrounding areas.
System #1
$ _________
ACCESSIBLE AREAS INCLUDED ONLY:
System #2
$ _________
VOID IF NOT CHECKED
OTHER WORK
Filters___ Filter Troughs___ Plenum Chamber___ Ducts___
Stove Work
Fans___ Firewalls___ Inside Fan Housings___ Outside of hood___
$ _________
(per hour) $ __________
Floors directly under cooking line___ Other___ (list)
Installation of Access Panels
Describe System or other details
# ________
$ _________
(one time charge)
Other
$ _________
(explain)
Sub Total
$ _________
Taxes
$ _________
GRAND TOTAL
$ _________
REGULAR SERVICE
STOVE WORK
Every _______ Months
(Note number of items to be cleaned)
(per exhaust cleaning)
__ ovens, __ salamanders, __ bakery ovens, __ coolers, __ star burners
Total
$ ________
__ charbroilers, __ deep fryers, __ grill tops, __ woks, __ other (explain)
Price includes Taxes
CAVEAT: NFPA#96 REQUIREMENTS
DUCTS: Clean-out access openings are required (by property owner) in horizontal ductwork and each change in direction. Contractors’ responsibility is
limited to report on conditions of inaccessibility only.
ACCESS PANELS: By law, only properly listed access panels may be retrofitted into existing ductwork and fan housings. (NFPA #96 Standard 4-3 of
the 1998 Edition, 7.5.2 of the 2001 Edition)
FANS: Fans are required to be tippable and be provided with sufficient flexible electrical conduit for fan to be removed safely. Contractor will use due
care but will not be responsible for consequences resulting from insufficient or faulty wiring or electrical components, worn bearings, fan belts or other
unforeseen conditions.
WASTE WATER: Contractor takes no responsibility for the composition of the grease removed from the exhaust system.
ACCESSIBLE AREAS CLEANED ONLY
Areas not cleaned will be noted on the After Service Follow-Up Report.
The After Service Follow-up Report is not to be considered an inspection or validation of the Code compliance of the exhaust system.
All work to be completed in a workmanlike manner according to standard practices. There may be charges for extra work requested that
is not written on this form. “24 hour notice of cancellation prior to scheduled service is required or a service charge will be assessed.”
This tender to be a binding contract if accepted for performance within thirty days hereof, with payment to be made to the contractor on
completion of service and presentation of invoice to customer.
This contract is for a _____ year period with servicing to be performed every ________ months.
E. & O.E. WILL BE ENTERED
These systems may require cleaning more often due to circumstances beyond our control.
CLEANING COMPANY REPRESENTATIVE
DATE
CUSTOMER ACCEPTANCE
_________________________________________
____________
_______________________________
This proposal is valid for ______ days.
Terms of payment: ____________________________
This form is the creation of Phil Ackland. It is a SAMPLE only. Confirm with local authority prior to using.
Permission is granted to reproduce so long as the following copyright marking is added:
© 2003 Phillip Ackland Holdings Ltd.
Cleaning Proposal
Restaurant Name: ____________________________ Contact: _______________________ Position: _________________
Address: _______________________________________________
Bill to: ____________________________________
City: _____________________ State/Prov: ______ Zip: _________ Address: ___________________________________
Phone: ___________ Fax: ___________ Estimator: _____________ City: ______________________ Zip: ___________
:
DESCRIBE WORK TO BE PERFORMED
Number of Systems to be cleaned: _____
# of Hoods (inside): __ Type: ______________________________
# of Filters: __ Type: __________________________ # of Fans: __ Type/Size: __________________________________
Work to be done in a professional manner, during non-operating hours. Precautions
COST OF FIRST CLEANING
will be taken to protect and cover cooking equipment and surrounding areas.
System #1
$ _________
ACCESSIBLE AREAS INCLUDED ONLY:
System #2
$ _________
VOID IF NOT CHECKED
OTHER WORK
Filters___ Filter Troughs___ Plenum Chamber___ Ducts___
Stove Work
Fans___ Firewalls___ Inside Fan Housings___ Outside of hood___
$ _________
(per hour) $ __________
Floors directly under cooking line___ Other___ (list)
Installation of Access Panels
Describe System or other details
# ________
$ _________
(one time charge)
Other
$ _________
(explain)
Sub Total
$ _________
Taxes
$ _________
GRAND TOTAL
$ _________
REGULAR SERVICE
STOVE WORK
Every _______ Months
(Note number of items to be cleaned)
(per exhaust cleaning)
__ ovens, __ salamanders, __ bakery ovens, __ coolers, __ star burners
Total
$ ________
__ charbroilers, __ deep fryers, __ grill tops, __ woks, __ other (explain)
Price includes Taxes
CAVEAT: NFPA#96 REQUIREMENTS
DUCTS: Clean-out access openings are required (by property owner) in horizontal ductwork and each change in direction. Contractors’ responsibility is
limited to report on conditions of inaccessibility only.
ACCESS PANELS: By law, only properly listed access panels may be retrofitted into existing ductwork and fan housings. (NFPA #96 Standard 4-3 of
the 1998 Edition, 7.5.2 of the 2001 Edition)
FANS: Fans are required to be tippable and be provided with sufficient flexible electrical conduit for fan to be removed safely. Contractor will use due
care but will not be responsible for consequences resulting from insufficient or faulty wiring or electrical components, worn bearings, fan belts or other
unforeseen conditions.
WASTE WATER: Contractor takes no responsibility for the composition of the grease removed from the exhaust system.
ACCESSIBLE AREAS CLEANED ONLY
Areas not cleaned will be noted on the After Service Follow-Up Report.
The After Service Follow-up Report is not to be considered an inspection or validation of the Code compliance of the exhaust system.
All work to be completed in a workmanlike manner according to standard practices. There may be charges for extra work requested that
is not written on this form. “24 hour notice of cancellation prior to scheduled service is required or a service charge will be assessed.”
This tender to be a binding contract if accepted for performance within thirty days hereof, with payment to be made to the contractor on
completion of service and presentation of invoice to customer.
This contract is for a _____ year period with servicing to be performed every ________ months.
E. & O.E. WILL BE ENTERED
These systems may require cleaning more often due to circumstances beyond our control.
CLEANING COMPANY REPRESENTATIVE
DATE
CUSTOMER ACCEPTANCE
_________________________________________
____________
_______________________________
This proposal is valid for ______ days.
Terms of payment: ____________________________
This form is the creation of Phil Ackland. It is a SAMPLE only. Confirm with local authority prior to using.
Permission is granted to reproduce so long as the following copyright marking is added:
© 2003 Phillip Ackland Holdings Ltd.

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