Service Reservation

* denotes a required field

Equipment Information:

Make*

Model*

Serial Number*

Equipment Description

Select Preventative Maintenance Service Desired

Preventative Maintenance Description

Select Repair Service Desired

Select Repair Service Description

Business Information:

Contact Name*

Company Name*

Company Address*

City*

State*

Zip*

Phone*

Email*

Equipment Location

Same as Business

Equipment Address

City

State

Zip

Date Requested

Time Requested

Bill’s Lift Service, Inc. ● 1048 W. 9th St. Upland, CA 91786 ● Phone: 909.920.9339

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