Required Forms Online | Duckworth Pump

This form is due before your scheduled appointment

LIABILITY FORM

This form is good indefinitely, the form expires only when you move, and a new owner has taken occupancy. We look forward to serving you with your well and/or pump system. By signing, you agree below is appropriate, and you are authorizing Duckworth Pump and Well Services to access your property for the purpose of providing the work and/or services requested. We will let you know if and when water service will need to be turned off and/or when water service will be restored. If there are significant delays, or surprises encountered, we will endeavor to keep you updated with the contact information provided. Please let us know if there is anything important or unique regarding your property, or anything we should treat with special care (landscaping, etc). We follow the "farmer's rule" regarding gates and doors: if you find it open, leave it open; if you find it shut, shut it behind you. If you want an open gate shut, or an unlocked door locked when we leave, please let us know. Duckworth Pump and Well Services will complete your project with the appropriate level of diligence and care, exceeding general industry standards. Nevertheless, the Customer recognizes there are conditions and circumstances over which Duckworth Pump and Well has no control and as a contractor, cannot be held responsible for damage or problems incurred from sub-standard work done by previous contractors, old and/or corroded components, or unusual circumstances that cannot be reasonably anticipated. Duckworth fully warranties and stands behind our work and equipment for at least a full year, and longer for some components. All items installed remain the property of Duckworth Pump and Well Services until the associated invoice is paid in full. Failure to remit payment may result in the retrieval of our equipment or the process of being sent to collections. If that becomes necessary, we will return the items to our shop and then refund any remaining retainer or down payment, once associated labor has been paid. As a result of site conditions (topography, saturated soils, landscaping, vegetation, slopes, mud, and other similar conditions or barriers) we have determined there is an increased likelihood of our vehicle/equipment getting stuck and/or causing damage to your property. We will take the utmost care in protecting your property and to prevent getting stuck; however, the nature of this particular site is such that some damage and/or getting stuck is a possibility. The equipment required to complete the work is heavier and wider than a typical residential vehicle. By signing this waiver, the party authorizing this work acknowledges damage may occur to their lawn, landscaping or other property feature. Specific concerns areas follows: Damage to Lawn Causing Ruts Damage to Landscaping Damage to Fence or other Hardscape Other: The party authorizing this work and the property owner will not hold Duckworth Pump and Well Services Liable for the above damage, or other damages, provided they perform their duties with reasonable care and diligence. In addition, the party authorizing this work and the property owner acknowledge they will be responsible for costs associated with towing or other professional services in the event any equipment becomes stuck. The authorizing party and property owner agree to the added expense of for the use of construction mats to prevent equipment from becoming stuck and to prevent property damage. By signing below, I attest that I agree to the above terms and that I am an authorized representative for the property(ies) upon which the proposed work it to take place and am responsible for paying my bill in full.

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