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What We Cover
2 Air Conditioners Garbage Disposal 5 Point tune-up Standard Seer Upgrade
Plumbing Unknown Pre-existing Conditions Heating Electrical
Freon Recovery Water Heater (up to 50 Gal) Circuit Boards Line Clearing up to 6ft
Dishwasher Oven/Range Microwave
Refrigerator with Ice Maker & Dispenser Washer Dryer
Note: This plan requires a $75 (deductible) service fee
Choose Deluxe Package*
 T
Seller`s Coverage
Seller`s Coverage
No Deductible
No Deductible
Stoppage Coverage
Stoppage Coverage
Double Oven
Double Oven
Pool or Spa (with shared equipment)
Pool or Spa (with shared equipment)
Additional Pool OR Spa Additional Pump & Motor
Additional Pool OR Spa Additional Pump & Motor
Extended Plumbing
Extended Plumbing
Each Additional Air Conditioner
Each Additional Air Conditioner
Each Additional Water Heater
Each Additional Water Heater
Emergency Service
Emergency Service
Garage Door Opener
Garage Door Opener
Water Softener
Water Softener
Second Refrigerator
Second Refrigerator
Stand Alone Freezer
Stand Alone Freezer
Coverage Total
Homeowner`s application
Address to be covered*

Street 2:

Apt/Unit #

City:*

State:*

Zip Code:*

Phone:

Home Owner/ Buyer`s Mailing Address
Home Owner/Buyer`s Name*

Send confirmation Email to:*

Enter valid email
Home Owner Mailing Address:*

Home Owner Mail Street 2:

Home Owner Mailing City:*

Home Owner Mailing State:*

Home Owners Mailing Zip Code:*

Agent`s Information
Agents Name

Phone:

Agent Code

BFS assigned Salescode
Real Estate Company

Agents Email address

Address Line 1:

Address Line 2:

City:

State:

Zip Code:

Closing Company
Closing Company

Closing Date

Escrow Officer

Email address

Phone:

Fax:

If Seller`s Coverage has been selected, seller`s coverage begins when this application is submitted and expires 6 Months from the listing date.
Sellers Coverage includes AC, Heating, Minor Plumbing & Electric and Water Heater.
Enter Seller Coverage Begin Date*

Seller`s Name

Seller Phone #

Seller`s Email

Seller Address 1*

Seller Address 2

Seller City*

Seller State*

Seller Zip Code*

Place your order
Choose Payment Method*

Mail your check to :
BFS Home Warranty
3500 N. 28th Terrace
Hollywood, FL 33020-1104

Call: 800-237-9910
Name on Credit Card

Card Brand

Card Number:

Expiration Month

Expiration Year:

CVV2:

Phone #

Card Billing Same as Home Owner Mailing Address?*

Card Billing Address

Card Billing line 2:

Card Billing City

Card Billing State

Card Billing Zip Code

How did you hear about us?
Realtor Mailer Internet Friend/Neighbor 

Comments:

Confirmation #:

Florida - A/C CA-C056778 Florida - A/C CA-C057400 Florida- Plumbing CFC1430745
Florida -Electrical ES-0000336 - Florida Electrical EC13007734
Nevada A/C 0040504, 0081113 Nevada Water Heater 0046467 Nevada Plumbing 0081114
Texas Plumbing M-44053 Texas A/C TACLB20853E, TACLB33262E, TACLB98475E
Arizona A/C 280095,279402 Arizona Plumbing 289307
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