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Application for Silver/ Gold coverage
$299.00 * Silver Plan includes parts & labor for all functional parts for the following items:
A/C unit (up to 5 Tons) Heating
Water Heater (up to 50 Gallons) Thermostat
Refrigerator Ice Maker Oven/Range
DishWasher Garbage Disposal
Upgrade to Gold! Gold Plan $539.00
Gold Plan covers items listed above for Service AND Replacement.
Gold Plan also includes the Standard SEER upgrade.

*Terms and Conditions apply.
Inspection report of covered products may be required.
BFS reserves the right to determine pre-existing conditions on covered products.
Property To Be Covered
Owner`s Name*

Owner`s Email

Address 1*

Suite or Apt #

City*

State*

Zip Code*

Cell Phone #

Home Phone Number

Age of Home

Salesperson Name

Choose Your Plan
 
Additional options available :
2nd Air Conditioner
2nd Air Conditioner
Second Refrigerator
Second Refrigerator
A/C over 3 Tons / per ton
A/C over 3 Tons / per ton
Door Seals and Gaskets (Silver Only)
Door Seals and Gaskets (Silver Only)
Double Oven
Double Oven
Freezer
Freezer
Ice Maker / Ice Water Dispenser
Ice Maker / Ice Water Dispenser
A/C & Heat Emergency Service
A/C & Heat Emergency Service
Microwave
Microwave
Microwave (Labor Only )
Microwave (Labor Only )
Package/Water Source A/C
Plumbing & Electric (Silver only )
Plumbing & Electric (Silver only )
Pool Motor (Silver only )
Pool Motor (Silver only )
Printed Circuit Boards & Touch Pads (Silver only)
Printed Circuit Boards & Touch Pads (Silver only)
Self-Cleaning Oven
Self-Cleaning Oven
Washer & Dryer
Washer & Dryer
Second Water Heater (up to 50 glas)
Second Water Heater (up to 50 glas)
MINIMUM SEER A/C Replacement (per system)
MINIMUM SEER A/C Replacement (per system)
Sub-Total:
Tax * local county/city tax may apply (7.00%):
Total for Plan Protection:
 
Payment Information
Payment Method*

Please make mail your check to:
Broward Factory Service
3500 N. 28th Terrace
Hollywood, FL 33020
Card Brand*

Credit Card #

Expiration Date

CVV#

Card Holders Name


Billing Address

Address Line 2

Billing City

Billing State

Billing Zip

Confirmation #

Send Confirmation Email to:*

 
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
Notice to TX customers: you, the buyer, have other rights and remedies under the Texas deceptive trade practices consumer protection act which are in addition to any remedy which may be available under this contract. For more information concerning your rights, contact the consumer protection division of the attorney general`s office, your local district or county attorney or the attorney of your choice. Prices subject to change without notice.

Notice to NV customers: If you are not satisfied with the way BFS has handled your claim, you may contact our corporate office at 954-920-9774. If satisfaction of the claim is not provided, you may contact the Nevada Division of Insurance at 1-888-872-3234.

The rate charged for the service agreement is not subject to regulation by the Office of Insurance Regulation.
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