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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 / Ice Maker / Water Dispenser
Second Refrigerator / Ice Maker / Water Dispenser
Door Seals and Gaskets (Silver Only)
Door Seals and Gaskets (Silver Only)
Double Oven
Double Oven
Freezer
Freezer
A/C & Heat Emergency Service
A/C & Heat Emergency Service
Microwave
Microwave
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)
Washer & Dryer
Washer & Dryer
Second Water Heater (up to 50 glas)
Second Water Heater (up to 50 glas)
Sub-Total:
Tax * local county/city tax may apply (7.00%):
Total for Plan Protection:
 
Payment Information
Payment Method*

 

3.5 % Credit Card Payment
I understand a 3.5% convenience fee will be added for Credit Card payments.
**Monthly Payment/Auto Renew option will not incur credit card convenience fee
Monthly Payment, Automatic Renewal and Cancellation terms
Your service contract agreement will automatically renew at the end of each annual term continuously with Broward Factory Service aka BFS unless either party gives the other written/electronic notice of cancellation with a minimum of 30 days before the renewal date. Upon renewal of the contract, an email notification will be sent within 5 days of your credit card charge along with a copy of your renewal agreement which includes terms and conditions. Monthly amounts due are 12 equal payments of the agreed annual contract amount on the home warranty application. The first payment will be due upon signing the application and thereafter will be scheduled either on the 15th of the month or the last business day of the month, depending on date of application.

If you choose to cancel an existing in force contract, you are subject to and agree to the following terms and conditions:
- Upon termination of agreement/monthly payments, no refund is due to customer.
- In the case that BFS Home Warranty’s service cost is greater than the agreement price paid to date, customer shall owe to BFS service cost minus agreement price paid to date up to a maximum of the full agreement price as provided in the account summary on the original order form and agreement.
- Cancellations require a 30-day notice that should be sent via email to sales@browardfactory.com. Please include your agreement number and service site address with your request.
Up to date Terms and Conditions can be found at www.bfshomewarranty.com/TC
 
 
YES! Sign me up for monthly payments and automatic renewals*

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

Property Address*

Email Address*

Phone Number*

Total Contract Amount

applicable tax may be added
Monthly Payment amount

12 equal monthly payments
Choose Payment*

Card Brand .*

Credit Card # .

Expiration Date .

CVV# .


Billing Address .

Billing City .

Billing State .

Billing Zip .

Routing Number .

enter your bank routing number
Bank account # .

Enter your bank account number
Verify Routing # .

reenter Routing Number
Verify Bank account # .

reenter your bank account
 
Routing Number

enter your bank routing number
Bank account #

Enter your bank account number
Verify Routing #

reenter Routing Number
Verify Bank account #

reenter your bank account
Verify Bank account #

reenter your bank account
Card Brand*

Credit Card #

Expiration Date

CVV#

Card Holders Name


Billing Address

Address Line 2

Billing City

Billing State

Billing Zip

 
By signing below, I agree to the above terms and conditions and authorize Broward Factory Service to charge the below credit card monthly unless I provide notice of cancellation.
 
Enter your name

I agree to terms stated above
Date*

Date of Acceptance
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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