Alliance Land Surveyors | Order Acknowledgement

TITLE

Company:*

Name

First Last

Contact Information

Phone:	Email:

Address

Street Address Address Line 2 City State ZIP Code

REQUESTOR

Name

First Last

Contact Information

Phone:	Email:

Address

Street Address Address Line 2 City State ZIP Code

PARTY RESPONSIBLE FOR PAYMENT

Company:

Name

First Last

Contact Information

Phone:	Email:

Address

Street Address Address Line 2 City State ZIP Code

Property Information

Subject Property Address:*

Street Address Address Line 2 City State ZIP Code

Locked Gates:*

Yes
No

What is the Gate Code?

Dogs:*

Yes
No

Requested Date

Due Date:

MM

DD

YYYY

Closing Date:

MM

DD

YYYY

Services*

Select all the services required

Special Instructions or Comments:

*

Any Order Acknowledgement shall constitute a binding contract between the parties, subject to the conditions hereof and shall constitute the entire agreement between Alliance Land Surveyors, LTD. and seller. This order shall supersede any other agreements or understanding prior to this date of the order. The acceptance of this Order Acknowledgement shall, by acknowledgement, shipment of documents, performance of services, or commencement of work constitute acceptance of the terms and conditions set forth in the Order Acknowledgement. These terms and conditions may be modified or terminated with written request, at anytime. If these Terms expire or are terminated for any reason: Customer agreess to pay any amounts that have accrued before, and remain unpaid, as of the date of termination or expiration.

Yes, I acknowledge and agree to the terms of this agreement; please submit my Survey Request.

Schedule A & B of the Title Commitement

Drop files here or

Order Acknowledgement

TITLE

REQUESTOR

PARTY RESPONSIBLE FOR PAYMENT

Property Information

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