Workshop Acceptance Form Order Number Name * Workshop Name * Email Address * Contact No’s: Tel * Address Address Line 1 * City * Address Line 2 * State / Province / Region * Country * Sales Consultant Information Sales Agent Name * Cell Number * Sales Agent Surname * Email address * Product Options Please tick if you would like one of these options Gold Unlimited Service Plan Yes/No * Yes No Platinum Unlimited Service Plan Yes/No * Yes No Ceramic Coating Yes/No * Yes No Vehicle Sterilization Yes/No * Yes No Agree with terms towards services and sales on our products • On all online credit card cash sales will be 10% commission. • Workshop Labour rate @ R450.00 an hour labour/Less 18% Yes/No * Yes No I/We * Is the workshop part of a dealership group? * Yes No Dealership Dealership name * I hereby confirm that the Autoserv Global Agent has explained all the relevant options and requirements pertaining to the sale of Autoserv Global non regulated value-added products at your Dealership. I/We hereby confirm and accept my/our options and abide by all liabilities including terms and conditions with regards to the sale of Autoserv Global products to support the GLOBAL GREEN DRIVE PROGAM Happy Motoring & make a difference !
