Jobsite Details

Business/Customer Name *

Date * +

Site Contact

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address

Generator Details

KW Rating *

Model Number *

Serial Number *

Problem/Reason For Request *

0/255 characters

Payment Information and Authorization

Service Location Type *

By filling out this form, ESSE is being authorized to process your credit to establish terms with your business.

Billing Address *

Business Name

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address

Tax Exempt Status *

**If exempt, you will need to submit your Tax Exempt Certificate to exemptions@essellc.com.***

Payment Type *

Please note that we charge 3.5% on all credit card transactions.

Payment Type *

Name Shown On Card *

Credit Card Type *

Credit Card Number *

Expiration Date (mm/yy) *

Purchase Order / Reference Number

Preferred Way To Receive Final Invoice *

Mail to Billing Address Above

Mail to Different Address

Email

Must be uploaded to an Invoice Submission Portal

Invoice Submission Web Portal Address *

Invoice Submission Email Address *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

By signing below you agree that this service call is performed pursuant to ESSE, LLC standard terms and conditions, which are available upon request. These will apply to this request and supersede all others now or attached to a subsequent service call and/or purchase order. Services provided may be chargeable, if not warranty in nature and therefore, agree that payment shall be issued at the time of service.

*Rates effective 04-01-24 and are subject to change

Normal Hours Pricing (Monday - Friday 7:00 AM - 6:00 PM)

Labor: $176 Per Hour | Travel: $176 Per Hour | Mileage: $3.25 Per Mile

Overtime Hours Pricing (Tuesday - Thursday 6:00 PM - 7:00 AM)

Labor: $264 Per Hour | Travel: $264 Per Hour | Mileage: $3.25 Per Mile

Weekend Hours Pricing (Friday 6:00 PM - Monday 7:00 AM)

Labor: $352 Per Hour | Travel: $352 Per Hour | Mileage: $3.25 Per Mile

Holiday Hours Pricing

Labor: $352 Per Hour | Travel: $352 Per Hour | Mileage: $3.25 Per Mile

Service Disposal Fee: $80.00

Name *

Date * +

Signature *

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