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Furnace Rental Online Application Form

Bosanac Heating & Electric offers Furnace Rental for its customers at the convenience of low monthly payments.

RENTAL benefits:

  • Low, affordable monthly rates
  • No up-front equipment costs
  • No repair bills - just worry-free home comfort
  • Free equipment replacement during contract term - should your equipment be un-repairable as a result of normal use
  • Service provided by responsive, local service providers
  • Rate Increase Protection - Your Vista contract will not be subject to arbitrary, unexpected, and excessive rate increases. The contract includes a rate increase guarantee.
  • The convenience of payment on your local gas utility bill (where available) or by pre-authorized payment

Required fields are marked with *


FIRST NAME *
LAST NAME *
DATE OF BIRTH *
STREET # *
STREET NAME *
UNIT
CITY / TOWN *
POSTAL CODE *
PHONE *
PHONE (alt.)
E-MAIL *

* I AM THE HOMEOWNER    I AM A TENANT    RENTAL PROPERY THAT I OWN

NEW EQUIPMENT


* NEW EQUIPMENT TYPE(S) +


PREFERRED INSTALL DATE & TIME


* IS THIS A COMMERCIAL APPLICATION? Yes    No
(i.e. restaurant, office, retail store...)

OLD EQUIPMENT


CURRENT RENTAL PROVIDER


OLD EQUIPMENT TYPE(S) +


OLD RENTAL RATE  $ 

* DID YOU SIGN AN AGREEMENT WITH YOUR OLD RENTAL EQUIPMENT PROVIDER? Yes    No

+ Use CTRL key to select more than one equipment type.
COMMENTS and NOTES


*  You authorize Bosanac Heating & Electric to make any inquiries concerning your credit and you authorize any consumer reporting agency, or any other company with whom you have financial relations to furnish credit information to Bosanac Heating & Electric.

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