Siemer Preferred Customer Program Form HiddenCompany Email for Maintenance Plan Applications Administrative field: do not enter data hereHiddenNo Reply Email Administrative field: do not enter data hereHiddenCompany Name Administrative field: do not enter data herePlans* SPC 1 System Monthly Plan(1 Air Conditioner, 1 Furnace) $24/mo. fee SPC 2 Systems Monthly Plan(2 Air Conditioners, 2 Furnaces) $48/mo. fee SPC 3 Systems Monthly Plan(3 Air Conditioners, 3 Furnaces) $72/mo. fee SPC 4 Systems Monthly Plan(4 Air Conditioners, 4 Furnaces) $96/mo. fee Humidifier Monthly Plan(Includes The Humidifier Pad) $4 each/mo. fee Tanked Water Heather Monthly Plan(1 Tanked Water Heater) $8.25/mo. fee Tankless Water Heater Monthly Plan(1 Tankless Water Heater) $13.25/mo. fee Add On's Humidifier Monthly Plan(Includes The Humidifier Pad) $4/mo. fee Tanked Water Heather Monthly Plan(1 Tanked Water Heater) $8.25/mo. fee Tankless Water Heater Monthly Plan(1 Tankless Water Heater) $13.25/mo. fee Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*Referred by: I want to pay by* Check ACH HiddenTerms and Conditions I agree to the Terms and Conditions Agree to be Contacted* By submitting this form I am agreeing to be contacted by a representative of Siemer Heating & Cooling to confirm and sign up for an annual Maintenance Plan agreement. Need HVAC Service? Contact the experts at Siemer Heating & Cooling. Call us at 219-923-9234! REQUEST SERVICE
