SERVICE REQUEST FORM

THIS SERVES AS OUR CONFIRMATION OF SERVICE AND ITS CHARGES.

Problem: Software Hardware PM Conversion

Details:
Corrupted BOMON and software, resulted to pending update in the POS;
 prz file to correct the PWD computation
 Missing April 29,2019 transaction in the backoffice
 Delay of sales transmittal in the backoffice
 Offline even though cables are intact
Service Charge 5000.00 Stipend/day (Php896)
Actual Transportation Lodging (if applicable)
Virus Clean up (5000 if applicable)
Form Of Payment
Cash Upon Service (Applicable for SW enrolled and Standard Services only)
Bank Deposit (Fax Deposit Slip together with the approved SRF)
Money Transfer (Fax acknowledgement receipt and with approved SRF)

ANSI Bank Details:

Metrobank Account (Branch: MBTC Downtown Center)
Account#: 3-016-08556-2
Account Name: ANSI Information Systems Inc.
Money Transfer Consignee (For Bank Holiday or No Metrobank in their Area)
ANSI Information Systems
Suite 511 Tytana Plaza Bldg. Binondo, Manila
Attention: Maria Fe Tancioco

Note: Please read carefully before signing this confirmation and kindly fax this back if it is
agreeable with you.

For ANSI use only:

Date of SRF: May 3, 2019
Store/Branch: CF RCBC
Service Date: _________________
Conforme: Ms. Evelyn Cheng
(Signature over Printed Name) Noted By: ____________________
(ANSI Representative)

FAX NUMBER: (02) 2417442 or (02) 2414189