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844-4-JET-FIX
CRS# 8BQR005D
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Work Authorization Form
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CUSTOMER INFORMATION
Customer Name
*
Contact Name
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First
Last
Contact Email Address
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Email address for invoicing.
Mailing Address
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Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
--- Select country ---
Afghanistan
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Phone Number
*
FedEX/UPS Account #:
AIRCRAFT INFORMATION
Registration Number
*
Aircraft Serial Number
*
Make
*
Model
*
Work Scope
*
ACTT
ACTC
Oil Type
Engine 1: SN
Engine 1: Hours
Engine 1: Cycles
Engine 2: SN
Engine 2: Hours
Engine 2: Cycles
Engine 3: SN
Engine 3: Hours
Engine 3: Cycles
Aircraft and/or Engine Parts Warranty Program?
*
Yes
No
If Yes, Account #:
SIGNATURE
I hereby authorize the below-described work to be performed by Empire Aviation USA, INC (hereinafter referred to as EAU) pursuant to the Labor Rate and Service Agreement between said Company and EAU. I agree to pay all charges in full upon receiving of the Final Invoice Via Email within a three (3) Day period. Unless otherwise agreed between EAU and Company in writing. If EAU does not receive payment at the time the plane is completed, the customer must sign an acknowledgment accepting the accuracy of the invoice before the plane is Returned to Service. Refer to Terms and Conditions as well as Terms of payment written below.
As aircraft owner or authorized by owner: I hereby grant you and/or your employees' permission to operate the aircraft herein described on taxiways, runways, in flight or elsewhere for the purpose of testing and/or inspection. To ensure complete payment, I grant EAU a lien and security interest, with all the rights and remedies provided by Florida law, on the airplane and the airplane parts described in the maintenance authorization. The lien and security interest will secure the payment of all sums now due or which become due for authorized work performed and parts supplied by EAU together with reasonable fees if collection efforts are necessary including but not limited to attorneys’ fees. I also agree that you are not responsible for loss or damage to the aircraft or articles left in aircraft in case of fire, theft, or any other cause beyond your control. Receipt of this estimate is hereby acknowledged. Pursuant to the stipulations governing Part 135 and managed aircraft operations, in instances where the requisition of work is conducted through the management company or the Part 135 operator, it is hereby agreed that the aforementioned operator shall assume full financial liability for all labor executed, parts furnished, and/or services rendered as a consequence of this work authorization regardless of the company/name provided on this work authorization.
TERMS AND CONDITIONS:
Consumables:
A fee of 6% on labor will be charged for consumables, not to exceed $3,000 to cover all shop supplies, hazmat and environmental disposal fees.
Tooling/Rental charges:
Any special tooling and/or equipment rentals required will be additional and billed on the final invoice.
Hazardous Materials:
Unless specifically stated otherwise, fees incurred by EAU for the disposal of Hazardous Materials, such as tires, batteries, etc., will be additional and billed on the final invoice.
Freight:
Unless stated otherwise, the cost of freight will be additional and billed on the final invoice.
Customer Furnished Parts:
Customer furnished parts must comply with FAA FAR 145.200, Paragraphs (i) and (ii), and will be subject to a 10% handling fee, based on current manufacturer list price.
Discrepancies:
The proposal does not include labor for repairs of any discrepancies in the aircraft found during the work scope. Discrepancy repairs will be completed on a time and material basis following customer approval.
Test Flights:
If a local test flight is required, the customer is responsible for providing a qualified flight crew and for all operating costs related to such test flights.
*135 Training Requirements:
Management specific Part 135 training requirements will be additional and billed on the final invoice. Operator agrees to supply EAU with the pertinent sections of their FAA approved operators manual (GMM, GOM, etc.) to include the desired return to service statement. Operator also agrees to provide training to the designated EAU RII inspector prior to start date of the work requiring RII signoffs.
Parts Pricing:
Pricing for parts is based on current vendor pricing at the time of proposal(s) preparation and is subject to change if the vendor pricing changes at the time of actual purchase.
Vendor Incompatibilities:
EAU is not responsible for vendor to vendor incompatibilities which may be discovered during the course of the installation. Additional equipment, labor or engineering required to complete the installation will result in additional charges and billed on the final invoice.
Core Returns:
All exchange parts are subject to vendor acceptance of exchange core. Should exchange core be rejected or subjected to an additional charge by the vendor at any time for reasons of abnormal wear and tear, damage, unauthorized modification or other discrepancies, the customer agrees to reimburse EAU for resultant additional costs.
Aircraft Documentation:
For the purpose of completing the proposed work scope, the customer must furnish in a timely manner requested documentation for the aircraft, including, but not limited to: aircraft logbooks, W&B data, RVSM manual, wiring prints, completion documents, flight manual supplements, instructions for continued airworthiness, FAA Form 337 major repair and alteration documentation.
Vendor Parts and Labor:
Third-party vendor parts and labor shall be limited to the warranty provided by the supplying vendor, if any. EAU will use reasonable efforts to assist customer in obtaining any such third-party vendor warranties upon customer's written request.
Warranty Coverage Conditions:
The customer must provide EAU written notice of a warranty claim and a description of the subject of the warranty claim no later than thirty (30) days after the discovery of the defect. Claims made outside of any applicable warranty period will not be covered. The workmanship warranty period is sixty (60) days after return to service of the aircraft.
Working days:
Working days are defined as Monday thru Friday (excluding Holidays). Should additional work be required, the estimated down time may require extension. Proposal(s) do not include overtime. Any overtime required will be approved by the customer prior to work commencing.
Terms of Payment
• For estimates in excess of $10,000, a 50% down payment will be required prior to start of work
• Unless otherwise stated, full balance is due upon delivery of aircraft
• 3.0% bookkeeping fee
• Our estimates are valid for 90 days and should be used as general information for planning purposes and are to be used as a guideline in determining costs.
• Actual costs may vary and are subject to change without prior notice
Signature
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Date
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