Builder Signature In Lieu Of Purchase Order

This form is to be used in lieu of a purchase order in the event of an emergency where replacement or repair may be delayed due to lack of purchase order.  By signing this form, you hereby authorize FloorWorks to do work as outlined in scope of work section you have filled out below.  FloorWorks accepts this signed form as an authorization to purchase materials and furnish labor to complete work requested by you. 

 Please fill in all information and fax back to:
FloorWorks                 770-416-1780

Community:     ______________________________ Lot #___________
Builder Name: ______________________________________________
Address:          ______________________________________________

Authorized by: ______________________________________________
                             Printed Name

                            ______________________________________________
                             Signature
Title: _______________________

Cell#:_______________________            Trailer#:_________________

Amount Authorized: $__________________

Scope of work: _____________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________