FULL THROTTLE MARINE
Customer Intake & Service Authorization Form
Specializing in Older Model Boats and Performance Improvements
Date: ______
Service Order Number: ______
CUSTOMER INFORMATION
| Field | Information |
|---|---|
| Customer Name: | _______ |
| Address: | _______ |
| _______ | |
| City, State, ZIP: | _______ |
| Primary Phone: | _______ |
| Secondary Phone: | _______ |
| Email Address: | _______ |
| Preferred Contact Method: | ☐ Phone ☐ Email ☐ Text Message |
VESSEL INFORMATION
| Field | Information |
|---|---|
| Vessel Make: | _______ |
| Vessel Model: | _______ |
| Year: | _______ |
| Vessel Identification Number (VIN/HIN): | _______ |
| Length: | ___ feet |
| Current Location: | ☐ Customer's Property ☐ Marina ☐ Our Facility |
| Location Details: _________ |
ENGINE INFORMATION
| Field | Information |
|---|---|
| Number of Engines: | ☐ 1 ☐ 2 ☐ 3+ (specify: _____) |
| Engine Make: | _______ |
| Engine Model: | _______ |
| Engine Year: | _______ |
| Engine Type: | ☐ Outboard ☐ Inboard ☐ Stern Drive (I/O) |
| Engine Size/Horsepower: | _______ |
| Fuel Type: | ☐ Gasoline ☐ Diesel |
| Hours on Engine(s): | _______ |
| Last Service Date: | _______ |
SERVICE REQUEST
Brief Description of Issue or Service Needed:
Customer's Desired Completion Date: _______
Priority Level: ☐ Routine Maintenance ☐ Urgent ☐ Emergency
ESTIMATE OF SERVICES TO BE PERFORMED
Based on initial assessment and customer request, the following services are anticipated:
| Service Description | Est. Labor Hours | Est. Materials Cost | Est. Total |
|---|---|---|---|
Labor Rate: $______ per hour
Estimated Total Cost: $______
Note: This is an estimate only. Actual costs may vary based on additional findings during service. Customer will be contacted for approval before any work exceeding this estimate by more than $__ (or ____%) is performed.
ADDITIONAL SERVICES AVAILABLE
Would you like information about any of the following services?
☐ Engine Performance Tuning ☐ Propeller Sizing and Optimization ☐ Marine Electronics Installation ☐ Dock and Lift Maintenance ☐ Welding and Fabrication Services ☐ Winterization Services ☐ Pre-Season Preparation
PAYMENT & LEGAL AGREEMENT
Payment Terms
Accepted Payment Methods: ☐ Cash ☐ Check ☐ Credit/Debit Card ☐ Bank Transfer
Payment Terms: ☐ Payment due upon completion ☐ 50% deposit required ☐ Other: _____
Deposit Amount (if applicable): $__ Date Paid: _____
Mechanic's Lien Notice & Service Agreement
IMPORTANT: PLEASE READ CAREFULLY BEFORE SIGNING
By signing below, the customer acknowledges and agrees to the following terms:
-
Authorization for Service: I authorize Full Throttle Marine to perform the services described in this form on the vessel identified above.
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Payment Guarantee: I agree to pay Full Throttle Marine for all authorized services, parts, materials, and labor performed on the vessel at the rates specified in this agreement.
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Mechanic's Lien: I understand that under [State] law, Full Throttle Marine has the right to place a mechanic's lien on the vessel for the full amount of services rendered if payment is not received in accordance with the payment terms specified. This lien gives Full Throttle Marine a legal claim against the vessel until all charges are paid in full.
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Excess Work Authorization: I understand that if additional work beyond the estimate is discovered during service, Full Throttle Marine will contact me for approval before proceeding with work exceeding the estimate by more than $__ (or ___%).
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Storage Fees: If the vessel is not removed from Full Throttle Marine's facility within _ days of service completion and notification, I agree to pay storage fees of $_____ per day.
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Liability Waiver: I understand that Full Throttle Marine will exercise reasonable care in the service and storage of my vessel. However, Full Throttle Marine is not responsible for damage caused by defects in the vessel, normal wear and tear, or circumstances beyond our control.
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Personal Property: I have removed all personal property of value from the vessel. Full Throttle Marine is not responsible for personal items left in or on the vessel.
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Parts Warranty: Parts installed carry the manufacturer's warranty. Labor is warranted for _____ days from service completion.
-
Accuracy of Information: I certify that all information provided in this form is accurate and complete to the best of my knowledge.
CUSTOMER SIGNATURE & AUTHORIZATION
I have read, understood, and agree to the terms outlined in this Customer Intake & Service Authorization Form, including the Mechanic's Lien Notice and Service Agreement.
Customer Signature: _______
Printed Name: _______
Date: _______
FOR OFFICE USE ONLY
Accepted By: _____ Date: ___
Technician Assigned: _________
Scheduled Start Date: __ Target Completion: __
Notes:
Full Throttle Marine Reliable Service for Older Model Boats
909 21st Ave W, Palmetto, FL 34221 Phone: (904) 417-8198 Email: service@fullthrottlemarine.shop Website: www.fullthrottlemarine.shop
FORM VERSION 1.0 | January 2026