Service Request Form & Customer Information:

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Name:
Address:
City:
State:
Zip:
Primary Phone:
Cell Phone:
Home Phone:
Email:

   May we send you information about us?

How did you hear about us? yellow pages
Web Search
Business
Other
   If other, Please Specify:

How will you be paying today? Cash
Visa
Master Card

System Information:

Manufacturer:
Model #:
SN#:

Please describe your problem/work:

Protecting your Data is your responsibility –There is always a danger of data loss when your computer is being serviced or repaired. We recommend that all data on your system is backed up prior to any service.

YES, I want my data backed up for me $50.00
NO, I have already backed up my data or it is OK if it is lost. I understand that Michiana PC is not responsible for data loss.
 

You must select one of the above options before service can be performed.

Please be advised that if we have to reinstall the operating system you could LOSE all data and software. If you want Michiana PC to reinstall your software (It will be at charged at regular hourly rates) you need to provide us with all software disks INCLUDING PRODUCT REGISTRATION KEY(s). Michiana PC will call you with an estimate if repairs are complex and more time is needed outside the $25.00 diagnostic fee. Additional time will be billed at $65.00/hr. If you DO not wish to repair the system after diagnosis you will still be charged $10.00. Items not picked up after 30 days will become Michiana PC property.


Michiana PC Pricing  

Standard Hourly technician rate	$65/hour
Travel or Pickup and Delivery(within 20 miles)	$20
Diagnostics Fee  (Waived if we do the work)	$10
General PC Cleanup and Maintenance	$50
Memory Upgrades while you wait	$25
Hard Drive Upgrade	$50
Re Install Windows with Recovery Partition	$50
Reinstall Windows with Recovery Discs	$75
Re install Windows without Recovery Media	$100
Install Software title such as Office	$25
Backup Hard Drive to USB drive	$50