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                                Vendor Profile for AMERICA FRESH AIR & HEAT | Orlando, FL | Property Preservation | Property Maintenance for Property Preservation : .      </strong>
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        <td width="10" style="background-image:url(/gfx/env/panel_bg.png);">&nbsp;</td>
        <td align="left" style="background-image:url(/gfx/env/panel_bg.png);">          <div><span class='font_Arial_18_39F_Normal'><strong>AMERICA FRESH AIR & HEAT - Orlando, FL</strong></span></div><div style='color:#000055'><font size='2'><strong>Coverage Area:</strong> FL</font><br><font size='2'><strong>Counties Served:</strong> Orange, Osceola, Seminole, Polk...</font></div></td>
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        <td valign="top">                              </p>
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              <tr>
                <td width="880" colspan="4" bgcolor="#cfffbf" style="border-bottom:2px dotted #999; border-top:2px dotted #999"><font size="3"><b> <em>General Service Request - Fill in the form below to submit your service request.</em></b></font></td>
              </tr>
                                          <tr>
                <td colspan="4" align="left" valign="middle" class="records" style="border-bottom:2px dotted #999">                  <input name="Request_ID" type="hidden" id="Request_ID" value="GVR20230531155306" />
                  <input name="dfid" type="hidden" value="4" />
                  <input name="Status" type="hidden" id="Status" value="Active" />
                  <input name="Request_Date" type="hidden" id="Request_Date" value="2023-05-31" /></td>
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              <tr>
                <td align="center" valign="top" class="records"><table width="340" border="0" cellspacing="0" cellpadding="0">
                  <tr>
                    <td height="20" colspan="2"><strong>Property Type:</strong> <span style="font-size:11px; color:#F00;">(required)</span></td>
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                    <td width="170"><em>Residential</em></td>
                    <td width="170" class="font_Arial_11_005_Normal"><input type="radio" name="Property_Type" id="Property_Type" value="Residential - Single Family" />
                      Single Family</td>
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                    <td>&nbsp;</td>
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                      Multi-Family</td>
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                  <tr>
                    <td>&nbsp;</td>
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                      Condo / Townhome</td>
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                  <tr>
                    <td>&nbsp;</td>
                    <td class="font_Arial_11_005_Normal"><input type="radio" name="Property_Type" id="Property_Type" value="Residential - Apartment/Loft" />
                      Apartment / Loft</td>
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                  <tr>
                    <td>&nbsp;</td>
                    <td class="font_Arial_11_005_Normal">&nbsp;</td>
                  </tr>
                  <tr>
                    <td><em>Commercial</em></td>
                    <td class="font_Arial_11_005_Normal"><input type="radio" name="Property_Type" id="Property_Type" value="Commercial - Office Building / Highrise" />
                      Office Building / Highrise</td>
                  </tr>
                  <tr>
                    <td>&nbsp;</td>
                    <td class="font_Arial_11_005_Normal"><input type="radio" name="Property_Type" id="Property_Type" value="Commercial - Retail / Storefront" />
                      Retail / Storefront</td>
                  </tr>
                  <tr>
                    <td>&nbsp;</td>
                    <td class="font_Arial_11_005_Normal"><input type="radio" name="Property_Type" id="Property_Type" value="Commercial - Warehouse / Industrial" />
                      Warehouse / Industrial</td>
                  </tr>
                  <tr>
                    <td>&nbsp;</td>
                    <td class="font_Arial_11_005_Normal"><input type="radio" name="Property_Type" id="Property_Type" value="Commercial - Coliseum / Performance Hall" />
                      Coliseum / Performance Hall</td>
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                  <tr>
                    <td>&nbsp;</td>
                    <td class="font_Arial_11_005_Normal"><input type="radio" name="Property_Type" id="Property_Type" value="Commercial - School / Training Center" />
                      School / Training Center</td>
                  </tr>
                  <tr>
                    <td>&nbsp;</td>
                    <td class="font_Arial_11_005_Normal"><input type="radio" name="Property_Type" id="Property_Type" value="Commercial - Worship Center " />
                      Worship Center </td>
                  </tr>
                  <tr>
                    <td>&nbsp;</td>
                    <td class="font_Arial_11_005_Normal"><input type="radio" name="Property_Type" id="Property_Type" value="Commercial - Hotel / Lodge" />
                      Hotel / Lodge</td>
                  </tr>
                  <tr>
                    <td>&nbsp;</td>
                    <td class="font_Arial_11_005_Normal">&nbsp;</td>
                  </tr>
                  <tr>
                    <td><em>Other</em></td>
                    <td class="font_Arial_11_005_Normal"><input type="radio" name="Property_Type" id="Property_Type" value="Other / Unspecified" />
                      Other / Unspecified</td>
                  </tr>
                  <tr>
                    <td>&nbsp;</td>
                    <td>&nbsp;</td>
                  </tr>
                  <tr>
                    <td height="20" colspan="2"><strong>Property Address</strong> <span style="font-size:11px; color:#F00;">(required)</span></td>
                  </tr>
                  <tr>
                    <td height="50" colspan="2" align="left" valign="top" class="records"><input name="Property_Address" type="text" id="Property_Address" size="42" />
                      <br />
                      <input name="Property_Unit_Number" type="text" id="Property_Unit_Number" size="19" />
                      (Unit Number)</td>
                  </tr>
                  <tr>
                    <td height="20"><strong>Property City</strong><span style="font-size:11px; color:#F00;">(required)</span></td>
                    <td><strong>Property State</strong><span style="font-size:11px; color:#F00;">(required)</span></td>
                  </tr>
                  <tr>
                    <td height="50" align="left" valign="top" class="records"><input name="Property_City" type="text" id="Property_City" size="19" /></td>
                    <td align="left" valign="top" class="records"><select name="Property_State" id="Property_State">
                      <option value="" selected="selected"> - - - - - </option>
                      <option value="AL">Alabama</option>
                      <option value="AK">Alaska</option>
                      <option value="AZ">Arizona</option>
                      <option value="AR">Arkansas</option>
                      <option value="CA">California</option>
                      <option value="CO">Colorado</option>
                      <option value="CT">Connecticut</option>
                      <option value="DE">Delaware</option>
                      <option value="DC">District of Columbia</option>
                      <option value="FL">Florida</option>
                      <option value="GA">Georgia</option>
                      <option value="HI">Hawaii</option>
                      <option value="ID">Idaho</option>
                      <option value="IL">Illinois</option>
                      <option value="IN">Indiana</option>
                      <option value="IA">Iowa</option>
                      <option value="KS">Kansas</option>
                      <option value="KY">Kentucky</option>
                      <option value="LA">Louisiana</option>
                      <option value="ME">Maine</option>
                      <option value="MD">Maryland</option>
                      <option value="MA">Massachusetts</option>
                      <option value="MI">Michigan</option>
                      <option value="MN">Minnesota</option>
                      <option value="MS">Mississippi</option>
                      <option value="MO">Missouri</option>
                      <option value="MT">Montana</option>
                      <option value="NE">Nebraska</option>
                      <option value="NV">Nevada</option>
                      <option value="NH">New Hampshire</option>
                      <option value="NJ">New Jersey</option>
                      <option value="NM">New Mexico</option>
                      <option value="NY">New York</option>
                      <option value="NC">North Carolina</option>
                      <option value="ND">North Dakota</option>
                      <option value="OH">Ohio</option>
                      <option value="OK">Oklahoma</option>
                      <option value="OR">Oregon</option>
                      <option value="PA">Pennsylvania</option>
                      <option value="PR">Puerto Rico</option>
                      <option value="RI">Rhode Island</option>
                      <option value="SC">South Carolina</option>
                      <option value="SD">South Dakota</option>
                      <option value="TN">Tennessee</option>
                      <option value="TX">Texas</option>
                      <option value="UT">Utah</option>
                      <option value="VT">Vermont</option>
                      <option value="VA">Virginia</option>
                      <option value="WA">Washington</option>
                      <option value="WV">West Virginia</option>
                      <option value="WI">Wisconsin</option>
                      <option value="WY">Wyoming</option>
                    </select></td>
                  </tr>
                  <tr>
                    <td height="20" colspan="2"><strong>Service Request:</strong> <span style="font-size:11px; color:#F00;">(required)</span></td>
                  </tr>
                  <tr>
                    <td colspan="2" align="left" valign="top" class="records"><textarea name="Service_Request" id="Service_Request" cols="40" rows="5"></textarea></td>
                  </tr>
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                <td colspan="2" align="left" valign="top" class="records" style="background-image:url(/gfx/env/panel_bg.png);"><table width="270" border="0" cellspacing="0" cellpadding="0">
                  <tr>
                    <td width="235" height="20"><strong>Your First Name</strong></td>
                    <td width="235"><strong>Your Last Name</strong></td>
                  </tr>
                  <tr>
                    <td height="50" align="left" valign="top" class="records"><input name="First_Name" type="text" id="First_Name" size="19" />
                      <br />
                      <span style="font-size:11px; color:#F00;">(required)</span></td>
                    <td align="left" valign="top" class="records"><input name="Last_Name" type="text" id="Last_Name" size="19" />
                      <br />
                      <span style="font-size:11px; color:#F00;">(required)</span></td>
                  </tr>
                  <tr>
                    <td height="20" colspan="2"><strong>Your Email Address</strong></td>
                  </tr>
                  <tr>
                    <td height="50" colspan="2" align="left" valign="top" class="records"><input name="Email_Address" type="text" id="Email_Address" size="42" />
                      <br />
                      <span style="font-size:11px; color:#F00;">(required)</span></td>
                  </tr>
                  <tr>
                    <td height="20" colspan="2"><strong>Your Phone Number</strong></td>
                  </tr>
                  <tr>
                    <td height="50" colspan="2" align="left" valign="top" class="records"><input name="Phone_Number" type="text" id="Phone_Number" size="42" placeholder="###-###-####" /><br />
                    <span style="font-size:11px; color:#F00;">(required)</span></td>
                  </tr>
                  <tr>
                    <td height="20" colspan="2"><strong>Your Company</strong></td>
                  </tr>
                  <tr>
                    <td height="50" colspan="2" align="left" valign="top" class="records"><input name="Company" type="text" id="Company" size="42" /></td>
                  </tr>
                  <tr>
                    <td height="20"><strong>Your City</strong></td>
                    <td><strong>Your State</strong></td>
                  </tr>
                  <tr>
                    <td height="50" align="left" valign="top" class="records"><input name="City" type="text" id="City" size="19" />
                      <br />
                      <span style="font-size:11px; color:#F00;">(required)</span></td>
                    <td align="left" valign="top" class="records"><select name="State" id="State">
                      <option value="" selected="selected"> - - - - - </option>
                      <option value="AL">Alabama</option>
                      <option value="AK">Alaska</option>
                      <option value="AZ">Arizona</option>
                      <option value="AR">Arkansas</option>
                      <option value="CA">California</option>
                      <option value="CO">Colorado</option>
                      <option value="CT">Connecticut</option>
                      <option value="DE">Delaware</option>
                      <option value="DC">District of Columbia</option>
                      <option value="FL">Florida</option>
                      <option value="GA">Georgia</option>
                      <option value="HI">Hawaii</option>
                      <option value="ID">Idaho</option>
                      <option value="IL">Illinois</option>
                      <option value="IN">Indiana</option>
                      <option value="IA">Iowa</option>
                      <option value="KS">Kansas</option>
                      <option value="KY">Kentucky</option>
                      <option value="LA">Louisiana</option>
                      <option value="ME">Maine</option>
                      <option value="MD">Maryland</option>
                      <option value="MA">Massachusetts</option>
                      <option value="MI">Michigan</option>
                      <option value="MN">Minnesota</option>
                      <option value="MS">Mississippi</option>
                      <option value="MO">Missouri</option>
                      <option value="MT">Montana</option>
                      <option value="NE">Nebraska</option>
                      <option value="NV">Nevada</option>
                      <option value="NH">New Hampshire</option>
                      <option value="NJ">New Jersey</option>
                      <option value="NM">New Mexico</option>
                      <option value="NY">New York</option>
                      <option value="NC">North Carolina</option>
                      <option value="ND">North Dakota</option>
                      <option value="OH">Ohio</option>
                      <option value="OK">Oklahoma</option>
                      <option value="OR">Oregon</option>
                      <option value="PA">Pennsylvania</option>
                      <option value="PR">Puerto Rico</option>
                      <option value="RI">Rhode Island</option>
                      <option value="SC">South Carolina</option>
                      <option value="SD">South Dakota</option>
                      <option value="TN">Tennessee</option>
                      <option value="TX">Texas</option>
                      <option value="UT">Utah</option>
                      <option value="VT">Vermont</option>
                      <option value="VA">Virginia</option>
                      <option value="WA">Washington</option>
                      <option value="WV">West Virginia</option>
                      <option value="WI">Wisconsin</option>
                      <option value="WY">Wyoming</option>
                    </select>
                      <br />
                      <span style="font-size:11px; color:#F00;">(required)</span></td>
                  </tr>
                  <tr>
                    <td colspan="2" align="left" valign="top" class="records">&nbsp;</td>
                  </tr>
                </table></td>
                <td align="left" valign="top"><table width="245" border="0" cellpadding="0" cellspacing="0">
                  <tr>
                    <td height="20"><strong>Maintenance Request Confirmation</strong></td>
                  </tr>
                  <tr>
                    <td align="left" valign="top"> Solve the problem below.</td>
                  </tr>
                  <tr>
                    <td align="left" valign="top">0 + 4 =                       <input name="Message_Confirmation" type="password" id="Message_Confirmation" size="2" maxlength="2" style="text-align:center; color:#555"/>
                      <span style="font-size:11px; color:#F00;">(required)</span></td>
                  </tr>
                  <tr>
                    <td align="right" valign="top"><br />
                      Your IP Address:
                      3.233.219.103                      <br />
                                            <font size="1" color="#999999"><em>(Logged for security.)</em></font><br />
                      <br />
                      <input name="IP_Address" type="hidden" id="IP_Address" value="3.233.219.103" />
                      <input name="Required" type="hidden" id="Required" value="Property_Type,Property_Address,Property_City,Property_State,Service_Request,First_Name,Last_Name,Email_Address,Phone_Number,City,State" />
                      <font size="3"><b><img src="/gfx/logos/PreferredRequestIcon.png" width="100" height="100" /><br />
                        </b></font><br />
                      <span class="arial13">Enter Security Code:
                        <input class="formcodeview" name="confirmation" type="text" id="confirmation" size="5" value="6663" readonly="true" />
                        <input class="formcodeconf" name="confirmation_code" type="password" id="confirmation_code" size="5" maxlength="4" />
                        </span> <br />
                      <input type="submit" name="Submit" id="Submit" value="Submit This Request" style="font-size:20px; background:#ff0000; color:#FFFFFF; font-weight:bold;" /></td>
                  </tr>
                  <tr>
                    <td>&nbsp;</td>
                  </tr>
                </table></td>
              </tr>
                                                      </table>
          </form>
                    <br />
          <table width="400" border="0" align="center" cellpadding="0" cellspacing="0">
            <tr>
              <td align="center"><a href="/Vk5EMjAxNDAxMDkxMjA2Mzk=">Return To Vendor Profile</a></td>
            </tr>
          </table></td>
      </tr>
    </table>
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