Free Quotation of Service request Form

 
 
 
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By clicking on the "Authorize" button below, you signify that you agree to be bound by these Terms and Condtions of Service and Aceptable Use Policy. I authorize Miami RA, Inc. / rafaelanazco.com to initiate an electronic debit to my Bank/Credit Card account in the amount specified on estimate or invoice. This authorization is to remain in full force and effect unless you provide written notification via fax (866) 521-0341 to Miami RA, Inc. / rafaelanazco.com within an appropriate timeframe as to allow Miami RA, Inc. / rafaelanazco.com to act on it. If your payment is returned unpaid, additional attempts may be made to process the payment, and you will be charged a returned item fee of $35.00 up to the maximum allowed by law. Cancellation of your account will discontinue all services and products. Fees are non-refundable. Early cancelation fee is $150.00. Late fee is $1.00 for each day after due date. Call (305) 421-7235 with any question regarding this authorization.

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The Form

Account Information

When you pay an invoice or other charge, you authorize Miami RA Inc. to charge your payment account in the amount of the relevant transaction. You repr0d386desent and warrant that you have the funds available to satisfy your requested payment amount. Your acknowledge that the origination of ACH transactions to your account must comply with United States law, and with no intension of later dipute.

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Conduct Business Electronically

The decision whether to do business electronically is your, Your consent to do business electronically and our agreement to do so covers all transactions you conduct through our Merchant.

Withdrawal of Consent

If you later decide that you do not want us to process any transaction electronically for services rendered, write to us at Miami RA Inc., If you withdraw your consent you must bring your balance to zero, we may terminate your use of our services.

Miami RA Inc

Please make sure to real our Terms and Conditions of Service, should you have any quesitons of need further information please do not hesitate to contact us:
T: (305) 421-7235 or email at billing@rafaelanazco.com.