Form
  • FSC209 Culfidant Community Home Care On-Site Service Request Form

  • This form is to set up the access for either culfidant home care specialist/agent and or Culfidant certified contractors to provide various on-site services such as repair/fix, cleaning, and other property related services etc. 

    If this is an emergency (Fire/Flood), please do NOT fill in the form. Instead, conduct the following immediately:

    1. If it is fire, make sure yourself is safe first, then call 911 and txt (587)774-1206 immediately. 
    2. If it is flooding, turn off the main water shut off valve first, then txt the number above immediately.  
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  • How to access and conduct the work by Contractor

    Due to the insurance/liability concern, it is a must requirement that either the current resident to be present in person ALL the time for the contractor to gain access and conduct the on-site service work; Or, a certified culfidant home care agent/specialist to be present on behalf of the resident and there shall be a charge of $100.00 /hr for the agent to conduct such task, plus $45.00 of dispatch fee, which shall be paid by the resident immediately as part of the rent (whenever it is applicable). 

    You shall be available during either-or, a minimum 4-hour window from 9:00 am to 1:00 pm (Am section), or afternoon window from 12:00 to 4:00 pm (PM section) with a minimum 2 or 3 days advanced notice for our office to set it up properly with the proper contractor. 

  • PLEASE READ THE FOLLOWING CAREFULLY

    01. FINAL TIME AND DATE - Our office shall make an arrangement with the proper contractor to set it up and send you the confirmation email and/or text. It is your FULL responsibility to check with our office via text 587 774 1206 if you are uncertain about the appointment and, make arrangement to make sure you are at home if this is the option applicable.

    02. YOUR AVAILABILITY - You are required to be available at the home and on the phone #, you provided ALL the time in order to allow the contractor to get access and perform the work at your home. If you miss the call or not available for the contractor to access the home, there shall be $150.00 "no show" charge to be paid immediately by you. Or we will assume you have decided to get this issue fixed on your own, within a reasonable time period (3-5 day) and we will conduct the final inspection as such and conduct the after-work (with the only option of our agent to be there along with the contractor) as needed with all the charges (maintenance fee and agent fee) to you, which shall be regarded as part of the rent whenever it is applicable.

    03. FINAL CHARGE - based on the inspection report issued by the contractor, as well as the lease agreement if applicable, our office shall decide exclusively if the work is wear and tear and who shall be responsible for the final payment on the cost occurred. And you shall be fully responsible for the charge once such a decision has been made and it shall be regarded as part of the rent whenever it is applicable. Any unpaid cost shall lead to the activation of the clause that you are responsible for all the consequent maintenance cost with the reserved right of our office to inspect and follow-up on such services and/or maintenance issues.

    By submitting this form, I have acknowledged that I shall comply with the above fully.

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