Card Charge Approval / Approbation des frais de carte Our agent directed you to this form as our records indicate that you do not have either a help desk contract for phone support, or require credit card approval for an on-site service call. Help Desk Telephone Support is billable at $110 per incident, and On-site Service Calls are billable at $110/hr for labor and $95/hr for travel (both ways), plus parts used. After hours On-site Service calls are billable at $220/hr for labor and $190/hr for travel (both ways) plus parts used. To avoid these fees, please contact our admin department at 1-800-657-9436 ext 2253 to discuss additional support options for your restaurant. After submitting this form a member of our credit team will contact you during our standard business hours (M-F 9-5 EST) to secure to secure payment and/or discuss your future support/service needs. Please have your credit or debit card ready.Name of Person Authorizing Credit Card to be billed / Nom de la personne autorisant la facturation de la carte de crédit*Contact Phone Number / Numéro de Contact*Contact Email* Name of franchisee / Nom de franchisee*Name of Franchise / Nom de la Franchise*Restaurant ID #*Confirm / Confirmez*Please indicate below which option applies. This confirms you have have been advised and approve billing at the rate and amount indicated above, as agreed during your call with the help desk. Veuillez indiquer plus bas quelle option s'applique. Cela confirme que vous avez été informé et que vous approuvez la facturation au taux et au montant indiqués ci-dessus, comme convenu lors de votre appel avec le service d'assistance.HD SupportOn-Site CallEstimated Amount Quoted / Montant estimé indiqué*By submitting this form I, the submitter, agree to billing and give QST the authority to hold any applicable charges, and that the location is in compliance with the requirements listed above. En soumettant ce formulaire, je, le soumissionnaire, accepte de facturer et donne à la QST le pouvoir de retenir tous les frais applicables, et que l'emplacement est conforme aux exigences énumérées ci-dessus.