• Purchase Asure Extended Service Plans for Amana and Daikin Equipment Here

    This form should be completed for all new plan purchases of Asure Extended Labor warranties. For Net terms account, a PO number is required. For COD accounts, add "COD" to PO Field and someone from Standard Supply will contact you for payment information.

  • End-User Information

    (Company or Homeowner who purchased the warranty for their personal protection)

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  • Dealer/Contractor Information

  • System Information

  •  -  - Pick a Date
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  • Should be Empty: