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This agreement is between Amaculate Housekeeping Service, Spokane, Washington, and its Employees (hereinafter referred to as "Amaculate") and (type your full name in the box below):
(hereinafter referred to as "Customer")
Customer has instructed Amaculate to clean the interior of his/her curio case or china cabinet. The duty involves picking up or somehow moving various items kept in the case/cabinet so that the shelves can be cleaned and/or dusted, the interior glass can be cleaned and, perhaps, the curio items and/or china cabinet articles themselves may need to be cleaned in some fashion.
Customer hereby releases Amaculate from all liability arising out of cleaning the interior of the curio case/china cabinet or its (their) contents. Customer understands that he/she is completely responsible for repairing or replacing any damaged item or items on the interior or stored in the interior of the case/cabinet, even if Amaculate may have caused the need for repair or replacement.
Signed this day (type in the date):
in the following county (type in the county name):
in the following state (type in the state name):
I have read, completed and signed this form with the
understanding that everything written herein is true and correct
and I agree to the above and sign of my own free will.
By: ________________________________________
(Customer's signature above)
Below, For Company Use Only
Received by Amaculate on: _______________________________
Copyright ©
1996-2008 Amaculate
Housekeeping Service. All rights reserved.
Last Revised:
March 13, 2008