Justin Posey Motorsports

6557 Reed Road

Pittsboro, IN 46167

Shop (317) 892-8119

Cell (217) 799-6299

Email- justin@jpmpowerplants.com

Website-www.jpmpowerplants.com

Name: ________________________________

Date Shipped: ___/___/___

Date Needed:___/___/___

Billing Address: ________________________________________________________

City: ___________________________ State: __________ Zip: ________________

Shipping Address: (if different) _________________________________________________

City: _________________________ State: ___________ Zip: ________________

Day Phone: ______________ Cell Phone: _________________

Alt. Phone: ______________

e-mail:

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Engine Type: ________________________

Racing Class: ___________________________

Work Requested: Please check the work you are requesting.

Rebuild Engine-----------------$200.00 Plus Parts

Re-block Engine---------------$350.00 Plus Parts

Tech Rebuild-------------------$50.00 Minimum (Cost Depends on time and parts needed)

Dyno Tune Engine------------$30.00 Per Hour

Power Flow Loop Pipe-------$85.00 Non Coated

Power Flow Loop Pipe-------$105.00 Coated

Power Flow Muffler Pipe----$50.00 Non Coated

Power Flow Muffler Pipe----$70.00 Coated

Please Specify on muffler pipe if the pipe is for a Flat Head or an Animal and class.

Be specific about any problems with the engine.

Please note: Due to limited space and in order to decrease our liability exposure, engines need to be shipped as soon as possible once they are finished. A $5.00 per day storage charge as well as a 1.5% interest charge will be added to all invoices for engine(s) not shipped or picked up within 10 business days of notification of completion. Any engine left unpaid for after 30 days will be sold for the amount of the original invoice price. Payment in full is expected when work is completed. We accept cash, money orders, and all major credit cards. A damaged engine will not win any races. Justin Posey Motorsports will not return any engine in an inappropriate shipping container that risks damage to the engine. Any engine shipped in a container considered unsuitable will be returned to the customer in a reusable shipping container and a $20 container fee will be charged. Please note: ALL FLUIDS MUST BE DRAINED before shipping an engine. If a shipper determines the contents of a package could be hazardous, they may not deliver. Additionally, if an engine arrives covered in oil, a cleaning charge may be included on your invoice. Racing is an inherently dangerous sport. Justin Posey Motorsports has no control over applications or use of our products and there are therefore no warranties expressed or implied nor is there any guarantee of fitness for application. It is the user's sole responsibility to assess and assume all risks associated with any product manufactured or sold by Justin Posey Motorsports. By using our products, the user accepts these conditions.

I have read and accept the above terms and conditions and pre-authorize all recommended repairs and/or maintenance up to:

$50.00  $100.00  $350  $1000 Other Amount $_______

Signature: ______________________________________

Date: ____/____/______

Special Instructions: _____________________________________

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