Credit Card Authorization Form

Thank you for choosing Iowa Fire Equipment Company

At IA Fire, we value your privacy and security. Please know that this card will be kept on file in Iowa Fire Equipment Company Rolodex Credit Card Company which is CardConnect. CardConnect is PCI compliant. Iowa Fire is PCI compliant. Each user to this account has their own login, and only the last four numbers of the credit card will be seen after being entered into our Rolodex online.

Complete the below form to give Iowa Fire Equipment Company authorization to charge the credit card of your choosing.

* Indicates a required field

Contact Information

Please enter your name and contact information below.

Name:

Email:

Phone Number:

Authorization Agreement

I hereby authorize IOWA FIRE EQUIPMENT COMPANY to charge the credit card listed below. Please know that this card will be kept on file in Iowa Fire Equipment Company Rolodex Credit Card Company which is CardConnect. CardConnect is PCI compliant. Iowa Fire is PCI compliant. Each user to this account has their own login, and only the last four numbers of the credit card will be seen after being entered in to our rolodex online. Our company policy is all credit card payment have an additional 3.5% convenience fee to the total of payment.

Acknowledge and agree to the above terms:

Yes

Account Information

Name as it appears on the card:

Card Type:

Visa

Mastercard

Card Number:

Expiration Date:

Card SVC:

Mailing address to the above card:

City:

State:

Zip:

Authorized Signature for the above card

Authorized Signature:

Print your name.

Draw your signature.

Clear Signature

Today's Date:

Iowa Fire Equipment Company offers commercial fire protection.

Since 1960 Iowa Fire Equipment Company has been providing fire protection equipment and service to the general public in Iowa and 16 surrounding states. Our goal is to install and maintain all types of fire protection equipment and systems at competitive prices while demonstrating unmatched professionalism in fire systems installation and service. Find out what makes Iowa Fire a trusted source across the midwest.

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Des Moines, Iowa

2800 Delaware Avenue
Des Moines, IA 50317
Phone: 515-265-8030
Fax: 515-265-7649
office@iafire.com
› More about Des Moines, Iowa

Iowa City, Iowa

327 First Street
Iowa City, IA 52240
Phone: 319-337-4434
Fax: 319-337-5401
iowacity@iafire.com
› More about Iowa City, Iowa

Springfield, Missouri

1869 E St Louis St.
Springfield, MO 65802
Phone: 417-799-2383
Fax:
springfield@iafire.com
› More about Springfield, Missouri

Terre Haute, Indiana

1472 Wabash Avenue
Terre Haute, IN 47803
Phone: 515-265-8030
Fax:

› More about Terre Haute, Indiana

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