96 Linwood Plaza, #518
Fort Lee, NJ 07024
(201) 886 2515


Thank you for hiring E-Z Clean for your house cleaning assignment, service of which was provided to you today.

We hope you liked our service, and will consider us again for a future cleaning.

As a formality to attest that our service professional(s) did in fact arrive at your residence and provide you with service, please kindly complete this form and sign below as your confirmation to this.

Thank you,

E-Z Clean
Customer Service
201 886 2515

The allocated time for this cleaning assignment was ______labor-hours.

The number of service professionals provided for my assignment was______.

The duration hours for this task was____hours (labor-hours divided by number of service professionals.

Service was completed within the allocated time____Yes,____No.
If no, I requested additional______labor-hour(s) to be billed by E-Z Clean at their prevailing rates.
If no, I did not wish to pay additionally therefore I accept the cleaning professionals did the best they were able to do and they prioritized areas of greatest importance within the allocated time_______.

Out of a score of 5 stars (with 5 being the highest), I rate today’s service____stars.
Start time of service professional(s)________/Finish time of service professional(s)________.

I do hereby attest that E-Z Clean’s service professional(s) did arrive at my residence today and that cleaning service has been provided and to my satisfaction.

Customer Name (please print):


Customer Signature                                                                                                Date: