HTPG

HTPG Warranty Submittal Form

Details: Published on 17 September 2012; Hits: 14874

* Required

Submitted By:

Company Name: *

Street Address: *

City: *

State: *

Zip: *

Contact Name: *

Email Address: *

Phone Number: *

Credit or Pay To (if different from above):

Check if same as above:

Company Name:

Street Address:

City:

State:

Zip:

Contact Name:

Email Address:

Phone Number:

Unit Information:

Unit Model: *

Unit Serial Number: *

Service Date: *

Compressor Model:

Compressor Serial Number:

Facility Name and Number:

Installation Location:

Street Address:

City:

State:

Zip:

Commission Date: (if known)

Service Work Order Number:

Service Invoice Number:

Description of Problem:

Do not submit claim until problem is corrected.
Standard warranty coverage is for one year and is for parts only.
A copy of the service invoice must accompany submittal form.

Description of service performed and items under warranty:

Requested Amounts:

Labor Cost Requested (in USD): $

Material Costs Requested (in USD): $

Total of Claim Requested (in USD): $

Click in field for total. Numbers and decimal only.

Supporting Documents:

Attach Supporting Document(s):

Acceptable formats: .jpg, .pdf, .doc, .docx, .xls
Maximum size: 15 MB each / Maximum files: 3

Enter Verification Code: *

*If you receive a verification code error, please re-attach your supporting documents, if any, and enter your validation code again before submitting.