Service Request - Powertech

Company(Required)

Full Name(Required)

Address(Required)

Street Address Address Line 2 City State Postcode

Phone(Required)

Email(Required)

Required Date(Required)

PO Number

Equipment

Manufacturer	Model	Serial Number	Asset Number	Service Required	Calibration Interval	Actions

There are no Equipments.

For return of your instrument(s) please ensure you select one (1) of the following:

Returning Equipment(Required)

Own Courier

Pick Up

Powertech Return

Address @{address:33.1:fallback[Address 1]} @{address:33.2:fallback[ ]} @{address:33.3:fallback[Suburb]} @{address:33.4:fallback[State]} @{address:33.5:fallback[Postcode]}

Please confirm the address is correct?(Required)

Yes

No

New Address(Required)

Street Address Address Line 2 City State Postcode

Courier Name(Required)

Account Number(Required)

Please note that the return of the product(s) WILL NOT be covered by Powertech’s insurance, and as such Powertech will not accept any liability after it leaves our premises.

Decontamination

All equipment must undergo decontamination prior to being sent or delivered to any office of Powertech.

Please identify the materials to which items may have been exposed.

Volatile Organic Compounds (VOCs)

Semi Volatiles

Hydrocarbons

Controlled Substances or Drugs

Other

If Other, please specify(Required)

Was any attempt made to remove the materials indicated above?

If yes, please list specifically what was done to the items.

I confirm the above information is true and complete to the best of my knowledge and belief.

Note:

Failure to accurately disclose the above information may result in legal action.
The service / calibration / repair of the unit(s) cannot be started until this section is completed and signed. Failure to complete this section may result in the unit(s) being returned at your cost.

Name(Required)

Position(Required)

Conditions of Service / Calibration / Repair

For Repairs a minimum quote fee of $140.00 (per instrument) applies (waived if repairs are approved).
Repairs and parts cannot commence without an order number.
Cash Sale customers are to complete payment before the instruments are returned, in the case of repairs if parts are required there may be prepayment required at the discretion of Powertech.
Powertech will not be responsible for;
- Services completed without order numbers,
- Instruments that have not been claimed within 60 days of completion, or
- Delays in spare parts delivery from manufacturers

If you have any questions, please contact us on 1300 736 292 or email calibration@powertech.com.au

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SERVICE REQUEST FORM

Decontamination

Conditions of Service / Calibration / Repair