Bauer BG 25 - Defects Liability Claim

To:
BAUER Maschinen GmbH
After Sales Service Department
P.O. Box 12 60
86522 Schrobenhausen, Germany
Phone +49 8252 97-2586
Fax +49 8252 97-2587
From (Customer, Agent):
Phone:
Fax:
Total number of pages of claim:
DEFECTS LIABILITY CLAIM
1. Product specifications
Equipment:
Constr. no.:
Constr. year:
Operating hours:
Current location of the equipment, postal address:
Date of commissioning:
Date of damage:
2. Description of damage
Please describe damaged parts and state their material number
Name of damaged part
Material no.
Construction no.
Note (symptoms/malfunctions, causes, position of damaged parts):
3. Delivery of new parts and repair
Replacement of damaged parts from customers own stock?
Replacement of damaged parts by ordering from after sales service?
Shipment (by courier, air or sea freight):
Delivery address:
Information for a proforma invoice:
Replacement work by customer, agent?
Yes
No
Estimated working time (hrs):
Estimated additional costs:
Date
Name of claimant
(please print)
Signature
Company
4. For internal use only (to be filled in by BAUER)
Subject to warranty?
Yes
No
If yes, give order number:
If no, give reasons:
Further reports:
Further actions:
Return of damaged parts by:
Estimated working time (hrs):
(Signed by authorized BAUER employee)
910.396.2 01/2003