Blue Giant BG ZERO - Page 8

Warranty Claim Form
ATTN: WARRANTY MANAGER Email: customersupport@bluegiant.com
Dealer ID # Dealer Name Claim Form Date (MM/DD/YYYY)
Has Unit Been Maintained / Lubricated as Specified in Accordance with Owner’s Manual?
Yes No
Equipment Model # Serial # Customer
Date of Equipment Sale (MM/DD/YY) Hour Meter Reading Customer Address
Equipment Purchase Invoice # Dealer Repair Order # City / State / Province
Submitted By (Print Full Name) Title Zip / Postal Code
Phone: Fax: Email:
Labor Total Hours: Rate:
Labor Total: $
Start Date
(MM/DD/YY)
Travel Total Hours: Rate:
Labor Total: $
Start Date
(MM/DD/YY)
Description of Fault:
Nature of Fault:
Corrective Procedure (Full Details Required, Incomplete Information will Delay Process)
Blue Giant Part # Part Description QTY.
Blue Giant Replacement
Part(s) Invoice Number(s)
Price Total
$
$
$
$
$
$
$
$
$
$
Freight P E
The totals calculated on this form are estimates only. Warranty guidelines may apply. Final totals will appear on your
warranty invoice. Please go to www.BlueGiant.com for Warranty Coverage and Warranty Guidelines for your product.
$
$
GL # WC # RGA#
A confirmation receipt will be faxed back with a warranty claim number attached. If Blue Giant deems that part(s) need to be returned, an RGA numbered form
will be faxed as well. Please include a copy of the RGA form with returning part(s) to Blue Giant Brampton location only.
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0.00
0.00
0.00
0.00
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0
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