Broce FMJ470 - Page 3

Broce Manufacturing Company, Inc.
WARRANTY REGISTRATION
Purchaser - Type of Business
Construction/Highway Rental Asphalt Contractor
Equipment Dealer Municipality Other
1. The Purchaser has been instructed and/or has read the manual and understands proper
preventive maintenance, operation and safety precautions.
2. The Warranty and Limitations of Liability are found in the Warranty pages enclosed in the
Parts and Operators Manuals.
3. BroceManufacturingCo.Inc.reservestherighttomakedesignchangesormodications
to Broce products at any time without incurring any obligation to make similar changes or
 modicationstopreviouslysoldunits.
4. If this Document is not signed and returned to Broce Manufacturing Co. Inc., the warranty
begins at the date of delivery to the Dealership.
I hereby acknowledge acceptance of above and conditions in the Warranty Policy
Purchaser/Owner: ___________________________________________________________
Dealer Representative: _______________________________________________________
Broce Manufacturing Co. Inc.
1460 South 2nd Avenue
Dodge City, KS 67801
(877) 227-8811
Purchased From (Dealership)
Company: _____________________________________________________
Address: _____________________________________________________
City: _________________________ State: ____ ZIP: ___________
Delivery Date to Dealer: ___ / ___ / ___ Unit Hours: _________________
Model Number: ________________ Serial Number: ______________
Purchaser
Company: _____________________________________________________
Address: _____________________________________________________
City: _________________________ State: ____ ZIP: __________
Delivery Date to Dealer: ___ / ___ / ___ Unit Hours: _________________