6 DATES AND SIGNATURES — ALL ENVIRONMENTS
All checklists and this completed form should be returned only if Micromeritics will be
performing this installation.
PROJECTED INSTALLATION DATE
This is not a commitment for a specific installation date. After reading the site preparation
requirements in this document, enter a date your site will be prepared and a preferred date for
installation. After returning the checklist and signed form to Micromeritics, your Micromeritics
representative will contact you to confirm an installation date.
When would installation be most convenient? Date: __________/________/________
COMMITMENT STATEMENT AND SIGNATURE FORM
I have read this document and understand my responsibilities regarding preparations for the
installation of our analysis system. I believe this site is ready for the system to be installed.
Signature:
Date:
Name (Printed):
Title (Printed):
Company:
City / State / Zip:
Phone Number:
Fax Number:
E-mail:
Analyzer:
Model: Serial No.:
Is the Customer Representative also the End User? Yes ______ No ______
RETURN THE COMPLETED CHECKLIST AND FORMS TO:
Micromeritics Instrument Corporation
ATTN:Service Operations Manager
4356 Communications Drive
Norcross, GA / USA / 30093-2901
Email: Service.Helpdesk@Micromeritics.com
Fax: 1-770-662-3604
6 Dates and Signatures — All Environments
Flex Series Pre-installation Instructions and Checklist
350-42870-01 (Rev H) — Apr 2021
6 - 1
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