UM-PRORUNNER_Mk5-1.2-EN-US 201
Appendix
19 Appendix
19.1 Product registration form
Fill in this form and send it to support@qimarox.com for correct product registration.
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* Draw a circle around the choice.
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THIS FORM IS USED TO INFORM THE USER OF QIMAROX PRODUCTS ABOUT
MODIFICATIONS ON THE USED EQUIPMENT AND TO IMPROVE OUR SERVICE ON
THE EQUIPMENT. THE CONTACT BETWEEN USER AND QIMAROX WILL BE
THROUGH THE SUPPLIER / INTEGRATOR.
Machine type * Mk 1 Mk 5 Mk 9
Order number Qimarox
Serial number
Integrated by
Order number integrator
Installation date
Start production date
Your reference (line / machine number)
Contact details user
Company name
Address
Zip code
Town / city
Country
Phone number
Fax number
e-mail
website
Technical contact user
First name
Last name
Function
e-mail
Phone number
spare parts ordered * yes no
contact for service contract * yes no
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