REED B Series - Warranty Claim Form

OPERATION and MAINTENANCE
B20HPC-SKE-V25 4 of 75
13822 Oaks Avenue
Chino, CA 91710
reedpumps.com
(909) 287 - 2100
WARRANTY CLAIM FORM
Claim Number:
Date:
Distributor Account Number
:
End User Account Number:
Distributor:
End User:
Address:
Address:
City: State: Zip:
City: State: Zip:
Phone ( )
Phone ( )
Pump Model:
Pump Serial Number:
In Service Date:
Hours of Operation:
Failure
Date:
Repair Date:
Do not send part(s) until requested by REED
or until claim is approved. All parts requested to be
returned must have a Return Authorization Number provided by REED
and shipping freight prepaid.
Parts must ship within 30 days from REED request.
Return Authorization Number: Ship Date:
Part Number Description Qnty
Unit
Price
Total
Price
Replacement
Part Invoice
No.
Failure Description and Cause:
REED Comments:
Claim Value Approved:$ Claim Value Denied:$
REED Print Name, Sign, and Date:
Dealer Print Name, Sign, and Date: