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195 Repair Form Rev 1-0

195 Repair Form Rev 1-0 - COUNTRYMAN ASSOCIATES INC 195...

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Unformatted text preview: COUNTRYMAN ASSOCIATES INC. 195 Constitution Dr. Menlo Park, CA 94025 Phone 800-669-1422 REPAIR INFORMATION FORM Customer Information Company Name: _________________________________________ Date: ___________________________ Contact Person: __________________________________________ Fax: ____________________________ Billing Address: ___________________________________________ Email: ___________________________ City: ____________________________ State: ____ Zip: __________ Phone: __________________________ Shipping Address : _________________________________________ Countryman Associates City: ____________________________ State: ____ Zip: __________ does not ship to P.O. Boxes Shipping Recommendations You, the customer, are responsible for your product’s safe arrival at Countryman Associates. We recommend you ship your product to us by a method that gives you a signed delivery receipt, tracking number and insurance for the replacement value of your product. Good methods include Federal Express, UPS or Express Mail.for the replacement value of your product....
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