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custom-inquiry Caron - Service request form

Service Request Form

Service Request Form

Company name & physical address of the equipment requiring service:

Company Name*(*)

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Physical Address of Equipment

(*)

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(*)

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(*)

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(*)

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Bill to Address (If different):

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Tax Exempt*(*)

Yes (If yes, please email tax exempt certificate to [email protected])No Invalid Input

End user’s name, email and phone number for scheduling on site contact:

Name*(*)

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Email*(*)

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Phone Number*(*)

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Select one of the following*(*)

VWR QuoteDirect NET30 with CaronCheck box if you would like additional terms information Invalid Input

Serial numbers of chambers, incubators and water recirculators that require service:

How many equipments?(*)

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1.

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4.

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2.

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5.

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3.

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Serial numbers and bulb hours of photostability chambers that require service:

Serial #1

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UVA Bulb Hours

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VIS Bulb Hours

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Serial #2

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UVA Bulb Hours

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VIS Bulb Hours

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Are there any issues with the equipment we need to be prepared for? If so, note serial number with description of issues:

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Covid Company Policy:

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How did you find the Online Service Request Form?(*)

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Contact Caron Service if you have any questions or if your issue isn't addressed above.