Warranty Claim 2018-02-28T15:29:41+00:00

Warranty Claim Form

Include the work order/invoice for repairs with client signature as well as all receipts for required parts. All claims must be submitted to HVAC Protector within thirty (30) days of equipment failure date to be considered for payment.

Client Information

Name
Email

Phone Number
Fax Number
Contact Name
Date

Contractor Information

Contractor Name
Contractor Number

Contractor Contact Email
Contractor Phone Number

Claim Information

Unit Serial Number
Unit Model Number
Installation Date
Service Date
Unit Date Of Manufacture
Agreement Number

Labor Rate/Hour
Number of Hours
Total Amount For Labor

QTY
Parts Cost
Process Allowance
Parts Total
Total Claim Amount