Copyright 2/17 FORM #WV-117
I have inspected this equipment and find it in correct working condition. To the best of my knowledge,
the customer and his/her personnel are aware of, and agree to the above procedures.
Signed: ________________________________________________________ Date: ______________
(Dealer Representative)
The equipment has been thoroughly checked by the above named dealer representative, and I am
satisfied with his/her instructions. I have also read, understand, and agree to reverse side of page.
Signed: ________________________________________________________ Date: ______________
(Customer)
WARRANTY VALIDATION FORM
(
WHOLE TREE & LOADER FED CHIPPER)
PURCHASER / OWNER INFORMATION:
Company Name __________________________________ Contact Name _____________________
Mailing/Street Address _______________________________________ City _______________________
State ___________________ Zip Code _______ Country ______________ Telephone Number ( __ ) ________
E-mail ____________________________ Machine Model No. _______ Date Put Into Service ______
Machine Serial No. ____________________ Machine Work Order No. ________ Machine Hours _______
Engine Make _________________ Engine Serial No. __________________ Machine Color _______
DEALER / SELLER INFORMATION:
Dealer/Seller Name _______________________________ Contact Name _____________________
Mailing/Street Address _______________________________________ City _______________________
State ___________________ Zip Code _______ Country ______________ Telephone Number ( __ ) ________
IMPORTANT - WARRANTY WILL BE DEEMED NULL AND
VOID IF THIS FORM IS NOT FILLED OUT COMPLETELY AND
ACCURATELY AND RETURNED TO THE CUSTOMER DATA
DEPARTMENT WITHIN 10 DAYS OF EQUIPMENT DELIVERY
1. _____ The customer has received instruction and fully understands all operational, safety and maintenance requirements
of the equipment.
2. _____ The customer has received instruction and fully understands that everyone within 100 feet of the machine must
wear proper personal safety equipment including hard hat, face shield, safety glass, gloves, ear protection and/or other
items per OSHA and ANSI requirements.
3. _____ The customer has received instruction and fully understands the equipment maintenance schedules and procedures.
The customer understands that it is their responsibility to perform scheduled maintenance that includes periodic relief valve
adjustments, retightening all fasteners as needed, periodic cleaning of flow divider, clutch and belt adjustments, and other
items.
4. _____ The customer has received instruction and fully understands not to reach into the infeed hopper with hands or feet.
5. _____ The customer has received instruction and fully understands that the operators must always be located within
easy reach of all feed control and shut down devices.
6. _____ The customer has received instruction and fully understands that this machine is designed to be ‘loader’ fed
and is to follow all feeding instructions in the manual. The customer understands that under no circumstances should the
operator hand feed these machines or use anything other than mechanical devices, knuckle boom loader or the machines
loader to feed these machines.
7. _____ The customer has received instruction and fully understands the purpose of and proper operation of any and all
safety devices and guards. The customer understands to never attempt to override any safety device or guard.
8. _____ The customer has received instruction and fully understands that before performing any maintenance on the machine
the ignition key must be removed, the cables must be completely disconnected from the battery, the disc/drum must have come to
a complete stop, and the disc/drum lock must be installed. The customer understands they must allow the necessary time for the
disc/drum to come to a complete stop before opening the disc/drum housing or start any maintenance or service procedures. The
customer has received instruction and fully understands the purpose of the beltshield inspection hole and that they are never to attempt
any maintenance or service procedures until visually confirming the belts have come to a complete stop.
9. _____ The customer has received instruction and fully understands that the machine is not to be operated without the
factory approved hood pin assembly in place and padlocked, the machine is not to be operated with any type of make
shift hood pin, and the machine is not to be operated under any circumstances with the chipper hood open or unsecured.
10. _____ Customer has reviewed and fully understands limited warranty, and all written and visual instructions.
11. _____ The customer has received instruction and fully understands that warranty will not apply if the machine is operated
with replacement parts or equipment not manufactured or recommended by Bandit Industries, Inc.
12. _____ Customer has received, been advised, and understands the manuals, and the Safety/Service video supplied
with the chipper. A video is supplied for equipment models as available.
13. _____ All Danger, Warning and Operational decals are properly displayed on equipment and fully understood by customer.
14. _____Customer has been instructed, understands, and agrees that all potential operators must: See the supplied video,
be instructed on all the Danger, Warning and Operational decals, read the manual and follow the procedures.
Customer Data Department
6750 Millbrook Road
Remus, MI, USA 49340
Phone: (800) 952-0178 in USA
Phone: (989) 561-2270
Fax: (989) 561-2273
Website: www.banditchippers.com
