MACHINE DELVERY FORM
DEALER:________________________________________________________ SERIAL NUMBER:_________________
LOCATION (CITY, STATE):_________________________________________
INSTALL DATE:____________________
CUSTOMER:_____________________________________________________ HOUR METER:____________________
CONTACT:______________________________________________________ INSTALLED BY:___________________
ADDRESS:_______________________________________________________
CITY:_______________________STATE_______ZIP______________________
PHONE:_______________________ FAX:__________________________
TOMCAT MODEL NUMBER:_______________________________________
OPTIONS: 1.______________________________________ 4.______________________________________
2.______________________________________ 5.______________________________________
3.______________________________________ 6.______________________________________
BRUSHES:_____________________________________________ BROOM:_______________________________
SOAP:________________________________________________
BUYER'S REPRESENTAVE HAS:
1. RECEIVED INSTRUCTION IN PROPER OPERATION OF THIS MACHINE.
2. RECEIVED OPERATOR'S MANUAL FOR THIS MACHINE.
3. BEEN MADE AWARE THAT ANY OPERATOR SHOULD READ THE MANUAL
BEFORE OPERATING THIS MACHINE.
DEALER REP. PRINT:___________________________________ SIGN:__________________________________
CUSTOMER PRINT:____________________________________ SIGN:__________________________________
R.P.S. CORPORATION
P.O. BOX 368
RACINE, WI 53401
PHONE: 800-450-9824
FAX 866-632-6961
WWW.FACTORYCAT.COM
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