308607
103
Horizon Form #6
Horizon Fluid Management Systems
Warranty Registration and Checkout Form
1. Site Identification
Customer Name:
Address:
City/State/Zip:
Phone Number:
Key Contact Name:
2. Installer Identification
Company Name:
Address:
City/State/Zip:
Phone Number:
Key Contact Name:
3. System Hardware Identification and Checkout
Master Control Module
Slave Control Module(s)
Administrative Keypad
Enhanced Keypad/Barcode Reader
Basic Keypad
Air Solenoids
Fluid Solenoids
Oil Pulse Meters
AntiFreeze/WWF Pulse Meters
# in System
Operation Verified?
4. System Software Identification & Checkout
(check if/when completed)
Run Options Configured:
Passwords
Job #
Vehicle ID
Optional Field
Presets?
Output Options Configured: Printer
Computer
5. Attachments (MANDATORY!)
(check when attached)
Copies of all System Design Forms
Copy of system map/floor plan
Printout of Software Setup
6. Installer Signoff
I certify that I have checked out all system
components and functions, and that they
operate according to system design specs
and customer expectations.
Installer Name:
Company:
Date Completed:
7. Customer Signoff
I agree that the system has been installed to my
expectations and that I have been informed as to proper
system operation. I accept control of the system.
Customer Name:
Company:
Date Completed:
Summary of Contents for Horizon Fluid Management Systems
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