REED B50HPG, Technical Manual, Page: 5 / 235

OPERATION and MAINTENANCE
Rev 1.2 4 of 80
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WARRANTY CLAIM FORM
Claim Number: Date:
Distributor Account Number: End User Account Number:
Distributor: End User:
Address: Address:
City: State: Zip: City: State: Zip:
Phone ( ) Phone ( )
Pump Model:
Pump Serial Number:
In Service Date:
Hours of Operation:
Failure Date:
Repair Date:
Do not send part(s) until requested by
REED
or until claim is approved. All parts requested to be
returned must have a Return Authorization Number provided by REED and shipping freight prepaid.
Parts must ship within 30 days from REED request.
Return Authorization Number: Ship Date:
Part Number Description Qnty
Unit
Price
Total
Price
Replacement
Part Invoice No.
Failure Description and Cause
:
REED
Comments
:
Claim Value Approved:$ Claim Value Denied:$
REED
Print Name, Sign, and Date:
Dealer Print Name, Sign, and Date: