WARRANTY VALIDATION FORM
(RECYCLER)
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
Copyright 2/17 FORM #WV-118
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)
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 the hazards of working under, and how to properly
lock, the feedwheel in the up position.
5. _____ The customer has received instruction and fully understands that the operators must always be located within
easy reach of controls and shut down devices, and know how to use, activate, and maintain the fire extinguishers.
6. _____ The customer has received instruction and fully understands, and agrees that all potential operators must use
proper shut down procedures, check for fires, and remove all potential fire hazards. Always clean off and remove all
flammable debris such as: wood, mulch, oils, fuels, etc. from anywhere materials collect.
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 cutter head
must have come to a complete stop. The customer understands they must allow the necessary time for the cutter head to
come to a complete stop before performing any type of maintenance or service procedures. The customer has received
instruction and fully understands the purpose of the beltshield inspection door 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 the operational, electrical, and radio devices on
the machine, and no one is to be within restricted area, around recycler, while it is running.
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 recycler. 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
