Service/Repair Request HORIBA U-50 Series

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A HARD COPY OF THIS FORM MUST BE SENT WITH ANY EQUIPMENT RETURNED TO OUR OFFICE
Name:*
First Last
Company:*
Email:*
Phone:*
Address: (for return of equipment)*
Street Address Town/City State Postcode Country
Model:*
Serial Number: (HGS NO. on the metal plate on the probe - see picture)*
Work Required:*
Details:*
Purchase Order Number:
Estimate Service fee: (Excludes GST)
Price:
DO Membrane Replacement: (Excludes GST)
Price:
** Note: These prices do not include any other parts, batteries, sensors, repairs etc which may be required to complete the service.
** A firm quote including freight will be emailed after we have inspected the equipment.
** After this form is submitted online, please pack the equipment carefully (to avoid damage in transit) and send to HORIBA Australia Pty Ltd, 11 McDougall Street, Kotara, NSW 2289 together with a copy of this form.
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