Coil Claim Form
 
ADP Purchase Order #
Reference #
Company Name
Contact
Address
Phone#
Fax #
Model #
Serial #
Contractor
Job Name
Installed Date
Failled Date
Detailed Description of defect (if leak indicate location)
Failure location


Other (please describe)
Note: This order can not be processed without the full model and serial number of the unit.
 

Phone: 316 263-8179 or 800 835-1010, Fax: 316 263-2040 or 800 835-1150
224 Indiana,    Wichita,  Ks   67214
8:00 AM to 5:30 PM M-F,  8:00-Noon on Saturday,  Closed on Sundays and Holidays.
Tempstar Distributor for Kansas


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