HomeMy WebLinkAboutimg600— I.— yv.L1. TG I I Vill; I" //LJluJu-7J
Field Repair Request Form RUUD
Rheem Service Providers Only eel
Authorization Number
Authorized Service Provider ASP FAX Number
I --
Dispatch Date Model Number Serial umber ASP Phone Nt;amber _
Ro i-2 17 IM 77,5'- — ---
Email Address
tnspatching Agent:
Reported Problem:
Requested Action:
Service Time Authorized
Travel Time Authorized
Customer Name
Phone Number
61tomer Address
Part Number
12, ---------------------
1 3,
�D—isp�floonof Parts
Service Time Used
Travel Time Used
Start Date 12 ZoI w v
Rheem Reported Problem Code: I CC01
1 hour _ 0.0 hours
Resolution Code
1 hour ❑ 0.0 hours
7-sjl3 117y Alternate Phone Number
Gh I State F L — TP 3201 V
I
Authorized Service Provider out below:
Part Name Source
ASP Itheem Distributor
Credit Account (] Send Ren1'acempnt r�
Hours _ Amount Billed (see contract):
Hours _ Amount Billed
Travel time must be a
pproved k Rheem Contract Support Grou
Start Time I1: 00 End DateI4� 2tA End Tiine 12:3a
Customer signature:
Date:
Bill To: --Rheem
--- Dispatcher [ ]
°• *All fields must be o ulated for the clairh to be rocessed" �
'•• Claims may pithar },o f o.,.a i��� nen ,�.,... .. I
Rheem Contract Services
1241 Carwood Court �� �1 SiOe �"� - Rep�'ir Document 200
Mon64T4Doc. toot er %� (009117 Lf3 a � � � !.__) I�
14011VI- �► -O4