LP-605 Rev. 000 Rel. 009 Date 8.16.18
60
Customer Installation Record Form
The following form should be completed by the qualed installer / service technician for you to keep as a record of the installation in case
of a warranty claim. After reading the important notes at the bottom of the page, please also sign this document.
Customer’s Name
Date of Installation
Installation Address
Product Name / Serial Number(s)
Comments
Installer’s Code / Name
Installers Phone Number
Signed by Installer
Signed by Customer
Installation Notes
IMPORTANT
Customer: Please only sign after the qualed installer / service technician has fully reviewed the installation, safety, proper operation, and
maintenance of the system. If the system has any problems please call the qualed installer / service technician. If you are unable to make
contact, please call your sales representative.
Distributor / Dealer: Please insert contact details.
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