Performance Check Request

Use this form to arrange for a performance check (only available on certain premier products). The performance check is not to be considered a start-up. The purpose of the performance check is to verify the equipment is installed correctly, safely, supplied utilities match data tag, is operating properly, and the customer is satisfied with the performance. Calibration may be performed if unit is hot, yet still remains the responsibility of the installer as described in the Owner/Ops manuals.

"*" indicates required fields

Dealer*

Dealer Contact*

Dealer Phone*

List Manufacturers*

List Models*

Serial Number(s)*

List One of the Following: : Invoice#, PO# or Acknowledgement#*

Date of Installation*

Date unit was put into service*

Preferred day/time for check out*

Please list any problems or concerns with equipment*

Job Name*

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Fax*

Contact*

First Last

Email*

Installed By*

Hours per day of operation*

Signature*

Company*

Date*

Performance Check Request

We’re Here When You Need Us

(973) 812-4277

Sales@PecinkaFerri.com

3 Spielman Road Fairfield, NJ 07004