FIELD REPAIR INVOICE - LABOR CONSIDERATION REQUEST

This must be submitted within 60 DAYS of Service Date for Labor Consideration.

Fill out all applicable information in the form below, and our Field Service Rep, Mark Sommers, will reach out shortly.

*Attach any necessary documents (refrigerant invoice, crane invoice etc.) using the 'attachments' button.

Dealer Company Name
Dealer Contact Name
Dealer Phone Number
Dealer Email Address
Dealer Street Address
Dealer City
Dealer State	Alabama  Alaska  Alberta  Arizona  Arkansas  British Columbia  California  Colorado  Connecticut  Delaware  District of Columbia  Florida  Georgia  Hawaii  Idaho  Illinois  Indiana  Iowa  Kansas  Kentucky  Louisiana  Maine  Manitoba  Maryland  Massachusetts  Michigan  Minnesota  Mississippi  Missouri  Montana  Nebraska  Nevada  New Brunswick  New Hampshire  New Jersey  New Mexico  New York  Newfoundland and Labrador  North Carolina  North Dakota  Northwest Territories  Nova Scotia  Nunavut  Ohio  Oklahoma  Ontario  Oregon  Pennsylvania  Price Edward Island  Puerto Rico  Quebec  Rhode Island  Saskatchewan  South Carolina  South Dakota  Tennessee  Texas  Utah  Vermont  Virginia  Washington  West Virginia  Wisconsin  Wyoming  Yukon
Dealer Zip
INVOICE #
INVOICE Date
Customer Name
Customer Street Address
Customer City
Customer State	Alabama  Alaska  Alberta  Arizona  Arkansas  British Columbia  California  Colorado  Connecticut  Delaware  District of Columbia  Florida  Georgia  Hawaii  Idaho  Illinois  Indiana  Iowa  Kansas  Kentucky  Louisiana  Maine  Manitoba  Maryland  Massachusetts  Michigan  Minnesota  Mississippi  Missouri  Montana  Nebraska  Nevada  New Brunswick  New Hampshire  New Jersey  New Mexico  New York  Newfoundland and Labrador  North Carolina  North Dakota  Northwest Territories  Nova Scotia  Nunavut  Ohio  Oklahoma  Ontario  Oregon  Pennsylvania  Price Edward Island  Puerto Rico  Quebec  Rhode Island  Saskatchewan  South Carolina  South Dakota  Tennessee  Texas  Utah  Vermont  Virginia  Washington  West Virginia  Wisconsin  Wyoming  Yukon
Customer Zip
Outdoor - MODEL #
Outdoor - SERIAL #
Indoor - MODEL #
Indoor - SERIAL #
Accessory - MODEL #
Accessory - SERIAL #
Customer Complaint
Date INSTALLED
Date FAILED
Date SERVICED
Resolution
LABOR: Hours X Rate = Charge
Attachments (if applicable)

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