Pump Repair Authorization
Your Company Name
Your Phone Number
Best Email for Contact
Your Company Location – Ship To Address
Please Select One for Your Repair – WARRANTY REPAIRS REQUIRE INVOICE FROM ORIGINAL PURCHASE
Click or drag a file to this area to upload.
Please Attach Original Invoice If Warranty Repair
I hereby request Lubromation Inc. to contact me with a written repair estimate on my equipment. Estimate charges are: $10.00 for Hand-Held Items $30.00 for grease or oil pumps, reels and other lubrication components $100.00 for any Ink Pump or pressure primer assembly
Amount You Authorize Lubromation Inc. To Repair Equipment For (Not To Exceed)
Your Payment Type For Repair
Customer Notes – Equipment Issues
en_USEnglish