Warranty Claim Form

This field is for validation purposes and should be left unchanged.

Machine Information

Name(Required)

First Last

Name of the person filling out the form

Phone(Required)

Contact number we can reach if additional information is needed

Email(Required)

Email address we can use if additional information is needed

Serial Number(Required)

Serial number of the subject MEC lift

Date of Repair(Required)

Date that repairs were completed and the machine was returned to service

Model Number(Required)

Model number of the subject MEC lift

Hour Meter

Hour meter reading of the subject MEC lift. The hour meter is located in or near the lower control panel

Service Call Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

A complete address is required when travel reimbursement is requested. Enter the address where the machine was located if the repair was completed in the field. If the machine was repaired in the dealer's shop, enter 'Shop' in this field

Dealer Information

Dealer(Required)

Name of the owner and/or company that repaired the machine (e.g., Joe's Rentals)

Customer Invoice or Claim #(Required)

Your internal work order, invoice, or case number used to track this claim in your system

Branch Location (City, State)(Required)

Address of the shop where the MEC lift was repaired, or the shop from which the technician was dispatched if the repair was completed in the field

Phone #

General phone number of the shop location

Details

Detail of Failure(Required)

Technician's detailed description of the warrantable failure or problem

Detail of Correction(Required)

Technician's detailed description of the work completed to perform the warranty repair

Parts Used

List the part number, quantity, description, cost, and MEC invoice number for each warrantable part replaced. This information can be found on the invoice included with the parts. Do not list parts that are not covered under the MEC warranty statement

Parts

Item Part #

Qty

Part Description

Cost Each

MEC Invoice #

Charges

Labor Hours

Time required to complete the warrantable repair. Reimbursement is limited to nominal diagnostic and repair time only. Time spent reviewing instructions, contacting support, locating tools, locating the machine, signing in, moving the machine, etc. are not reimbursable

Travel Hours

Nominal travel time to and from a job site for mobile repair. Maximum is 3 hours. A job site address is required to claim travel reimbursement

Other

For special charges authorized by MEC warranty personnel in advance only. Reimbursement is subject to MEC authorization

NOTE: Freight charges to inlcude parts return freight and will not be reimbursed
MEC labor rate is $95.00 per hour
**Travel reimbursement is $95.00 an hour up to 3 hours max.

*Required Field

Total Parts

Total Labor

Total Travel

Total Credit (U.S. Dollar)

These fields must be completed using the information entered above

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