WARRANTY CLAIM FORM (Claim must be faxed to 613-443-1138) (All photos must be indicated with the body serial number) * Dealer Claim Date: _________________
* Body Owner Claim Date: __________________
* Beau-Roc Dealer Name: ____________________ * Pictures of Problem Sent * Pictures of Repair Sent
Yes Yes
* Contact Name: _____________________
No * Date Sent: ________ Via No
* Date Sent: ________ Via
* Dump Body Serial Number: __________________
Dump Body Model: ____________
* Dealer Purchase Date: ______________ * Body Owner Purchase Date: _______________ D/M/Y D/M/Y * Date of Original Installation of Body: _______________ * Dealer Installed: Yes No D/M/Y
* Please describe the nature of the problem(s) in detail:
* Please indicate necessary repairs & labour time involved: (Explain)
* Opinion: Is problem due to design or related to another issue (please describe)? Suggestions:
General Manager/Owner Signature: ___________________ Date: _____________________ D/M/Y Office Only
Approved by:_______________________________________ Date:____________________________________
* All Fields Must be Filled Out For Warranty To Be Approved