Service Center Equipment Form

Please fill in the form below for any test equipment you will be sending to our Service Center. It will help us more efficiently meet your needs.

Enter your "Ship-to" information:
Items marked with a * are required fields.

* Contact Name
Title
Department
* Organization
* Street Address Line 1
Street Address Line 2
* City
* State/Province
Postal or Zip Code
* Country
E-mail
Telephone
Phone Extension
* FAX
This is the fax number we'll use for sending quotes, etc.

Enter your "Bill-to" & Payment information:

  Click if same as Ship-to.
Contact Name
Department
Organization
Street Address Line 1
Street Address Line 2
City
State/Province
Postal or Zip Code
Country
E-mail
Telephone
FAX
Purchase Order Number
Payment Method Credit card (MasterCard, Visa, Discover, or American Express - please fax or phone your card number, the name on the card, and expiration date to us
Fax: 314-638-3200 Phone:314-638-3800
Purchase order
 (only with approved credit)
Cash on Delivery 

Enter our return shipping instructions:

Shipping terms Prepay & add to invoice
Ship freight collect against my account:
Account number
Carrier FedEx (BC Group's preferred carrier)
UPS
DHL
U.S. Postal Service
Other:
Shipping Method Next Business Day AM delivery
Next Business Day standard delivery
2nd Business Day
3rd Business Day
Ground/Cheapest Way
Shipping Insurance
Instructions 		Unless you give us other instructions below, we will insure for fair market replacement value and pass the cost on to you:

Shipping Instructions to our Customers

  • Pack carefully! Use plenty of packing material, a sturdy box, and high quality tape.
  • It is preferable to not place multiple items in the same box. If you must do this, use plenty of padding between the items.
  • Purchase adequate shipping insurance to cover the equipment in case of loss or damage by the carrier.
  • Put clearly legible shipping and return addresses on the box.
  • International customers: Be sure to use a carrier who delivers to our dock. Some carriers leave the package at the airport. You will incur additional charges if we must send a courier to the airport to retrieve your shipment.

Enter your Equipment information:

ITEM 1

Manufacturer
Model
Serial Number
Equipment Type
Property/ID Number
Service Required
Check all that apply 		 Calibrate
 "As-Found/As-Left" readings/data (additional charge will apply)
 Repair (Please describe symptoms or problem below)
Repairs needed/symptoms
(Please be as specific as possible)
Any special instructions (replace leads/probes, etc.)  
Quote information $
Enter an amount which you'll approve without a written quote. If the work exceeds this amount, we will send a quote.
Warranty information -
If you think this unit may be under new product or service warranty with the manufacturer, with us, or with any other company, please describe here

ITEM 2

Manufacturer
Model
Serial Number
Equipment Type
Property/ID Number
Service Required
Check all that apply 		 Calibrate
 "As-Found/As-Left" readings/data (additional charge will apply)
 Repair (Please describe symptoms or problem below)
Repairs needed/symptoms
(Please be as specific as possible)
Any special instructions (replace leads/probes, etc.)  
Quote information $
Enter an amount which you'll approve without a written quote. If the work exceeds this amount, we will send a quote.
Warranty information -
If you think this unit may be under new product or service warranty with the manufacturer, with us, or with any other company, please describe here

ITEM 3

Manufacturer
Model
Serial Number
Equipment Type
Property/ID Number
Service Required
Check all that apply 		 Calibrate
 "As-Found/As-Left" readings/data (additional charge will apply)
 Repair (Please describe symptoms or problem below)
Repairs needed/symptoms
(Please be as specific as possible)
Any special instructions (replace leads/probes, etc.)  
Quote information $
Enter an amount which you'll approve without a written quote. If the work exceeds this amount, we will send a quote.
Warranty information -
If you think this unit may be under new product or service warranty with the manufacturer, with us, or with any other company, please describe here

ITEM 4

Manufacturer
Model
Serial Number
Equipment Type
Property/ID Number
Service Required
Check all that apply 		 Calibrate
 "As-Found/As-Left" readings/data (additional charge will apply)
 Repair (Please describe symptoms or problem below)
Repairs needed/symptoms
(Please be as specific as possible)
Any special instructions (replace leads/probes, etc.)  
Quote information $
Enter an amount which you'll approve without a written quote. If the work exceeds this amount, we will send a quote.
Warranty information -
If you think this unit may be under new product or service warranty with the manufacturer, with us, or with any other company, please describe here

ITEM 5

Manufacturer
Model
Serial Number
Equipment Type
Property/ID Number
Service Required
Check all that apply 		 Calibrate
 "As-Found/As-Left" readings/data (additional charge will apply)
 Repair (Please describe symptoms or problem below)
Repairs needed/symptoms
(Please be as specific as possible)
Any special instructions (replace leads/probes, etc.)  
Quote information $
Enter an amount which you'll approve without a written quote. If the work exceeds this amount, we will send a quote.
Warranty information -
If you think this unit may be under new product or service warranty with the manufacturer, with us, or with any other company, please describe here

ITEM 6

Manufacturer
Model
Serial Number
Equipment Type
Property/ID Number
Service Required
Check all that apply 		 Calibrate
 "As-Found/As-Left" readings/data (additional charge will apply)
 Repair (Please describe symptoms or problem below)
Repairs needed/symptoms
(Please be as specific as possible)
Any special instructions (replace leads/probes, etc.)  
Quote information $
Enter an amount which you'll approve without a written quote. If the work exceeds this amount, we will send a quote.
Warranty information -
If you think this unit may be under new product or service warranty with the manufacturer, with us, or with any other company, please describe here

ITEM 7

Manufacturer
Model
Serial Number
Equipment Type
Property/ID Number
Service Required
Check all that apply 		 Calibrate
 "As-Found/As-Left" readings/data (additional charge will apply)
 Repair (Please describe symptoms or problem below)
Repairs needed/symptoms
(Please be as specific as possible)
Any special instructions (replace leads/probes, etc.)  
Quote information $
Enter an amount which you'll approve without a written quote. If the work exceeds this amount, we will send a quote.
Warranty information -
If you think this unit may be under new product or service warranty with the manufacturer, with us, or with any other company, please describe here

ITEM 8

Manufacturer
Model
Serial Number
Equipment Type
Property/ID Number
Service Required
Check all that apply 		 Calibrate
 "As-Found/As-Left" readings/data (additional charge will apply)
 Repair (Please describe symptoms or problem below)
Repairs needed/symptoms
(Please be as specific as possible)
Any special instructions (replace leads/probes, etc.)  
Quote information $
Enter an amount which you'll approve without a written quote. If the work exceeds this amount, we will send a quote.
Warranty information -
If you think this unit may be under new product or service warranty with the manufacturer, with us, or with any other company, please describe here

ITEM 9

Manufacturer
Model
Serial Number
Equipment Type
Property/ID Number
Service Required
Check all that apply 		 Calibrate
 "As-Found/As-Left" readings/data (additional charge will apply)
 Repair (Please describe symptoms or problem below)
Repairs needed/symptoms
(Please be as specific as possible)
Any special instructions (replace leads/probes, etc.)  
Quote information $
Enter an amount which you'll approve without a written quote. If the work exceeds this amount, we will send a quote.
Warranty information -
If you think this unit may be under new product or service warranty with the manufacturer, with us, or with any other company, please describe here

ITEM 10

Manufacturer
Model
Serial Number
Equipment Type
Property/ID Number
Service Required
Check all that apply 		 Calibrate
 "As-Found/As-Left" readings/data (additional charge will apply)
 Repair (Please describe symptoms or problem below)
Repairs needed/symptoms
(Please be as specific as possible)
Any special instructions (replace leads/probes, etc.)  
Quote information $
Enter an amount which you'll approve without a written quote. If the work exceeds this amount, we will send a quote.
Warranty information -
If you think this unit may be under new product or service warranty with the manufacturer, with us, or with any other company, please describe here

Click here to check on the status of in-work items in our Service Center.