Heidolph Rotacool Mini - Manual (Page 41)

Appendix
1.01 Rotacool mini 39
9.4 Confirmation of condition of unit
Should your instrument require repairs, please complete this declaration and
mail or fax it to Heidolph Instruments GmbH & Co KG (see chapter 7.4, page
35).
1. Details about the unit
Model
Serial number
Reason for repair
submission
2. Has the unit been cleaned or de-
contaminated / sterilized? yes no
3. Is the unit in a condition which
does not represent any health
threats for the staff of our service
department? yes no
If not, which substances has the
appliance come into contact with?
4. Information about sender
Surname, first
name
Company
Department
Street
City, postcode/ZIP
Country
Phone
E-Mail
5. Legally binding declaration The customer is aware of being
legally liable to Heidolph Instruments
for any damages arising from in-
complete or incorrect information.
Date
Signature