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Machine repair

Assignment for repair

Fields with * are required

End user

Purchaser

Imbema dealer

Purchaser

I offer the following machine for repair: *

Size / Orbit (only with sanding machines):

Serial number: *

Date of purchase:

Failure description:

Warranty / quotation first
	My machine falls within warranty, see copy purchase (backing plates are excluded).
	Please repair my machine asap without a quotation if the costs are below € . If the costs are higher please inform me.
	Please send me a quotation of the costs before the repair will take place.

Date *
Name purchaser *

Hereby I send the purchase for repair to Imbema Rhiwa, the document needed for transport I will receive from Imbema Rhiwa.