Service Inquiry Service Inquiry Form The following information is required for service. Contact Information First Name: Last Name: Email: Phone: Billing Information Company Name: Address: City: State: Zip Code: Schedule When will we receive your equipment that needs service, or when would you like our technician on site? Start Date: Requested Completion Date: Service Request Model Number: Serial Number: Service Cost Authorization:Estimate OnlyWarranty CoverageUp To $200Up To $500Up To $1000Repair at any cost Problem Description: Service Rates: Bench Service: $105/hr Min 1hr Field Service: $115/hr + $35/hr travel : I agree to the above rate information for non-warranty work. Terms & Conditions Lighthouse Productions charges a minimum of (1) hour service/evaluation rate for all work not covered under manufacturer warranty. Warranty status of the equipment shall be determined by the conditions of the manufacturer warranty. Some manufacturers may require the original, dated, bill of sale for the equipment in order to authorize warranty service. If Lighthouse Productions is unable to reproduce Customer complaint, the minimum service rate is still due regardless of warranty status. Parts required for service and/or repair are billed in addition to labor charges. If the Customer declines further service for any reason after initial inspection, the minimum shop service rate will still be charged. Payment is due at time of pickup, unless otherwise determined by open account status. Lighthouse Productions reserves the right to hold equipment until payment is made in full. Equipment not picked up within 30 days from service completion will either (1) incur a storage fee, or (2) be disposed of, at the discretion of Lighthouse Productions. Disposal of equipment shall not void any payments due to Lighthouse Productions for services provided. I agree to all listed terms and conditions as stated above and personally guarantee payment, or am an authorized agent of purchasing entity. : I agree to the Terms & Conditions above.