Service Request - CEC Smart Positioning

Date(Required)

Drop Off Location(Required)

Columbus, OH (2329 Performance Way)

Smart Positioning HQ (2300 E. Kemper Rd.)

Cadiz (290 Old Steubenville Pike)

Dayton (7570 New Carlisle Pike)

Massillon (2200 Venture Circle SE)

Perrysburg (12500 Williams Rd.)

Piketon (3668 US Route 23 South)

Richfield (3942 Brecksville Rd.)

Zanesville (818 Lee St.)

Name of who is dropping off the equipment(Required)

First Last

Billing & Shipping

Company Name(Required)

Contact Person Name(Required)

Company Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Work Phone(Required)

Fax(Required)

Email(Required)

Billing & Shipping (If Different)

Company Name

Contact Person Name

Company Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Work Phone

Fax

Equipment Description

Equipment (Make, Model, and Serial Number)(Required)

Equipment (Make, Model, and Serial Number)

Items Included with Unit to Be Serviced(Required)

Additional Items: (Name, Sensor, and S/N)

Service Details

Description of service requested:(Required)

Estimate Contact Information

Request for Estimate(Required)

Yes

Amount Authorized(Required)

Estimate Contact Name:(Required)

First Last

Estimate Contact Phone:(Required)

Operator/User Name:(Required)

First Last

Operator/User Phone:(Required)

P.O. Number:(Required)

Job Number/Location:(Required)

Service Agreement

• An estimate fee will be assessed for any non-warranty repair that is denied. • Any equipment left at CEC for more than 90 days will be considered abandoned & become property of CEC. • CEC is not liable for any loss of data during service. • CEC is not liable for any damages or losses that may be incurred as a result of the use of this equipment once it leaves our possession. By signing this Service Repair Form, you hereby acknowledge that you understand & accept the terms & conditions of this Service Repair Form set forth by CEC.

Name(Required)

First Last

Date(Required)

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