Service Request - FIXE - PD

Service Request

Perfect Descent Technical Service

Contact Information

Company

Company *

Tax ID *

Representative

Contact Person *

Phone *

Email *

Billing and Delivery Address

Billing Address

Billing Address *

City *

Postal Code *

Province/State *

Country *

Delivery Address

Delivery Address *

City *

Postal Code *

Province/State *

Country *

PD Devices

Device no. 1

Device Information:

Serial Number * Where to locate the serial number

Manufacturing Date *

date_format_invalid

Last Revision Date *

date_format_invalid

New device without revisions

Certificate Type *

certificate A

certificate C

Tape Length *

8 m

12 m

16 m

Preferred Carabiner Type for Replacement *

Steel (standard)

Aluminum

Dual Connection

No carabiner / loop

Lanyard replacement

Do not replace lanyard

The Lanyard is a wear element that must be checked daily by the climbing gym. The recommended life of the Lanyard is 12 months. That is why we replace the lanyard by default in each revision. If you do not want us to replace it, check this box. In this case, you commit to changing the lanyard yourself in the coming months before the next revision. *In any case, Fixe reserves the right to replace the lanyard if it does not meet the parameters established by the manufacturer.*

Additional Comments:

Summary

Information Summary

Contact Information

Company:

Tax ID:

Contact Person:

Phone:

Email:

Billing Address

Billing Address:

City:

Postal Code:

Province/State:

Country:

Delivery Address

Delivery Address:

City:

Postal Code:

Province/State:

Country:

Devices

General Comments

Comments:

Serial Number Location

Ubicación número de serie