Barker Collection Request

*Required information.

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Details

Claim Handler / Administrator Name: *

Claim Number:

Policyholder Name:

Cellphone Number:

Home Phone Number:

Accept Terms and Conditions: *

Work Phone Number:

Email Address: *

Client Street Address: *

Suburb: *

City: *

Province: *

Country: *

Peril - Occurred after (According to client as per the claim form - We will independently verify this information:

Lightning Storm Accidental Damage Power Outage

Special instructions to PartServe Channel Support:

Date and Time of Incident:

Excess Applicable? *

Client claiming for the following item/s:

Make:

Model Number: *

Serial Number: *

Date of Purchase:

Fault Description: *

Accessories Included: *

Terms and Conditions

PLEASE READ THE TERMS AND CONDITIONS CAREFULLY

Terms and Conditions:

PartServe reserves the right to sell any unit/equipment that is not collected within 14 day of completion to defray expenses.
All jobs carry a three month warranty from date of invoice.
Warranty is void if the equipment has been tampered with.
Copy of the job card MUST be presented before a job can be released.
COD payments must be made in cash or via credit card on the day of collection.
EFT payments must reflect in the Company's STD Bank Account and verified by the Finance Department before collection.
NO CHEQUE PAYMENTS accepted.
Software is not covered by warranty terms and conditions.
A NON REFUNDABLE assessment fee will be charged on all quotes.

***PARTSERVE CANNOT BE HELD LIABLE FOR ANY LOSS OR DAMAMGE TO CUSTOMER DATA***