Instruction Protocol, Signatures - CareFusion LE200 LC Original Instruction

17.3 Instruction protocol, signatures

By signing this protocol, the authorized h/p/cosmos service personnel and the customer confirm the receipt and understanding of all
safety information, the performed instruction and commissioning according to the instruction protocol [cos15228-03]. The customer
confirms the receipt of the listed devices including all accessories and options according to the h/p/cosmos delivery note. Disregard
of safety information, intended or forbidden use, as well as unauthorized maintenance or lack of maintenance and regular safety
checks may lead to injury or even death and can damage the device. Furthermore, this will result in loss of liability and warranty.
Please fill out the instruction protocol and send it back to h/p/cosmos by fax (+49 8669 8642 49), email (sales@h-p-cosmos.com) or
mail).
h/p/cosmos sports & medical gmbh
Am Sportplatz 8
DE-83365 Nussdorf-Traunstein
Germany
h/p/cosmos device, model name
name in clear block letters
name in clear block letters
customer´s stamp / address:
device serial number
h/p/cosmos dealer / technician
h/p/cosmos dealer / technician
date and signature
date and signature
cos105000-2016-00 en
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