UBC BEST Operating And Maintenance Manual page 33

Manufacturer: UBS Cool-B, LLC
"Refrigeration Equipment Plant"
309255, village Novaya Tavolzhanks, w/o No. Pionerskaya
Str., Belgorod region, Shebekinsk district, Russia
Identification No. 3120083886
Tear-off coupon
For commissioning within
warranty period
Filled by the Manufacturer (Seller)
Device name in accordance with specification, brand
Factory No.
(surname, first name, patronymic of the responsible person of the manufacturer (seller)) (signature)
Stamp here
Filled by the Executant
Executant
(Company, organization name, legal address)
Date of warranty claim
(Surname, first name, patronymic of the responsible person of the Executant) (Signature)
Stamp here
Signature of the consumer who confirms
the implementation of commissioning works
The tear-off counterfoil for maintenance during
period.
Series В
Executant
(Company, organization name, legal address)
Withdrawn
(Surname, first name, patronymic of the responsible person of the Executant) (Signature)
Stamp here
Form N5 –Guarantor
Series В
Date of manufacture
(Year, month, date)
(Signature, date)
months of warranty
(Year, month, date)
32
months of
N