Bandit INTIMIDATOR 15XP/1390 Operating & Parts Manual page 15

WARRANTY VALIDATION FORM
(HAND FED CHIPPER)
IMPORTANT - WARRANTY WILL BE DEEMED NULL AND
VOID IF THIS FORM IS NOT FILLED OUT COMPLETELY AND
ACCURATELY AND RETURNED TO THE CUSTOMER DATA
DEPARTMENT WITHIN 10 DAYS OF EQUIPMENT DELIVERY
PURCHASER / OWNER INFORMATION:
Company Name __________________________________ Contact Name _____________________
Mailing/Street Address _______________________________________ City _______________________
State ___________________ Zip Code _______ Country ______________ Telephone Number ( __ ) ________
E-mail ____________________________ Machine Model No. _______ Date Put Into Service ______
Machine Serial No. ____________________ Machine Work Order No. ________ Machine Hours _______
Engine Make _________________ Engine Serial No. __________________ Machine Color _______
DEALER / SELLER INFORMATION:
Dealer/Seller Name _______________________________ Contact Name _____________________
Mailing/Street Address _______________________________________ City _______________________
State ___________________ Zip Code _______ Country ______________ Telephone Number ( __ ) ________
1. _____ The customer has received instruction and fully understands all operational, safety and maintenance requirements
of the equipment.
2. _____ The customer has received instruction and fully understands that everyone within 100 feet of the machine must
wear proper personal safety equipment including hard hat, face shield, safety glass, gloves, ear protection and/or other
items per OSHA and ANSI requirements.
3. _____ The customer has received instruction and fully understands the equipment maintenance schedules and procedures.
The customer understands that it is their responsibility to perform scheduled maintenance that includes periodic relief valve
adjustments, retightening all fasteners as needed, periodic cleaning of flow divider, clutch and belt adjustments, and other items.
4. _____ The customer has received instruction and fully understands not to reach into the infeed hopper with hands or feet.
5. _____ The customer has received instruction and fully understands that the operators must always be located within
easy reach of all feed control and shut down devices.
6. _____ The customer has received instruction and fully understands that the wooden push paddle must be used to push
small debris into the chipper and the operator is not to reach into or kick debris into the infeed hopper area of the machine.
7. _____ The customer has received instruction and fully understands the purpose and how to operate the last chance
device, and if used the machine has been operated in an unsafe manner. The customer understands to never attempt to
override any safety devices or guards.
8. _____ The customer has received instruction and fully understands that before performing any maintenance on the
machine the ignition key must be removed, the cables must be completely disconnected from the battery, the disc/drum
must have come to a complete stop, and the disc/drum lock must be installed. The customer understands they must
allow the necessary time for the disc/drum to come to a complete stop before opening the disc/drum housing or starting
any maintenance or service procedures. The customer has received instruction and fully understands the purpose of
the beltshield inspection hole and that they are never to attempt any maintenance or service procedures until visually
confirming the belts have come to a complete stop.
9. _____ The customer has received instruction and fully understands that the machine is not to be operated without the
factory approved hood pin assembly in place and padlocked, the machine is not to be operated with any type of make
shift hood pin, and the machine is not to be operated under any circumstances with the chipper hood open or unsecured.
10. _____ The customer has reviewed and fully understands limited warranty, and all written and visual instructions.
11. _____ The customer has received instruction and fully understands that warranty will not apply if the machine is
operated with replacement parts or equipment not manufactured or recommended by Bandit Industries, Inc.
12. _____ The customer has received, been advised, and understands the manuals, and the Safety/Service video supplied
with the chipper. A video is supplied for equipment models as available.
13. _____ All Danger, Warning and Operational decals are properly displayed on equipment and fully understood by customer.
14. _____ The customer has been instructed, understands, and agrees that all potential operators must: See the supplied
video, be instructed on all the Danger, Warning and Operational decals, read the manual and follow the procedures.
15. _____ The customer has been advised of all safety options.
I have inspected this equipment and find it in correct working condition. To the best of my knowledge,
the customer and his/her personnel are aware of, and agree to the above procedures.
Signed: ________________________________________________________ Date: ______________
The equipment has been thoroughly checked by the above named dealer representative, and I am
satisfied with his/her instructions. I have also read, understand, and agree to reverse side of page.
Signed: ________________________________________________________ Date: ______________
Copyright 2/17 FORM #WV-122
(Dealer Representative)
(Customer)
Customer Data Department
6750 Millbrook Road
Remus, MI, USA 49340
Phone: (800) 952-0178 in USA
Phone: (989) 561-2270
Fax: (989) 561-2273
Website: www.banditchippers.com