Dates And Signatures - All Environments - Micromeritics FLEX Series Pre-Installation Instructions

6 D
ATES AND
All checklists and this completed form should be returned only if Micromeritics will be
performing this installation.
P I
ROJECTED NSTALLATION
This is not a commitment for a specific installation date. After reading the site preparation
requirements in this document, enter a date your site will be prepared and a preferred date for
installation. After returning the checklist and signed form to Micromeritics, your Micromeritics
representative will contact you to confirm an installation date.
When would installation be most convenient? Date: __________/________/________
C S
OMMITMENT TATEMENT AND
I have read this document and understand my responsibilities regarding preparations for the
installation of our analysis system. I believe this site is ready for the system to be installed.
Signature:
Name (Printed):
Title (Printed):
Company:
City / State / Zip:
Phone Number:
E-mail:
Analyzer:
Is the Customer Representative also the End User?
R
ETURN THE COMPLETED CHECKLIST AND FORMS TO
Micromeritics Instrument Corporation
ATTN: Service Operations Manager
4356 Communications Drive
Norcross, GA / USA / 30093-2901
Flex Series Pre-installation Instructions and Checklist
350-42870-01 (Rev H) — Apr 2021
S — A
IGNATURES
D
ATE
S
Model:
Email: Service.Helpdesk@Micromeritics.com
Fax: 1-770-662-3604
6 Dates and Signatures — All Environments
E
LL NVIRONMENTS
F
IGNATURE ORM
Fax Number:
Serial No.:
Yes ______ No ______
:
Date:
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