CE Site Visit Request Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Please read before completing this site visit request formIMPORTANT: Prior to scheduling a site visit an effort must be made to resolve the problem by the dealer’s service technician/service manager by visiting the site and gathering the necessary diagnostic information. The dealer’s technician must contact the local Customer Assurance Team from the jobsite and describe the problem in detail. The service technician must perform the steps that the Customer Assurance Manager requests during support call.Name *FirstLastEmail *FeeThere is a $500.00 per system fee for any jobsite visit requested. Please select your region. *— Select Choice —Central Plains (ND, SD, NE, KS, IA, MO)Florida (FL)Mid-Atlantic (MD, VA, WV, Washington D.C.)Mid-South (AR, LA, MS, TN)Northeast (NJ, NY)Southeast (NC, SC)South Central (North-TX, OK, AR)South Texas (South-TX)CanadaDealer informationCompany Name *Company 6 Digit Account Number *Customers without an account number use account #991122Service Manager Name *Service Manager Phone Number *Service Manager Email *Has your company's Service Manager visited this jobsite? *YesNoTechnical Support Case# *Job Site InformationJobsite – Customer Name *Jobsite Address *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEquipment InformationOutdoor Unit/Package Unit Model Number *Indoor Furnace/Fan Coil Unit Model Number *Indoor Evaporator Coil Model NumberThermostat or Control BrandThermostat Startup DateOutdoor Unit/Package Unit Serial Number *Indoor Furnace/Fan Coil Serial Number *Indoor Evaporator Coil Serial NumberThermostat ModelIf Infinity/Evolution, Software VersionOutdoor Unit/Package Unit Startup Date *Indoor Furnace/Fan Coil Startup Date *Indoor Evaporator Coil Startup DateThermostat SerialDescription of problem *Scheduling OptionsIMPORTANT! Dealer Service Manager and/or Owner must be present during any and all job site visits. A technician with all necessary tools and proper technical expertise must also be present as we provide diagnostic assistance ONLY! If the dealer service manager or owner is not present the site visit fee will not be refunded regardless of findings.Preferred date and time you would like to schedule the visit. *DateTimeAlternate date and time you would like to schedule the visit. *DateTimeWe will try to accomodate the requested times as best as possible, but may not be avialable due to prior commitments. Failure of the Technician and Service Manager to appear within 30 minutes of the scheduled time will result in forfeiture of the site visit fee(s) and the visit will require rescheduling. Rescheduling for a future time or date without a minimum of 24 hours notice will require the site visit fee(s) to be paid again.Purchase order for the site visit. *Provide a number or reference text here for billing even if your account is a cash account. This will provide a reference number for this request.NameSend Message
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