CE Site Visit Request Form Veuillez activer JavaScript dans votre navigateur pour remplir ce formulaire.Veuillez activer JavaScript dans votre navigateur pour remplir ce formulaire.Please read before completing this site visit request form IMPORTANT: 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 telephone the Carrier/Bryant Distributor Technical Support Representative from the jobsite and describe the problem in detail. The service technician must perform the steps that the Distributor Technical Support Representative requests during telephone call. System Technical Support Request Form We recommend completing the “System Technical Support Request Form” prior to a site visit. In most cases this form can help in finding setup or operational deficiencies. This form will only apply to residential split systems installed either residentially or commercially. This form is not a requirement but is heavily recommended, this form can also be utilized for everyday troubleshooting a system if needed. Complete the System Analyzer Form Here Prénom *Nom de famille *E-mail *Fee There is a $650.00 per system fee for any job site visit requested. This will cover up to 4 hours on site. Additional time will be charged at the rate of $150.00 per hour. For locations more than 50 miles from the nearest qualified available TSR, as per Google Maps shortest distance, an additional charge of $3.50 per mile will be added. Should the visit require an overnight stay an additional charge of $350.00 per night will be added. This additional fee is charged if the time on the job plus travel each way exceeds 10 hours. In the event the TSR determines that the issue is the sole responsibility of the manufacturer and not related to a discrepancy in application, installation, start up, or maintenance procedures, all fees will be waived. This is at the sole discretion of the TSR and must be approved by their manager. Refund While performing the site visit or job inspection, should the Technical Support Representative find that the problem is due to a manufacturing defect, the fee will be credited back to the account or credit card. If you have made payment by check or cash, you will receive a full refund after due processing. If the issue is related only to Unapproved Application, Improper Installation, Incorrect Startup Practices, Unapproved Usage, a or Lack of Maintenance no fees will be refunded. Cases à cocher *By checking this box I agree to the fee and refund policy listed above.Veuillez sélectionner votre région. *Select RegionGrandes Plaines (Dakota du Nord, Dakota du Sud, Nebraska, Kansas, Iowa, Missouri)Floride (FL)Mid-Atlantic (MD, VA, WV, Washington D.C.)Nord-Est (NJ, NY)Sud-Est (NC, SC, TN, MS)Centre-Sud/Sud du Texas (TX, OK, AR, LA)CanadaDealer informationNom de l'entreprise *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? *OuiNonHas a System Analyzer Form been completed for this issue? *OuiNonIf “No” please select the proper form on the confirmation page and complete it in order for the site visit to be performed.Job Site InformationJobsite – Customer Name *Jobsite Address *Adresse Ligne 1Ligne d'adresse 2Ville— Sélectionner state —AlabamaAlaskaArizonaArkansasCalifornieColoradoConnecticutDelawareDistrict de ColombieFlorideGéorgieHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianeMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNouveau MexiqueNew YorkCaroline du NordDakota du nordOhioOklahomaOregonPennsylvanieRhode IslandCaroline du SudDakota du SudTennesseeTexasUtahVermontVirginieWashingtonVirginie occidentaleWisconsinWyomingÉtatCode postalJob Type *Commercial Package UnitCommercial Split SystemResidential Split SystemResidential Package UnitMulti FamilyAutreInformations sur l'équipementPlease Describe Other Job Type *Package Unit Model Number *Package Unit Serial Number *Package Unit Start Up Date *Numéro de modèle de l'unité extérieure *Numéro de série de l'unité extérieure *Outdoor Unit Startup Date *Indoor Furnace/Fan Coil Unit Model Number *Indoor Furnace/Fan Coil Serial Number *Indoor Furnace/Fan Coil Startup Date *Indoor Evaporator Coil Model NumberIndoor Evaporator Coil Serial NumberIndoor Evaporator Coil Startup DateThermostat or Control Brand *Thermostat Model *Thermostat SerialThermostat Startup DateIf Infinity/Evolution, Software VersionDescription 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. *DateTempsAlternate date and time you would like to schedule the visit. *DateTempsFailure 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.NomEnvoyer le message