Equipment Repair Request

Equipment Repair Request and Service Agreement

This Equipment Repair Request and Service Agreement (the "Agreement") is entered into between the parties identified below on the date of the last signature. The parties agree as follows:

WHEREAS

WHEREAS, Client Name: (the "Client") is the owner or authorized custodian of the equipment described below; and

WHEREAS, Service Provider: (the "Provider") is engaged in providing equipment repair and maintenance services and is willing to perform the repairs under the terms set forth herein; and

WHEREAS, Client requests that Provider perform the repair work described in this Agreement and Provider agrees to perform such work consistent with the terms below.

REQUESTER & CONTACT INFORMATION

EQUIPMENT DETAILS

Equipment Type:    Manufacturer:

Model:    Serial Number:    Asset Tag:

Warranty Status: In force Expired Unknown

SYMPTOMS / PROBLEM DESCRIPTION

SCOPE OF WORK

Provider shall perform diagnostic, repair, and testing services as described below. Provider will document repairs and replaced parts and will return such documentation to Client upon completion.

PAYMENT TERMS

Estimated total cost: $    Deposit required: $

Hourly labor rate: $    Parts cost estimated separately:

Late payment fee: on outstanding balances.

AUTHORIZATION & REPAIR APPROVAL

Client authorizes Provider to perform diagnostic work and estimates. Provider will not proceed with repairs in excess of the estimated total cost without prior written authorization except where immediate work is necessary to prevent imminent damage or safety risk.

Client authorizes repairs up to the estimated total cost without further authorization.

If equipment is declared non-repairable, Client authorizes Provider to dispose of or recycle the equipment in accordance with Provider's standard practices and charge reasonable disposal fees.

TERM AND TERMINATION

This Agreement commences on Start Date: and, unless earlier terminated, continues until End Date: or completion of the work.

Either party may terminate this Agreement for material breach if the breach is not cured within days after written notice. Upon termination, Client shall pay Provider for all work performed and parts ordered up to the effective date of termination.

CONFIDENTIALITY

Each party shall maintain the confidentiality of proprietary or nonpublic information disclosed in connection with the performance of this Agreement and shall not disclose such information to third parties except as required by law or as necessary to perform the services. Confidential information does not include information that is or becomes publicly available without breach of this Agreement.

LIMITATION OF LIABILITY; WARRANTY

Provider warrants that repairs will be performed in a workmanlike manner for a period of from completion, limited to parts and labor provided by Provider. EXCEPT AS EXPRESSLY SET FORTH, PROVIDER MAKES NO OTHER WARRANTIES, EXPRESS OR IMPLIED. NEITHER PARTY SHALL BE LIABLE FOR INDIRECT, INCIDENTAL, OR CONSEQUENTIAL DAMAGES EXCEPT FOR DAMAGE CAUSED BY GROSS NEGLIGENCE OR WILLFUL MISCONDUCT.

GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the State of without regard to its conflicts of law principles.

ENTIRE AGREEMENT

This Agreement, together with any written estimates or appendices signed by the parties, constitutes the entire agreement between Client and Provider with respect to the subject matter and supersedes all prior or contemporaneous oral or written agreements and understandings. Any amendment must be in writing and signed by both parties.

ADDITIONAL TERMS

ACCEPTANCE

By signing below, the undersigned represent and warrant that they are authorized to bind their respective party and that they accept the terms of this Agreement. Client acknowledges that Provider may retain possession of the equipment until payment in full is received for services and parts.

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