Pipette repair receipt document

Please note! The cost of collection of the pipette by Lumitron from the customer's site and back to the customer's site is NIS 70 + VAT.
A pipette that has been tested in the laboratory and no repair has been ordered in respect of the fault will be charged the cost of the test in the amount of NIS 100 (excluding the cost of the transportation)
The pipette must be cleaned and disinfected before sending it to Lumitron for repair.
We cannot repair a pipette that has not been cleaned and disinfected.

A problem was detected in the following Form. Submitting it could result in errors. Please contact the site administrator.

Date

Orderer’s Name

Telephone

Company / Institution’s Name

Laboratory Name

Address

Department

Building

Floor

Room

Select quantity of pipettes (up to 4)

1 2 3 4

Model

Serial Number

The pipette has been cleaned and sterilized before sending it for treatment by

Date

Fault Description

Model

Serial Number

The pipette has been cleaned and sterilized before sending it for treatment by

Date

Fault Description

Model

Serial Number

The pipette has been cleaned and sterilized before sending it for treatment by

Date

Fault Description

Model

Serial Number

The pipette has been cleaned and sterilized before sending it for treatment by

Date

Fault Description

Please Note!

At the end of the process the form above will be sent to the email address you specified. This form must be printed and attached to the shipment

Form Details Statement

By my signature, I confirm that the pipette has been cleaned and sterilized and that all the details are correct.

Pipette repair receipt document

Pipette repair receipt document

Please Note!

Endotoxin & TOC Conference

Endotoxin & TOC Conference