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FLEXICAM INDIA PVT.LTD Doc No.

: FIPL-SS01-SRFL

SERVICE REQUEST FORM Rev No.: 00

(NON-WARRANTY MACHINE) Rev Date: APRIL 2018

Date:__________________________

Company Name: _________________________


Address (City/Country): ______________________
Machine Serial #: ___________________________

Machine Model: ____________________________

Contact Person: ____________________________ Contact Number: __________________

Description of the problem:

Schedule of Service Fee


INR
Technical Service Visit charges for First day INR 20,000.00
Technical Service Visit charges from second day INR /Day 7000.00
*Day is for 8 hr. Service fee for Extra hours INR /Hr 1000.00
**Per Day/ Hour billing includes travel time from Delhi or Coimbatore
Travel, Boarding & Lodging to be arranged by customer.
18% GST will be applicable on final invoice.

The undersigned, representing the above client, hereby understand and accept the
above charges.

Name : Signature:

Designation : __________________ (Company Stamp)


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FlexiCAM India Pvt.Ltd • B-38(New no:226) • New Ashok Nagar • Delhi-110096 • India
Phone +91-9971816117

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