Download Meter Treater Documentation

EXTENDED WARRANTY DOCUMENTATION
RMA#________
Assigned by Meter-Treater, Inc. upon receipt of
Documentation
For Office USE ONLY
PLEASE PRINT
________________________
Current Date___/___/___
Utility or Power Company
Mr./Mrs./Ms.___________________
First Name
____________________
Last Name
(
) ________________
Area Code
Home Telephone No.
________________________
_______________
_______
_____________
Street Address
City
State
Zip Code
Meter-Treater, Inc’s (MTI) transmittal of this warranty documentation to you is not an indication of whether or not the
warranty applicable to your unit is still valid or has expired, or whether or not the claimed damage is covered.
Determination as to (a) whether or not a unit is covered under a valid warranty or (b) whether or not any damage is
covered by warranty (if valid), can not be made until such time as MTI receives the unit from the utility company, In the
event it is determined after receipt of the unit that the warranty has expired, MTI will not process the warranty claim
and any further communication regarding the damages sustained must go through your utility company directly. For
this warranty to be validated, the MTI surge protective device (SPD) must have sustained transient voltage damage as
defined by IEEE C62 Standards. The transient voltage/surge must have entered via the utility’s power line and passed
through the SPD causing consequential damage to standard residential equipment or appliances located inside a
residence. The SPD’s light(s) must be extinguished with power applied and surge activity must be verified by MTI.
Damage associated with any cause other than transient voltage surge will not be considered (i.e. damage associated
with any power system fault or flaw such as an over voltage is not covered. An over voltage is any transmission
greater than nominal voltage, including but not limited to that occurring when a high-voltage line comes in contact with
a low-voltage line or a loose/open neutral). Under no circumstances, will Meter-Treater, Inc. guarantee
performance for a lightning strike.
This warranty excludes all wells, well pumps and supplementary pump equipment and all stand-alone “electronic
equipment” using microchip, microprocessor or transistor technology, such as but not limited to computers, televisions,
DVD Players/Recorders and Security Systems. Notwithstanding any other term of the warranty, in no event will
medical or life support equipment be covered under this warranty.
Meter-Treater, Inc. must be given written notice of connected equipment damage within seven (7) working days of the
discovery of the damaged equipment. Failure to so notify MTI within said time frame will result in denial of the claim.
Upon receipt of the warranty documentation form, Meter-Treater, Inc. will notify the power company to remove the
device.
See a copy of the warranty for details.
Please contact the Warranty Department at (800) 342-6890 for assistance in completing this form.
Please mail the Warranty Documentation Package to:
Meter-Treater, Inc.
Attn: Warranty Department
1349 South Killian Drive
Lake Park, FL 33403-1918
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(MS)WI173-07/12/10
EXTENDED WARRANTY DOCUMENTATION
PLEASE READ THE INSTRUCTIONS
CAREFULLY BEFORE COMPLETING THE FORM
1. Meter-Treater, Inc. MUST have been given notice of connected equipment damage within seven (7)
working days of the discovery of the damaged equipment.
2. The Warranty Documentation Form MUST be signed and returned to Meter-Treater, Inc. within thirty
(30) days from the date you notified MTI in writing of the damage in order for the claim to be considered.
In any event, the claim will only be considered if a valid warranty is in existence.
3. To ensure we receive your Warranty Documentation Form, Meter-Treater recommends that written
correspondence be sent in such a manner that it may be tracked by you (e.g. US Mail Certified Letter).
4. The Warranty Documentation Form can not be processed without estimate(s), invoice(s) or receipts.
Warranty Documentation Forms submitted without estimate(s), invoice(s) or receipts will be denied. All
estimates, receipts for essential items already repaired, or repair invoices MUST be supplied for
damaged equipment reported. You agree to cooperate with Meter-Treater, Inc. in the processing of your
claim and provide any supplemental information requested by Meter-Treater, Inc. within ten (10)
business days. Failure to do so will result in the claim being rejected and Meter-Treater, Inc. shall have
no further liability.
5. All estimates and invoices must be on an itemized billing form with companies’ name, address, and
telephone number. Breakdown of services, repairs made, parts, labor time, etc., must be included on all
invoices and estimates.
6. All damaged equipment must be retained until settlement has been finalized. We may request the
damaged equipment or component be sent to Meter-Treater, Inc. for repair or evaluation.
7. Meter-Treater, Inc. or your Utility Company will provide you a written response after evaluating the
returned SPD and the information you have provided in this form. Meter-Treater, Inc.’s liability, per
occurrence, will not exceed $5,000.00 to any one (1) specific device or appliance with a maximum of
$500,000.00 over the life of this warranty. In addition, if it is determined that you are entitled to
compensation, you will be given either the fair market value of the damaged equipment immediately
preceding the failure, reimbursed for reasonably incurred repairs, or paid the cost of reasonable
estimated repairs. Meter-Treater, Inc. shall only be liable to pay those damages incurred which are
covered under this warranty and for which you have not recovered or do not intend to recover from a
third party or insurance carrier. In no event shall you be entitled to a “double recovery”.
8. Please attach any necessary information or comments if additional space is required.
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(MS)WI173-07/12/10
EXTENDED WARRANTY DOCUMENTATION
PLEASE PRINT
Date of incident: ___/___/___
Time of incident:_______________
Weather Conditions at Time of incident__________________________
Description of Incident that caused the damage (use additional paper if needed)
Depending upon SPD model installed at the meter, you may have one (1) or two (2) red indicator light(s).
Normal operation for the Meter-Treater® device has the light(s) “on” if there is power available. Please
check the light(s) on the Meter-Treater® device and describe whether they are ON or OFF:
__________________________
EQUIPMENT INFORMATION
Damaged Item Description:
______________________________
Repairable? O Yes O No
Labor:$____________________
Replacement parts:$_____________
Total: $_____________
Appliance Type: ____________
Date of Original Purchase___/___/___
If known
Original price: $_______
If known
Brand:_____________________
Model number:__________________
Estimate(s)/Invoice(s) enclosed? O Yes O No
Damaged Item Description:
__________________________________
Repairable? O Yes O No
Labor: $____________________
Replacement parts:$_____________
Total: $_____________
Appliance Type: _____________
Date of Original Purchase ___/___/__
If known
Original price: $_______
If known
Brand:______________________
Model number:_________________
Estimate(s)/Invoice(s) enclosed? O Yes O No
Use additional paper if necessary
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(MS)WI173-07/12/10
EXTENDED WARRANTY DOCUMENTATION
PLEASE PRINT
Additional Comments or Information:
Total dollar amount that you are requesting for reimbursement: $_________________
Before signing and returning this form, please check to ensure that you have completed the
following:
o ____ Read through and completed the form in its entirety.
o ____ Enclosed all applicable estimates, receipts, and invoices.
o ____ Included any other document(s) that may be relevant.
For your protection, the law requires you to be advised of the following: It is a criminal act to
make false, fraudulent or multiple claims regarding the same occurrence, or to assist in the
preparation or presentation of false, fraudulent or multiple claims regarding the same occurrence.
Violators of this provision may be subject to criminal prosecution.
Has a claim for this incident been filed with your primary insurance carrier?
Yes_____ No________
________________________________________________
Name of Primary Home Insurance Carrier
$_____________________________________________________________________
Amount (if any) paid to you for this incident by Primary Home Insurance Carrier
Your signature: _______________________
Date:______________
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(MS)WI173-07/12/10

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