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íà òåõíè÷åñêîå îáñëóæèâàíèå èëè ðåìîíò îáîðóäîâàíèÿ
1. Ïðåäïðèÿòèå: ___________________________________________________________________________
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2. Êîíòàêòíîå ëèöî: _______________________________________________________________________
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3. Óñëîâíîå îáîçíà÷åíèå îáîðóäîâàíèÿ: ______________________________________________________
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4. Çàâîäñêîé íîìåð: _______________________ Äàòà ïðèîáðåòåíèÿ: ______________________________
5. Ôàñóåìû ïðîäóêò è òàðà: _________________________________________________________________
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7. Ïðåòåíçèè ê ðàáîòå îáîðóäîâàíèÿ: _________________________________________________________
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Àäðåñ íàõîæäåíèÿ îáîðóäîâàíèÿ:____________________________________________________________
Îòâåòñòâåííîå ëèöî (ÔÈÎ, òåë.) ____________________________________________________________
Ïðåäñòàâèòåëü çàêàç÷èêà
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Ì.Ï. _____________________
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