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The following procedures must be followed to process all claims against BR-111™ exotic hardwood flooring:
■
Consumer must have read and understood product warranty.
■
Consumer must have read and followed installation instructions and maintenance recommendations.
■
Dealers must provide flooring samples and photos of defective flooring materials.
■
Copy of BR-111
™
and distributor invoice must be attached to the claim form.
■
Claim form must be entirely completed. For questions that do not apply to the particular jobsite, please write n/a.
Distributor Name:_____________________________________________________________________________________ Today’s Date:_______________________
Street Address: __________________________________________________________________________________________________________________________
City: ________________________________________________________________ State: __________________________ Zip: ______________________________
Retailer Name: _______________________________________________________________________________________Tel. #(____)_________________________
If part of a buying group, please list: _______________________________________________________________________________________________________
Street Address: __________________________________________________________________________________________________________________________
City: ________________________________________________________________State: ___________________________ Zip: ______________________________
Installation Company Name: ___________________________________________________________________________Tel. #(____)_________________________
Street Address: __________________________________________________________________________________________________________________________
City: ________________________________________________________________ State: __________________________ Zip: ______________________________
Consumer or Jobsite Name:____________________________________________________________________________ Tel. #(____) ________________________
Street Address: __________________________________________________________________________________________________________________________
City: ________________________________________________________________ State: __________________________ Zip: ______________________________
Product Code: _______________________________________________________ BR-111
™
Invoice # ___________________________________________________
Product Species:______________________________________________________ Product Thickness: _______________ Product Width:_____________________
Total Square Footage of Job: ___________________________________________ Total Square Footage Installed:________________________________________
Approx. Square Footage Involved in Claim:_______________________________ Inspected by #:_____________________________________________________
____________________________________________________________________________________________________________(small piece of paper found inside carton of material)
Date Product was delivered to jobsite: ___________________________________ Date Product Installed:_______________________________________________
Date Problem Was Noticed:_______________________________________________________________________________________________________________
Complaint of Product:____________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
Site Inspection:
❏ New Construction ❏ Remodel
Date of Site Inspection: _______________________________________________
Is building structurally complete and enclosed?
❏ Yes ❏ No
Where HVAC systems fully operational prior to the installation of the hardwood flooring?
❏ Yes ❏ No
Type of heating system: _______________________________________________ Type of air conditioning system:_______________________________________
Are HVAC systems fully operational at all times after installation of the hardwood flooring? ❏ Yes ❏ No
Check exterior of jobsite. Is all drainage directed away from the structure?
❏ Yes ❏ No
If not, please describe: _____________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
Product is installed on what grade level:
❏ Above ❏ On ❏ Below
Is any part of the hardwood flooring installed over a crawl space?
❏ Yes ❏ No Temperature and relative humidity of crawl space: ________________
If yes, please describe: _____________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
If known, relative humidity of the interior environment at time of installation: __________________________________
Relative humidity of the interior environment at time of inspection:______________________________________________________________________________
109
12800 NW 107th Court
•
Medley, Florida 33178
•
(800) 525-BR111(2711)
•
Fax (800) 577-2711
•
www.br111.com
8/30/04
