RFQ & New Coverage Request Form
Customer Information
*
Company Name
Contact Name
Your Email Contact
*
example@example.com
Equipment Detail Section
Manufacturer Provided Coverage
Equipment Age
New if less than 2-years old from installation date
Older than 2-years from installation date (how many years)
Trade Type
*
HVAC
Refrigeration
Plumbing
Electric
Application Type
*
Residential
Commercial
Mult-Family
Other
Equipment Type
AC Split System, Geothermal Split System, AC Condenser, Unit Heaters, etc.
Equipment Size
Ex. 5-Tons | 3HP (Horse Power) | 5-KW etc. (how you select this equipment when ordering)
What is the Limited Parts warranty provided by the manufacturer?
Select based the application type selected above. Ex. 1,2,3,5,7,10,12-years. *If there is no limited parts warranty from the manufacturer, we won't be able to create a coverage.
What is the Labor warranty provided by the manufacturer?
Ex. 1 year, 2 year, etc. *Most have no labor
What is the Compressor warranty provided by the manufacturer?
If no compressor, leave this blank Ex. 1,2,3,5,10,12-years
What type of compressor does the equipment have?
Scroll, semi-hermetic, screw, Etc.
Number of Compressors?
If your equipment has more than 1, how many?
Size of Compressor(s)
List the sizes if more than 1 compressor
Are compressors tandem?
Desired Warranty Coverage
Coverage Type
Labor only
Parts & Labor
Parts Only
Other
Labor start Date
91st day from purchase date
2nd year
6th year
11th year
Other
Labor Term Length - expires from installation date
1
2
3
5
7
10
12
Other
Labor Rate - *labor rate will be paid based on the coolCARE labor allowance table
$125
$175
$250
Other
Extended parts coverage period: Choose the start date and end date. Usually that would be the year after the manufacturer warranty expires. Ex. for a 1-year part warranty you select 2 and the year you want to go through.
1
2
3
4
5
6
7
8
9
10
11
12
Refrigerant Type (if included)
Ex. R410A, R432, R454, R404A, R-22, etc.
Additional Information:
Add Model Numbers Here or information about when the job would be completed
Job Files
Browse Files
Drag and drop files here
Choose a file
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of
Number of Systems for Multi-Family Jobs
Ex. 50, 100, 150 units
Job Name
This will be listed on the quote sent back
Submit
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