Warranty Form

Contractor Information

Contractor Name*

Contractor Address*

Contractor City*

Contractor State*

Contractor Zip*

Contractor Main Phone Number*

Contractor Contact Name*

Contractor Contact Phone (If different than above)

Ext:

Contractor Contact Email*

Preferred Contact Method

Phone Email

Installation Information

Installation Type*

Residential Commercial

Homeowner First Name*

Homeowner Last Name*

Installation Address*

Installation City*

Installation State*

Installation Zip*

Installation Contact Email

Installation Contact Phone*

Warranty Portal - Amana Goodman & Daikin Ductless

Warranty Type*

Faulty Part Type*

Unit Serial Number*

Unit Model Number*

Associated Outdoor Unit Serial Number*

Associated Outdoor Unit Model Number*

Reference Number

Additional Reference Number:

HVAC Distributors Order Number (S-Number) for Faulty Part*

Unit Installation Date*

Faulty Part Failure Date*

Faulty Component Is*

Cause Code*

Reason for Failure:*

Service Performed:*

Replacement Information*

Quantity:

Failed Part #:

Failed Part Serial #
(*required for compressors):

Replacement Part #:

Replacement Part Serial #
(*required for compressors):

Warranty Portal - Daikin Commercial

Warranty Type*

Faulty Part Type*

Unit Serial Number

Unit Model Number

Reference Number

Additional Reference Number:

HVAC Distributors Order Number (S-Number) for Faulty Part*

Unit Installation Date*

Faulty Part Repair Date*

Faulty Component*

Cause Code*

Reason for Failure:*

Service Performed:*

Replacement Information*

Quantity:

Failed Part #:

Failed Part Serial #
(*required for compressors):

Replacement Part #:

Replacement Part Serial #
(*required for compressors):

Warranty Portal - ClimateMaster

Warranty Type*

Faulty Part Type*

Reason for Failure*

Unit Serial Number*

Unit Model Number*

Reference Number

Additional Reference Number:

HVAC Distributors Order Number (S-Number) for Faulty Part*

Unit Installation Date*

Faulty Part Failure Date*

Additional Detail:

Replacement Information*

Quantity:

Failed Part #:

Failed Part Serial #
(*required for compressors):

Replacement Part #:

Replacement Part Serial #
(*required for compressors):

Warranty Portal - Honeywell

Faulty Part Model #*

Faulty Part Date Code

Reference Number

Additional Reference Number:

HVAC Distributors Order Number (S-Number)*

Faulty Part Installation Date*

Faulty Part Failure Date*

Faulty Part Type*

Reason for Failure*

Quantity*

Additional Detail*:

HTP

Faulty Part Type*

Reason for Failure*

Unit Serial Number*

Unit Model Number*

Reference Number

Additional Reference Number:

HVAC Distributors Order Number (S-Number) for Faulty Part*

Unit Installation Date*

Faulty Part Failure Date*

Additional Detail*

Replacement Information*

Quantity:

Failed Part #:

Replacement Part #:

LG

Warranty Type*

Faulty Product Type*

In-Home Warranty:* Yes No

Unit Serial Number*

Unit Model Number*

Reason for Failure*

Resolution*

Unit Purchase Date*

Reference Number

Additional Reference Number:

HVAC Distributors Order Number (S-Number) for Faulty Part*

Repair Start Date*

Repair End Date*

Additional Detail:

Replacement Information*

Quantity:

Failed Part #:

Failed Part Serial #
(*required for compressors):

Replacement Part #:

Replacement Part Serial #
(*required for compressors):

Lochinvar

Warranty Type*

Faulty Part Type*

Unit Serial Number*

Unit Model Number*

Reference Number

Additional Reference Number:

HVAC Distributors Order Number (S-Number) for Faulty Part*

Unit Installation Date*

Faulty Part Repair Date*

Replacement Information

Replacement Product Serial #*

Replacement Product Model #*

HVAC Distributors Order Number (S-Number) for Replacement Part*

Quantity:

Failed Part #:

Failed Part Serial #
(*required for compressors):

Product Date Code

Detailed Reason for Failure (Do Not State 'Defective')*

Luxaire

Warranty Type*

Failure Part Type*

Is this a Comfort Plan Warranty Claim*? Yes No

Unit Serial Number*

Unit Model Number*

Reference Number

Additional Reference Number:

HVAC Distributors Order Number (S-Number) for Faulty Part*

Unit Installation Date*

Unit Registration Date*

Additional Detail:

Replacement Information*

Quantity:

Failed Part #:

Failed Part Serial #
(*required for compressors):

Replacement Part #:

Replacement Part Serial#
(*required for compressors):

Panasonic

Warranty Type*

Failure Part Type*

Unit Serial Number*

Unit Model Number*

Reason for Failure*

Resolution*

Faulty Part Repair Date*:

Faulty Part Repair Call Received Date*:

Reference Number

Additional Reference Number:

HVAC Distributors Order Number (S-Number) for Faulty Part*

Repair Location*

Additional Detail:

Replacement Information*

Quantity:

Failed Part #:

Failed Part Serial #
(*required for compressors):

Replacement Part #:

Replacement Part Serial #
(*required for compressors):

York/Source1

Warranty Type*

Faulty Part Type*

Unit Serial Number*

Unit Model Number*

YS Letter:

SI Number:

Reference Number

Additional Reference Number:

HVAC Distributors Order Number (S-Number) for Faulty Part*

Unit Install Date*

Faulty Part Failure Date*:

Additional Detail:

Replacement Information*

Quantity:

Failed Part #:

Failed Part Serial #
(*required for compressors):

Replacement Part #:

Replacement Part Serial #
(*required for compressors):

Other

Manufacturer:

Unit Serial Number*

Unit Model Number*

Reference Number

Additional Reference Number:

Unit Installation Date*

Reason for Failure* (Please be specific about the failure. Do not give a reason of “defective,” “bad” etc.)

Resolution*

Reference Number

Additional Reference Number:

HVAC Distributors Order Number (S-Number) for Faulty Part*

Additional Detail:

Replacement Information*

Quantity:

Failed Part #:

Replacement Part #:

Initial Claim Request

Review an Existing Claim
or Complete a Draft Claim.

To file a Warranty Claim you must agree to the following conditions:

Contractor Information

Installation Information

Warranty Portal - Amana Goodman & Daikin Ductless

Replacement Information*

Warranty Portal - Daikin Commercial

Replacement Information*

Warranty Portal - ClimateMaster

Replacement Information*

Warranty Portal - Honeywell

HTP

Replacement Information*

LG

Replacement Information*

Lochinvar

Replacement Information

Luxaire

Replacement Information*

Panasonic

Replacement Information*

York/Source1

Replacement Information*

Other

Replacement Information*

Warranty Form

Initial Claim Request

Review an Existing Claim or Complete a Draft Claim.

To file a Warranty Claim you must agree to the following conditions:

Contractor Information

Installation Information

Warranty Portal - Amana Goodman & Daikin Ductless

Replacement Information*

Warranty Portal - Daikin Commercial

Replacement Information*

Warranty Portal - ClimateMaster

Replacement Information*

Warranty Portal - Honeywell

HTP

Replacement Information*

LG

Replacement Information*

Lochinvar

Replacement Information

Luxaire

Replacement Information*

Panasonic

Replacement Information*

York/Source1

Replacement Information*

Other

Replacement Information*

Review an Existing Claim
or Complete a Draft Claim.