
RKI Instruments, Inc. 33248 Central Avenue, Union City, CA 94587 Phone (510)441-5656 Fax (510)441-5650
World Leader In Gas Detection & Sensor Technology Form 09-01-14
www.rkiinstruments.com Revision F; 08/28/09
Service Order Form
Use this return form for all repairs including calibration and warranty repair. Date:____________
Please use one form per instrument
To Expedite this Service Order please include a “Not To Exceed” amount. For Non RKI Distributors, method of payment for all
non-warranty repairs to be made by credit card or check prior to instrument return.
Repair Warranty Serial #
Shipping Account #: Reference #:
Shipment method when returned Overnight by 8:30 am Overnight by 10:30 am 2 day
3 day Ground
Estimate approval before repair? Yes No Not to exceed cost $
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Company Name
Phone # Fax #
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Contact Name
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Email
Billing Address
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Shipping Address
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Please list instrument & accessories being returned: ____________________________________________________________________
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Please give a detailed description of the problem: _____________________________________________________________________
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Please Note:
• There is an $85 estimate charge per instrument. Estimate fee is waived if instrument is repaired.
Shipping charges are additional and are generally pre-paid and added to the invoice.
• All repairs must be accompanied with completed Service Order Form.
• Payment must be by credit card or check only.
• Do not return compressed gas cylinders with repair.
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