Document Scanner Service Request Form

Document Scanner Charge Service Request

Hardware Details

(Building Floor, Office Number, Etc.)

Payment Options

Select One of the Following Payment Options
SMA Covered for current customer.
Please enter your existing Contract ID
Signed Corporate Purchase Order
Maximum upload size: 10MB
Please upload PDF, JPG, or PNG copy of Purchase Order
Los Angeles local service only. Call (800) 215-1743 x 75 for other Service Areas.

Charge Call Billing Information

Billling Address
Credit Card
Card Number

TierFive provides next available scanner service call for $395 and includes first 2 hours of travel and onsite service. No additional parts or labor included.

Preventive maintenance and cleaning will be performed, any break-fix issues will be evaluated. If there is a minor issue (like a jam or slipped belt etc) that is able to be field re-mediated with no needed parts or additional labor then the repair can be made at that time by technician.

Else if parts labor are required to re-mediate? Then 2 options are available:
1) If we have parts are on truck and issue is field serviceable (no bench time) technician will explain and quote onsite and customer can then approve any additional costs for parts labor and we can re-mediate immediately.
2) Else if part/s must be ordered or remediation requires tear down in service center then a cost estimate will be provided later and if approved we will either return with parts or depot service unit and return it once the issue is re-mediated.

Web Signature
Signed Date