WARRANTY & REPAIR APPLICATION

CUSTOMER AND ORDER DATA Customer name Contact Account no. or address E-mail Tel. no. no. of order/delivery note Your Van der Ende ref. or invoice reference

PRODUCT DATA Van der Ende item no. Serial no. only if item no. is Brand Type only if item no. is unknown unknown If multiple articles are involved, please copy the table below.

AMBIENT CONDITIONS OF PRODUCT USE Ambient temp. °C Air humidity % RH Dusty environment yes/no Condensation yes/no Vibration - in Vibration - standstill yes/no yes/no operation Outdoor installation yes/no Application:

DESCRIPTION OF THE FAILURE

Error message on display:

HAZARDOUS SUBSTANCES (ALSO IN RELATION TO THE SAFETY OF VANDER ENDE CO-WORKERS) yes/no (if yes, submit information Hazardous substances in pump beforehand!) If so, which hazardous substances?

HANDLING REQUIRED BY YOU Re warranty/repair Quote to be Substitute product yes/no/already supplied submitted yes/no/in excess of € ..... beforehand Defective material to be Inspection yes/no yes/no returned report

VAN DER ENDE IN-COMPANY DATA WRA number Order no. Received in complete Finalised condition

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Van der Ende Pompen B.V. · Postbus 10, 2676 ZG, Maasdijk · Maasambacht 4, 2676 CW, Maasdijk · Telephone 0174 515050 · Fax 0174 514848 Rabobank 34.03.41.610 · CoC&I The Hague 27230471 · VAT number NL8000.78.378.B01 · [email protected] · www.vanderendegroep.nl EXPLANATION WITH THE WARRANTY & REPAIR APPLICATION

For warranty and repair handling, all Van der Ende companies apply the Metaalunie conditions (to be downloaded via www.vanderendegroep.nl or provided by mail upon request). In addition, the following conditions apply.

General: . Please fill out the tables as completely as possible; . The completed form should be attached to the outside of the (transport) packaging in a prominent way; . Failure to submit a completed WRA form may lead to a delay in handling; . The product/products are delivered to our premises by you and for your account; . Obviously, the products should be properly packed for transport; . In case of repaired products, our standard schedule for transport costs applies (to be downloaded via www.vanderendegroep.nl); . We consider the safety and well-being of our co-workers to be of paramount importance. If a product may contain substances that could be dangerous to our co-workers, you should inform us beforehand.

Warranty: . Article 14 of the Metaalunie conditions is used as a basis for granting warranty; . Warranty will not be granted for defects resulting from: normal wear and tear, injudicious use, lacking/incorrect maintenance or repairs: . In terms of liability we apply article 13 of the Metaalunie conditions; . If no failures are detected on a product, an amount of € 35,- will be charged for inspection, plus applicable transport costs.

Repair . If (after a quote has been submitted) no repair takes place and a new/replacement product is not bought from us, we will charge € 35,- for inspection; . If we have not received approval for repair within 4 weeks from the quote, the products will be returned to you in a non-repaired (and possibly dismantled) condition. This procedure will automatically entail an invoice for inspection costs (€ 35,-) plus transport costs (according to our transport cost schedule, to be downloaded from www.vanderendegroep.nl); . The above procedure also applies if failures are established; . Transport costs for shipping repaired products are charged in keeping with our transport cost schedule.

Please send this form beforehand to sales@vanderendegroep (or by fax to the number below). When sending materials, please make sure you add a copy of the form to the shipment.

As a general rule, total completion of the form is conducive to a swift settlement of your warranty/repair application.

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Van der Ende Pompen B.V. · Postbus 10, 2676 ZG, Maasdijk · Maasambacht 4, 2676 CW, Maasdijk · Telephone 0174 515050 · Fax 0174 514848 Rabobank 34.03.41.610 · CoC&I The Hague 27230471 · VAT number NL8000.78.378.B01 · [email protected] · www.vanderendegroep.nl