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INSTALLATIE- EN KEURINGSCERTIFICAAT
KLANT: _______________________________________________
STRAAT: ______________________________________________
STAD: ________________________________________________
POSTCODE: ___________________________________________
PROVINCIE: ___________________________________________
TEL: __________________________________________________
Leveringsdatum: _________________________________________
Leveringsdocument: _____________________________________
Apparaat mod.: _________________________________________
Serienummer: _____________________ Jaar:_______________
De klant verklaart, na de voltooiing van de installatie van het Apparaat, dat de werkzaamheden vakkundig en in overeenstemming met de instructies
van deze handleiding zijn uitgevoerd. Hij verklaart bovendien de goede werking gecontroleerd te hebben en op de hoogte te zijn van de aanwijzingen
noodzakelijk voor het correcte gebruik, het correcte beheer en onderhoud van het Apparaat..
Handtekening van de KLANT Handtekening van de DEALER / INSTALLATEUR
Kopie voor de dealer of installateur
INSTALLATIE- EN KEURINGSCERTIFICAAT
KLANT: _______________________________________________
STRAAT: ______________________________________________
STAD: ________________________________________________
POSTCODE: ___________________________________________
PROVINCIE: ___________________________________________
TEL: __________________________________________________
Leveringsdatum: _________________________________________
Leveringsdocument: _____________________________________
Apparaat mod.: _________________________________________
Serienummer: _____________________ Jaar:_______________
De klant verklaart, na de voltooiing van de installatie van het Apparaat, dat de werkzaamheden vakkundig en in overeenstemming met de instructies
van deze handleiding zijn uitgevoerd. Hij verklaart bovendien de goede werking gecontroleerd te hebben en op de hoogte te zijn van de aanwijzingen
noodzakelijk voor het correcte gebruik, het correcte beheer en onderhoud van het Apparaat..
Handtekening van de KLANT Handtekening van de DEALER / INSTALLATEUR
Stempel van de Dealer:
Stempel van de Installateur:
Voornaam: __________________________________________
Achternaam: _________________________________________
Adres: ______________________ Postcode:_______________
Stad: _______________________________________________
Tel.:________________________________________________
Stempel van de Dealer:
Stempel van de Installateur:
Voornaam: __________________________________________
Achternaam: _________________________________________
Adres: ______________________ Postcode:_______________
Stad: _______________________________________________
Tel.:________________________________________________
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