New Account Application

*(denotes required field)

Company:

Company Name: *

Company Information:

Bill To Address (Street Address, City, State, Zip): *

Attention: *

A/P Manager: *

Phone Number: *

Fax Number: *

Email Address: *

Ship To Address (Street Address, City, State, Zip): *

Attention: *

Phone Number: *

Fax Number: *

Email Address: *

Tax Exemption:

Are you tax exempt (must provide form): *

Yes


No

Contact for Repair Decisions:

Contact Name: *

Phone Number: *

Email Address: *

Bank Information:

Bank Name: *

Account Number: *

Bank Address: *

Credit References:

Company Name: *

Address: *

Phone Number: *

Company Name:

Address:

Phone Number:

Company Name:

Address:

Phone Number:

Due to our ISO 9002 certifications, we will need a signed copy of your Purchase Order if you want to be set up for NET 30 terms. While determining your account terms you may be required to pay by a credit card to establish payment history. We accept Visa, MasterCard, and American Express. How will your company pay for calibration and repair services?

Check One: *

Purchase Order


Credit Card


Both

Please specify which calibration method you would like AcuCal, Incorporated to perform on all of your TMDE equipment:

Check One: *

Standard Calibration – This includes the calibration certificate and calibration label


Standard Data – additional fees will apply
(please see the explanation of before and after data below.)


Joint Naval Audit Certification Team (JNACT) Calibration – VA Lab 7CB/HI Lab 7AC


With JNACT Data: additional fees will apply (please see the explanation of before and after data below.)


Z540-1-1994 Logo on the calibration certificate – no data


Z540-1-1994 before and after data – additional fees will apply


Z540.3-2006 before and after data with test uncertainty ratios – additional fees will apply


ISO/IEC 17025:2005 Accredited Calibration with before and after data with uncertainty calculations
additional fees will apply (17025 Accredited Calibration can only be done in VA laboratory)

Please select one of the following to determine the calibration interval for all of your TMDE equipment. AcuCal will not certify test equipment with the calibration interval greater than that by the manufacturer specifications:

Check One: *

Manufacturer Suggested Interval


DOD Interval: Metpro


DOD Interval: Afcav


AcuCal Assistance – Would you like AcuCal to assist you in determining your calibration intervals?


Other

Terms & Conditions:
- All fees apply regardless of the unit passing or failing calibration.
- Additional equipment presented at time of calibration may require revision of purchase order prior to performance of services requested.
- Repair estimates will be provided upon failure of calibrations. A minimum charge of $45.00 (evaluation fee) will be charged on all estimates. This fee varies based on the complexity of the instrument being presented but will not exceed the amount of the quoted calibration fee. Labor rate on all repairs is $95.00 per hour.
- A valid purchase order must be presented prior to performance of services.
- If before and after data is required, it must be clearly stated on the purchase order. No data readings will be provided as part of the normal calibration process. Before and After readings are available for an additional fee.

Data Provided:
All calibrations receive a certification of calibration and a calibration label affixed to the instrument.

Optional Data:
Before and after data – individual parameter readings are taken at the time of receipt. After data is an additional set of data provided in the event the unit was found to be out of tolerance or in need of repair. This data would reflect all measurements after service has been provided. This data can be one in the same if unit was received in tolerance and no other service is required. This data is provided at an additional fee based on the complexity of the calibration service required.

On-Site Service:
– Due to increasing fuel cost a fuel surcharge of 3.5% will be applied to the per unit cost.
– Items requiring repair can be transported to AcuCal Incorporated at no additional charge to the customer. Items must be submitted prior to departure of onsite crew. Delays in repair will not be incurred by AcuCal for units being transported in this manner. The mobile unit may not be returning directly to AcuCal’s home office upon departure. Please coordinate any transportation with onsite crew and main office.
– A cancellation fee of 25% will be billed in the event that the customer cancels the onsite visit after it has been scheduled and is within 10 days of the scheduled calibration visit. 35% will be billed if cancelled after the mobile laboratory has departed for the scheduled job.

Policy Notice:
In order to reduce downtime, repair and administrative costs, AcuCal, Incorporated will no longer provide a written repair estimate for units requiring reusable parts such as batteries, fuses, etc, and minor repairs will be performed if the cost is less than $25.00. Customers will be billed for all expendable parts without further notice. This is a cost-saving effort that will allow us to reduce your labor charges on minor repairs and no labor will be invoiced in these instanced. It is the customer’s responsibility to modify or amend any of its internal paperwork to meet the payment terms of this account. It is the customers responsibility to disseminate the terms of this account to the appropriate personnel involved.

The information included herein is true and accurate to the best of my knowledge. It is my responsibility and my companys responsibility to notify AcuCal Incorporated of any changes in the information provided.

I have read and agree to the terms of service *

All information included in the application will be held in strict confidence and will be used only for establishing credit, account and invoicing information. A 2.5% finance charge and/or late payment penalties may be applied to late paid invoices.

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