APPENDIX VI
57
NAME :
COMPANY/INSTITUTE :
ADDRESS :
POSTCODE +CITY :
COUNTRY :
PHONE :
FAX :
I would like to receive a price list for recalibration
I would like to submit my instruments for recalibration
Type/Model: Qty: Requested delivery time
I intend to send the instruments to
Kipp & Zonen on:
. . . . . ./. . . . . ./. . . . . .
I would like to receive the instrument(s)
back on:
. . . . . ./. . . . . ./. . . . . .
Conformation by Kipp & Zonen
□
Yes, the dates are acceptable to us
□
No, unfortunately the dates do not fit into our calibration
schedule. We suggest the following dates:
. . . . . ./. . . . . ./. . . . . .
. . . . . ./. . . . . ./. . . . . .
Fax +31-15-2620351
or mail to:
Kipp & Zonen P.O. Box 507 2600AM
Delft The Netherlands
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