Please enable JavaScript in your browser to complete this form.Name *FirstLastCompany Name *Phone *Email *Site Address *Address Line 1CityState / Province / RegionPostal CodePriority LevelHighNormalLowLocation of effected equipment *Office EnvironmentEngineering EnvironmentServer RoomManufacturering EnvironmentRetail EnvironmentOtherIf other… *Describe FaultFault code displayed on control unitNo display on control unitWater leaking from air conditioningFoul odur coming from air conditioningOther FaultIf other fault *Is the system in question under an active Chilltek maintenance plan? *YesNoDiscounted rates apply to systems under an active Chilltek maintenance plan.Terms of Service *I accept the terms of service belowChilltek Payment Terms.. Value of Materials/part will be paid in full before being delivered to site. Outstanding balance will be paid in full in, within Invoice payment terms as listed below: 7 Days from invoice date – Standard Terms. 30 days from invoice date – Formerly agreed by Chilltek. If for any reason Invoices cannot be settled within the Invoice Payment Terms, please contact us in advance of the due date, failure to do so will result in Chilltek issuing a final invoice in the claim of interest, a fixed penalty charge or recovery costs under The Late Payments of Commercial Debt Regulations 2013. Please ask if you require copy of our current Site Rates.. Submit