REPAIR / ORDER FORM
REPAIR / ORDER FORM
SUPERCHARGER REPAIR / PARTS Order Form:
Please print / ship, via U.S.P.S. only, (NOT UPS – they cannot ship to a P.O. Box),
with check or money order, payable to: “L. MANESS”,
P.O Box 221, Palmer, TX, 75152— Please EMAIL Tracking #, so we know it’s coming !
NAME:_____________________________________________
ADDRESS: __________________________________________
City/State/ZIP:_______________________________________
PHONE#:___________________________________________
EMAIL:_____________________________________________
Make/Model:_________________________________________
Description of PROBLEM/DESIRED REPAIR AND/OR PARTS needed:_________________________________________________________________
By signing this form I hereby recognize and agree to the following. All sales are FINAL. NO refunds. Prices subject to change without notice. All items and services are sold and performed AS-IS. It is recommended for you to REMOVE ALL ACCESSORIES, pulleys, brackets, etc. You may leave them on if you like, but we ARE NOT responsible for lost or damaged accessories ! L. Maness is NOT RESPONSIBLE for any damage to parts of any kind, due to a failure of any kind. All parts are aftermarket, experimental performance parts, intended for use on off-road vehicles only. NO WARRANTIES expressed, nor implied. BUYER ASSUMES ANY AND ALL RISK. Parts are not guaranteed as fit for any particular purpose. Any parts that may be sold or installed are not manufactured by L. Maness and therefore is not liable for any part failure of any kind, resulting damage from any part failure, or damage or failure due to misuse. This is your receipt/statement of work. Not responsible for items lost or damaged in shipping. Test / use / inspect item immediately upon receipt. Any shortages or concerns must be reported within 3 days of receipt. Any item(s) left over 60 days, with no contact, is abandoned property in Texas.
Signature:____________________________________________ Date:_________________