Language
English (Canada)
French (Canada)
WARRANTY REQUEST FORM
TO BE FILLED OUT AFTER FOLLOWING POSSIBLE SOLUTIONS IN THE TROUBLESHOOTING GUIDES.
CONTACT INFORMATION
(For individual filling out this form)
Form Submitted by?
Please Select
Builder
Retailer
Service Company
End User/Homeowner
Company Name
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Job/Tag Name
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PRODUCT INFORMATION
Product Brand
Please Select
Spa Electrics
Pura Vida
ICO
Other
Spa Electrics Model
Please Select
Atom Light
Argon Light
Atom Retro Light
Fosmon Remote
R10 Retro
R6 Retro
R8 Retro
LVX 100
LVX 100P
LVX 50
LVX 50P
LitYard2
PuraVida Model
Please Select
Pura Vida PMIII-82PV
Pura Vida PSII-48PV
PuraVida2 PV2-42C
PuraVida2 PV2-82C
Model
Please Select
Model
ICO UUID#
Found inside the product box or in the settings section of the app if the product has been registered.
Product Model
Please Select
Atom Multi Plus
Atom P-Type
Atom Retro
R10 Retro
LVX 100
LVX 100P
LVX 50
LVX 50P
Pura Vida PMIII-82PV
Pura Vida PSII-48PV
PuraVida2 PV2-42C
PuraVida2 PV2-82C
Product Serial Number
*
What is the Issue and/or what replacement parts are required?
*
Please indicate the controller (power supply) model (ie. AQ---)
How was the product winterized?
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INSTALLATION INFORMATION
Date of Install
-
Month
-
Day
Year
Date of Purchase
-
Month
-
Day
Year
(Please provide proof of purchase to end user below)
Builder/Installer Name (if applicable)
Additional Comments or Questions
Please provide Proof of Purchase. *REQUIRED FOR ALL WARRANTY REQUESTS*
*
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Invoice to end user/homeowner required
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Please provide photo of product/reported issue
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