Repair Request Form

Repair Request Form

To schedule a service repair pick-up, please complete the form below and one of our team members will be in touch.
General Inquires

For more information on our cleaning solutions and supplies please visit our website (www.ScolesSystems.com) or call (732-681-4545) to speak with one of our experts.
Business / School Name*
Please enter name of company or district
If a school, please check which of the following co-ops you belong to:

Ed Data ContractESCNJHCESC
Site Contact Name:*

First NameLast Name
E-mail Address:*
Phone Number:*
Please enter in correct format
Machine Location Address:*

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Machine Type:*
Please provide the machine type: vacuum, floor scrubber, sweeper, etc...
Make / Model:*
Please provide the Brand/Model
Serial Number:
Description of the Problem:*
What are the problems you are having with your machine? Be specific.
Please mark all accessories of the machine.

HoseBattery ChargerWandPads/BrushesSqueegeeNO ACCESSORIESOther
PLEASE NOTE: ALL ACCESSORIES MUST BE AVAILABLE FOR PICK-UP OR AT THE TIME OF SERVICE TO PROPERLY ASSESS THE MACHINE.
IMPORTANT: ALL MACHINES TANKS MUST BE EMPTY OF WASTE AND/OR SOLUTION, PRIOR TO PICK-UP OR SERVICE. *A $65 HAZARD FEE WILL BE APPLIED TO THOSE MACHINES THAT ARE NOT EMPTIED.
Should be Empty: