IT Service Ticket Form

Duranet Warranty Application

Please complete all relevant fields and upload your test results before submitting the form. If you experience any difficulties, please contact warranty@duranet.in
Authorised Installer Company Details
Installer Company Name*
Installer Company Address*
Street Address
City
Country
Postal / Zip Code
Phone Number*

Country CodeArea CodePhone Number
Installer Company Email Address
example@example.com
Authorised Installer Contact Person Details
Installer Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*

Country CodeArea CodePhone Number
Installer Registration Number*
Registration Number on DCI Certificate
End-user Information
End-user Company Name*
End-user Company Address*
Street Address
City
Country
Postal / Zip Code
Phone Number*

Country CodeArea CodePhone Number
End-user Company Email Address
example@example.com
Contact Person Name*

First NameLast Name
Job Title*
Installation Start Date*

DayMonthYear
Date
Installation Completion Date*

DayMonthYear
Date
Exact Project Name to be printed on Certificate *
Name to be Printed on Certificate
Product List (Enter each Duranet part number used in the installation)
Select type of Cable used:*

CopperFiber
Select the cable category*

Category 6 UTPCategory 6A U/UTPCategory 6A F/UTPCategory 6A U/FTP
Cable Part No.*

DNC-C6USCGY-LS305DNC-C6USCGY-LS305DNC-C6USCGY-LS305DNC-C6USCGY-LS305
Keystone Part No.*

DNC-KS6UMWH-WS
Patch Panel Part Number*

DNC-PPXU1U-24LDNC-PPXU1U-48L
Patchcords Part Number*

DNC-C6UPC**-0.5MDNC-C6UPC**-1.0MDNC-C6UPC**-2.0MDNC-C6UPC**-3.0MDNC-C6UPC**-5.0MDNC-C6UPC**-10.0MDNC-C6UPC**-15.0MDNC-C6UPC**-20.0M
Total Number of Nodes :
Enter Number of Nodes here
Upload Test Results here

Upload Test Results
Cancelof
I hereby certify that I am authorized to represent the above installer company, and that this installation conforms to the End-user's Specifications and the guidelines set forth in the Duranet Specifications and further agree to be bound by the provisions of the warranty for this system which I request to be registered by Duranet.
Full Name*

First NameLast Name
Invoice Number*
Date

DayMonthYear
Date
Should be Empty:

Duranet Warranty Application

Authorised Installer Company Details

Authorised Installer Contact Person Details

End-user Information

Product List (Enter each Duranet part number used in the installation)