MAPEI PRODUCT WARRANTY APPLICATION FORM v2

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MAPEI PRODUCT WARRANTY APPLICATION FORM

Version 11-2020
On 1 January 2021, MBP (NZ) Ltd became the exclusive distributor of Mapei products in New Zealand, having purchased the assets and business of Mapei New Zealand Ltd.

Form Guidelines:

Only a valid Mapei trained cardholder or approved applicator or installer that applies Mapei or Polyglass product/s shall complete all sections of this form and submit it to MBP (NZ) Ltd. This form is not designed for DIY users or homeowners.

*Your request will not be processed if these guidelines are not followed
1. Please make sure you get your applicator card or letter which contains your applicator number ready when filling up this form because if the applicator number does not match with your name in our database, we automatically delete the application and not continue to process your request.
2. If the property address you provide is incomplete and does not match any of the addresses found in "Postal Address Finder", "Google Maps", or "Auckland Council Geomap", then we will not process your application. If your address cannot be found on these platforms, we recommend you wait when it's updated by the local council.
  - The proper address must contain:
    
    Street number
    
    Street name
    
    Suburb (whenever possible)
    
    City / Province
    
    Zip Code
3. Please do not submit more than one application for the same project. An exception is applied to projects with multiple flats/units/floors ie: apartment buildings with multiple rooms and units.
4. Fields that are marked with * means it's a required field. Those without are optional.
If you agree to all of this, click the "Next" button to proceed
APPLICATION SUMMARY

Installation date:	{21Date}	Issue date:	{dateReviewed}
Warranty number:	{referenceNumber}	Applicator number:	{applicatorNumber}
Name of applicator:	{firstName} {lastName}
Applicator company:	{company}
Property owner:	{aProperty}{aCompany} {typeA136} ; {bProperty138}{bCompany139} {businessType} ; {cProperty}{cCompany} {businessType144}
Project address:	{projectAddress}
Building consent number:	{13Building}
Application Description:	{42Installation}
Products under warranty:	{typeA}

ADMIN AREA
STATUS*
COMMENTS
REVIEWED BY*
DATE REVIEWED*

DayMonthYear
Date
The project address provided by the applicator:

{fullAddress165}

Copy and paste to POSTCODE Finder to verify
PROJECT ADDRESS*
Copy and paste the verified project address to display on the warranty document
The products applied by the applicator:

{31Mapei106}{32Polyglass} sqm
APPROVED PRODUCTS UNDER WARRANTY*

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APPLICATOR DETAILS

The details of the installer who owns a Mapei Academy applicator number and did the job.
For the applicator finder, you must key in your applicator number, first name, and last name as written on your Mapei Academy applicator card (ie:1234johnsmith) and don't put any spaces in between and no capital letters. Otherwise, it won't work. For privacy and security, we highly discourage you to share your Mapei Academy applicator card with anyone. If the applicator finder did not find your applicator information, continue by filling the form manually.
APPLICATOR FINDER *
FILL FORM MANUALLY
APPLICATOR NUMBER*
Please make sure to review that all the information here is correct
FIRST NAME*
LAST NAME*
APPLICATOR NAME*
COMPANY*
PHONE NUMBER ON RECORD*
MOBILE NUMBER*
EMAIL ADDRESS ON RECORD*
EMAIL ADDRESS*
Where you want communication about this warranty to be sent to.

LIQUID MEMBRANE TRAINED
POLYGLASS TRAINED
INDUSTRIAL FLOORING TRAINED
CAR PARK TRAINED
SPORTS FLOORING TRAINED
TNS TRAINED
EMAIL OF THE PROPERTY OWNER
example@example.com (Please fill up this field if you want to send a copy about the warranty to the property owner.)

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1. PROJECT DETAILS
HOW MANY OWNERS DOES THIS PROPERTY HAVE?*
1.1.a. SELECT PRIMARY PROPERTY OWNER TYPE*
a.) PROPERTY OWNER NAME*

First NameLast Name
a.) COMPANY NAME*
BUSINESS TYPE*
1.1.b. SELECT SECONDARY PROPERTY OWNER TYPE
b.) PROPERTY OWNER NAME*

First NameLast Name
b.) COMPANY NAME*
BUSINESS TYPE*
1.1.c. SELECT THIRD PROPERTY OWNER TYPE
c.) PROPERTY OWNER NAME*

First NameLast Name
c.) COMPANY NAME*
BUSINESS TYPE*
1.2. PROPERTY ADDRESS (COMPLETE ADDRESS OF THE PROJECT)
Provide "Flat" or "Block" details only if applicable.
This is ideal for apartment blocks and different units in a multiple storey building.
UNIT DETAILS
STREET NUMBER*
Could accept range: 7B-9B but please do NOT write here ' Lot ' or ' Block ' numbers, USE the fields above.
STREET NAME*
SUBURB
CITY*
ZIP / POSTAL CODE*
FULL ADDRESS
This is a Read Only field which cannot be modified and only designed for you to confirm address
FULL ADDRESS + PRODUCT + DATE VERIFICATION
1.3. BUILDING CONSENT NUMBER

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2. DATES
2.1. DATE OF INSTALLATION*

DDMMYYYY
2.2. DATE OF PURCHASE*

DDMMYYYY
# OF DAYS*
Days between installation & purchase
{typeA133} Days between installation date & purchase date
ERROR!!! The purchase date must be earlier than the installation date which means "# OF DAYS" should not be a negative figure.
2.3. The applicator has checked the date of the product to confirm it is good for use before installation?*

Yes
2.4. PRODUCT PURCHASED FROM*
Name of retailer or distributor
Please retain your product receipt/invoices as they will be required if you need to make a claim against a warranty in the future.
2.5. UPLOAD RECEIPT/S*

Browse Files
Show proof of purchase Cancelof

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3. PRODUCTS USED ON THIS PROJECT
3.1. MAPEI WATERPROOFING PRODUCTS*
3.2. POLYGLASS SHEET MEMBRANE PRODUCTS

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5. DECLARATION
5.1. Prior to the installation of the products, was a check done to ensure the substrate is correct for the MAPEI products and the products are appropriate for the required end use?*

Yes
5.2. Prior to the installation of the MAPEI products, has the applicator read and fully understood the current Product Technical Data Sheet (TDS) and the application procedure for the products?*

Yes
5.3. The installation has been done to meet the New Zealand Building Code (NZBC) requirements Sections, Durability and Moisture as applicable to the application?*

Yes
5.4. The applicator has completed the appropriate Mapei Academy product training course and holds a valid trained Mapei product applicator card?*

Yes

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6. PRODUCT WARRANTY TERMS

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8. APPLICATOR DECLARATION
I, {firstName} {lastName} with applicator number {applicatorNumber}, the installer of the above-listed products, confirm that I have read and understood the product warranty terms and that the information given in sections 1 to 6 of this warranty request is correct.

I understand that MBP (NZ) Ltd will rely upon the information given in this document, for the purpose of releasing a product warranty.

*On 1 January 2021, MBP (NZ) Ltd. became the exclusive distributor of Mapei products in New Zealand, having purchased the assets and business of Mapei New Zealand Ltd.
APPLICATOR INITIALS / SIGNATURE*

Clear

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SUBMISSION SUMMARY
Name of applicator:	{firstName} {lastName}	Applicator number:	{applicatorNumber}
Email:	{emailAddress223}	Phone:	{mobileNumber}
Card validity status:	WATERPROOFING MEMBRANE CARD: {liquidMembrane} POLYGLASS CARD: {polyglassTrained} INDUSTRIAL FLOORING CARD: {industrialFlooring} CARP PARK FLOORING CARD: {carPark} SPORTS FLOORING CARD: {sportsFlooring} TNS FLOORING CARD: {tnsTrained}
Applicator company:	{company}
Property owner:	{aProperty}{aCompany} {typeA136} ; {bProperty138}{bCompany139} {businessType} ; {cProperty}{cCompany} {businessType144}
Project address:	{fullAddress165}	Building consent number:	{13Building}
Description of application:	{42Installation}
Products requested to be covered by warranty:	{31Mapei106} {32Polyglass}

Should be Empty:

	CARD VALIDITY STATUS
WATERPROOFING MEMBRANE CARD:	{liquidMembrane}
POLYGLASS CARD:	{polyglassTrained}
INDUSTRIAL FLOORING CARD:	{industrialFlooring}
CARP PARK FLOORING CARD:	{carPark}
SPORTS FLOORING CARD:	{sportsFlooring}
TNS FLOORING CARD:	{tnsTrained}

MAPEI PRODUCT WARRANTY APPLICATION FORM

APPLICATION SUMMARY

ADMIN AREA

APPLICATOR DETAILS

1. PROJECT DETAILS

2. DATES

3. PRODUCTS USED ON THIS PROJECT

4. APPLICATION AREA

5. DECLARATION

6. PRODUCT WARRANTY TERMS

8. APPLICATOR DECLARATION