[INSERT LOGO]

Pickup Receipt
123 Station Street
Springfield, NY 10108
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ORDER INFORMATION
0OR OR1ER NO( TE+2NI+I)N 1)TE
CLIENT INFORMATION
0IRST N)3E 3I L)ST N)3E
)11RESS
+ITY ST)TE 4I +O1E
2ONE E3)IL )11RESS
PARTS RECEIVED

1e56top

Laptop

Net&oo6

)ll$in$One

Ser7er

8e9&oard

o'er +ord

OS 1i56

Soft'are 1i56

+ +o-ponent

3o.5e

:S* 1e7i,e

;Ot!er<
COMPUTER DESCRIPTION PHYSICAL DESCRIPTION
*R)N1 3)8E O=ER)LL +ON1ITION
3O1EL +OLOR
RO1:+T 8EY
:SERN)3E )SS%OR1
:SERN)3E )SS%OR1
:SERN)3E )SS%OR1
INITIAL ASSESSMENT INITIAL OBSERVATIONS
o'er to +

Ye5

No

:nte5ted
=ideo 1i5pla95

Ye5

No

:nte5ted
*oot5 to OS

Ye5

No

:nte5ted
Error 3e55age5

Ye5

No

:nte5ted
TECHNICIANS NOTES
Legal Agreement on next page... age 1 of 2
LEGAL AGREEMENT - Customer agrees to te !o""o#$%g terms
LE)SE RE)1 T2E 0OLLO%ING TER3S O0 SER=I+E +)RE0:LLY(
T!e5e ter-5 go7ern t!e pro7i5ion of an9 ,o-p.ter 5.pport 5er7i,e5
;>Ser7i,e5?< pro7ided &9 @*.5ine55 Na-eA
@*.5ine55 Na-eA pro7ide5 9o. 'it! a,,e55 to and .5e of t!e Ser7i,e5
5.&Be,t to 9o.r ,o-plian,e 'it! t!e Ter-5( @*.5ine55 Na-eA re5er7e5
t!e rig!t to ref.5e to pro7ide t!e Ser7i,e5 to an9one at an9 ti-e 'it!o.t
noti,e for an9 rea5on( Yo. repre5ent and 'arrant to .5 t!at 9o. are at
lea5t 18 9ear5 oldC 9o. !a7e t!e rig!t, ,apa,it9 and a.t!oriDation
ne,e55ar9 to legall9 &ind 9o.r5elf to t!e Ter-5(
Authorization to Access your Computer
Yo. a,6no'ledge t!at &9 9o.r .5e of t!e Ser7i,e5 9o. are a.t!oriDing
@*.5ine55 Na-eA to a,,e55 and ,ontrol 9o.r ,o-p.ter for t!e p.rpo5e5
of ,o-p.ter diagno5i5, 5er7i,e and repair(
In ,onne,tion 'it! deli7ering t!e 5er7i,e5 @*.5ine55 Na-eA -a9
do'nload and .5e 5oft'are, gat!er 595te- data, ta6e ,ontrol of 9o.r
,o-p.ter and a,,e55 or -odif9 9o.r ,o-p.ter 5etting5( *9 a,,epting
t!e5e ter-5, 9o. !ere&9 grant @*.5ine55 Na-eA t!e rig!t to ,onne,t to
9o.r ,o-p.ter, do'nload, in5tall and .5e 5oft'are on 9o.r ,o-p.ter to
gat!er 595te- data, repair 9o.r ,o-p.ter, ta6e ,ontrol of 9o.r ,o-p.ter
and ,!ange t!e 5etting5 on 9o.r ,o-p.ter '!ile perfor-ing t!e 5er7i,e5(
Quotes
)n9 7er&al E.ote gi7en &9 @*.5ine55 Na-eA i5 gi7en a5 a g.ide &a5ed
on li-ited infor-ation pro7ided &9 a ,.5to-er( ) 7er&al E.ote i5
intended to gi7e t!e ,.5to-er an e5ti-ate on t!e pri,e and not an
a55.ran,e t!at t!e prod.,t or 5er7i,e 'ill &e 5old at t!at pri,e(
Any written quote will be provided by <Business Name> at that price. All
written quotes are valid for only 7 days. Once work commences after a
technician has evaluated the system should it appear that the cost to repair is
more than quoted no work will commence without e!plicit client approval.
Legal Rights
T!e ,lient i5 t!e legal o'ner or a.t!oriDed repre5entati7e of t!e legal
o'ner of t!e propert9 and all data and ,o-ponent5 ,ontained t!erein
5ent to @*.5ine55 Na-eA( Yo. -.5t &e t!e o'ner, or !a7e t!e
per-i55ion of t!e o'ner, for .5 to 'or6 on 9o.r eE.ip-ent( %e 'ill onl9
ta6e in5tr.,tion5 for 'or6 fro- t!e de5ignated o'ner(
If eE.ip-ent i5 left 'it! @*.5ine55 Na-eA and i5 not ,olle,ted 'it!in
5iFt9 ;G0< da95 after 'e notif9 9o. t!at t!e reE.e5ted 5er7i,e i5 ,o-plete,
'e 'ill treat 9o.r eE.ip-ent a5 a&andoned and &e,o-e5 t!e 5ole
propert9 of @*.5ine55 Na-eA(Yo. agree to !old @*.5ine55 Na-eA
!ar-le55 for an9 da-age or ,lai- for t!e a&andoned propert9, '!i,! 'e
-a9 di5,ard at o.r 5ole di5,retion( )n9 and all ,!arge5 are 5till 9o.r
re5pon5i&ilit9(
Software Installation
@*.5ine55 Na-eA -a9 need to do'nload and or r.n 5oft'are on 9o.r
per5onal ,o-p.ter to !elp diagno5e and re5ol7e 9o.r per5onal
te,!nolog9 pro&le-( @*.5ine55 Na-eA -a9 need to rein5tall 5oft'are
t!at 'a5 in,l.ded a5 part of 9o.r ,o-p.terH5 original ,onfig.ration(
Yo. agree t!at 'e -a9 do'nload and .tiliDe Soft'are fro- t!ird part9
'e& 5ite5 or +15 and a,,ept an9 appli,a&le li,en5e agree-ent5 on 9o.r
&e!alf( Yo. a,6no'ledge and agree t!at 'e -a9 do'nload and in5tall
trial 7er5ion5 of Soft'are t!at 'ill eFpire and ,ea5e to f.n,tion after a
,ertain period of ti-e ;.5.all9 t!irt9 da95< .nle55 9o. p.r,!a5e a li,en5e
to ,ontin.e .5ing 5.,! Soft'are(
Backup Services Potential !ata Loss
%!ile @*.5ine55 Na-eA 'ill -a6e all rea5ona&le effort5 to 5afeg.ard t!e
,ontent5 ;data< 5tored on 9o.r ,o-p.ter, 9o. .nder5tand and agree t!at
prior to ,onta,ting or allo'ing @*.5ine55 Na-eA to perfor- diagno5ti,,
repair, or ot!er 5er7i,e5 on 9o.r ,o-p.ter, it i5 9o.r re5pon5i&ilit9 to &a,6$
.p t!e data, 5oft'are, infor-ation or ot!er file5 5tored on 9o.r ,o-p.ter
di565 andIor dri7e5 if 9o. 5o de5ire( Yo. a,6no'ledge and agree t!at
@*.5ine55 Na-eA andIor it5 t!ird$part9 5er7i,e pro7ider 5!all not &e
re5pon5i&le .nder an9 ,ir,.-5tan,e5 for an9 lo55, alteration, or ,orr.ption
of an9 5oft'are, date or file5
If 9o. do not !a7e a &a,6.p of 9o.r 5oft'are and data, 'e ,an pro7ide 9o.
'it! o.r data &a,6.p 5er7i,e at an additional ,o5t( 2o'e7er, 'e ,annot
g.arantee t!e integrit9 of t!e data '!en &a,6ing .p(
Confi"entiality
@*.5ine55 Na-eA agree5 not to di5,lo5e an9 and all infor-ation or data
file5 5.pplied 'it!, 5tored on, or re,o7ered fro- ,lientJ5 eE.ip-ent eF,ept
to e-plo9ee5 or agent5 of @*.5ine55 Na-eA 5.&Be,t to ,onfidentialit9
agree-ent5 or a5 reE.ired &9 la'(
#pgra"es
@*.5ine55 Na-eA ,an 5.ppl9 -an.fa,t.rer 5pe,ifi, .pgrade5 or 5pare
part5 on reE.e5t( lea5e note !o'e7er t!at 'e ,annot g.arantee
,o-pati&ilit9 'it! 9o.r ,.rrent 595te- or ,onfig.ration( @*.5ine55 Na-eA
'ill offer 5.gge5tion5 and ad7i,e on .pgrade5 &.t i5 not lia&le for an9
,o-pati&ilit9 i55.e5(
Payment $erms
)ll 'or6 -.5t &e paid in f.ll .pon ,o-pletion of 5er7i,e( If an a-o.nt
re-ain5 delinE.ent 1K da95 after it5 i55.e date, an additional #L penalt9
'ill &e added for ea,! 'ee6 of delinE.en,9 or t!e -aFi-.- per-itted &9
la'( In ,a5e ,olle,tion pro7e5 ne,e55ar9, t!e ,lient agree5 to pa9 all fee5
in,.rred &9 t!at pro,e55(
Limite" Lia%ility
@*.5ine55 Na-eA 5!all not &e lia&le for an9 ,lai-5 regarding t!e p!95i,al
f.n,tioning of eE.ip-entI-edia or t!e ,ondition or eFi5ten,e of data on
5torage -edia 5.pplied &efore, d.ring or after 5er7i,e(
In no e7ent 'ill @*.5ine55 Na-eA &e lia&le for an9 da-age to t!e
laptopIde56topIeE.ip-ent, lo55 of data, lo55 of re7en.e or profit5, or an9
5pe,ial, in,idental, ,ontingent, or ,on5eE.ential da-age5, !o'e7er
,a.5ed, &efore, d.ring or after 5er7i,e e7en if @*.5ine55 Na-eA !a5 &een
ad7i5ed of t!e po55i&ilit9 of da-age5 or lo55 to per5on5 or propert9(
@*.5ine55 Na-eA lia&ilit9 of an9 6ind 'it! re5pe,t to t!e 5er7i,e5,
in,l.ding an9 negligen,e on it5 part, 5!all &e li-ited to t!e ,ontra,t pri,e
for t!e 5er7i,e5(
T!e ,lient and @*.5ine55 Na-eA agree t!at t!e 5ole and eF,l.5i7e
re-ed9 for .n5ati5fa,tor9 'or6 or data 5!all &e, at @*.5ine55 Na-eAH5
option, additional atte-pt5 &9 @*.5ine55 Na-eA to re,o7er 5ati5fa,tor9
data or ref.nd of t!e a-o.nt paid &9 t!e ,lient( T!e partie5 a,6no'ledge
t!at t!e pri,e of @*.5ine55 Na-eA 5er7i,e5 'o.ld &e -.,! greater if
@*.5ine55 Na-eA .ndertoo6 -ore eFten5i7e lia&ilit9(
T!e ,lient i5 a'are of t!e in!erent ri565 of inB.r9 and propert9 da-age
in7ol7ed in laptopIde56top repair, in,l.ding 'it!o.t li-itation, ri565 d.e to
de5tr.,tion or da-age to t!e -a,!ine, -edia, or data and ina&ilit9 to
repair t!e -a,!ine or re,o7er data, in,l.ding t!o5e t!at -a9 re5.lt fro-
t!e negligen,e of @*.5ine55 Na-eA, and a55.-e5 an9 and all 6no'n
ri565 of inB.r9 and propert9 da-age t!at -a9 re5.lt5(
SIGN)T:RE" 1)TE"
age 2 of 2