S.W.A.T.
Services
S.W.A.T.
Services
Supporting a Wide Array of Technology
SERVICE REQUEST FORM
[email protected]
Date:
Name: ______________________________________
Company: _______________________________________
Mailing Address: _____________________________________________________________________________________
City: ____________________
State: ______
Zip: ____________
County: ____________________
Phone Number: ________________________________
Can Be Reached Number: __________________________
E-mail Address: _________________________________
Computer Administrator Password: __________________
How many people use this computer? (User Accounts)?
1
2
3
4
5+
What is the primary application that this computer will be used for? Check all that apply.
Internet Applications
Is this sytems to be used in:
Business Applications
Home
Graphics Applications
Broadband
Other: ____________
Office
What type of Internet connections do you have?
Do you use wireless networking?
Gaming Applications
Yes
Dial-Up
Satellite
No
What external peripherals are attached to this computer? Check all that apply.
Printer
Scanner
External Storage
Game Controller
MP3/iPod/Audio Device
Digital Camera
Other: _________________
What type of data is stored on this computer? Check all that apply
Games
Photos
MP3s
How long do you plan to keep this computer?
Videos
1-2 years
2-4 years
5+ years
Describe the problem(s):
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Authorized Amount (Not to Exceed): _____________________________
Initials: _____________
CITIZENS S.W.A.T. SERVICES AGREEMENT
Citizens Telephone Cooperative, Inc.’s computer technicians are bound by software licensing agreements.
To install or reinstall software, applications, or the operating system, Citizens requires proper and legal
licensing, the original manufacturer’s CD, and/or the Windows Certificate of Authenticity. By giving
consent to Citizens to install software on your computer, you are authorizing Citizens’ computer technicians
to accept the End User License Agreements on your behalf.
Citizens or its employees is in no way responsible for any data or loss thereof residing on your computer.
The customer acknowledges responsibility for backing up data before delivering the equipment to Citizens
or for including specific backup requests. FURTHERMORE, CITIZENS OR ITS TECHNICIANS
SHALL HAVE NO LIABILITY TO YOU OR ANY OTHER PERSON OR ENTITY WITH RESPECT TO
ANY LIABILITY, LOSS, DAMAGE, OR INJURY TO PERSONS OR PROPERTY CAUSED DIRECTLY
OR INDIRECTLY BY THE WORK PERFORMED.
You hereby give your consent for Citizens technicians to remove or install any software on your computer
that is needed to fix problems with your computer. If you do not have Anti-Virus or Malware protection,
a Citizens technician will notify you and install these for you upon your request or purchase thereof.
Citizens cannot guarantee to fix every computer brought in for repair. Citizens has the right to refuse
services. All labor performed by a Citizens technician is warranteed for 15 days from the original date of
pickup with proof of receipt. The labor warranty solely covers previous work performed and does not include
any new issues, should they arise.
IF YOUR COMPUTER OR ITS PARTS ARE CURRENTLY COVERED BY A MANUFACTURER’S
WARRANTY, ANY WORK PERFORMED ON YOUR COMPUTER COULD VOID THAT WARRANTY.
FOR YOUR PROTECTION PLEASE REFER TO YOUR COMPUTER’S MANUFACTURER’S WARRANTY
AGREEMENT BEFORE HAVING WORK PERFORMED ON YOUR SYSTEM BY A CITIZENS COMPUTER
REPAIR TECHNICIAN.
The customer agrees that all charges are due and payable before the equipment may be released to the
Customer. The customer agrees that Citizens may retain the equipment as security until payment is
received in full or until satisfactory payment arrangements have been made. The Customer agrees that if
the equipment is left for a period exceeding 90 days from the repair date the equipment may be sold to
recover unpaid amounts. These provisions shall not be construed to preclude any other lawful rights to
collect the full amount owed.
REPAIRS MAY TAKE LONGER THAN 24 HOURS.
By signing below, you are agreeing to the above Computer Repair Service Agreement with Citizens.
Signature: _______________________________
Date: ______________________