New Customer Form Home » New Customer Form Company Information New Customer Form Company Name * Contact Name * Phone Number Fax Number Email * Ship To: Street Address * Address Line 2 * City * State * AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code * Bill To: Same as previous Street Address * Address Line 2 * City * State * AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code * ICS Standard terms are NET 30, additional fees will apply if your company deviates from this. Name on Calibration Report: * Tax Exempt Number: * QA Requirements Checkboxes NIST Traceable Calibration NIST Traceable Calibration with Data ISO/IEC 17025 Accredited Calibration* Other QA Requirements *Calibration results will be reported without factoring in the effect of uncertainty on the assessment of compliance Please Define Other Requirements Technical Requirements Calibration Procedures: ICS selected calibration procedures. (Manufactures Manual, NAVAIR, ANSI, internally generated, or other industry accepted method based on appropriate standards used by ICS to perform required test.) Identified on calibration record. Customer supplied calibration procedure. Must be reviewed and approved prior to use. Calibration Intervals: ICS does not recommend any calibration interval but by not specifying a calibration interval above, a calibration interval of 12 months will be agreed upon. Out of Tolerance Conditions Return the gage as-is Proceed with a limited or special calibration Have us provide a quote on the replacement cost Notify you on a case-by-case basis for each gage Other Please Specify Other Shipping Requirements Carrier UPS FedEx Customer Pick-up OtherOther Service Standard 1 Day 2 Day Customer Shipping Account # Special Shipping Instructions: NOTE: Insurance on return shipments is the responsibility of the customer. Insurance is optional. If insurance is required, the customer must inform ICS in writing, and state the declared value of each piece of equipment. ICS will not be held responsible for damages incurred during shipping. Should information on this form be used for all future services performed by ICS? * Yes No Form Completed by: * Date * Equipment List Upload Drop a file here or click to upload Choose File Maximum file size: 134.22MB Accepted file types: doc, docx, xls, Max. file (Excel or Word file) Captcha If you are human, leave this field blank. Submit Start with us New customer? Contact us here. Please feel free to complete the New Customer Form. Contact Us Current customer? InstrumentCS.Live! Log in to your ICS Live! account. Request a Consultation
