pb heat, llc boiler program guide - peerless® boilers

Peerless® Boiler

ESA Program Guide

Welcome to the Peerless® Boiler ESA Program!

The Peerless® Boiler ESA Program was specifically designed to help protect your commercial

and residential customers after the original factory warranty expires. The Extended Service

Agreement (ESA) provides PARTS ONLY or PARTS and LABOR coverage for:

Residential Equipment

o New equipment – coverage up to 5 or 10 years after installation.

o Equipment is considered “new” up to 1 year after installation and is eligible

for Extended Warranty Coverage during that time.

Commercial Equipment

o New equipment – coverage up to 5 years after installation.

o Equipment is considered “new” up to 6 months after installation and is

eligible for Extended Warranty Coverage during that time.

The coverage start date is the 91st day after the purchase date or installation date, whichever is

later. The coverage end date is either 5 or 10 years (based on the coverage chosen) from the

installation date.

The Extended Service Agreement makes the “perfect marketing tool” because you can:

Generate additional income from sales from existing customers.

Lock in your customers for future services & maintenance agreements.

When you offer a customer an ESA, 65% of the time they will say yes!

Dealer Enrollment

You need to enroll in the program to sell ESAs to your customers. To sign up for the Peerless®

Boiler Program, the following documents are required:

The enclosed enrollment form

Certificate of Insurance (COI) and workers’ compensation (COI must list Trinity

Warranty as the certificate holder)

A completed W-9 form

Submit the following documents to Trinity Warranty Solutions via:

Email: [email protected] (preferred since it is time-stamped/documented)

Fax: 312-445-8726

Mail: 150 Pierce Road, Suite 600, Itasca, IL 60143 Upon receipt of your completed enrollment application and the required documents, we will send you a welcome email with your Trinity account number.

Orders

Our coverage is inclusive of the manufacturer’s warranty. All exclusions in the manufacturer’s

warranty apply to the extended warranty. Your labor rate is $100 per hour. You will also

receive one (1) $100/hour trip reimbursement and a process allowance (PA) for parts in- or out-

of-warranty.

The price sheet includes the order codes for the following coverages:

1) 5 Year Parts Only

2) 10 Year Parts Only

3) 5 Year Parts and Labor

4) 10 Year Parts and Labor (Residential Only)

The following models receive FREE 1-year parts and labor coverage when the equipment is registered (parts from PB Heat, LLC and labor from Trinity Warranty; labor coverage to begin on the 91st day). RESIDENTIAL BOILERS - Peerless® PureFire® Residential Series, PFW Series, Cast 92-2, PBC Combi Series COMMERCIAL BOILERS - Peerless® PureFire® Commercial Series, PFW Series, Cast 92-4

mailto:[email protected]

After you submit the order, we will send you the Extended Service Agreement (ESA) listing you

as the servicer of record. The ESA includes the equipment and equipment owner’s information,

as well as the coverage start and end dates. You can forward the ESA to the equipment owner

and keep a copy for your files.

An “A”-Rated insurance company backs the ESA to ensure the equipment owner is covered

throughout the terms of the agreement. Trinity Warranty administers the ESAs. Terms and

Conditions may have slight variations by state.

How to Sell the Extended Service Agreement (ESA) Successfully

There are several ways to sell ESAs to your customer both successfully and profitably. Here are some of our suggestions:

1. Offer the ESA at the point of every sale for new equipment. 2. Wrap the cost of the ESA within the equipment cost and use it as a selling feature of the

equipment. 3. Sell the ESA as an add-on, like an accessory. 4. Use an ESA as a ‘Good/Better/Best’ selling aid with the type of equipment that you are

selling.

Claims

We prefer you submit claims via email ([email protected]), since email is time-stamped and

documented. You also may submit claims via fax (312-445-8726).

We pay a flat rate for diagnosis and travel time to the jobsite at $100. We pay for one technician only;

listed rates have been adjusted to account for two technicians where applicable. We use the schedule

below as a guide for paying labor.

mailto:[email protected]

Peerless Boilers Residential Pricing

Parts and Labor

Model5 Year

Order Code

5 Year

Parts & Labor

10 Year

Order Code

10 Year

Parts & LaborModel

5 Year

Order Code

5 Year

Parts & Labor

10 Year

Order Code

10 Year

Parts & Labor

63-03 UPNAPC $262.33 UP464F $539.94 MIHII-04 UPNAPC $262.33 UP464F $539.94

63-03L UPNAPC $262.33 UP464F $539.94 MIHII-05 UPNAPC $262.33 UP464F $539.94

63-04 UPNAPC $262.33 UP464F $539.94 MIHII-06 UPNAPC $262.33 UP464F $539.94

63-04L UPNAPC $262.33 UP464F $539.94 PBC-34 UPAAM9 $278.59 UP66P3 $626.82

63-05 UPNAPC $262.33 UP464F $539.94 PBC-40 UPAAM9 $278.59 UP66P3 $626.82

63-05L UPNAPC $262.33 UP464F $539.94 PBC-52 UPAAM9 $278.59 UP66P3 $626.82

63-06 UPNAPC $262.33 UP464F $539.94 PF-110 UPPMWY $268.85 UPHNP9 $592.78

64-07 UPNAPC $262.33 UP464F $539.94 PF-140 UPPMWY $268.85 UPHNP9 $592.78

92-2 UPPMWY $268.85 UPHNP9 $592.78 PF-200 UPPMWY $268.85 UPHNP9 $592.78

DE-03 UPNAPC $262.33 UP464F $539.94 PF-210 UPPMWY $268.85 UPHNP9 $592.78



DE-06 UPNAPC $262.33 UP464F $539.94 PP-120 UXCCFW $79.06 UX6RNW $122.19

EC/ECT-03 UPNAPC $262.33 UP464F $539.94 PP-30-LB UXCCFW $79.06 UX6RNW $122.19

EC/ECT-04 UPNAPC $262.33 UP464F $539.94 PP-40 UXCCFW $79.06 UX6RNW $122.19



GM-05 UPNAPC $262.33 UP464F $539.94 PSCII-03 UPNAPC $262.33 UP464F $539.94




MI-03 UPNAPC $262.33 UP464F $539.94 PV-120 UXCCFW $79.06 UX6RNW $122.19




MI-07 UPNAPC $262.33 UP464F $539.94 WB90-03 UPPMWY $280.93 UPA3H3 $620.01

MI-08 UPNAPC $262.33 UP464F $539.94 WB90-04 UPPMWY $280.93 UPA3H3 $620.01

MI-09 UPNAPC $262.33 UP464F $539.94 WBV-03 UPNAPC $262.33 UP464F $539.94

MI85-03 UPNAPC $262.33 UP464F $539.94 WBV-04 UPNAPC $262.33 UP464F $539.94

MI85-04 UPNAPC $262.33 UP464F $539.94 WV-05 UPNAPC $262.33 UP464F $539.94

MI85-05 UPNAPC $262.33 UP464F $539.94 WV-DV-03 UPNAPC $262.33 UP464F $539.94

MI85-06 UPNAPC $262.33 UP464F $539.94 WV-DV-04 UPNAPC $262.33 UP464F $539.94

MIHII-03 UPNAPC $262.33 UP464F $539.94

Labor: $100/Hour, $100 Trip, $35 PA

5/31/2018

Peerless Boilers Residential Pricing

Parts Only

Model5 Year Order

Code

5 Year

Parts Only

10 Year Order

Code

10 Year

Parts OnlyModel

5 Year Order

Code

5 Year

Parts Only

10 Year Order

Code

10 Year

Parts Only

63-03 UXRE66 $34.94 UXYAYR $70.65 MI85-03 UXRE66 $34.94 UXYAYR $70.65

63-03L UXRE66 $34.94 UXYAYR $70.65 MI85-04 UXRE66 $34.94 UXYAYR $70.65

63-04 UXRE66 $34.94 UXYAYR $70.65 MI85-05 UXRE66 $34.94 UXYAYR $70.65

63-04L UXRE66 $34.94 UXYAYR $70.65 MI85-06 UXRE66 $34.94 UXYAYR $70.65

63-05 UXRE66 $34.94 UXYAYR $70.65 MIHII-03 UXRE66 $34.94 UXYAYR $70.65

63-05L UXRE66 $34.94 UXYAYR $70.65 MIHII-04 UXRE66 $34.94 UXYAYR $70.65



92-2 UXE4R9 $43.54 UXWR74 $89.98 PBC-34 UX94HH $49.33 UXY9AN $99.95

DE-03 UXRE66 $34.94 UXYAYR $70.65 PBC-40 UX94HH $49.33 UXY9AN $99.95

DE-04 UXRE66 $34.94 UXYAYR $70.65 PBC-52 UX94HH $49.33 UXY9AN $99.95

DE-05 UXRE66 $34.94 UXYAYR $70.65 PF-110 UXE4R9 $43.54 UXWR74 $89.98

DE-06 UXRE66 $34.94 UXYAYR $70.65 PF-140 UXE4R9 $43.54 UXWR74 $89.98

EC/ECT-03 UXRE66 $34.94 UXYAYR $70.65 PF-200 UXE4R9 $43.54 UXWR74 $89.98




GM-05 UXRE66 $34.94 UXYAYR $70.65 PSCII-03 UXRE66 $34.94 UXYAYR $70.65




MI-03 UXRE66 $34.94 UXYAYR $70.65 WB90-03 UXE4R9 $43.54 UXWR74 $89.98

MI-04 UXRE66 $34.94 UXYAYR $70.65 WB90-04 UXE4R9 $43.54 UXWR74 $89.98

MI-05 UXRE66 $34.94 UXYAYR $70.65 WBV-03 UXRE66 $34.94 UXYAYR $70.65

MI-06 UXRE66 $34.94 UXYAYR $70.65 WBV-04 UXRE66 $34.94 UXYAYR $70.65

MI-07 UXRE66 $34.94 UXYAYR $70.65 WV-05 UXRE66 $34.94 UXYAYR $70.65

MI-08 UXRE66 $34.94 UXYAYR $70.65 WV-DV-03 UXRE66 $34.94 UXYAYR $70.65

MI-09 UXRE66 $34.94 UXYAYR $70.65 WV-DV-04 UXRE66 $34.94 UXYAYR $70.65

5/31/2018

Peerless Boilers Commercial Pricing

Parts and Labor

Model5 Year

Order Code

5 Year

Parts & LaborModel

5 Year

Order Code

5 Year

Parts & Labor

211A-04 UPFY9F $611.09 LC-11 UP9MWF $1,278.17

211A-05 UPRCKC $677.33 LC-12 UP9MWF $1,278.17

211A-06 UP9YWH $840.58 LC-13 UP9MWF $1,278.17

211A-07 UP9YWH $840.58 LC-14 UP9MWF $1,278.17

211A-08 UPAPFP $1,045.18 PF-300 UPAEEH $441.31

211A-09 UPAPFP $1,045.18 PF-399 UPEKH4 $529.28

211A-10 UPAPFP $1,045.18 PF-460 UPEKH4 $529.28

211A-11 UP9MWF $1,278.17 PFC-1000 UP77R6 $728.47

211A-12 UP9MWF $1,278.17 PFC-1500 UPM7EE $906.55

211A-13 UP9MWF $1,278.17 PFC-850 UP77R6 $728.47

211A-14 UP9MWF $1,278.17 SC/SCT-05 UPFY9F $611.09

64-08 UPFY9F $611.09 SC/SCT-06 UPFY9F $611.09

64-09 UPFY9F $611.09 SC/SCT-07 UPFY9F $611.09

64-10 UPFY9F $611.09 SC/SCT-08 UPRCKC $677.33

64-11 UPFY9F $611.09 SC/SCT-09 UPRCKC $677.33

64-12 UPRCKC $677.33 SC/SCT-10 UPRCKC $677.33

92-4 UPEKH4 $529.28 TCII-04 UPRCKC $677.33

LC-04 UPRCKC $677.33 TCII-05 UP9YWH $840.58

LC-05 UPRCKC $677.33 TCII-06 UPAPFP $1,045.18

LC-05R UPRCKC $677.33 TCII-07 UPAPFP $1,045.18

LC-06 UP9YWH $840.58 TCII-08 UP9MWF $1,278.17

LC-07 UPAPFP $1,045.18 TCII-09 UP9MWF $1,278.17



LC-10 UP9MWF $1,278.17

Labor: $100/Hour, $100 Trip, Tiered PA

5/31/2018

Peerless Boilers Commercial Pricing

Parts Only

Model5 Year

Order Code

5 Year

Parts Only

10 Year Order

Code

10 Year

Parts OnlyModel

5 Year

Order Code

5 Year

Parts Only

10 Year Order

Code

10 Year

Parts Only

211A-04 UXRF4W $185.73 UXP4P4 $412.47 GM-08 UX4PAA $176.87 UX4EF9 $397.95

211A-05 UXE7W7 $238.14 UXKEAP $535.81 LC-04 UXRF4W $185.73 UXP4P4 $412.47

211A-06 UXE7W7 $238.14 UXKEAP $535.81 LC-05 UXE7W7 $238.14 UXKEAP $535.81

211A-07 UXFNHH $373.91 UX9C3C $841.29 LC-05R UXE7W7 $238.14 UXKEAP $535.81

211A-08 UXFNHH $373.91 UX9C3C $841.29 LC-06 UXE7W7 $238.14 UXKEAP $535.81

211A-09 UX6NCX $603.98 UXFPYE $1,358.94 LC-07 UXFNHH $373.91 UX9C3C $841.29

211A-10 UX6NCX $603.98 UXFPYE $1,358.94 LC-08 UXFNHH $373.91 UX9C3C $841.29

211A-11 UX6NCX $603.98 UXFPYE $1,358.94 LC-09 UX6NCX $603.98 UXFPYE $1,358.94

211A-12 UX6M76 $806.55 UXPKYK $1,814.74 LC-10 UX6M76 $806.55 UXPKYK $1,814.74

211A-13 UX6M76 $806.55 UXPKYK $1,814.74 LC-11 UX6NCX $603.98 UXFPYE $1,358.94

211A-14 UX6M76 $806.55 UXPKYK $1,814.74 LC-12 UX6M76 $806.55 UXPKYK $1,814.74

64-07 UX4PAA $176.87 UX4EF9 $397.95 LC-13 UX6M76 $806.55 UXPKYK $1,814.74

64-08 UX4PAA $176.87 UX4EF9 $397.95 LC-14 UX6M76 $806.55 UXPKYK $1,814.74

64-09 UX4PAA $176.87 UXRKY9 $6,253.52 PFC-1000 UXE7W7 $238.14 UXE7W7 $535.81

64-10 UX4PAA $176.87 UX4EF9 $397.95 PFC-850 UXE7W7 $238.14 UXKEAP $535.81

64-11 UX4PAA $176.87 UX4EF9 $397.95 SC/SCT-05 UX4PAA $176.87 UX4EF9 $397.95

64-12 UXRF4W $185.73 UXP4P4 $412.47 SC/SCT-06 UX4PAA $176.87 UX4EF9 $397.95

CC-03 UX4PAA $176.87 UX4EF9 $397.95 SC/SCT-07 UXRF4W $185.73 UX4EF9 $397.95

CC-04 UX4PAA $176.87 UX4EF9 $397.95 SC/SCT-08 UXRF4W $185.73 UXP4P4 $412.47

CC-05 UXRF4W $185.73 UXKEAP $535.81 SC/SCT-09 UXRF4W $185.73 UXP4P4 $412.47

CC-06 UXE7W7 $238.14 UXKEAP $535.81 SC/SCT-10 UXE7W7 $238.14 UXKEAP $535.81

CC-07 UXFNHH $373.91 UX9C3C $841.29 TCII-04 UXFNHH $373.91 UX9C3C $841.29

CC-08 UXFNHH $373.91 UX9C3C $841.29 TCII-05 UXFNHH $373.91 UX9C3C $841.29

CC-09 UX6NCX $603.98 UXFPYE $1,358.94 TCII-06 UX6NCX $603.98 UXFPYE $1,358.94

CC-10 UX6NCX $603.98 UXFPYE $1,358.94 TCII-07 UX6NCX $603.98 UXFPYE $1,358.94

CC-11 UX6NCX $603.98 UXFPYE $1,358.94 TCII-08 UXFNHH $373.91 UX9C3C $841.29

CC-12 UX6NCX $603.98 UXFPYE $1,358.94 TCII-09 UX6M76 $806.55 UXPKYK $1,814.74

EC/ECT-06 UX4PAA $176.87 UX4EF9 $397.95 TCII-10 UX6M76 $806.55 UXPKYK $1,814.74

GM-07 UX4PAA $176.87 UX4EF9 $397.95 TCII-11 UX7KY9 $2,109.80 UXPNRY $4,747.05

5/31/2018

Peerless Boilers Accessory Pricing

Accessory5 Year

Order Code

5 Year

Parts & Labor

10 Year

Order Code

10 Year

Parts & Labor

Automatic feeder UPM4YH $28.75 UPCXNW $57.50

Manual Reset Aquastat UPACAW $28.75 UPK4PC $57.50

Immersion Aquastat UPEW4H $28.75 UPWY49 $57.50

Strap On Aquastat UPFPW3 $28.75 UPEY77 $57.50

Back Flow Prevention Valve UP4NCW $28.75 UPKXXY $57.50

Relays UPFK44 $28.75 UPE7RN $57.50

Expansion Tank UPF7MX $28.75 UP4KH9 $57.50

Low water cutoff UPY3P7 $28.75 UP6FX4 $57.50

Transformers UPAANW $28.75 UP764K $57.50

Manual reset pressuretrol UPHE3K $28.75 UPPRN7 $57.50

Zone Valves UPCK66 $43.13 UPA767 $86.25

Circulator <= 1 HP UPHH6N $57.50 UP6YW9 $115.00

Programmable T/Stat UPEFPF $28.75 UP4AKN $71.88

SWG Power Ventilator UPA4FC $57.50 UPNMEK $93.44

Side Shot sidewall power Venter UP4PMY $86.25 UPWAE3 $165.31

Tekmark Zone Control 367 UPMPEW $86.25 UPHKH9 $165.31

Labor: $100/Hour, $100 Trip, $35 PA

5/31/2018

Reimbursement Schedule

Boiler Reimbursement Guidelines Hours

Residential Hours

Commercial

Aquastat 1.0 1.5

Boiler reset control with circulator relay and low water cut-off 1.5 2.5

Boiler Pumps (circulator) 2.5 3.5

Gas Burners 1.0 1.5

Cad Cell 1.0 1.5

Pressure /temperature gauge 1.0 1.5

Expansion Tank 2.5 3.5

Fan & Limit Control 1.5 2.5

Main control or ignition module 1.0 1.5

Relay 1.0 1.5

Flame Sensor 1.0 1.5

System sensor 1.0 1.5

Flue Damper 1.0 1.5

Fuel Pump – oil system 1.0 1.5

Gas Valve 1.5 2.5

Outdoor Sensor 1.5 2.0

Igniter– spark ignition (electrode) non-sealed combustion 1.0 1.5

Igniter – spark ignition (electrode) sealed combustion 1.5 2.5

Inducer fan 1.0 1.5

Blower 1.5 2.5

Flame roll out or Spill switch 1.0 1.5

Misc. Internal Wiring or Harness 1.0 1.5

Pressure Switch 1.0 1.5

Primary Heat Exchanger 6.0 8.0

Selector Switch 1.5 1.5

Pilot assembly 1.0 1.5

Transformer 1.0 1.5

Pressure relief valve 1.0 1.5

Tankless coil 1.5 2.5

Commercial Process Allowance:

$1.00 - $49.99 = $15

$50.00 - $149.99 = $35

$150 - $249.99 = $50

$250 and Up = $75

Residential Process Allowance: $35

Labor: $100/Hr

1 Hour Trip Charge @$100.00

91st day start on labor

Invoices will be required to validate the cost of parts. We will reimburse out-of warranty parts at your

cost, plus a process allowance. In-warranty parts only receive a process allowance. See the specifics

concerning exclusions listed in the terms and conditions of the ESA. Residential equipment is considered

single-family dwelling/condominium/ Apartments.

Once you submit your correctly completed claim, we will process a check for you within 30 days.

Multiple Repairs Multiple Repair codes allow the highest cost repair to be applied first at 100%, the second repair at 75%,

and any additional repairs on the same ticket at 50% of the applicable repair code.

What is excluded under this Extended Service Plan (including, but not limited to):

1. All exclusions in the manufacturer’s warranty apply to the extended warranty. 2. Costs of normal maintenance (i.e. tune-ups, associated part(s), adjustments, filters, installation and

start-up). 3. Any failure caused by lack of maintenance. 4. Overtime, holiday, or emergency labor. 5. Overnight freight cost for replacement part(s). 6. Belts are only covered if damaged by another failure. 7. Cabinets, latches, hinges or any non-electrical/mechanical parts. 8. Acts of God/Environmental conditions (flooding, storms, lightning, etc.).

Remember, this plan is not a maintenance agreement; it is for mechanical breakdowns only, therefore no adjustments or resets are covered.

Transfer of Agreement

The agreement is transferable for only $30.00. The equipment owner can simply fill out the enclosed

form with a check and submit it to Trinity Warranty. Service calls are not covered unless the transfer has

been initiated and processed.

Cancellation

You may cancel this Plan at any time. If this Plan is canceled before the 31st

day after the purchase date:

1. You will be refunded the full purchase price of the Plan, decreased by the amount of any claims paid under the Plan; and No cancellation fee will be imposed.

If this Plan is canceled on or after the 31st

day of the purchase date: 1. You will be refunded the prorated purchase price of the Plan based on the time remaining

(calculated in months) less a decrease by the amount of any services or claims that have been provided or paid under this Extended Service Plan.

2. A cancellation fee will be imposed in the amount of $50.

Business Name: Date:

Address:

City: State: Zip:

Primary Contact: Phone Number:

Fax Number: Cell Number:

E-Mail Address:

Signature Date

Printed Name Title

PEERLESS BOILER DEALER SIGN-UP FORM

PLEASE PRINT OR TYPE

The parties agree that upon execution of the Dealer Sign-Up Form (“Dealer Agreement”) by Trinity Warranty (“Trinity”), Dealer shall be

authorized to offer the Trinity Extended Service Agreement (“ESA”) for sale to its customers subject to the following conditions.

1 Dealer shall pay Trinity for Extended Service Agreement (ESA) within net 30 days from the date of invoice from Trinity. 2 Dealer shall submit order with equipment owner information (name, address, and equipment information) to Trinity for processing. 3 Dealer shall notify each holder of an ESA that the ESA is not valid until the ESA is paid for in full by the Dealer. 4 When the ESA has been processed and is returned to the Dealer, it is the responsibility of the Dealer to verify the accuracy of the information on the ESA. If there is a discrepancy, the Dealer is to notify Trinity immediately. Failure to notify Trinity may negate coverage in the future. 5 Dealer agrees to verify coverage (including but not limited to coverage dates and covered equipment) on the ESA prior to initiating any repairs. 6 Claims submitted to Trinity by the Dealer shall represent services actually performed by the Dealer on the equipment listed on the Trinity ESA. 7 Dealer shall have the right to refuse any service calls. 8. There is no overtime or holiday rate. There is only one (1) person per job allowed unless previously approved by Trinity Warranty.

9. Dealer shall guarantee labor for 90 days on all repairs performed within the terms of the ESA. 10. Any use of the Trinity Warranty name in any sales or marketing program (including, but not limited to, direct mailing, brochures, or advertisements) must first have written approval from Trinity. 11. Any ESA sold by the Dealer to equipment owner remains your customer to service as long as the Dealer remains in business or in the event that Trinity discovers fraud or misrepresentations on the part of the Dealer.

12. In the event that Trinity discovers fraud or

misrepresentation on the part of the Dealer, Trinity shall promptly

notify the Dealer of its evidence and findings. Upon notice, Trinity

may take such actions as reasonable and necessary including, but

not limited to, requiring the dealer to immediately terminate

offering the Trinity Warranty, conduct an accounting review of the

Dealer’s records, or terminate this Dealer Agreement.

Any written modification to the information listed above shall not be effective or accepted without prior written consent of Trinity Warranty. To complete your enrollment, please include the following with your completed information:

• W-9 Form • Certificate of Insurance showing General Liability (state minimum is required) and Workers’ Compensation • Trinity Warranty must be listed as a certificate holder

Your completed form may be submitted via email to [email protected] or fax to 312-445-8726.

I have read the above conditions that apply to this form.

TRINITY WARRANTY • 150 Pierce Road • Suite 600 • Itasca, IL 60143 • [T] 877-302-5072 • [F] 312-445-8726

PEERLESS BOILER DEALER ORDER FORM

Contractor Name

Contractor No.

Equipment Owner

Dealer Purchase Order No. GL Purchase Order No.

Address

Phone Number

City

State Zip Code

Date Installed (Install Date required for processing)

Agreement Charge (Amount paid by the consumer and only required in some states)

LIST EQUIPMENT TO BE COVERED

Equipment Type

Brand Equipment Type

Brand

Model No.

Model No.

Serial No.

Serial No.

Size

Order Code Size

Order Code

LIST OEM WARRANTY – IN YEARS LIST OEM WARRANTY – IN YEARS

PARTS HEAT EXCHANGER OTHER PARTS HEAT EXCHANGER OTHER

Equipment Type

Brand Equipment Type Brand

Model No.

Model No.

Serial No.

Serial No.

Size

Order Code Size

Order Code



Equipment Type

Brand Equipment Type

Brand

Model No.

Model No.

Serial No.

Serial No.

Size

Order Code Size

Order Code



Please complete this form and send it to [email protected]. Trinity Warranty, 150 Pierce Road, Suite 600, Itasca, IL 60143 | Tel: 877-302-5072 | Fax 312-445-8726

Please complete and submit this form, along with the company repair work order/invoice with customer signature and receipts for parts to Trinity

Warranty via e-mail, fax or mail. All claims and invoices must be submitted within 60 days of the failure date to be considered for payment. Customer Name

Submission Date

Address

City

State Zip Code

Phone

Agreement No.

Dealer Name

Address

City

State Zip Code

Phone

Fax.

Dealer No.

Email Address

Complaint

Equipment Model No.

Equipment Serial No.

Service Date

Install Date

REPAIR / LABOR DESCRIPTION HOURLY RATE NUMBER OF HOURS LABOR TOTAL

PARTS DESCRIPTION QUANTITY COST PROCESS ALLOWANCE PARTS TOTAL

Parts are inclusive of OEM Warranty. With companion repairs, the primary repair is reimbursed at 100%, the secondary at 75%, and any additional repairs at 50%. Residential Process Allowance: $35 Commercial Process Allowance: $1.00 - $49.99 = $15 $50.00 - $149.99 = $35 $150 - $249.99 = $50 $250 and Up = $75

Send Completed Claim to: Trinity Warranty Solutions 150 Pierce Road, Suite 600 Itasca, IL 60143 Tel 877-302-5072 Fax 312-445-8726 Email Completed Claim to: [email protected]

Labor Total

Process Allowance

Parts Total

Tax __________% (if applicable)

Total

PEERLESS BOILER CLAIM FORM

pb heat, llc boiler program guide - peerless® boilers

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