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Personal Information

* Indicates a required field
Customer Number:
* First Name:
* Last Name:
Business (if applicable):
* Phone: e.g. 603-555-5555
Extension:
* Address:
* City:
* State: * Zip:
* Email:
* Have we serviced your computer before? Yes No
* Will the computer be serviced On-site or at Systems Plus? On-site At Systems Plus
* Would you like priority service if available? (regular priority rates will apply see below) No Yes

Please review our service rates if you have any questions.
Computer Information
Type of Computer: (Dell, Apple, HP, etc.)
* Computer Logon User name:
* Computer Logon Password:
Internet Service Provider:
ISP User name:
ISP Password:
* Operating System:
Problem you are having
ALL services are billed with 1 hour $75 minimum
(Even if no problem is found)
* Symptom of problem:
Special instructions:
Additional Information
Additional Items dropped off with computer
Power Cable/AC Adapter: Yes No
Carrying Case: Yes No
CD’s & Software: Yes No
Other:
* Is your data backed up? Yes No
Please keep in mind that Systems Plus Computers, Inc. cannot be held responsible for customers’ data. We will make every possible attempt to preserve the information that is so important to you, but please do regular backups. Don’t have a backup solution? Speak to one of our sales people, they would be happy to make recommendations!
* Is your machine under warranty? Yes No
* Did you purchase it here? Yes No
Please be aware that manufacturers’ warranties are warranties for hardware malfunctions only. These warranties do not cover viruses, OS patches, data recovery/installation or other program and software related issues.

Systems Plus Computers, Inc. is committed to providing excellent customer service, and will happily provide these software fixes and repairs to our customers at our regular billable rate.

Thank you very much for your understanding and cooperation.
Our Policy
Customer Acknowledgment and Agreement
I hereby authorize the work described above, and agree to pay for the requested service upon completion, I understand that Systems Plus Computers, Inc. will perform the requested work to the best of its ability, and that they are not liable for any damages caused by delay or other performance. The sole remedy for Systems Plus Computers, Inc. liability of any kind, including negligence, shall be limited to the reperformance of any defective service by Systems Plus Computers, Inc. and in no event include any incidental or consequential damages. I am responsible for having enough licensed copies of software for my equipment. I understand that reformatting hard drives or reloading software may result in loss of my personal data, and I should make daily backups. Furthermore, equipment left beyond 30 calendar days is considered abandoned equipment and will become property of SPCI.
Systems Plus Computers, Inc.

Centerra Park 12 Centerra Parkway, Suite 20, Lebanon, NH 03766
DRIVING DIRECTIONS
800-388-8486 | 603-643-5800 | FAX 603-643-9900
Hours: M-F 8:30-5:30 Sat 10:00-2:00 Sun Closed

Hanover 5 South Street , Hanover NH 03755
Hours: M-F 9:00-6:00 Sat 10:00-4:00 Sun Closed
© 2001-2006 Systems Plus Computers, Inc. All Rights Reserved.
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