Model Number
Serial Number

*Facility Name

*Contact First Name

*Contact Last Name

*Street Address

Street Address 2



*Postal Code



*Phone Number

*For Commercial Owners and Property Managers Only: You may use qualified onsite maintenance personnel to perform the inspection and repair. Alternatively, you may use your regular equipment service provider to perform this work, in accordance with the pre-determined fee schedule. If you do not have qualified maintenance personnel or service provider Goodman will arrange for this inspection and replacement to be performed by a service contractor. At apartment buildings, property managers are responsible for identifying the apartments where the affected air handlers are located. Do you require Goodman to send a technician?