Water Cooler Maintenance | Clear Arctic Springs

First Name *

Last Name *

Organization or Company *

Phone *

Extension

Email Address *

Street Address *

Apartment, suite, etc

# of Coolers for Maintenance *

Need your cooler picked up? *YesNo

Need you need a loaner? *YesNoWe provide loaner coolers free of charge for your convenience

Required Maintenance *When we take a cooler in for repair it will be cleaned as well

Reason for RepairIf you are getting a cooler repaired please let us know what part is broken or what indication there is of a repair needed. Please let us know with as much detail possible as some repairs are possible to perform on site

Preferred Date of Servicing