Brown Bottling Group

Please complete the following form.  If you are unable to complete a required field, please call 1-800-209-9225 to submit your request for rapid response.  Note: Asterisk (*) denotes required information.

*Contact Name

*Company Name

Location of Equipment:

*Address

*City

*Zip

*Asset Number: (6-digit number, on label with bar code)

Sample Bar Code:

*Phone Number:

*Email Address:

Business Hours:

*Equipment Type:

Slush

Cooler

Fountain

Vendor

Other

*Problem: --Select-- CO2 Leak Machine Leaking No Power Noise Bad Taste Drain Not Working Syrup Leak Water Leak Not Freezing Not Dispensing Overflowing Freezing Up Other problem described in "Additional Instructions"

*Problem --Select-- No Power Doors Not Closing Lights Not Working Noise Not Cooling Water Leaking Other problem described in "Additional Instructions"

*Problem --Select-- Product Not Dispensing No Syrup Flat Drink - No Carbonation Product Too Warm Bad Taste No Power Water Leak Syrup Leak Drain Not Working CO2 Leak Other problem described in "Additional Instructions"

*Problem --Select-- Coin Jam No Power Not Cooling Takes Money Vending Wrong Product Will Not Accept Dollar Bills Will Not Give Change Out of Prlduct Will Not Take Coins Other problem described in "Additional Instructions"

*Other Problem:

Additional Instructions:

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