{"id":541,"date":"2014-10-14T04:08:03","date_gmt":"2014-10-14T10:08:03","guid":{"rendered":"http:\/\/apexequipmentltd.com\/?page_id=541"},"modified":"2022-12-13T01:47:31","modified_gmt":"2022-12-13T08:47:31","slug":"request-service","status":"publish","type":"page","link":"https:\/\/www.apexequipmentltd.com\/?page_id=541","title":{"rendered":"Request For Service"},"content":{"rendered":"<p>Please fill out the form below for your repair and maintenance requests and we will get back to you as soon as we can.<\/p>\n<div class=\"content-white\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f628-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"628\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F541#wpcf7-f628-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"628\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f628-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7dtx_version\" value=\"5.0.5\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<div class=\"row\">\n\t<aside class=\"col-sm-6\">\n\t\t<p><label for=\"email\">Your Email Address <span class=\"text-danger\">*<\/span><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" id=\"email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email\" \/><\/span>\n\t\t<\/p>\n\t<\/aside>\n<\/div>\n<div class=\"row\">\n\t<aside class=\"col-sm-6\">\n\t\t<p><label for=\"custName\">Name of Company <span class=\"text-danger\">*<\/span><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"custName\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"custName\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"custName\" \/><\/span>\n\t\t<\/p>\n\t<\/aside>\n\t<aside class=\"col-sm-6\">\n\t\t<p><label for=\"addr\">Address <span class=\"text-danger\">*<\/span><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"addr\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"addr\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"addr\" \/><\/span>\n\t\t<\/p>\n\t<\/aside>\n<\/div>\n<div class=\"row\">\n\t<aside class=\"col-sm-6\">\n\t\t<p><label for=\"contact\">Contact<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"contact\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"contact\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"contact\" \/><\/span>\n\t\t<\/p>\n\t<\/aside>\n\t<aside class=\"col-sm-6\">\n\t\t<p><label for=\"city\">City <span class=\"text-danger\">*<\/span><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"city\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"city\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"city\" \/><\/span>\n\t\t<\/p>\n\t<\/aside>\n<\/div>\n<div class=\"row\">\n\t<aside class=\"col-sm-6\">\n\t\t<p><label for=\"phoneNum\">Phone Number <span class=\"text-danger\">*<\/span><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"phoneNum\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" id=\"phoneNum\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"phoneNum\" \/><\/span>\n\t\t<\/p>\n\t<\/aside>\n\t<aside class=\"col-sm-6\">\n\t\t<p><label for=\"province\">Province\/State <span class=\"text-danger\">*<\/span><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"province\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"province\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"province\" \/><\/span>\n\t\t<\/p>\n\t<\/aside>\n<\/div>\n<div class=\"service-form\" style=\"background-color: #fc0;\">\n\t<div class=\"row\">\n\t\t<aside class=\"col-sm-4\">\n\t\t\t<p><label>Manufacturer<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"manufacturer1\"><select class=\"wpcf7-form-control wpcf7-select\" id=\"manufacturer1\" aria-invalid=\"false\" name=\"manufacturer1\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"All Prime Pumps\">All Prime Pumps<\/option><option value=\"ARGAL\">ARGAL<\/option><option value=\"ARI Valve Company\">ARI Valve Company<\/option><option value=\"Atlantic (AGI)\">Atlantic (AGI)<\/option><option value=\"Coreau\">Coreau<\/option><option value=\"Dickow Pump Company\">Dickow Pump Company<\/option><option value=\"Enviropump\">Enviropump<\/option><option value=\"IKA\">IKA<\/option><option value=\"Liberty Process\">Liberty Process<\/option><option value=\"Northern-Pump\">Northern-Pump<\/option><option value=\"OMG\">OMG<\/option><option value=\"Peroni Pompe\">Peroni Pompe<\/option><option value=\"Roth Pump\">Roth Pump<\/option><option value=\"Rotomac\">Rotomac<\/option><option value=\"Tapflo\">Tapflo<\/option><option value=\"Teikoku\/Chempump\">Teikoku\/Chempump<\/option><option value=\"Torishima\">Torishima<\/option><option value=\"Vanton\">Vanton<\/option><option value=\"ZUWA Germany\">ZUWA Germany<\/option><option value=\"Other\">Other<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/aside>\n\t\t<aside class=\"col-sm-4\">\n\t\t\t<p><label>Model<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"model1\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"model1\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"model1\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/aside>\n\t\t<aside class=\"col-sm-4\">\n\t\t\t<p><label>Serial Number<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"serialnum1\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"serialnum1\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"serialnum1\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/aside>\n\t<\/div>\n\t<div class=\"row\">\n\t\t<aside class=\"col-sm-4\">\n\t\t\t<p><label>Manufacturer<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"manufacturer2\"><select class=\"wpcf7-form-control wpcf7-select\" id=\"manufacturer2\" aria-invalid=\"false\" name=\"manufacturer2\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"All Prime Pumps\">All Prime Pumps<\/option><option value=\"ARGAL\">ARGAL<\/option><option value=\"ARI Valve Company\">ARI Valve Company<\/option><option value=\"Atlantic (AGI)\">Atlantic (AGI)<\/option><option value=\"Coreau\">Coreau<\/option><option value=\"Dickow Pump Company\">Dickow Pump Company<\/option><option value=\"Enviropump\">Enviropump<\/option><option value=\"IKA\">IKA<\/option><option value=\"Liberty Process\">Liberty Process<\/option><option value=\"Maag\">Maag<\/option><option value=\"OMG\">OMG<\/option><option value=\"Peroni Pompe\">Peroni Pompe<\/option><option value=\"Roth Pump\">Roth Pump<\/option><option value=\"Rotomac\">Rotomac<\/option><option value=\"Tapflo\">Tapflo<\/option><option value=\"Teikoku\/Chempump\">Teikoku\/Chempump<\/option><option value=\"Torishima\">Torishima<\/option><option value=\"Vanton\">Vanton<\/option><option value=\"ZUWA Germany\">ZUWA Germany<\/option><option value=\"Other\">Other<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/aside>\n\t\t<aside class=\"col-sm-4\">\n\t\t\t<p><label>Model<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"model2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"model2\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"model2\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/aside>\n\t\t<aside class=\"col-sm-4\">\n\t\t\t<p><label>Serial Number<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"serialnum2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"serialnum2\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"serialnum2\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/aside>\n\t<\/div>\n\t<div class=\"row\">\n\t\t<aside class=\"col-sm-4\">\n\t\t\t<p><label>Manufacturer<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"manufacturer3\"><select class=\"wpcf7-form-control wpcf7-select\" id=\"manufacturer3\" aria-invalid=\"false\" name=\"manufacturer3\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"All Prime Pumps\">All Prime Pumps<\/option><option value=\"ARGAL\">ARGAL<\/option><option value=\"ARI Valve Company\">ARI Valve Company<\/option><option value=\"Atlantic (AGI)\">Atlantic (AGI)<\/option><option value=\"Coreau\">Coreau<\/option><option value=\"Dickow Pump Company\">Dickow Pump Company<\/option><option value=\"Enviropump\">Enviropump<\/option><option value=\"IKA\">IKA<\/option><option value=\"Liberty Process\">Liberty Process<\/option><option value=\"Maag\">Maag<\/option><option value=\"OMG\">OMG<\/option><option value=\"Peroni Pompe\">Peroni Pompe<\/option><option value=\"Roth Pump\">Roth Pump<\/option><option value=\"Rotomac\">Rotomac<\/option><option value=\"Tapflo\">Tapflo<\/option><option value=\"Teikoku\/Chempump\">Teikoku\/Chempump<\/option><option value=\"Torishima\">Torishima<\/option><option value=\"Vanton\">Vanton<\/option><option value=\"ZUWA Germany\">ZUWA Germany<\/option><option value=\"Other\">Other<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/aside>\n\t\t<aside class=\"col-sm-4\">\n\t\t\t<p><label>Model<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"model3\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"model3\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"model3\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/aside>\n\t\t<aside class=\"col-sm-4\">\n\t\t\t<p><label>Serial Number<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"serialnum3\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"serialnum3\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"serialnum3\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/aside>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<aside class=\"col-sm-6\">\n\t\t<p><label for=\"salesperson\">Salesperson<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"salesperson\"><select class=\"wpcf7-form-control wpcf7-select\" id=\"salesperson\" aria-invalid=\"false\" name=\"salesperson\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Apex Equipment\">Apex Equipment<\/option><option value=\"Original Manufacturer\">Original Manufacturer<\/option><option value=\"3rd party provider\">3rd party provider<\/option><\/select><\/span>\n\t\t<\/p>\n\t<\/aside>\n<\/div>\n<div class=\"row\">\n\t<aside class=\"col-sm-6\">\n\t\t<p><label for=\"pumpfluid\">Pumped Fluid<span class=\"text-danger\"><\/span><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"pumpfluid\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"pumpfluid\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"pumpfluid\" \/><\/span>\n\t\t<\/p>\n\t<\/aside>\n<\/div>\n<p class=\"paddingTop10\"><label for=\"reasons\">Type of service required<\/label>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"reasons\"><textarea cols=\"40\" rows=\"4\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"reasons\" aria-invalid=\"false\" name=\"reasons\"><\/textarea><\/span>\n<\/p>\n<p class=\"paddingTop20\"><label>Please check one of the following:<\/label>\n<\/p>\n<p class=\"list-checkbox\"><span class=\"wpcf7-form-control-wrap\" data-name=\"prodLine\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"prodLine[]\" value=\"Warranty\" \/><span class=\"wpcf7-list-item-label\">Warranty<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"prodLine[]\" value=\"Credit\" \/><span class=\"wpcf7-list-item-label\">Credit<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"prodLine[]\" value=\"Repair\" \/><span class=\"wpcf7-list-item-label\">Repair<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"prodLine[]\" value=\"Parts Quote\" \/><span class=\"wpcf7-list-item-label\">Parts Quote<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"prodLine[]\" value=\"Other\" \/><span class=\"wpcf7-list-item-label\">Other<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<div class=\"row\">\n\t<aside class=\"col-sm-3 col-xs-6\">\n\t\t<p><div class=\"cf7-cf-turnstile\" style=\"margin-top: 0px; margin-bottom: -15px;\"> <div id=\"cf-turnstile-cf7-1974651591\" class=\"cf-turnstile\" data-sitekey=\"0x4AAAAAABH9IJFy9O9YI0L9\" data-theme=\"light\" data-language=\"auto\" data-size=\"normal\" data-retry=\"auto\" data-retry-interval=\"1000\" 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class=\"btn-blue marginRight14\" value=\"Reset\" \/><input class=\"wpcf7-form-control wpcf7-submit has-spinner btn-blue\" type=\"submit\" value=\"Submit\" \/>\n<\/p><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"12\"\/><script>document.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p>\n<\/form>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Please fill out the form below for your repair and maintenance requests and we will get back to you as soon as we 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