
I have inspected this equipment and nd it in correct working condition. To the best of my knowledge, the customer and
his/her personnel are aware of, and agree to the above procedures.
Signed: ________________________________________________________________________ Date: ______________
(Dealer Representative)
The equipment has been thoroughly checked by the above named dealer representative, and I am satised with his/her
instructions. I have also read, understand, and agree to reverse side of page.
Signed: ________________________________________________________________________ Date: ______________
(Customer)
White-Bandit Industries, Inc. copy / Yellow-Dealer copy / Pink-Customer copy
Copyright 2/17 FORM #WV-124
WARRANTY VALIDATION FORM
(STUMP GRINDER)
PURCHASER / OWNER INFORMATION:
Company Name __________________________________________________ Contact Name ______________________________
Mailing/Street Address _____________________________________________________ City _______________________________
State ____________________ Zip Code _________ Country ___________________ Telephone Number ( ___ ) _____________
E-mail _______________________________________ Machine Model No. _____________ Date Put Into Service _____________
Machine Serial No. __________________________________ Machine Work Order No. _____________ Machine Hours _________
Engine Make ______________________________ Engine Serial No. ___________________________ Machine Color _________
DEALER / SELLER INFORMATION:
Dealer/Seller Name ________________________________________________ Contact Name _______________________________
Mailing/Street Address _____________________________________________________ City _______________________________
State ____________________ Zip Code _________ Country ___________________ Telephone Number ( ___ ) _____________
1. _____ The customer has received instruction and fully understands all operational, safety and maintenance requirements of
the equipment.
2. _____ The customer has received instruction and fully understands that everyone within 100 feet of the machine must wear
proper personal safety equipment including hard hat, face shield, safety glass, gloves, ear protection and/or other items
per OSHA and ANSI requirements.
3. _____ The customer has received instruction and fully understands the equipment maintenance schedules and procedures. The
customer understands that it is their responsibility to perform scheduled maintenance that includes periodic relief valve
adjustments,retighteningallfastenersasneeded,periodiccleaningofowdivider,clutchandbeltadjustments,and
other items.
4. _____ The customer has received instruction and fully understands not to reach near the cutter head with hands or feet or to be
locatedneardebriseldwithenginerunning.
5. _____ The customer has received instruction and fully understands that the operators must always be located within easy
reach of all control and shut down devices.
6. _____ The customer has received instruction and fully understands to not start grinding a stump without checking for power lines,
water lines, sewer lines, phone lines, etc.
7. _____ The customer has received instruction and fully understands the purpose of and how to operate the shut down/shut-off
devices, and will not attempt to override any safety devices or guards.
8. _____ The customer has received instruction and fully understands that before performing any maintenance on the machine
the ignition key must be removed, the cables must be completely disconnected from the battery, the cutter head must
have come to a complete stop, and the cutter head lock must be installed. The customer understands they must allow
the necessary time for the cutter head to come to a complete stop before opening the cutter head guard or start any
maintenance or service procedures. If applicable the customer has received instruction and fully understands the
purpose of the beltshield inspection hole and that they are never to attempt any maintenance or service procedures
untilvisuallyconrmingthebeltshavecometoacompletestop.
9. _____ The customer has received instruction and fully understands the machine is not to be operated without the factory
approved cutter head guard in place, the machine is not to be operated with any type of make shift cutter head guard,
and the machine is not to be operated under any circumstances with the cutter guard open or unsecured.
10. _____ The customer has reviewed and fully understands limited warranty, and all written and visual instructions.
11. _____ The customer has received instruction and fully understands that warranty will not apply if the machine is operated with
replacement parts or equipment not manufactured or recommended by Bandit Industries, Inc.
12. _____ The customer has received, been advised, and understands the manuals, and the Safety/Service video supplied with
the grinder. A video is supplied for equipment models as available.
13. _____ All Danger, Warning and Operational decals are properly displayed on equipment and fully understood by customer.
14. _____ The customer has been instructed, understands, and agrees that all potential operators must: See the supplied video,
be instructed on all the Danger, Warning and Operational decals, read the manual and follow the procedures.
IMPORTANT - WARRANTY WILL BE DEEMED NULL AND VOID IF THIS
FORM IS NOT FILLED OUT COMPLETELY AND ACCURATELY AND
RETURNED TO THE CUSTOMER DATA DEPARTMENT WITHIN 10 DAYS
OF EQUIPMENT DELIVERY
Customer Data Department
6750 Millbrook Road
Remus, MI, USA 49340
Phone: (800) 952-0178 in USA
Phone: (989) 561-2270
Fax: (989) 561-2273
Website: www.banditchippers.com