Unitate emitenta: ___________________

NOTA DE CONSTATARE
Denumire piesă _________________________________________________________________________________
Cod piesă _________________________________________
Marca / tip auto _________________________________________ Tip motor ______________________________
Nr. înmatriculare ________________________________________ An fabricaţie ___________________________

În data de ________________________________, kilometraj ________________________________, la autovehiculul

sus numit conform devizului de montaj nr.__________________ _________________________________s-au efectuat
următoarele operaţii: ______________________________________________________________________________
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Prelucrări mecanice conexe_________________________________________________________________________
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În data de ______________________________, kilometraj _____________________________________autovehiculul
sus numit s-a prezentat în unitatea noastră cu următoarea reclamaţie de garanţie:
________________________________________________________________________________________________
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După demontarea / analiza piesei am constatat următoarele: _______________________________________________
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Părerea noastră este: ______________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Solicităm: ________________________________________________________________________________________
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Data: Persoana care a efectuat constatarea:

Ştampila unităţii: Nume: _________________________________
Numar telefon: ___________________________
Semnătura: _____________________________

* Se completează obligatoriu toate câmpurile!

ElcarGid – Str. Transilvaniei, nr. 510, Buzău

Tel: 0238.72.33.74 | Fax: 0374.09.42.37 | Mobil: 0729.88.11.22
RO 15204785 | J10/118/2003 | IBAN RO76RZBR0000060003188579 Raiffeisen Bank Buzău
Email: office@elcargid.ro | Web: www.elcargid.ro