Republic Companies - » LUXAIRE SPIFF CLAIM

LUXAIRE SPIFF CLAIM

Dealer(Required)

Email Confirmation(Required)

Sales person(Required)

Air Conditioner / Heat Pump Model(Required)

Condenser Serial Number(Required)

Furnace / Air Handler(Required)

Furnace or AH Serial Number(Required)

Additional Equipment

Additional Equipment Serial Number

Total Spiff Amount

Have these units been registered for warranty on HVAC Navigator?(Required)

Yes

All equipment must be registered in order to qualify for spiffs.

Where was the equipment installed?

Installation Date(Required)

Homeowner Name(Required)

Installation Address(Required)

City

State

Zip Code

Comments

This field is for validation purposes and should be left unchanged.