Work Order Customer InformationWho have you communicated to?*To better serve you, we want to find out if you have already talked to one of our computer specialists. Dallas Office Tampa Office None yet Name* First Last Company Name* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Email* ECM or CPC InformationChoose ECM or CPC Service*Choose an option for your ECM or CPC service.Choose service...ECM DiagnosticCPC DiagnosticECM RepairCPC RepairExpedited CPC RepairECM ExchangeCPC ExchangeProgramming OptionRepair OptionSelect options for ECM Repair. I understand and will accept , if my ecm unit IS NOT repairable, that I will require an Exchange unit. Save me shipping charges. If my unit is not repairable or usable as a core, DO NOT SEND IT BACK TO ME. I AM NOT willing to accept an Exchange unit if my ecm unit IS NOT repairable. Send it back to me and charge me shipping & handling. Exchange Option*Select options for ECM Exchange. I AM purchasing an Exchange unit from TruckEcm. Also, I understand that my unit will be shipped out the same day if I place my order before 2 pm . Otherwise; it will ship out the next business day. Programming Option*Select options for ECM Programming. Parameters Adjustment ECM Programming/Reprogramming Processing InformationEngine Make*Choose make...CumminsDetroit DieselCaterpillarPaccarYear* Engine Serial Number (ESN)* Engine Model Number (Ex. Detroit 6067_ _ 60) ECM or CPC Part #* VIN #* Please describe the problem with your ECM or CPC*Where did you find us?GoogleEbayReferralWebsiteOtherTerms & Conditions CUSTOMER AGREES TO THE FOLLOWING CLAUSES: • All devices received for diagnostic will have a standard minimum of $100 diagnostic fee. • All devices worked on for repair or exchange will have a minimum service cost of $200 regardless of the device been repairable or not. • There are NO REFUNDS for repairs, programming, services, or purchases done once delivered to the customer. The customer has 2 weeks to test the ECM/CPC on their truck, for final tuning or adjustments. • When purchasing an ECM or a CPC, a core of the same model must be provided. If the core is not available, a refundable core fee will be charged. For a core fee to be refunded, the core must be a REPAIRABLE core that is not burnt or damaged. • All devices left at TruckECM after 15 days become property of TruckECM. • I understand that any services rendered by TruckECM may void the original manufacturer’s warranties for the device. TruckECM does not assume, and expressly disclaims, any liability in the event that the manufacturer’s warranties are voided due to service provided by TruckECM. • TruckECM will not be held responsible for any damage from electrical repairs on the truck. Electrical/electronic parts are easily damaged by improper installation, testing, electrical short circuits, oil leaks, coolant leaks, etc. Follow instructions for proper installation of modules. • I expressly waive all claims against TruckECM for any damages to the device due to service by TruckECM which includes, but is not limited to: truck damage, towing fees, down time losses or expenses that are incidental to the service rendered by TruckECM. • I understand TruckECM warrants ECM repairs and exchanges for a period of one (1) year from the date of service. Warranty covers the ECM hardware and not the services provided such as the diagnostics or programming done. Some ECMs get damaged and are not repairable again, for what the customer is offered the option to purchase another ECM. • HEAT TREATMENT: TruckECM will not be responsible for any damages due to, or related to, heat treatment that may be required to repair your device. You are aware there is a chance that your device will not power up after the heating process and you assume all risk regarding any heat treatment service performed on your device. • The programming services delivered by TruckECM are BASIC and standard for the engine serial number provided. I understand any services rendered by TRUCK ECM may void the original manufacturer’s warranties for the device. TRUCK ECM does not assume and expressly disclaims, any liability in the event that the manufacturer’s warranties are voided due to service provided by TRUCK ECM. I expressly waive all claims against TRUCK ECM for any damages to the device due to service by TRUCK ECM which includes, but is not limited to: truck damage, towing fees, down time losses or expenses that are incidental to the service rendered by TRUCK ECM. DISCLAIMER: Warranty is neither transferrable nor redeemable and only covers ECM's under normal use. Warranty does not cover failures caused by abuse, damage from improper installation, damage from faulty truck wiring or components, external conditions (such as welding on truck, lightning, supply voltage spikes, any adverse weather conditions, etc.). TruckECM Warranty/Liability shall be limited to the cost of the ECM and does not covert labor, towing, or damages resulting from ECM failure. Not all functions of the stock ECM/CPC are tunable using the software TruckECM has available and truckecm will notify client if a certain request cannot be fulfilled. Customer is responsible for obtaining accurate scan-tool data upon request so accurate tuning of the vehicle can occur. On any mail-order customer programming where TruckECM does not have access to the customer’s truck, TruckECM cannot be held responsible for any misapplication, mis-calibration and malfunction of custom programs. TruckECM is not responsible for any other problems or faults that could exist in the customer ’s vehicle that custom programming or programmed ECM is intended to be used in. TruckECM will not be held responsible for any damage from any attempt of repairs. PLEASE NOTE: IF OUR UNIT IS SENT OUT FIRST, THE CUSTOMER IS RESPONSIBLE FOR THE PROGRAMMING OF FEATURES/PARAMETERS AS WE WILL NOT HAVE ACCESS TO THE ORIGINAL PROGRAMMING TO BE TRANSFERRED OVER TO THE NEW ECM. THERWISE; YOU, AS THE CUSTOMER, ARE RESPONSIBLE TO PROVIDE US WITH A FULL AND ACCURATE PRINT-OUT FOR YOUR TRUCK. IF THIS IS NOT PROVIDED, TRUCK ECM CAN NOT WARRANTY THAT THE PROGRAMMING WILL BE ACCURATE AND THAT THE ECM WILL WORK WITHOUT ISSUES WHEN PLACED ON THE TRUCK. IN THE CASE WHERE THE CUSTOMER WILL REQUEST CUSTOM PROGRAMMING, TRUCKECM CAN NOT BE HELD RESPONSIBLE FOR ANY MISAPPLICATION, MISCALIBRATION, AND MALFUNCTION OF CUSTOM PROGRAMS. FURTHERMORE, TRUCKECM CAN NOT BE HELD ACCOUNTABLE FOR ANY OTHER PROBLEMS OR FAULTS THAT COULD EXIST IN THE CUSTOMER’S TRUCK THAT THIS CUSTOM PROGRAMMING IS INTENDED TO BE USED IN.Electronic Signature*By checking this box you are electronically signing our work order form. I have read and agree to the terms and conditions. EmailThis field is for validation purposes and should be left unchanged.