Request for Service

Bortek welcomes your questions, comments and feedback. For our customers located within DE, MD, NJ, NY, OH, PA, and WV, please complete the form below for a response within 2-4 business hours. Customers outside the above noted states will be addressed within 48 hours. Your personal information is protected by our privacy policy.

* Denotes a required field.

Customer Information

Company Name *

Your Name *

Email Address *

Address*

City *

State *

Zip *

Phone *

How quickly do you need service? *

When would be the best time for service?

Does your service address differ from your company address? Yes No

Unit Information #1

Unit Type *

Manufacturer

Model Number

Service Needed:

PM Service Estimate Repair Machine is Down

Do you need additional units serviced? Yes No