Germ Shields and Connectors
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Portland Safe Inc. - Equipment Repair Request Form
Please fill out the form as completely as possible. If you need a more immediate response or this is an emergency please call : 207-358-4000 - Items mark with a * are required
Thank you for filling out our form! We will be in contact with you shortly.
Company Name *
Contact Name *
Email Address *
Phone Number * - must be in the following format "XXX-XXX-XXX" including dashes
Please provide a short description of your repair issue