SERVICE AND REPAIR FORM – Hubert Jewelry – Fine Diamonds and Gemstones

CUSTOMER INFORMATION

Name*

First Last

Company Name

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Phone*

ITEM INFORMATION

Declared Value of the piece in US Dollars*

Description of the Item (one piece per form only)*

Description of the problem / Service to be performed*

SHIPPING & CONFIRMATION

Shipping Instructions / Shipping Address (if different)

After submitting this form, you will receive an email with a copy of the repair form attached. Please contact us if you don't. Read, print and ship such document along with the piece to be repaired following all the instructions below:

Make sure to carefully pack and protect your item in a hard paper box. Double boxing is ALWAYS recommended.
Select a shipping service that will insure your item for the amount you are declaring in the repair form.
Make sure to ship your item insured and with tracking capabilities. We recommend FEDEX or UPS overnight services, or USPS Registered and Insured Service.
For security purposes, avoid using wording which might express inadvertent reference to valuable goods, anywhere outside of the package. Sensitive words such as jewelry, gold, gem, diamond, etc should not be used in the package labeling.
Ship your item with a copy of the form which you will receive via email to the following address:

HUBERT INC.
606 S OLIVE ST STE 1110
LOS ANGELES, CA 90014

Date*

Consent*

By signing below, the customer agrees that the approximate value and description of the item listed in this repair form are correct to the best of his or her knowledge. The customer also agrees that the item is submitted to HUBERT's office for repair only. HUBERT will not act as an insurer of the item listed in this form. HUBERT will repair or replace any article that is lost, stolen, or damaged due to their negligence, up to the value declared in this form. If no value is listed, it will be assumed to be less than $100.00. The customer will pay for the returned shipping (which will be insured to the amount of the declared value or assumed value), even if the estimate is not approved. HUBERT Inc. will not be responsible for any items left for over 90 days. By shipping the item the customer accepts Hubert's terms and conditions.

I agree to these terms and conditions

Signature*

Phone

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

SERVICE / REPAIR FORM

CUSTOMER INFORMATION

ITEM INFORMATION

SHIPPING & CONFIRMATION