2-Exhibit C - EQUIPMENT COMPLETION-RETURN FORM 2026.docx
DOCX document 44 KB Posted
- Attached to
- Electric Motor and Pump Repair Services
- Solicitation number
- 260169-B-AS
- Issued by
- Pinellas County, Florida
About this file
This document is an Equipment Completion and Return Form for the City of Tarpon Springs, Florida's electric motor and pump repair services contract. The form serves as the standard documentation requirement for contractors providing repair services to the City's water and wastewater utilities divisions at three specified locations: the WWTP at 201 E Pine St, the RO Plant at 1624 L&R Industrial Blvd, and Utility Maintenance at 200 Dixie Hwy. The form applies to as-needed repairs of pumps, motors, gearboxes, drives, blowers, compressors, and related equipment. Contractors must complete the form to document all work performed, including specific repairs such as new wear rings, impellers, pump overhauls, motor rewinds, power cord replacements, and ceramic coating applications.
The form requires contractors to document comprehensive pump and motor final test results, including test voltage, mechanical noise, no-load amperage, electrical harmonics noise, loaded amperage, final megger test results at 500 volts, vibration analysis, and tank flow rate testing in gallons per minute. The contractor must provide the date work was completed and the date equipment was returned, along with comments regarding the service performed. Completed forms must be signed and dated by both the contractor's representative and the City's representative, with one copy submitted alongside invoices and supporting documentation that includes a breakdown of charges by bid items in accordance with the City's bid specifications.
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Other files
| File | Type | Posted |
|---|---|---|
| 4-ITB 260169-B-AS-jlRev1 Final.docx | DOCX document | |
| 1-Exhibit B - EQUIPMENT PICKUP FORM 2026.docx | DOCX document | |
| 6-Bid Receipt Form 260169-B-AS.pdf | ||
| 3-Exhibit A - MOTOR PUMP REPAIR EQUIPMENT LIST.docx | DOCX document | |
| 5-Bid Receipt Form 260169-B-AS.pdf |
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Text version
CITY OF TARPON SPRINGS
EQUIPMENT COMPLETION AND RETURN FORM
WWTP
201 E Pine St Tarpon Springs, FL
RO Plant 1624 L&R Industrial Blvd Tarpon Springs, FL Utility Maintenance 200 Dixie Hwy.
Tarpon Springs, FL
| Repair Estimate # |
| Invoice # |
AS-NEEDED PUMPS, MOTORS, GEARBOXES, DRIVES, BLOWERS, COMPRESSORS AND RELATED EQUIPMENT REPAIR SERVICES
(TO BE COMPLETED BY REPAIR CONTRACTOR EMPLOYEE)
Contractor Name:
Equipment Description: Serial/Tracking #:
WORK COMPLETED:
| New Wear Ring: | New Impeller: | Pump Overhaul: |
| Motor Rewind: | Replace Power Cord (size/length): |
Amount and Location of Ceramic Coating Applied:
PUMP/MOTOR FINAL TEST RESULTS:
| Test Voltage Results: | Mechanical Noise: | |||
| No-Load Amperage: | Electrical Harmonics Noise: | |||
| Loaded Amperage: | Final Meg Test – 500 Volts: | |||
| Vibration: | Tank Tested | gpm | ||
| Date Work Completed: | Date Equipment Returned: |
Comments:
Contractor shall sign, date, and submit one (1) copy of this form with invoices and supporting documentation including breakdown of charges by bid items in accordance with City of Tarpon Springs Bid.
Contractor’s Representative Printed Date (Signed)
City’s Representative Printed Date (Signed)
File details come from the government source that posted it. Updated .