6-Repair Forms.pdf
PDF 34 KB Posted
- Solicitation number
- 25/0162
- Issued by
- Harris County, Texas
About this file
This document is an HCTRA (Harris County Toll Road Authority) Intelligent Transportation System Repair Form, specifically designed for documenting CCTV camera repair work. The form provides a standardized template for technicians to record details of a repair incident, including fields for tollway location, response level, equipment details, repair timeline, technician information, problem description, and corrective actions taken.
The form includes sections for tracking parts and labor costs, with line items for describing repairs, quantities, unit prices, and extended amounts. There are also checkboxes to indicate whether traffic control is required and if lane closures on the tollway need additional approval. The bottom of the form includes space for a contractor signature and date, ensuring accountability and documentation of the repair work performed on the intelligent transportation system infrastructure.
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Text version
TIME REPORTED:
DATE:LOCATION: RESPONSE LEVEL:
CONDITION UPON
ARRIVAL:
TECHNICIAN(S)
ASSIGNED:
DATE REPAIR
COMPLETED:
DATE/TIME
ARRIVED:
DATE/TIME
DEPARTED:
TOLLWAY:
DATE:
NOTIFIED BY: DATE REPAIR
STARTED:
EQUIPMENT:
ADDITIONAL COMMENTS:
CONTRACTOR SIGNATURE:
IF LANE CLOSURES REQUIRED ON TOLLWAY, COMPLETE HCTRA LANE CLOSURE APPROVAL FORM
LINE
ITEM
NO.
PARTS REQUIRED FOR REPAIR: Y / N
TOTAL
DESCRIPTION OF PROBLEM(S):
JOB NO.
QUANTITYDESCRIPTION
UNIT
PRICE
EXTENDED
AMOUNT
PARTS, LABOR, TRAFFIC CONTROL REQUIRED TO REPAIR CCTV CAMERA
CORRECTIVE ACTION TAKEN:
HCTRA INTELLIGENT TRANSPORTATION SYSTEM REPAIR FORM
TRAFFIC CONTROL REQUIRED: Y / N
PARTS LEAD TIME:
File details come from the government source that posted it. Updated .