Attachment 2 - Work Certificate.doc

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Food Service Equipment Maintenance and Repair
Solicitation number
W564KV-21-Q-2000
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Text version

Attachment # 2

Work Certificate

Customer

Location of Equipment

Tel. No.
Date and Time of Call
Model
Manufacturer
Year of m.

Equipment Type

Acquisition Price
Repair Limitation
Date
Techn.
Start
Finish
Work

Unit

Cust. Printed Name
Customer Sign.

Total labor hrs

Type of Call (choose one)

Regular Repair

Emergency Repair

German Law Inspection

Preventive Maintenance

Control No.

Comm. Code
Inventory No
ESLIN- No.

Invoice Information

CLIN
Description
Value €
0001
Regular Repair hours
0002
Emergency Repair hours
0003
Replacement Parts
Total
€
Parts used
Qty
Price €

Total

Description of Failure

Description of Work Performed

Date, Signature (Technician)
Date, Signature (Inspector)

File details come from the government source that posted it. Updated .