Crane 2020_Attachment 4 - Work Certificate Inventory.pdf

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Attached to
Maintenance, Repair and Safety Inspection of Crane Systems
Solicitation number
W912PB-20-Q-3036
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ATTACHMENT 4 - Work Certificate Inventory Record (Name Contractor)

INVENTORY RECORD

PREVENTIVE MAINTENANCE AND REPAIR OF: "TYPE OF EQUIPMENT"

INVENTORY NUMBER: COMMUNITY:

CLIN'S

CLIN No. Quantity Maintenance Frequency

CLIN No. Quantity Maintenance Frequency

A = Annual S = Semiannual Q = Quarterly M = Monthly

J = Bi-Monthly W = Weekly B = Bi-Weekly D = Daily

EQUIPMENT TYPE: LOCATION, BUILDING #:

MANUFACTURER SERIAL #:

YEAR OF MANUFACTURE:

MANUFACTURER & MODEL #:

YEAR OF INSTALLATION:

OTHER EQUIPMENT SPECIFICATION:

(List numbers of maintenance steps performed as descripted in SOW CLIN MAINTENANCE PERFORMED : and/or information on maintenance performed IAW manufacturer's manual)

REMARKS : (EQUIPMENT CONDITION REPORT)

Inventory Label attached: Yes No

DATE TECHNICIAN INVENTORY ACCEPTED

DATE

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