Crane 2020_Attachment 5 - Work Certificate PM.pdf

PDF 156 KB Posted

Attached to
Maintenance, Repair and Safety Inspection of Crane Systems
Solicitation number
W912PB20Q3036
Issued by

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ATTACHMENT 5 - Work Certificate Preventive Maintenance (Name Contractor)

Work Certificate - Preventive Maintenance

Inventur Nr. / Inventory No.

Standort / Community

Kunde / Customer Adresse Geb./ Address Bldg.

Gerät Typ / Equipment Type Hersteller / Manufacturer

Modell / Model Baujahr / Year of Manufactured

CLIN Nr. Datum Beginn Datum Ende Technician Wartung Intervall Menge Einzelpreis Gesamtpreis

CLIN No. Date Start Date Finish Techniker Maint. Frequency Quantity Single Price Total Price

Material / Used Maintenance Parts:

Anlagenzustand / Condition of Equipment:

Safety Inspection Label attached: Yes No

Datum, Unterschrift (Kunde) / Date, Signature (Customer) Gesamt Preis / Total Price EURO

Datum, Unterschrift (Techniker) / Date, Signature (Technician) Datum, Unterschrift (Inspektor / COR) / Date, Signature (Inspector COR)

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