ExampleExhaustHoodServiceForm26JG012.docx

This is a Sample Exhaust Hood Service Form used by the Pinellas County School District in Florida for cafeteria and culinary exhaust hood maintenance and servicing. The form serves as a checklist and documentation tool for service representatives performing cleaning and maintenance work on exhaust hoods, make-up air units, and warewashing hoods at school facilities. The form captures 26 inspection and service items, including fan operation checks, blower belt replacement, bearing lubrication, hood and duct cleaning, filter maintenance, leak detection, roof drain inspection, sticker placement, and final site cleanup. The form requires service representatives to indicate completion status for each item using Yes, No, or Not Applicable checkboxes, and includes fields for recording the number of exhaust fans, intake fans, and blower belt sizes. Additional documentation fields include arrival and departure times, service representative name, school acknowledgment, date of service, and comments from stack inspection results. The form concludes with a section requiring confirmation that work performed is acceptable for payment.

The form does not independently contain pricing information, set-asides, funding sources, or contract award details. Rather, it functions as an operational document within the larger Cafeteria and Culinary Exhaust Hoods, Make-Up Air Units and Warewashing Hoods: Clean & Service solicitation issued by Pinellas County Schools with sealed electronic bids due by 3:00 pm on Tuesday, June 23, 2026, through the District's e-Procurement Portal. Bidders are directed to register through the OpenGov Procurement system to ensure automatic notification of any addendums or clarifications. The District noted consideration of prices established by the State of Florida Department of Management Services in bid evaluation.