IC 111 - 233 Blank Work Entry Form AMTRUST.pdf

PDF 119 KB Posted

Attached to
Audio Visual Maintenance and Support - Small Purchase
Solicitation number
25-551HDA-LEGAL-B-47664
Issued by
Illinois

About this file

The document is a Daily Work Entry Clearance Form for the Illinois Center, specifically for the Illinois Housing Development Authority (IHDA), to be used at either 233 North Michigan Avenue or 111 East Wacker Drive. The form is designed to provide detailed documentation and approval for contractors entering tenant spaces, with a work entry validity period of 30 days. It requires comprehensive information about the work to be performed, including dates of commencement and estimated completion, time allocations, and specific scope of work details.

The form includes sections for multiple contractors, their contact information, and certificate verification, with mandatory tenant representative approval for space access. There are designated areas for building office approval and tracking, ensuring a structured process for managing contractor entry and work activities. While no specific pricing, funding sources, or contract terms are detailed in this particular document, it serves as a critical administrative tool for managing and documenting contractor access and work assignments within the Illinois Center's facilities.

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Text version

Please check □ Building Location:

DAILY WORK ENTRY CLEARANCE FORM

233 NORTH MICHIGAN AVENUE | 111 EAST WACKER DRIVE

This form must be filled out and returned to the Office of the Building prior to any contractor coming in to do work in the tenant space or building.

Date of Request: / / THIS WORK ENTRY IS VALID FOR (30) DAYS ONLY).

Tenant Name or Area of Work: Illinois Housing Development Authority (IHDA) Suite:

Date work to commence: / / Estimated Completion Date: / /

Time (Regular): Overtime:

Scope of Work:

Certificate on File

Contractor: Phone/Pager: ( ) - Yes No

Phone/Pager: ( ) - Yes No

Phone/Pager: ( ) - Yes No

Supervisor: Phone/Pager: ( ) -

Tenant Access (must be signed by tenant representative before you can access their space):

Approved By: Date: / /

Phone or Cell Number: ( ) To Be Completed by the Office of the Building:

Approved By: Date: / /

Tenant Access (must be signed by tenant representative before you can access their space):
To Be Completed by the Office of the Building:

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