Exhibit_6_-_Work_Authorization_Form.xlsx

SCWAF

Service Call Work Authorization

Notification Time: SERVICE CALL CLASSIFICATION

Emergency:

Notification Date: Urgent:

Routine:

Building Number: Estimated Cost for Routine Repair Effort

Bay Number:

Fire Sprinkler System Number:

Fire Alarm System Number:

Brief Description of the Problem:

Work to be Performed:

Does this work require system impairment? Yes No If yes, complete Impairment Worksheet

Requesting Individual: Date:

Phone Number:

Date Work Started: Date Work Completed:

Time Work Started: Time Work Completed:

Provide brief description of work completed and materials/parts used during this effort.

Number of Hours Expended: CLIN Number to be Charged:

Cost of Equipment and Materials:

Contractor's Contract Officer Certification: Date:

&16Exhibit 6

Government Work Authorization I hereby authorize the repair work herein set forth to be done by you. You shall complete the following as necessary:

- Furnish all labor required to execute this work.

- Furnish all necessary parts and any other material required for this work.

- In the event that system impairment is required, complete Impairment Worksheet.

- Complete any other forms required to safely carry out authorized work.

- Notify additional personnel as required prior to starting and upon completion of the required repairs.

X________________________________________ Date:_________________ (Contracting Officer or Contracting Officer Representative)