TECHNICAL EXHIBIT 13 - Work Certificate Example.pdf

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Real Property Equipment Maintenance
Solicitation number
W912PB21Q3007
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Work Certificate

Tele No.

Work Certificate Number

WON (US Controll Number) / Follow Work Order

TASKORDER No. Inventar-Nr. / Inventory No. Clin No.Dat. U. Zeit d. Anrufs / Date and Time of Call

Ausstattung / Equipment Type

Sonstiges / Other

Rechnung und Information / Invoice Information

Bezeichnung Wert EUR

Datum

Date

Tech.

Techn.

Anfang

Start

Ende

Finish

Work

Unit

Kunde Unterschrift

Customer Sign.

Teile benötigt / Parts used

Teil / Part

Total AW (Labour hrs.)

Art des Anrufs / Type of Call

Total T&M

Total FFP

Total German Law Inspection

GRAND TOTAL

Preis / PriceMe / Qty.

Beschreibung des Schadens / Description of Failure

Beschreibung der ausgeführten Arbeiten / Description of Work Performed

Tag, Unterschrift / Date, Signature (Techniker / Technician) Tag, Unterschrift /Date, Signature (Auftraggeber / Inspektor / Inspector)

Address

Kunde / Customer

Preventive Maintenance (FFP)

German Law Inspection (FFP)

Inventory and Labeling (FFP)

Regular Repair Hours (T&M)

Emergency Call Hours (T&M)

Replacement Parts (T&M)

German Law DGUV V3

Rpe (mOhm)

Visual Check:

Riso (MOhm)

I Ableit (mA)

BAD: Good:

Info

Protokoll

Hersteller Model Baujahr Seriennummer

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