TECHNICAL EXHIBIT G - Work Certificate Example.pdf
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- Solicitation number
- W912PB-25-R-3006
About this file
This is a blank work certificate template form used for documenting maintenance and repair work on fire alarm systems at USAG Ansbach. The bilingual German-English form includes fields for customer information, work order details, equipment specifications, and service documentation. Key sections include spaces to record the work certificate number, task order number, inventory number, date/time of service, type of work performed (preventive maintenance, German law inspection, inventory/labeling, repairs, emergency calls), parts used, and labor hours. The form also contains specific fields for German DGUV V3 electrical safety inspection parameters including visual checks, resistance measurements (Rpe, Riso), and leakage current (I Ableit). The template provides separate sections for describing equipment failures and completed work, with signature lines for both technicians and inspectors. Pricing fields are included for both Time & Materials (T&M) and Firm Fixed Price (FFP) work.
This document appears to be Technical Exhibit G from the solicitation package, serving as a standardized form that the winning contractor will need to use when documenting maintenance and repair services on fire alarm systems within the USAG Ansbach facilities. The bilingual format reflects the contract's performance location in Germany and compliance with both U.S. military and German regulatory requirements.
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Text version
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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File details come from the government source that posted it. Updated .