Technical_Exhibit_05_-_Work_Order_Form_(27_May_2015).docx
DOCX document 14 KB Posted
- Attached to
- Troop Appliance Maintenance & Repair of and Dryer Duct Cleaning at Joint Base Lewis-McChord, Washington
- Solicitation number
- W911S8-16-R-0003
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Technical_Exhibit_05_-_Work_Order_Form
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Text version
TECHNICAL EXHIBIT 5
WORK ORDER FORM
APPLIANCE WORK ORDER
PART A (this is used for service calls and simple repairs)
1. Date Received: _________________; Priority: __________; FSBP Work Order #:_________________
2. Building Number: ______________; Floor Number: ________; Room Number: ______________________
3. Requestor: ____________________
4. POC: ___________________________________________
a. Duty Phone: ______________________________
b. Alternate Phone: ___________________________
5. Work Requested (problem): _________________________________________________________________
6. Mechanics Signature: ___________________________
7. Occupants Signature: ___________________________
8. Date Completed: _______________________________
PART B (this is used for extensive repairs and disconnect/install actions)
1. Parts Required: ___________________________________________________________________________
2. Parts Installed: ___________________________________________________________________________
3. Appointment Info (if applicable):
4. Appliance Ops Checked (pass/fail/date): _____________________________________________________
PARTC (information on newly installed appliance)
1. Make: __________________________________
2. Model Number: __________________________
3. Serial Number: __________________________
PART D (notes)
File details come from the government source that posted it. Updated .