EMR_2019_Attachment_10_-_Work_Certificate_PM.pdf

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Emergency Maintenance and Repair of HVAC Systems
Solicitation number
W912PB19R3000
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Work Certificate Preventive Maintenance

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ATTACHMENT 10 - Work Certificate Preventive Maintenance (Name Contractor)

CLIN Nr. Datum Beginn Datum Ende Technician Wartung Intervall Menge Einzelpreis Gesamtpreis

CLIN No. Date Start Date Finish Techniker Maint. Frequency Quantity Single Price Total Price

Anlagenzustand / Condition of Equipment:

Work Certificate - Preventive Maintenance

Kunde / Customer

Inventur Nr. / Inventory No.

Baujahr / Year of Manufactured

Standort / Community

Adresse Geb./ Address Bldg.

Gerät Typ / Equipment Type Hersteller / Manufacturer

Modell / Model

Material / Used Maintenance Parts:

Datum, Unterschrift (Techniker) / Date, Signature (Technician) Datum, Unterschrift (Inspektor / COR) / Date, Signature (Inspector COR)

Gesamt Preis / Total Price EURO

Datum, Unterschrift (Kunde) / Date, Signature (Customer)

EMR 2019_Attachment 10 - Work Certificate PM.xlsx

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