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Facilities Maintenance and Environmental Services

Contractor Work Completion Report for Plumbing/Fire Sprinkler Systems

This form is to used only after all work has been completed This form must be signed off on by a Store/Club Manager or any salaried member of Management assigned by Store/Club Manager

This Form (Will Not) be accepted if signed off by anyone other then a Salaried Member of Management (Store/Club Manager, Co. Manager, Assistant Manager) Store/Club #____________________________ STORE STAMP HERE Location: ______________________________ Work Order: ___________________________ Bid Amount: ___________________________ Start Date: _____________________________ ____________________________ Completion Date: _______________________ Were Store Shopping Carts Used As Barricades by Contractor: YES NO If Yes How Many: _______________________ Scope of Work That Was Completed: _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ YES NO 1. Was the quality of work satisfactory? 2. Was contractor cooperative with you? 3. Was clean up of completed work area satisfactory? 4. Was all work described above competed? 5. Overall Performance: EXCELLENT GOOD POOR 6. If (NO) is used on any of the above question please describe:________________________________ _________________________________________________________________________________ _________________________________________________________________________________ 7. Other Comments: __________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________

Manager Signature

Contractor Signature

Manager Signature-Printed

Contractor Signature- Printed





Microsoft Word - work-order-completion.doc

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Microsoft Word - work-order-completion.doc