Maintenance Work Order Form by xro60491


									                                             Maintenance Work Order Form
Date:                               Site:                                        Phone/Ext:

Staff requesting:                                            Supervisor approval

Nature of need:

To be completed by Building Manager:

Level of Urgency:         1                 2           3               4               5
 1 being top priority

Response: The maintenance department received your request on ____________
  Completion of this work will be completed on or before ____________________
  An assessment of project was completed and an outside service provider is required.

Outside Service Called ____ ____                Fiscal Director Approval_____________________________
                              Yes       No

Company Used ____________________________________                                 P.O. #______________

Schedule Date ________________
To be completed by Maintenance Technician:
Plan of Action: __________________________________________________________________
Date Completed_______________                           Time Spent On Task________________________
    1. Complete top portion of form.
    2. Forward to the Building Manager.
    3. The Building Manager will contact staff person requesting work order within 3 business days of receiving work
        order with a plan of action.

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