Physical Plant Work Order Request Form
Download a blank fillable Physical Plant Work Order Request Form in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Physical Plant Work Order Request Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2W.O. Request # __________________________
PHYSICAL PLANT WORK ORDER REQUEST FORM #L-1776
(rev. 3/03)
Date:____________________________________
Telephone Number: 785-8585
Location (Building) __________________________________________ Room Number ______________________
Originator _________________________________________________ Telephone _________________________
NOTE: An account number must be provided or the work order request will not be accepted and entered into
the system for the estimate/work to proceed.
Units to be Charged (Name)______________________________ Acct Number _____________________________
(Name)______________________________ Acct Number _____________________________
(Name)______________________________ Acct Number _____________________________
Date Needed: ________________________________________ Estimate Required YES____ NO____
SIGNATURES:
Department Chairperson’s Signature Requesting Estimate:_______________________________________________
Dean’s or Director’s Final Approval for Work to Proceed:________________________________________________
Funds Available During ____________ Fiscal Year
DESCRIPTION OF WORK TO BE PERFORMED (ATTACH SKETCH IF NECESSARY)
ESTIMATE INFORMATION (TO BE PREPARED BY PHYSICAL PLANT)
Hours
Labor $
Material $
O/S Services
Total Cost
1. Carpenter
_________
_________
_________
__________ ___________________
2. Painter
_________
_________
_________
__________ ___________________
3. Mason
_________
_________
_________
__________ ___________________
4. Fac Repr Worker
_________
_________
_________
__________ ___________________
5. Locksmith
_________
_________
_________
__________ ___________________
6. Electrician
_________
_________
_________
__________ ___________________
7. Plumber/Steamfitter
_________
_________
_________
__________ ___________________
8. Maint Mechanics
_________
_________
_________
__________ ___________________
9. HVAC
_________
_________
_________
__________ ___________________
10. Landscape Serv
_________
_________
_________
__________ ___________________
11. Custodial
_________
_________
_________
__________ ___________________
12. Motor Pool
_________
_________
_________
__________ ___________________
TOTAL ESTIMATE
_________
_________
__________ ___________________
SIGNATURES: The first approval signature indicates that the Department Chairperson requests an estimate for the
work requested. The second signature indicates that the work is to proceed after the estimate is approved, or if no
estimate is required, that the work is to proceed.
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business