Specifications

Generator Maintenance, Inspection and Repair Services Bid Number 6000001312
California Department of Corrections and Rehabilitation (CDCR) Exhibit A-2
SERVICE REPORT SAMPLE
Page 1 of 1
SERVICE REPORT
Date of Service: ________________
Type of Maintenance/Inspection
 Monthly  Quarterly  Semi-Annual  Annual
 Safety Inspection  Calibration
__________________ Hours Service Provided (To/From)
Provide explanation on all parts replaced
___________________________________________________________________
Repairs
_______________________Hours Service Provided (To/From)
TOTAL REPAIR HOURS
Were parts replaced?  Yes  No
Provide explanation for all parts replaced.
Location of Equipment
Description of Equipment
Equipment Make Make _____________ Model _____________ Serial Number______________
Description of service performed: (use back of this page if more space is needed)
Describe any noted deficiencies and suggested corrective action
The State assumes no responsibility for any work commenced by the Contractor and will not
reimburse the contractor for any work performed prior to approval and scheduling by the
Institution Contract Liaison or designee. Payment will only be made on invoices
accompanied by a Service Report signed by the Institution Contract Liaison or designee.
Name of Service Technician/Contractor
Authorized Institution Personnel
Print Name Here
Print Name Here
Signature Date
Signature Date
Bid 6000001312
State of California
11/14/2013 2:35 PM
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