Engineer Details:

Engineer: *

Date & Time Arrived: *

Date & Time Departed: *

Reason for visit and allocated time: *

Work Completed and Time taken: *

Job Notes or Recommendations: *

Customer Details:

Company Name: *

Address: *

Postcode: *

Contact Name: *

Contact Number: *

UPON SIGNING THIS FORM THE CUSTOMER AGREES THAT:

ALL OF THE WORDS LISTED ABOVE HAVE BEEN COMPLETED AND ENGINEER REPORTS AND RECOMMENDATION HAVE BEEN READ AND UNDERSTOOD.
A TEST OF THE ABOVE WORKS HAS BEEN COMPLETED AND IS SATISFACTORY

If this is not the case please state why:

DISCLAIMER:

UNLESS OTHERWISE AGREED WITH 100PROOF. THE APPLICATION OR USE OF ANY THIRD PARTY SOFTWARE OR HARDWARE ARE THE SOLE RESPONISIBILITY OF THE CLIENT AND 100PROOF ACCEPTS NO LIABILITY FOR ANY 3RD PARTY SOFTWARE/HARDWARE. INCLUDING BUT NOT LIMITED TO ANY LOSS OR DAMAGE OF ANY KIND INCRURED AS A RESULT OF ITS APPLICATION OR USE. ALL HARDWARE IS SUBJECT TO AVAILABILITY AND VIABILITY AS AGREED BY 100PROOF.

I/WE CONFIRM ALL WORK IS COMPLETED TO OUR SATISFACTION UNLESS OTHERWISE STATED ABOVE

Customer Sign Here:

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Customer Print Name: *

Todays Date: *