NORTH CAROLINA AGRICULTURAL AND TECHNICAL STATE UNIVERSITY
PHYSICAL PLANT
REQUEST FOR SERVICE
| SUBMIT One Copy |
(For Physical Plant use only) |
|
| 1. School or Department | Request No. | 9. Job Order No.:_________
10. Department Code: _____ 11. Supervisor Assigned: ___ |
| 2. Location of Work(Bldg. & Room No. or other identification) | 12. ID Number: _____________
ID Number: __________ |
|
| 3. Work Requested By: | 13. Funds - Code:__________
Material Cost:_________ Labor Cost:___________ |
|
| 4. For Further information call:
Name: _________________________________ |
Telephone: | 14. Sketch or Plan Attached
Yes ___ No ___ |
| 5. Date of Request: | 15. Date Received: ________ | |
| 6. Desired Completion Date & Comments: | 16. Date Job Scheduled:________ |
7. Detailed description of job required (use reverse side for additional
space). Include sketch if appropriate.
8. Request Approved By:
| ____________________________________
Dean or Director, Date |
__________________________________________
Vice Chancellor for Business and Finance, Date_ |
____________________________________ Property Custodian, Date |
__________________________________________ Vice Chancellor for Academic Affairs, Date or Vice Chancellor for Student Affairs, Date or Vice Chancellor for Research, Date or Vice Chancellor for Development and Univ. Relations |
(FOR PHYSICAL PLANT USE ONLY)
17. Request Approved By: _____________________________________________________Date:_____________
SUMMARY
|
Labor Hours |
Material Cost |
|||||
| Assigned To: | Craft Required |
Estimated |
Actual |
Estimated |
Actual |
Remarks |
| 18. TOTALS | ||||||
Estimator, Date:
19. Completed:
20. Inspected By:
21 Approved By:
Remarks:
PP_RFS(4/97)