Arcus Project Services (APS) - Request Form

• Contract

  Select Sainsburys Boots Evri CVS Argos Co-op Capita Other

  • Sainsburys
  • Boots
  • Evri
  • CVS
  • Argos
  • Co-op
  • Capita
  • Other

• Please name contract

• Site name and number

• Department

  Select M&E Refrigeration HVAC Biomass Building Fabric Shutter & Gates Flooring Roofing Drainage Other

  • M&E
  • Refrigeration
  • HVAC
  • Biomass
  • Building Fabric
  • Shutter & Gates
  • Flooring
  • Roofing
  • Drainage
  • Other

• State department

• Conducted on

  Date

• Prepared by

• Work Order Number

• Has the client requested a quote from APS?

  Yes

  No

• Please provide contact details of person requesting quote

• Please provide client contact details

• Please provide level of priority.

  Red - Equipment not working

  Amber - Equipment working

  Green - Additional request

• Type of equipment

• Location of equipment

  Select Roof Plant Room Shop Floor Warehouse Loading Bay Shop Front Customer Cafe Other

  • Roof
  • Plant Room
  • Shop Floor
  • Warehouse
  • Loading Bay
  • Shop Front
  • Customer Cafe
  • Other

• Please state location

• Does the job require communication network? e.g. BMS, Clover.

  Yes

  No

• Please provide details

• Is the job a new install or replacement?

  Select New Install Replacement BER Upgrade Upgrade Redesign Other

  • New Install
  • Replacement
  • BER Upgrade
  • Upgrade
  • Redesign
  • Other

• Are the works to be self-delivered or sub-contracted?

  Self-delivered

  Sub-contractor

  Other

• Please provide name of person(s) completing the work?

• Please provide any other photos of equipment, location and access.

  Media

Scope and HSQE

• Please provide a description of the work to be completed - inc dimensions, areas, method etc

• Are there any high risk H&S factors involved?

  Yes

  No

• Please provide detail

• Are there any special access requirements?

  Select MEWP Scaffold (Tower) Crane Stairwell Other

  • MEWP
  • Scaffold (Tower)
  • Crane
  • Stairwell
  • Other

• Please provide details

• Is there an asbestos register on site?

  Yes

  No

• Is asbestos present on site?

Any other relevant information

• Please provide any other relevant information you deem important for quoting purposes.