Title Page

  • Site Lead:

  • Installation Type:

  • Number of Fitters: (1-10)

  • Fitter Name:

  • 1st Fitter:

  • 2nd Fitter:

  • 1st Fitter:

  • 2nd Fitter:

  • 3rd Fitter:

  • 1st Fitter:

  • 2nd Fitter:

  • 3rd Fitter:

  • 4th Fitter:

  • 1st Fitter:

  • 2nd Fitter:

  • 3rd Fitter:

  • 4th Fitter:

  • 5th Fitter:

  • 1st Fitter:

  • 2nd Fitter:

  • 3rd Fitter:

  • 4th Fitter:

  • 5th Fitter:

  • 6th Fitter:

  • 1st Fitter:

  • 2nd Fitter:

  • 3rd Fitter:

  • 4th Fitter:

  • 5th Fitter:

  • 6th Fitter:

  • 7th Fitter:

  • 1st Fitter:

  • 2nd Fitter:

  • 3rd Fitter:

  • 4th Fitter:

  • 5th Fitter:

  • 6th Fitter:

  • 7th Fitter:

  • 8th Fitter:

  • 1st Fitter:

  • 2nd Fitter:

  • 3rd Fitter:

  • 4th Fitter:

  • 5th Fitter:

  • 6th Fitter:

  • 7th Fitter:

  • 8th Fitter:

  • 9th Fitter:

  • 1st Fitter:

  • 2nd Fitter:

  • 3rd Fitter:

  • 4th Fitter:

  • 5th Fitter:

  • 6th Fitter:

  • 7th Fitter:

  • 8th Fitter:

  • 9th Fitter:

  • 10th Fitter:

  • Client

Sign Off Details

  • Store Name:

  • Store Number:

  • Site Contact:

  • Date & Time On Site:

  • Main Contractor

To Be Completed By Client

  • Has the signing in book been completed / induction carried out?

  • Please explain:

  • Does the completed work reflect the agreed SoW and has it been delivered to an acceptable standard?

  • Please explain:

  • Has the store been handed over, fit for trade, with no snags?

  • Please explain:

  • Has all waste / rubbish been cleared from site, all fixtures clean?

  • Please explain:

  • Was our engineer appropriately dressed and working professionally at all times?

  • Please explain:

  • Is a revisit required to resolve outstanding issues?

  • Please explain:

To be completed by ATL Engineer

  • Was there any reason you were not able to complete all works as per SoW?

  • Please explain:

  • Were you required to undertake and extra / variations of works?

  • Please explain:

  • Who authorized additional works / variations?

Site / Store Comments

  • Please list any site/store comments below:

Engineer Comments

  • Engineer comments, including shortages:

Engineer Photos

  • Please attach any relevant Photographs here:

Sign Off - Site

  • Client representative name:

  • Position:

  • Signature:

  • Date and time of signature:

Sign Off - Engineer

  • Press the + symbol to add more fitters. Each person MUST sign this document.

  • Fitters Name + Signature
  • Name + Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.