Home Service & Supply Tools & Equipment Change Request/NPI Form. V2 Copy

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Personal Information:

• Name:

• Position Held

• Date Of Test:

  Date

Type Of Request:

• What Type of Request is this for:

  Change Request

  NPI

Supplier Information:

• Supplier Name:

• Supplier Contact:

General Information:

• Sky Contact:

• Item Description:

Sample Testing:

• Number of Samples

• Photo Of Each Sample:

  Media

• Sample Testing Comments:

• Sample Approved:

  Yes

  No

• Detail of Sample Approved:

• Photo of Approved Sample:

  Media

Supplier Information:

• Supplier Name:

• Supplier Contact:

General Information:

• Sky Contact:

• Date of Change Request

  Date

• Date Response Required By:

  Date

• Item Description:

• Current Sky SKU Code:

Details of Change Request:

• Details of the Change Request:

Expected Impacts of this Change:

• Change of Cost

  Yes

  No

  Not Known

• Detail of expected cost change:

• Change of Lead Time:

  Yes

  No

  Not Known

• Detail of expected Lead time change:

• Change of Delivery to UTL:

  Yes

  No

  Not Known

• Yes

  No

  N/A

• Detail of expected Delivery to UTL change:

• Change of MOQ

  Yes

  No

  Not Known

• Detail of expected MOQ change:

Approvals:

• Sample sent to Sky for approval:

  Yes

  No

• Date Sample Recieved:

  Date

• Sample Sent to:

• Sample Photo:

  Media

• Sample Testing Comments:

• Sample Approved:

  Yes

  No

• Why do you approve this item and which sample (s) do you approve:

• Why are the sample(s) not approved:

• Date:

  Date