Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Date
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Business Name:
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Business Address:
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Business Phone:
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Business Contact:
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Services Performed:
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Service Panel Review (Condition, Breakers, Connections, Code Compliance)
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Meter/Entrance Review
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Routine Inspection of Lighting System (Exterior, Interior, Emergency)
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Review of Switches and Outlets
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Test Smoke and Carbon Monoxide Detectors
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Annual Thermal Imaging in Panel and Electrical Components
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Set Up and Monitoring of Client Supplied Replacement Bulbs and Ballasts
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Complimentary Lighting Assessment
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15% Discount on Service Performed at Time of the Inspection
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10% Discount on Service Calls Between Review Periods
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Is the Customer Interested in a Complimentary Security/Automation Review?
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Frequency:
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Payment Terms:
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Price:
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Photos
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Client Signature:
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Mr. Electric Signature:
