Title Page

  • Store Location

  • Work Order Number

  • Is this a new EM call?

  • Initial Call Date

  • Callers Name

  • Inventory Number

  • Equipment Type

  • Item Code

  • OCC Reference

  • Description of Fault

  • Company Name

  • Condition on Arrival

Work Execution

  • Date

  • Technician Name / ID

  • Start Time

  • End Time

  • AW / Hours

  • Technician initials

  • Customer Initials

Materials / Work Description

  • Materials Used

  • Description of Work Performed

  • Is work complete

  • Labor Cost Category
  • Type & ELIN

  • Labor Cost

  • Subcontractor Labor Cost

Material Cost

  • Material

  • Material Subcontractor


  • Labor Total

  • Material Total

  • Subcontractor Total



  • Technician Signature

  • Store Manager Signature

  • Completed On

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.