Version 1.0
Prepared by: @Lorraine Sebata
Approved by: @Feli Capron @Samia Thompson
Reviewed date: 2025-12-19
Next review date: 2026-12-18
A step-by-step facility maintenance form that documents problems, obtains approval for contractor work, and verifies completion with cost tracking.
(Complete and submit to Office Manager)
Item | Details |
Date: | _________________ |
Your Name: | _________________ |
Department: | _________________ |
Priority: | ☐ Low (cosmetic) ☐ Medium (affects work) ☐ High (safety/urgent) |
Location: | ☐ Reception ☐ Office ☐ Restroom ☐ Kitchen ☐ Server Room ☐ Other: __________ |
What's broken? (Include serial number if applicable) | _________________________________________________ |
Item | Details |
Fix Type: | ☐ In-house (no cost) → Skip to Section D |
☐ External contractor needed → Continue below | |
Contractor Name: | _________________________________________________ |
What they'll do: | _________________________________________________ |
Estimated Cost: | $ _________________ |
Quote obtained? | ☐ Yes (attached) ☐ No (Search for 2–3 quotes before proceeding) |
Budget Category: | ☐ Repairs ☐ Equipment ☐ Safety |
(Required if cost exceeds $500)
Role | Sign-Off |
Office Manager (Confirms work is needed) | Signature: _________________ Date: _________ |
CFO/Finance (Approves budget) | Signature: _________________ Date: _________ |
(Fill out after contractor finishes)
Item | Details |
Completion Date: | _________________ |
Work Satisfactory? | ☐ Yes ☐ No (If no, hold payment) |
Final Cost: | $ _________________ |
Difference from Quote: | +/- $ _________________ |
Office Manager Approval: | Signature: _________________ Date: _________ |