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Customer/Point of Contact:

Department of Public Health & Social Services
Gabrielle Villagomez

Scheduled Date/Time:

06/09/2022, 10:00 am

Service Type:

Onsite

Charge Type:

Normal

Charge Code:

DPHS.5009: DPHSS - P226A03002 ActivPanel Nickel 65in Install

Rates:

DPHSS - P226A03002 ActivPanel Nickel 65in Install [TOTAL ANNUAL HOURS: 6]

Remaining Hours:

Est. Service Time (hrs):

Reference/PO #:

Taken By:

Kevin Hsueh

Customer Signature:

Print Name:

Date Signed:

Deliver Promethean Panel

Work Requested by: Gabrielle Villagomez

	Item	Serial Number	Notes

		Work Completed	Technician	Check-in	Check-out	Actual Hrs
	1	Check-in	Kevin Hsueh	06/09/2022 10:00 am

	Item	Serial Number	Condition	Qty	Price	Amount
TOTAL ($)						0.00

Filename
W39472

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