CityPlex Towers - MAINTENANCE REQUEST
Tenant
*
Tenant or Event
Contact
*
First
Last (required)
Event Date
-
Month
-
Day
Year
Date
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E-mail
Phone Number
-
Area Code
Phone Number
Tower:
T20
T30
T60
Base
Clinic
Clearity
Floor
Rm/Suite
Service Request Type
Temp. Adjust
Locks/Key/Door
Plumbing
Electrical
Light request
Furniture repair
Pest Control
Tenant Equip repair
HouseKeeping
Recycle Bin
Roof Leak
Other
Task
Service Requested
*
Request made to:
CityPlex Office
Security Office
Boiler Room
Online
Submit Form
Print Form
Back
Internal Office Use
Internal Office Use
Forward request to:
Boiler Room
Building Maintenance
Exec. Management for approval or FYI.
Energy Management Dept
Work Performed
Management Comment
Bill Back
yes
no
Completion Date
Tech Signature
Engineering Approval
Hours to complete work
Parts: $
Total to be invoiced: $
Parts Used / Invoice #
Date/Time
-
Month
-
Day
Year
at
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
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Submit Form
Print Form
Should be Empty: