CityPlex Towers - MAINTENANCE REQUEST
Tenant
*
Tenant or Event
Contact
*
First
Last (required)
Event Date
-
Month
-
Day
Year
Date
Date Picker Icon
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 to:
Boiler Room
Building Maintenance
Exec. Management for approval or FYI.
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
Date Picker Icon
Submit Form
Print Form
Should be Empty: