On-Site Client Report
DATE
*
/
Month
/
Day
Year
Date
Time
*
Hour Minutes
AM
PM
AM/PM Option
TECHNICIAN Full Name
*
Tech Email
*
example@example.com
Store#
*
Example: BK1234/ POP12345
NAME Of the Store
*
Example McDonald Popeye etc.
ADDRESS
*
CITY
*
STATE
*
ZIP
*
Please check in calling 561-810-1599 option 2 and get the Name of the rep
YES
Checked in with
*
Please Select
Randy
Eli
Alex
Felipe
Alan
Leo
Luis
Gaby
Carlos F
Carlos G
*
Inventory Completed and reported
What are you working on ?
*
Example DTD POS IDMB ODMB
Work Completed (explain all the work you already completed)
*
Please make all your notes of work completed at the site
Approval by Luis or Gaby ONLY (please choose one )
Please Select
Luis
Gaby
Was new cables pulled If yes how many feets?
Was any other parts used while onsite ?
IS SCOPE OF WORK 100%?
*
YES
NO
If NO, Please explain why
ONSITE HOURS
*
ROUND TRIP TRAVEL HOURS
ROUND TRIP MILES
Checked OUT call 561-10-1599 Option 2 and get the Reps name
YES
Checked OUT with
*
Please Select
Randy
Eli
Alex
Felipe
Alan
Leo
Luis
Gaby
Carlos F
Carlos G
DATE
*
/
Month
/
Day
Year
Date
Time you leaving site after exit code from NITP Dispatch 561-810-1599 Option 2
Hour Minutes
AM
PM
AM/PM Option
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Managers Name
*
First Name
Last Name
Managers Signature
*
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