• REPAIRS & MAINTENANCE INSURANCE FORM

  • Date*
     / /
    2 digit month, 2 digit day, 4 digit year

  • This form is to be completed monthly so that our maintenance crew can provide necessary maintenance/repairs.

     

  • Living Room: In good working order: If you checked NO above, please describe in detail what the concern is:
  • Family Room: In good working order: If you checked NO above, please describe in detail what the concern is:
  • Dining Room: In good working order: If you checked NO above, please describe in detail what the concern is:
  • Kitchen: In good working order: If you checked NO above, please describe in detail what the concern is:
  • Laundry Room: In good working order: If you checked NO above, please describe in detail what the concern is:
  • Bedrooms: In good working order: If you checked NO above, please describe in detail what the concern is:
  • Exterior: In good working order: If you checked NO above, please describe in detail what the concern is:
  • Plumbing: In good working order: If you checked NO above, please describe in detail what the concern is:
  • Electrical: In good working order: If you checked NO above, please describe in detail what the concern is:
  •  
  • Should be Empty: