Emergency Service Vendor Page | National Dispatch Se

National Dispatch Services Emergency Service Form

For field technicians to use in case of an emergency that has to be serviced before physical paperwork is available.

PO NUMBER (STARTS WITH R) - IF APPLICABLE

DATE OF SERVICE

NAME OF STORE BEING SERVICED

ISSUE BEING SERVICED

As you do not have access to the official NDS paperwork, you are accepting this form as a temporary work order until official paperwork can be sent. As with all jobs, a sign off sheet with the store manager's signature is required for the job to be considered complete and payment issued. By checking this box, you acknowledge that this form will be used as the sign off sheet for this emergency call and that if this form is not adequaletly completed, you will return to the store to get a sign off sheet signed at your own expense.

I certify that my company has all required licenses (if applicable) and insurance.

I acknowledge that my company will work according to the terms & conditions of the National Dispatch Services purchase order.

TIME CHECKING IN

TIME CHECKING OUT

STORE MANAGER'S NAME

STORE MANAGER'S SIGNATURE

Thank you.