Reference TOTL-SP05-F11

Office Egypt

ISO/IEC 17025 Form Issue n° / Date 00 / 01 April 19

Clause 6.6 Author / Approver K. Ahmed / M. Abd Elrazek

Externally provided products and services Page n° Page 1 of 2

Purchased Services Verification / Check Form

1
No. : Date: 20/7/2019
Purchase Order (P.O.) Number:
Service Provider Name: salzburg Service Provider Contacts: 0223892476
Service Provider Address: 96 el-thawra st. Heliopolis, cairo Egypt
Purchased Type:  Calibration  Maintenance  PT
Services Criticality:  Critical  Non-Critical
Instrument TOTL Code (for maintenance and calibration services): TOTL-C-1-3
Services Description:
Cleaning and maintenance of bomb

A: PT samples Upon Arrival Verification / Inspection 2:

Visual Inspection3:
 Pass  Fail (please list out reasons)

Name / signature: Date:

Technical Inspection (please check full compliance with the PT provider's

instructions):
 Accepted  Not Accepted (please list out reasons and suggested suitable corrective actions)

Storage Condition (Please fill this in accordance with specifications / requirements

of PT provider, standards, test method, etc. ):
Storage Condition is needed:  No  Yes (please indicate the proper storage conditions)

Name / signature: Date:

 Reference TOTL-SP05-F11

Office Egypt

ISO/IEC 17025 Form Issue n° / Date 00 / 01 April 19

Clause 6.6 Author / Approver K. Ahmed / M. Abd Elrazek

Externally provided products and services Page n° Page 2 of 2

Purchased Services Verification / Check Form

TOTL Manager Approval:
Signature: Date:

B: Other Services Verification / Check:

Verification / Inspection (Please verify / check that the service(s) comply with
specifications / requirements of standards, test method, manufacturer, etc ) 4:
Verification / Inspection  Pass (As applicable, please attach the verification / inspection records)
 Fail (please list out reasons & suggested suitable corrective actions)

Name / signature: A.I Date: 20/7/2019

TOTL Manager Approval:

Signature: Date:

1. Serial number to be added by lab. Admin or QO.

2. Fill this part ONLY for PT received samples. For any other services, fill section (B) directly and add suitable mark that
section (A) as not applicable.
3. Visual inspection will be done by Lab Admin or any Technical staff. Visual Inspection would include; but not limited to;
checking the following: Quantity acceptance, Quality Acceptance (seals, packaging, cleanness, etc.
4. For services related to equipment calibration and maintenance, verification / checks should insure that equipment is
working properly and can fit / achieve the relevant requirements.