Icon Equipment Solutions Philippines, Inc.

REPAIR ORDER
KM. 14 Greenfield Complex, Merville Access Road, Parañaque
City RO No. : RO004144
Tel. No.: (02) 824-7303
TIN 008-636-103-000

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CUSTOMER NO. CUSTOMER NAME AND ADDRESS ADVISOR PLATE NO.
C0000171 Gonzalodo Enterprises HIEDELYN A. GIVERA
DOC. DATE Sail Building YEAR/MAKE/MODEL ENG./TRANS
10/15/2020 JS205LC TRACKED EXCAVATOR
NRA Cebu City
STOCK NO. MODEL NO. CARLINE COLOR
Cebu City
SHAJE20BTJ2750104 JS205LC JS205 TX JCB Orange
Cebu
PURCHASE ORDER No. CHASSIS No. KILOMETERS PROD. No. EXP. DATE
LPE00130 SHAJE20BTJ2750104 1,704 02/13/2022
CA F/C CH REPRESENTATIVE TERMS TIN SELLING DEALER DELIVERY DATE NXT SVC DATE NXT SVC KM
Anjo Gonzalodo 30D 209-914-492-000 1/21/2020
ICON EQUIPMENT SOLUTIONS PHIL. INC.
C/C WAR INT MOBILE PHONE NO. BUSINESS PHONE NO. HOME PHONE NO. TIME RECEIVED DELIVERY KMS. INSURANCE INFO
09177041594 11:43:00 AM
AIR PWR TURBO
VEHICLE ID ENGINE NO. ESTIMATED DATE AND TIME DATE/TIME RELEASED
SHAJE20BTJ2750104 84491930 10/15/2020 05:00:00 PM 1/21/2020 11:56:49

J. No Chrg Item Description Quantity Unit Unit Price Amount

Labor
Replace coolant sensor
1 WAR SENSOR WATER-REPLACE
Remarks Location:Prosperidad, Agusan del Sur, Philippines
Parts

1 WAR 40/302723 SENSOR 1 PC

Sundries

1 WAR MILEAGE COST 1 LOT

1 WAR MISCELLANEOUS 1 LOT

Customer's Acknowledgment
I hereby authorize and agree to pay for, the above repair work to be done on my vehicle, including the purchase of all parts and materials necessary to perform the same. In the
event that the total cost of repair is not paid within sixty (60) days from the date of the notice of completion thereof, I hereby authorize and empower Icon Equipment Solutions
Philippines, Inc. to sell my vehicle at a public auction and apply the proceeds or part thereof to the cost of the repair, and the excess, if any, shall be turned over to me.

Prepared by/Date: Approved by/Date: Acknowledged & Received by (Customer)/Date:

Gonzalodo Enterprises
HIEDELYN A. GIVERA Signature over Printed Name Signature over Printed Name
Date and Time Printed: 3/4/21 15:08
 Time Clock Technician Techinician
Job No. Date Job Description / Work Done
Code Signature
Concern:
IN
Job 1 Cause:

OUT Correction:

Concern:
IN
Job 21 Cause:

OUT Correction:

Concern:
IN
Job 31 Cause:

OUT Correction:

Concern:
IN
Job 41 Cause:

OUT Correction:

Concern:
IN
Job 51 Cause:

OUT Correction:

Concern:
IN
Job 61 Cause:

OUT Correction:

Concern:
IN
Job 71 Cause:

OUT Correction:

No. of Roadtest Test Driver Km. Reading Guard on Duty Date/Time Remarks

RECOMMENDATION

All Job Request Completed

Signature:
Exterior Car Wash / Interior Vacuum
Quality Control Passed:
Released Checklist Done
Date:
Replaced Parts Inside Vehicle