AIRCON / CHILLER / PUMP / COOLING TOWER / AVR SERVICE REQUEST FORM

E-mail subject standard format: RFQ-BU-Store Name-Scope of Work-PR#

e.g. RFQ-RS-Bluewave-Leak Repair of FCU#1-PR#200081234

Note: Please put “Multiple PR#s” if PR# is more than one.

To be filled-out by Store Operations:   
STORE NAME:

CONTACT PERSON AND CONTACT NUMBER:  

  
  
STORE ADDRESS:     
HEALTH REQUIREMENTS:  
  
(New normal Safety Protocols, Rapid/Swab Test results, Health
Certificate, Quarantine, etc.)
WORKING PERMIT REQUIREMENTS / PARKING FEE:
  
(With Fee or Free of Charge?)
PREFERRED TIME OF REPAIR / MAINTENANCE:
  
(Day Shift or Night Shift? Weekday or Weekend?)  
LAST SCHEDULE OF PREVENTIVE MAINTENANCE  
  
(Please include the date and contractor who conducted the PM)   
Note: Endorse previous PR#/PO# if for Repeat Order
To be filled-out by Facilities Management Dept:  
START-UP DATE / EQUIPMENT LIFE:     
  
WARRANTY:  
  

HISTORY OF REPAIR/S:  
  
  
(Please include the PO# and description of repair – If applicable)
Note: Not applicable for PM requests.  
PM CONTRACT:

(Please specify if Store’s Equipment is under PM Contract.

If yes, kindly specify which contractor)
SERVICE REPORT:

(If the request is based on service report, please attach a copy and
specify the date of inspection)
PROBLEM ENCOUNTERED / REQUEST:  
  

  NOTE: Only COMPLETE requirements / documents will be processed.

1
 GENERATOR SERVICE REQUEST FORM

E-mail subject standard format: RFQ-BU-Store Name-Scope of Work-PR#

e.g. RFQ-SW-Commonwealth-Genset Change Oill-PR#200081234

Note: Please put “Multiple PR#s” if PR# is more than one.

To be filled-out by Store Operations / Facilities Management Dept.:    
STORE NAME:
  

CONTACT PERSON AND CONTACT NUMBER:  

  

STORE ADDRESS:     

HEALTH REQUIREMENTS:  
  
(New normal Safety Protocols, Rapid/Swab Test results,
Health Certificate, Quarantine, etc.)
START-UP DATE / EQUIPMENT LIFE:
  
  
(Gaano na katagal ang Genset?)
NAME OF CONTRACTOR ASSIGNED TO STORE:

BRAND:

MODEL:

CAPACITY:

REQUEST: 
 PM / Change Oil
 Repair
(If Change Oil, kindly indicate last schedule) 
PR NUMBER:

NOTE:
 Please coordinate correct material code with FMD.
 If request is based on service report, kindly attach a copy of SR for additional reference.
 Only COMPLETE requirements / documents will be processed.

2
 GENERATOR EMISSION TEST REQUEST FORM

E-mail subject standard format: RFQ-BU-Store Name-Scope of Work-PR#

e.g. RFQ-SW-Commonwealth-Genset Change Oill-PR#200081234

Note: Please put “Multiple PR#s” if PR# is more than one.

To be filled-out by Store Operations / Facilities Management Dept.:    
STORE NAME:
  

CONTACT PERSON AND CONTACT NUMBER:  

  

STORE ADDRESS:     

HEALTH REQUIREMENTS:  
  
(New normal Safety Protocols, Rapid/Swab Test results,
Health Certificate, Quarantine, etc.)

*NO. OF GENSET:

*NO. OF STACKS PER UNIT:

BRAND:

MODEL:   
  
CAPACITY:

START-UP DATE / EQUIPMENT LIFE:

(Gaano na katagal ang Genset?)

PR NUMBER:

NOTE:
 Material code: 5000808 EVALUATE,GENERATOR,TESTING
 300kw and below – exempted in emission testing; Please also confirm with Sir Norman Escobar of
Central Engineering
 those with * are required details from suppliers so please make sure it’s completely filled out before
sending RFQ
 If store is not familiar with the stacks/discharged pipe, forward concern to FMD for verification

3
 GENSET RENTAL REQUEST FORM

E-mail subject standard format: RFQ-BU-Store Name-Scope of Work-PR#

e.g. RFQ-SW-Commonwealth-Genset Change Oill-PR#200081234

Note: Please put “Multiple PR#s” if PR# is more than one.

To be filled-out by Store Operations / Facilities Management Dept.:    
STORE NAME:
  

CONTACT PERSON AND CONTACT NUMBER:  

  

STORE ADDRESS:     

HEALTH REQUIREMENTS:  
  
(NEW NORMAL SAFETY PROTOCOLS, RAPID/SWAB TEST
RESULTS, HEALTH CERTIFICATE, QUARANTINE, ETC.)
LOCATION OF ELECTRICAL ROOM AND GENSET   
(WITH PHOTO/S):   
ESTIMATED DISTANCE OF ELECTRICAL ROOM AND
GENSET:
# OF WIRES NEEDED:
VOLTAGE:

CAPACITY NEEDED:

DATE AND TIME NEEDED:

PR NUMBER:

NOTE:
 Only COMPLETE requirements / documents will be processed.

4
 ELEVATOR / ESCALATOR / WALKALATOR SERVICE REQUEST FORM

E-mail subject standard format: RFQ-BU-Store Name-Scope of Work-PR#

e.g. RFQ-RDS-Galleria-Repair of Elevator-PR#200081234

Note: Please put “Multiple PR#s” if PR# is more than one.

To be filled-out by Store Operations / Facilities Management Dept.:    
STORE NAME:
  

CONTACT PERSON AND CONTACT NUMBER:  

  

STORE ADDRESS:     

HEALTH REQUIREMENTS:  
  
(New normal Safety Protocols, Rapid/Swab Test results,
Health Certificate, Quarantine, etc.)
START-UP DATE / EQUIPMENT LIFE:
  
  
(Gaano na katagal ang Elevator / Escalator?)
HISTORY OF REPAIR/S:  
  
(Please include the PO# and description of repair – If
applicable)
NAME OF CONTRACTOR ASSIGNED TO STORE:

BRAND / MODEL:

PROBLEM ENCOUNTERED / REQUEST: 

PR NUMBER:

PHOTO:

NOTE:
 Please coordinate correct material code with FMD.
 If request is based on service report, kindly attach a copy of SR for additional reference.
 Only COMPLETE requirements / documents will be processed.

5
 BURGLAR ALARM SERVICE REQUEST FORM

E-mail subject standard format: RFQ-BU-Store Name-Scope of Work-PR#

e.g. RFQ-RS-Federal Bay-Repair of Burglar Alarm-PR#200081234
To be filled-out by Store Operations:   
STORE NAME:
  
  
CONTACT PERSON AND CONTACT NUMBER:  
  

STORE ADDRESS:     

HEALTH REQUIREMENTS:  
  
(New normal Safety Protocols, Rapid/Swab Test
results, Health Certificate, Quarantine, etc.)
START-UP DATE / INSTALLATION DATE:
  
(Kailan na-install ang Burglar Alarm? / Gaano na   
katagal ang Burglar Alarm?)
NAME OF CONTRACTOR ASSIGNED TO STORE:

COMPLETE MACHINE MODEL / TYPE:

SERIAL NUMBER:

PROBLEM ENCOUNTERED / TYPE OF REQUEST:

(Repair, Maintenance and/or

Adding/Deleting/Resetting of Password, etc.)
REMARKS:

NOTE:
Please prepare PR# using material code 5000046 (R&M Burglar Alarm) for processing.

6
 CCTV REPAIR / SERVICE REQUEST FORM

E-mail subject standard format: RFQ-BU-Store Name-Scope of Work-PR#

e.g. RFQ-RS-Galleria-Repair of CCTV-PR#200081234
To be filled-out by Store Operations:   
PLANT CODE:
  
  

STORE NAME:

CONTACT PERSON AND CONTACT NUMBER:  

  

STORE ADDRESS:     

E-MAIL ADDRESS:
HEALTH REQUIREMENTS:  
  
(New normal Safety Protocols, Rapid/Swab Test
results, Health Certificate, Quarantine, etc.)
START-UP DATE / INSTALLATION DATE:
  
(Kailan na-install ang CCTV? / Gaano na katagal ang   
CCTV?)
NAME OF CONTRACTOR ASSIGNED TO STORE:

CAMERA BRAND:
MODEL:

(DVR, CAMERA, HD, ETC.)

DEFECT:

(Repair, Replacement of Parts, On-site

Troubleshooting and/or Re-Cabling, etc.)
PHOTO:

NOTE:
Please prepare PR# using material code 5000051 (R&M CCTV SYSTEM) for processing.

7
 ADDITIONAL / RELOCATION / RE-CABLING / RE-WIRING OF CCTV CAMERA
SERVICE REQUEST FORM

E-mail subject standard format: RFQ-BU-Store Name-Scope of Work-PR#

e.g. RFQ-RS-Galleria-Repair of CCTV-PR#200081234
To be filled-out by Store Operations:   
PLANT CODE:
  
  

STORE NAME:

CONTACT PERSON AND CONTACT NUMBER:  

  

STORE ADDRESS:     

E-MAIL ADDRESS:
HEALTH REQUIREMENTS:  
  
(New normal Safety Protocols, Rapid/Swab Test
results, Health Certificate, Quarantine, etc.)
START-UP DATE / INSTALLATION DATE:
  
(Kailan na-install ang CCTV? / Gaano na katagal ang   
CCTV?)
NAME OF CONTRACTOR ASSIGNED TO STORE:

CAMERA BRAND:
MODEL:

(DVR, CAMERA, HD, ETC.)

*NO. OF EXISTING CAMERA/S:
*NO. OF EXISTING DVRS:
*REASON FOR REQUESTING ADDITIONAL
CAMERA/S:

NOTE:
Please prepare PR# using material code 5000289 (S&I CCTV SYSTEM) for processing.

8
 PAGING SYSTEM SERVICE REQUEST FORM

E-mail subject standard format: RFQ-BU-Store Name-Scope of Work-PR#

e.g. RFQ-RS-Don Antonio-Repair of Paging System-PR#200081234
To be filled-out by Store Operations:   
PLANT CODE:
  
  

STORE NAME:

CONTACT PERSON AND CONTACT NUMBER:  

  

STORE ADDRESS:     

E-MAIL ADDRESS:
HEALTH REQUIREMENTS:  
  
(New normal Safety Protocols, Rapid/Swab Test
results, Health Certificate, Quarantine, etc.)
START-UP DATE / INSTALLATION DATE:
  
(Kailan na-install ang PAGING SYSTEM? / Gaano na   
katagal ang PAGING SYSTEM?)
NAME OF CONTRACTOR ASSIGNED TO STORE:

BRAND:
MODEL:

DEFECT:

PHOTO:

NOTE:
Please prepare PR# using material code 5000114, R & M, PAGING SYSTEM AND BACK GROUND
MUS, for processing.

9
 ROLL UP DOOR SERVICE REQUEST FORM

E-mail subject standard format: RFQ-BU-Store Name-Scope of Work-PR#

e.g. RFQ-RS-Don Antonio-Repair of Roll up at Entrance-PR#200081234
To be filled-out by Store Operations:   
STORE NAME:
  
  
Store Contact Person and Contact Number:  

Store Address:     

Health Requirements:  
  
(New normal Safety Protocols, Rapid/Swab Test
results, Health Certificate, etc.)   
Installation Date:
  
(Kailan na-install ang roll up? / Gaano na katagal   
ang roll-up?)
NAME OF CONTRACTOR:
(Diatech/Lec Steel/ Others)
DATE OF LAST REPAIR:
(if repaired before)
MATERIAL:
(GL Steel/ Pre-painted/ Polycarbonate/ Stainless
Steel/ Grills)
TYPE OF ROLL UP:
(Motorized / Manual)
LOCATION OF ROLL UP:
(e.g Receiving Area/Customer Entrance)
INCIDENT/CONCERN:

PHOTO:

NOTE:
Please prepare PR# using material code 5000442 (R&M Roll up Door) for processing.
  

FIRE EXTINGUISHER SERVICE REQUEST FORM

10
E-mail subject standard format: RFQ-BU-Store Name-Scope of Work-PR#
e.g. RFQ-RS-Don Antonio-Refill of Fire Extinguisher-PR#200081234
STORE NAME:

STORE ADDRESS:

STORE CONTACT PERSON:

CONTACT NUMBER:

TOTAL # OF EXISTING FIRE EXTINGUISHERS:

(Please specify Fire Extinguisher Type and Size)

EXPIRATION DATE:

SUPPLIER ASSIGNED TO STORE:

PICK UP / DELIVERY:

(Please specify if direct to Store or DC)

PR#

11
 SUPPLY OF VISIFLEX PVC STRIP CURTAIN
Material code: 6002278
Store Name:   
Grade:
(Translucent or Yellow)
Thickness:

(Available: 2mm for translucent / 2mm
-3mm for yellow grade)
Width:

(Standard is 200mm; we'll request

quote from supplier if otherwise)  
Length: 
(Please indicate desired length)  
No. of strips: 

12
 OTHER EQUIPMENT SERVICE REQUEST FORM

E-mail subject standard format: RFQ-BU-Store Name-Scope of Work-PR#

e.g. RFQ-RS-Don Antonio-Repair of Vault-PR#200081234
To be filled-out by Store Operations:   
PLANT CODE:
  
  

STORE NAME:

CONTACT PERSON AND CONTACT NUMBER:  

  

STORE ADDRESS:     

E-MAIL ADDRESS:
HEALTH REQUIREMENTS:  
  
(New normal Safety Protocols, Rapid/Swab Test
results, Health Certificate, Quarantine, etc.)
START-UP DATE / EQUIPMENT LIFE:
  
  
(Gaano na katagal ang Equipment?)
NAME OF CONTRACTOR ASSIGNED TO STORE:

BRAND:
MODEL:

DEFECT:

PHOTO:

13
 PABX SERVICE REQUEST FORM

E-mail subject standard format: RFQ-BU-Store Name-Scope of Work-PR#

e.g. RFQ-RS-Don Antonio-Repair of Vault-PR#200081234
To be filled-out by Store Operations:   
PLANT CODE:
  
  

STORE NAME:

CONTACT PERSON AND CONTACT NUMBER:  

  

STORE ADDRESS:     

E-MAIL ADDRESS:
HEALTH REQUIREMENTS:  
  
(New normal Safety Protocols, Rapid/Swab Test
results, Health Certificate, Quarantine, etc.)
START-UP DATE / EQUIPMENT LIFE:
  
  
(Gaano na katagal ang Equipment?)
NAME OF CONTRACTOR ASSIGNED TO STORE:

BRAND:
MODEL:

DEFECT:

PHOTO:

14
 VAULT SERVICE REQUEST FORM

E-mail subject standard format: RFQ-BU-Store Name-Scope of Work-PR#

e.g. RFQ-RS-Don Antonio-Repair of Vault-PR#200081234
To be filled-out by Store Operations:   
PLANT CODE:
  
  

STORE NAME:

CONTACT PERSON AND CONTACT NUMBER:  

  

STORE ADDRESS:     

E-MAIL ADDRESS:
HEALTH REQUIREMENTS:  
  
(New normal Safety Protocols, Rapid/Swab Test
results, Health Certificate, Quarantine, etc.)
START-UP DATE / EQUIPMENT LIFE:
  
  
(Gaano na katagal ang Equipment?)
NAME OF CONTRACTOR ASSIGNED TO STORE:

BRAND:
MODEL:

DEFECT:

PHOTO:

15
 FAX MACHINE SERVICE REQUEST FORM

E-mail subject standard format: RFQ-BU-Store Name-Scope of Work-PR#

e.g. RFQ-RS-Don Antonio-Repair of Vault-PR#200081234
To be filled-out by Store Operations:   
PLANT CODE:
  
  

STORE NAME:

CONTACT PERSON AND CONTACT NUMBER:  

  

STORE ADDRESS:     

E-MAIL ADDRESS:
HEALTH REQUIREMENTS:  
  
(New normal Safety Protocols, Rapid/Swab Test
results, Health Certificate, Quarantine, etc.)
START-UP DATE / EQUIPMENT LIFE:
  
  
(Gaano na katagal ang Equipment?)
NAME OF CONTRACTOR ASSIGNED TO STORE:

BRAND:
MODEL:

DEFECT:

PHOTO:

16
 NEW ITEM REQUEST FOR RFQ

BUSINESS UNIT & STORE NAME:

STORE CONTACT PERSON:

CONTACT NUMBER:

STORE ADDRESS:
REQUEST:
QUANTITY:

PURPOSE:
RECOMMENDED BY:

(Please specify if recommended by Operations,

SPD or FMD)
SPECIFICATION/S:

SAMPLE PHOTO:

PREFERRED BRAND / MODEL:

(IF NECESSARY)

17