ESTABLISHMENT BANGSAR No. 58, Jalan Ang Seng, 50470 Kuala Lumpur Tel :03-2276 6771, 03-2076371 Fax :03-2276 0770 Whatsapp: 019-738 3352 Email: estbangsarjmb@gmail.com INSTALLATION / MINOR WORK FORM Resident / Owner/ Tenant Particulars: Name Unit No. Contact No. Date of work Time | commence TIME OF WORK —] Monday — Friday ‘9,00 am — 5.00 pm Saturday 9,00 am — 1.00 pm ‘Sunday / Public Holiday | Not Allowed Contractor's Particulars: Contractor Name VeNo. Contact No. Vehicle No. Worker's Name VCNo. WCNo. = VENo. ‘Scope of Works (Please Mark ~)) RM200.00 for Deposit Plumbing Services Painting / Wallpaper Electrical Services Cabinet Air-cond Services OTHERS: Date of Apply ‘Owner / Tenant is required to pay a sum of RM200.00 per unit being sect damages caused during the repair/ servicing/ maintenance/ shifting in & the RULES & REGULATIONS imposed by the Management [if any). Management reserve the right to stop any contractors, if we found not c: ‘or misuse of this application Signature :, uurity deposit to cover any out or non-compliance of, -ompliance to our house rule or Ofiee Use only (Deposit ForOffieUsconly | = Ofice Use nly fund ‘Deposit Received by. Checked by: ‘Claimer Name Date Date Date of Refund Choque No/Eash I) Signature Teal Refunded Signa ena Sigrature