LIFTRONIC PTY LIMITED

ABN 99 002 886 213

EMPLOYEE UNIFORM REQUISITION FORM

PLEASE RETURN TO RECEPTION - FOR PROCESSING

EMPLOYEE NAME: CONTACT #:_____________________ NEW EMPLOYEE

DEPARTMENT: EXISTING EMPLOYEE

APPROVED BY MANAGER: DATE:

DESCRIPTION SIZES SELECT SIZE QTY

CONSTRUCTION ALLOCATION: 3x SHIRTS, (3 x Tshirts to be worn under other clothing) 2x TROUSERS , 1x JACKET, 1x PR. BOOTS
BISLEY COOL UTILITY TROUSERS (NAVY) 77R, 82R, 87R, 92R, 97R, 102R, 107R
LT/W RAIL SHIRT X-TAPE (ORANGE) S, M, L, XL, 2XL, 3XL, 4XL
CONSTRUCTION 100% COTTON T-SHIRT (NAVY) S, M, L, XL, 2XL, 3XL, 4XL
EMPLOYEE JACKET WITH C/- SLEEVES
S, M, L, XL, 2XL, 3XL, 4XL
RAINCOAT X-TAPE (ORANGE) S, M, L, XL, 2XL, 3XL, 4XL

SERVICE ALLOCATION: 3x SHIRTS, 2x TROUSERS , 1x JACKET, 1x PR. BOOTS

BISLEY COOL UTILITY TROUSERS (BLACK) 77R, 82R, 87R, 92R, 97R, 102R, 107R
SERVICE EMPLOYEE COTTON STRIPE SHIRT BLACK/CHARCOAL 39, 40, 41, 42, 43, 44, 46, 48
JACKET WITH C/- SLEEVES S, M, L, XL, 2XL, 3XL, 4XL

MANAGER ALLOCATION: 3x SHIRTS, 2x TROUSERS , 1x JACKET, 1x PR. BOOTS

COTTON STRIPE SHIRT LIGHT BLUE (SERVICE) 41, 42, 43, 44, 46, 48
MNS BW LS SHIRT OXFORD BLUE (CONSTRUCTION) M, L, XL
SUPERVISOR/ MANAGER BISLEY COOL UTILITY TROUSERS (NAVY) (CONSTRUCTION) 77R, 82R, 87R, 92R, 97R, 102R, 107R
BISLEY COOL UTILITY TROUSERS (BLACK) (SERVICE) 77R, 82R, 87R, 92R, 97R, 102R, 107R
LAYER VEST (BLACK) S, M, L, XL, 2XL, 3XL, 4XL
LAYER JACKET (BLACK) S, M, L, XL, 2XL, 3XL, 4XL

1 x PAIR OF BOOTS ISSUED TO PERSONNEL TO THE VALUE OF $100.00

NOTE: Workboots purchase over $100.00 MUST be paid for by the employee
WORK BOOTS STEEL CAPPED WORKBOOTS

EMPLOYEE DECLARATION - WORKBOOTS

I, __________________________________________________________________ agree to have any additional monies deducted from my next pay for workboots
purchased.

EMPLOYEE SIGNATURE

** NOTE: Uniforms will be picked within 3 days of receipt of completed form OFFICE USE ONLY
UNIFORMS PICKED: YES / NO
WORKBOOTS PO No:
EXO TRANSFER OF STOCK: YES / NO
D398 | Rev. 0 | 05/07/19 UPLOADED TO CRM YES / NO