DE LA SALLE UNIVERSITY - DASMARIAS

FACILITIES MAINTENANCE OFFICE

Revised 01-15-10

JRF No. _________

JOB REQUEST FORM (JRF)

Date of Request:
Requisitioner:
Department/Unit:

Dean/Dept. Head: _______________________________

Signature over Printed Name

Chargeable to: __________________________________

(To be filled-up by REQUISITIONER)

Description/ Scope of Work

Date Needed

Purpose/Reason

Location

Qty

(To be filled-up by FMO Head)

Work Priority:
High
Medium
Low

Approved:
Signed by:

Cost Estimates:
Materials
Labor
Overhead
Contingencies
Tax
Total

Request Type:
Repair
Minor Const/Fab
Engineering
Special Event
Move Support
Others

Assigned Unit:
Civil Works ______
Electrical ________

(Attach all supporting documents and lay-out)

Charged to FMO R & M Budget

Disapproved:
Due to:

(FMO Head)
(For Major Fabrications, Renovations, Constructions - to be filled-up by ACCOUNTING OFFICE)
Charged to:
Allocated Budget: _________________________________
Budget Approved By: ______________________________
Date Approved: ___________________________________
Project No. ______________________________

Department
Fund
Others

Approved by:
(PRF Signatories)

Awarded to:
Outside Contractor
Date ___________
By: ____________________________________

In-house
Received by Dept. Head In-charge

Date

(BFO Director )

Summary of Bids/Quotations:
1 ___________________________
2 ___________________________
3 ___________________________
Original - FMO Head
Duplicate - Assigned Staff - FMO
Triplicate - Requisitioner

MRF No.
Job Assignment Sheet (EFJAS) No.
P ____________________
Assigned to:
____________________
Date started:
____________________
Date finished:
Note: Requests thru phone calls will not be entertained unless emergency