HVAC & Refrigeration Maintenance – Sign Off / Completion Checklist

Sign-off and completion checklist for HVAC and Refrigeration maintenance works. Captures works completed, technician details, site information, additional works, revisit requirements and recommendations.

Site details

Site name *

Date of works

Technician name *

Site location

Work order number

Send to manager *

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Job Details

Type of works performed *

Equipment / system description

Asset / unit tag / ID

Make & model

Serial number

Works start time

Works completion time

Works Completed

Document all works completed during this service visit. Provide full details of tasks performed, parts used and outcomes.

Description of works completed

Were all scheduled maintenance tasks completed? *

System operational status upon completion *

Supporting photo(s)

Add photo

Parts & Materials Used

None added. Skip this section if not applicable.

Additional Works & Revisit

Record any additional works identified during the visit, revisit requirements and items flagged for action.

Were any additional works identified during the visit? *

Is a revisit required? *

Parts on order for revisit

Parts on order – details

Client notified of revisit requirement

Items Flagged for Action

None added. Skip this section if not applicable.

Sign Off & Completion

Confirm all works have been completed satisfactorily and obtain client acknowledgement.

All works completed as per work order? *

Site left clean and tidy?

Client / site representative briefed on works completed?

Client / site representative briefed on additional works / recommendations?

Technician Declaration & Client Acknowledgement

Technician name (print) *

Technician signature *

Sign above the line

Client representative name (print)

Client signature

Sign above the line

Client acknowledges works completed as described

Before & After Photos

Before photo(s)

Add photo

After photo(s)

Add photo

WPCG form – photo

Add photo