AP 704.a
SCHOOL/BLDG.
SCHOOL YR.
DATE OF
REQUEST
REPAIR
TO BE BUDGETED
REQUISITIONED BY:
(TO BE COMPLETED BELOW THIS LINE IN MAINTENANCE OFFICE)
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
WORK NUMBER DATE:
I CERTIFY THAT THIS WORK WAS COMPLETED AS STATED ABOVE ON
SIGNED RECORDED COMPLETED
ADMINISTRATION OFC
Distribution by Originator:
Assistant Superintendent _________________________________
Building Principal and/or Service Area Supervisor ______________________________
Controller (If request has not been budgeted.) _________________________________
*Indicated area of revision