This document is a work completion form for a vendor. It requests information on a purchase order such as the PO number, whether the work is complete and fully tested, signatures from those authenticating and approving the work, and a section to fill out upon work completion with details of the work done, actual costs, and quality control notes. Payment of the invoice will be processed once this completed form is attached along with a service technical report.

1. Purchase Order No-
-
Amended/Revision PO -
PO Amount Budget Cost
Work Complete and Fully Tested? If No a hold-back of 50% will apply until work
completion or successful operational test completed -
bottom section to be completed upon work
completion and successful operational test
Authenticated By
Signature Date Signature Date
Approved By
Signature Date
Please attach this completed form to your Invoice along with your Service Technical Report for
payment to be processed
WORK COMPLETED AND SUCESSFUL OPERATIONAL TEST
Processed By
Description or Work
Quality Control Notes
Actual work Estimation Cost
Checked by
Yes No
WORK COMPLETION FORM
Vendor's Name
Centre
Location/Dept-