Fill in vehicle and customer details before beginning the inspection.
Customer Info
Unit Details
Dates
Completed By
25-Point Inspection — Part A. Select a condition code for each item.
O = OK
A = Advise
R = Rec. Repair
S = Severe/DOT
Part A Items
PART A
25-Point Inspection — Part B. Technician section.
O = OK
A = Advise
R = Rec. Repair
S = Severe/DOT
Part B Items
TECHNICIAN
Record PM tasks and complaint details for up to 4 tasks.
List all parts used per task on this repair order.
Authorization & Signature
I hereby authorize the above repair work to be completed by National Fleet Management ("NFM") including all necessary materials and labor, as determined by NFM, and hereby grant NFM express permission to operate the vehicle herein on streets, highways and elsewhere for the purpose of repairing, testing and/or inspecting the vehicle. An express mechanic's lien is hereby acknowledged on the above vehicle, as of the date of this Write Up, to secure the total amount of repairs agreed herein, subject to any additional necessary materials and labor charges to be agreed upon, and/or storage charges, if applicable.
Sign Below
Sign with your finger or stylus
NOT RESPONSIBLE FOR LOSS OR DAMAGE TO VEHICLES OR ARTICLES LEFT IN VEHICLES IN CASE OF FIRE, THEFT OR ANY OTHER CAUSE BEYOND NFM's CONTROL.