Job Completion / Acceptance Form

Contractor
Date

Vessel

Order Number
Req Number
Invoice Number

To be Completed by Superintendent
Job Description:

To be filled out by Contractor

To be filled out by Contractor Materials:

NOTE:
The work shall comply with rules of Classification Society. The class shall be maintained without
any restrictions at all times.

On Behalf of Company Name, I accept the work as completed and approved for Payment as per job
description above. I further accept all Parts and Labour supplied as correct.

Signed
Superintendent
Company Name: ………………………………………….