Electrical Testing Report

Electrical Testing Report and Service Agreement

Report No.:    Client Name:    Service Provider:

Project / Job No.:    Report Date:    Testing Date(s):

WHEREAS

WHEREAS, Client engages Service Provider to perform electrical inspection and testing services at the Site under the terms and conditions set forth in this Report and Service Agreement; and

WHEREAS, Service Provider represents that it has the qualifications, personnel, instruments and competence to perform the specified testing in accordance with accepted industry practices and the written Scope of Work below; and

NOW, THEREFORE, the parties agree that Service Provider will perform the testing services described herein and Client will pay in accordance with the Payment Terms set forth below.

SCOPE OF WORK

TEST METHODS & STANDARDS

Tests performed shall be recorded below. Service Provider certifies that instruments were calibrated according to accepted practice prior to testing and test results reflect conditions at time of testing. Selected methods:

Visual inspection    Continuity test    Insulation resistance (IR)    Earth/ground continuity

Functional / operational test    Thermal imaging    High potential (Hi-Pot)

EQUIPMENT TESTED (List each item)

TEST RESULTS SUMMARY

Continuity test: Pass    Fail

Insulation resistance (IR): Pass    Fail

Ground/earth continuity: Pass    Fail

OBSERVATIONS & RECOMMENDATIONS

SAFETY & LIMITATIONS

Tests were performed under conditions visible and accessible at the time of inspection. Service Provider does not assume responsibility for latent defects not discoverable during the agreed testing methods. Any energization or exposure to live conductors is performed only with Client authorization and at Client's risk unless otherwise agreed in writing.

PAYMENT TERMS

Total Fee: $    Invoice Issued:

Late fee/interest on overdue amounts:

Payment is due in full in accordance with invoicing. Client agrees to pay collection costs and reasonable attorney fees if the account is placed for collection.

TERM AND TERMINATION

Service commencement date:    Anticipated completion date:

Either party may terminate this Agreement for material breach upon written notice and a opportunity to cure. Termination for convenience requires written notice of .

CONFIDENTIALITY

Each party shall treat as confidential all non-public information disclosed in connection with the testing and shall not disclose such information to third parties except as required by law or as necessary to perform the services. Confidential information does not include information that is or becomes publicly available through no fault of the receiving party.

GOVERNING LAW

This Agreement and the interpretation of its terms shall be governed by the laws of: without regard to conflict of laws principles.

ENTIRE AGREEMENT

This Report and Service Agreement, including all schedules and attachments, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior agreements and understandings, whether written or oral. Any modification must be in writing and signed by both parties.

TECHNICIAN INFORMATION & CERTIFICATION

Technician Name:    License / Cert. No.:

Date Performed:

I hereby certify that the tests recorded in this report were performed by me or under my direct supervision in accordance with the methods noted, and that the results recorded are true and accurate to the best of my knowledge.

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