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Inhouse Installation
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Mobile Installation
Inhouse Installation
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Mobile Installation
Mobile Installations
"
*
" indicates required fields
1
Basic Information
2
Pre-Inspection Information
3
Installation Information
4
Post Inspection
Start Time
Hours
:
Minutes
AM
PM
AM/PM
Date
MM slash DD slash YYYY
Insurance Information
Client Appointed Time
Hours
:
Minutes
AM
PM
AM/PM
Client Appointed Date
MM slash DD slash YYYY
Reference Number
Insurance Company
Insurance Name
Insured's Contact
Insured's Address
Vehicle Details
Make
Model
Year
Chassis / Vin #
Vehicle Reg #
Inspection Sticker #
Mileage
Passenger Airbags
Yes
No
Door
2 Door
4 Door
Type
Hatchback
Station Wagon
SUV
Mini Van
Pick Up
Mini Truck
Full –size Truck
Sedan
Glass Details
Brand
Type
LFW
TRW
D Gass
Fender Glass
1/4 glass
Sun Roof
Moon Roof
Quality
Genuine New
Genuine used
O.E.STD
A.Market
Pre Inspection Photo Uploads
Full Front View
Full Rear View
Full Side View
Door Glass
Mileage photo
DOT #
Close up on Damage
Chasis Number
Others
Auto Body Detail
LFW
TRW
DOOR GLASS
FENDER GLASS
1\4 GLASS
S- Scratches
S- Scratches (Photos)
D- Dented
D- Dented (Photos)
Chipped
Chipped (Photos)
M- Missing
M-Missing (Photos)
R- Rust
R-Rust (Photos)
Inspected by (signature required)
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Customer Proof (signature required)
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Installation Information
Stock Item Dispathched
Time Glass was Set
Hours
:
Minutes
AM
PM
AM/PM
Vehicle Release Time
Hours
:
Minutes
AM
PM
AM/PM
Temperature at Start of Curving (degrees)
Relative Humidity at Start of Curving (percent)
Please enter a number from
0
to
100
.
Products Used
UA/ Mouldings Uni
Primer
Windshield rubbers
moulding strips
Repairs
Details of Products Used
Urethane Adhesive Lot Number / Expiration Date
Glass/Frt Prep Lot Number / Expiration Date
Glass/Frt Primer Lot Number / Expiration Date
Pinchweld Prep Lot Number / Expiration Date
Pinchweld Primer Lot Number / Expiration Date
D.O.T Number Lot Number / Expiration Date
Moldings Used Lot Number / Expiration Date
Primer Lot Number / Expiration Date
Other Products Used Lot Number / Expiration Date
Repairs (if any)
Photos Upload
Post Inspection
Post Inspection Checklist
Interior
Vacuumed then cleaned
Glass cleaned
Wipers ok
Sensors
Rear view mirrors secured
Inspection stickers
Tool kit check
Assembly
New DOT Installed
DOT Installed
*
Outside View Photo
Inside View Photo
WARRANTY ON LEAKAGE AND INSTALLATION
Nil
3 Months
6 Months
1 Year
Other
Define Other Warranty
*
Job Card Closing
End Time
Hours
:
Minutes
AM
PM
AM/PM
Customer Received and Specified Release Time (Name in Block Letters)
Customer Received and Specified Release Time (sign):
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Job Completed by (Name in Block Letters):
Job Completed by (sign):
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