Client Type*Cash/New Account HolderApproved Account Holder (30 Day)Business Name*Account Number*Email Address* Client*Client Representative*Contact Number*Email* Client Purchase Order*If EFT is received, Credit card will NOT be charged until day of inspection and costs are confirmed. Payment can be made by EFT transfer, but card details will be held as security.Card Holder's Name*Card Number*Expiry Date*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year20502049204820472046204520442043204220412040203920382037203620352034203320322031203020292028202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Security Code*Preferred Inspection Date Date Format: DD slash MM slash YYYY Name for the InspectionAddress of Inspection Street Address City State Postcode Contact Name for Inspection*Mobile NumberPreferred TimeMorningAfternoonMine Site*When is the equipment due on site Date Format: DD slash MM slash YYYY Plant DetailsPlant DescriptionPlant ManufacturerPlant ModelDate of Manufacture Date Format: DD slash MM slash YYYY Plant Serial NumberRegistration # (If Applicable)Asset # (If Applicable)Plant Unit Number - Reflective ID*Unloaded Mass (Mobile Plant Only)Plant Safety File - Minimum RequirementsOperational Risk AssessmentService HistoryFire Risk AssessmentPressure Vessel InspectionsRim Register and NDT ReportsBrake Test ReportsMaintenance Risk AssesmentRego PapersTerms and Conditions Non Account Holders will need to pay for the inspection prior to our inspector attending site and the issue of final reports. Account Holders must provide a purchase order prior to our inspector attending site and the issue of final reports Travel plant Inspection rate includes travel within a 70km radius of Singleton. Re-inspection Visits For each visit to verify any non-compliance, a non-compliance re-inspection charge as per the hourly rate will apply for each item of plant. Non-compliant inspections are valid for 30 days, after this time an initial inspection will need to be completed again. Delays delay charges will apply where an assessor has arrived to inspect the plant and is delayed due to plant not being available, documentation not readily available, authorised operator not available to operate plant or for any other delay beyond control of the assessor. Delays will be charged at $145/hr in 15min intervals, and will be additional to the plant inspection rate. A "lost time log" will be completed. Credit Card Fee A 1.4% credit card fee will be applied Terms and Conditions* I agree to these Terms and Conditions:
