Official SealDepartment of Budget and Management


#18-003247-0001
Supplemental Questionnaire

Last Name
First Name
1

Please describe in detail your experience working with elevators, escalators, moving walks, hoists and other related devices.  Please indicate the timeframe in which these duties were performed.

2

Describe in detail any investigative and report writing experience you possess; provide two examples of your report writing ability/experience.
3

Do you have a Qualified Elevator Inspector (QEI) certification and/or are you a licensed elevator mechanic?
Yes No
 

If yes, please indicate certificate or license. If No, indicate N/A
4

Do you possess a valid driver's license? Do you have reliable transportation, available to you at all times?
Yes No

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