<div>&#160;</div>
<div style="text-align: center"><span style="font-size: 26px">固定资产报修单<br />
</span>
<table class="xdLayout" tabindex="65535" border="1" bordercolor="#ffffff" width="600" align="center" style="border-bottom: medium none; border-left: medium none; border-collapse: collapse; word-wrap: break-word; table-layout: fixed; border-top: medium none; border-right: medium none">
    <colgroup><col style="width: 113px" /><col style="width: 183px" /><col style="width: 125px" /><col style="width: 179px" /></colgroup>
    <tbody valign="top">
        <tr style="min-height: 30px">
            <td colspan="2" style="border-bottom: black 1.5pt solid; border-left: #ffffff 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: #ffffff 1pt solid; border-right: #ffffff 1pt solid; padding-top: 1px">
            <div align="center">&#160;</div>
            </td>
            <td style="border-bottom: black 1.5pt solid; border-left: #ffffff 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: #ffffff 1pt solid; border-right: #ffffff 1pt solid; padding-top: 1px">
            <div align="right"><strong><font face="宋体" style="font-size: 11pt">报修日期</font></strong><font face="宋体" style="font-size: 11pt">:</font></div>
            </td>
            <td style="border-bottom: black 1.5pt solid; border-left: #ffffff 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: #ffffff 1pt solid; border-right: #ffffff 1pt solid; padding-top: 1px">
            <div align="center"><font face="宋体" style="font-size: 11pt">{DATA_1}</font></div>
            </td>
        </tr>
        <tr style="min-height: 30px">
            <td style="border-bottom: black 1pt solid; border-left: black 1.5pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1.5pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center"><font face="宋体" style="font-size: 11pt">资产编号</font></div>
            </td>
            <td style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1.5pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center">{DATA_2}</div>
            </td>
            <td style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1.5pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center"><font face="宋体" style="font-size: 11pt">资产名称</font></div>
            </td>
            <td style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1.5pt solid; border-right: black 1.5pt solid; padding-top: 1px">
            <div align="center">{DATA_3}</div>
            </td>
        </tr>
        <tr style="min-height: 30px">
            <td style="border-bottom: black 1pt solid; border-left: black 1.5pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center"><font face="宋体" style="font-size: 11pt">规格型号</font></div>
            </td>
            <td style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center">{DATA_4}</div>
            </td>
            <td style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center"><font face="宋体" style="font-size: 11pt">故障日期</font></div>
            </td>
            <td style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1.5pt solid; padding-top: 1px">
            <div align="center">{DATA_5}{OTHER_1}</div>
            </td>
        </tr>
        <tr style="min-height: 30px">
            <td style="border-bottom: black 1pt solid; border-left: black 1.5pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center"><font face="宋体" style="font-size: 11pt">购置日期</font></div>
            </td>
            <td style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center">{DATA_6}{OTHER_2}</div>
            </td>
            <td style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center"><font face="宋体" style="font-size: 11pt">是否在保修期内</font></div>
            </td>
            <td style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1.5pt solid; padding-top: 1px">
            <div align="center">{DATA_7}</div>
            </td>
        </tr>
        <tr style="min-height: 30px">
            <td style="border-bottom: black 1pt solid; border-left: black 1.5pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center"><font face="宋体" style="font-size: 11pt">厂 牌</font></div>
            </td>
            <td colspan="3" style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1.5pt solid; padding-top: 1px">
            <div style="text-align: left">{DATA_8}</div>
            </td>
        </tr>
        <tr style="min-height: 30px">
            <td style="border-bottom: black 1pt solid; border-left: black 1.5pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center"><font face="宋体" style="font-size: 11pt">存放地点</font></div>
            </td>
            <td colspan="3" style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1.5pt solid; padding-top: 1px">
            <div style="text-align: left">{DATA_9}</div>
            </td>
        </tr>
        <tr style="min-height: 100px">
            <td style="border-bottom: #000000 1.5pt solid; border-left: black 1.5pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center"><font face="宋体" style="font-size: 11pt">故障情况</font></div>
            </td>
            <td colspan="3" style="border-bottom: #000000 1.5pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1.5pt solid; padding-top: 1px">
            <div style="text-align: left">{DATA_10}</div>
            </td>
        </tr>
        <tr style="min-height: 30px">
            <td colspan="4" style="border-bottom: #000000 1.5pt solid; border-left: black 1.5pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: #000000 1.5pt solid; border-right: black 1.5pt solid; padding-top: 1px">
            <div align="center"><font face="宋体" style="font-size: 11pt"><strong>报修人核对及审批情况</strong></font></div>
            </td>
        </tr>
        <tr style="min-height: 100px">
            <td style="border-bottom: black 1pt solid; border-left: black 1.5pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: #000000 1.5pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center"><font face="宋体" style="font-size: 11pt">报 修 人</font></div>
            </td>
            <td colspan="3" style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: #000000 1.5pt solid; border-right: black 1.5pt solid; padding-top: 1px">
            <div style="text-align: left">{DATA_11}</div>
            <div style="text-align: right">{DATA_12}</div>
            </td>
        </tr>
        <tr style="min-height: 100px">
            <td style="border-bottom: black 1pt solid; border-left: black 1.5pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center"><font face="宋体" style="font-size: 11pt">部门经理</font></div>
            </td>
            <td colspan="3" style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1.5pt solid; padding-top: 1px">
            <div style="text-align: left">{DATA_13}</div>
            <div style="text-align: left">{DATA_14}</div>
            <div style="text-align: right">{DATA_15}</div>
            </td>
        </tr>
        <tr style="min-height: 100px">
            <td style="border-bottom: black 1pt solid; border-left: black 1.5pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center"><font face="宋体" style="font-size: 11pt">主管部门</font></div>
            </td>
            <td colspan="3" style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1.5pt solid; padding-top: 1px">
            <div style="text-align: left">{DATA_16}</div>
            <div style="text-align: left">{DATA_17}</div>
            <div style="text-align: right">{DATA_18}</div>
            </td>
        </tr>
        <tr style="min-height: 100px">
            <td style="border-bottom: black 1.5pt solid; border-left: black 1.5pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center"><font face="宋体" style="font-size: 11pt">财 务 部</font></div>
            </td>
            <td colspan="3" style="border-bottom: black 1.5pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1.5pt solid; padding-top: 1px">
            <div style="text-align: left">{DATA_19}</div>
            <div style="text-align: left">{DATA_20}</div>
            <div style="text-align: right">{DATA_21}</div>
            </td>
        </tr>
    </tbody>
</table>
</div>