Submit this form at least three weeks prior to the requested commissioning date. Project Name Service Requested - Select - Prewire Meeting Startup Startup + Owner Training Owner Training Follow Up Visit System nLight nLightAIR SensorSwitch Fresco ETC Other RGB/DMX System Date Requested Working Outside Normal Business Hours? Yes No *CSLA standard business hours are M-F, 8:00 AM to 5:00 PM CST If yes, what are these hours? Site Address Job Site Address Address 2 City State - None - Alabama Alaska American Samoa Arizona Arkansas Armed Forces (Canada, Europe, Africa, or Middle East Armed Forces Americas Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Federate States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming ZIP Code Parking Instructions PPE Requirements Hard Hat Safety Glasses Safety Vest/Hi-Vis Steel Toed Boots Background Check* Drug Screen* None PPE Documentation NOTE: For Background Check and Drug Screen, please provide instructions and a copy of the contract documents showing requirements.One file only.100 MB limit.Allowed types: txt rtf pdf doc docx odt ppt pptx odp xls xlsx ods. Installing Contractor PM Information Electrical Contractor Contractor PM Name Contractor PM Email Contractor PM Phone Number Installing Contractor Information Foreman Name Foreman Email Foreman Phone Number ____________________________________________________________________________________________________________________________________ IMPORTANT: The information provided in this form is essential for evaluating the readiness of the jobsite. Please carefully review the terms and requirements below before proceeding.Note: Any missing information could result in scheduling delays or additional charges. All applicable items on the attached Commissioning Request List must be completed before the arrival of the CSLA Field Service Technician. Requested days are not scheduled until confirmed by CSLA. CSLA cannot be responsible for dates that are not confirmed. Please allow an estimated three week lead time to schedule a Field Service Technician following the submission of this form to CSLA. All installation cables and wires are completed as specified by prints and labeled substitutions are to be noted. Please consult CSLA if equipment needs to be energized. Do not attempt to energize or otherwise operate the equipment before inspection is made, as this may damage the equipment and automatically void the warranty. If the site representatives are not available for training on the specified date, then a return visit may be billable. If the Field Service Technician arrives on site on the scheduled date and the site/system is not ready, additional days of service may be required and billed accordingly. I understand that the CSLA Field Service Technician can leave if the site is not ready. I understand that the CSLA Field Service Technician will not return to site without a new PO if the site is not ready on the scheduled date. I understand this applies to CAT5e/CAT6 terminations being completed properly. Is a detailed Sequence of Operations (SOO) available? Yes No **If an SOO is not available, the CSLA default SOO will be utilized by the Field Service Technician. ___________________________________________________________________________________________________________________________________ CANCELLATION: We require a minimum of 48 hours notification prior to cancellation of the confirmed date. Please submit your cancellation via email to the Controls Project Manager.BACK CHARGES: CSLA will not accept any back charges that were not authorized in advance before work was performed. Any back charge issues must be submitted in writing and reviewed for approval in writing by CSLA. The communication must be in writing regarding the back charge and must be set forth with specific reasons for the back charge, including all available backup data regarding the reason for the back charge. Back charges submitted after completion of the project will not be honored. Note: Verbal authorization can only be given by CSLA and must be followed by written notification as outlined above within 24 hours. Is this Project set to be completed in Phases? Yes No If Yes, please specify Please Complete the Commissioning Request Checklist: Questions Completed Will be completed by requested date N/A Missing and/or damaged items have been reported to CSLA Completed Will be completed by requested date N/A Lighting control system installed and wired via shop drawings and cut sheets provided Completed Will be completed by requested date N/A Lighting fixture & control types, serial numbers, and locations recorded (if applicable) Completed Will be completed by requested date N/A Approved control cable used and labeled at both ends Completed Will be completed by requested date N/A Control wire terminated at each end Completed Will be completed by requested date N/A All lighting fixtures installed with data and power connected Completed Will be completed by requested date N/A All CAT5e/CAT6 terminations are complete, and have been tested Completed Will be completed by requested date N/A Meter 0-10V control lines to ensure that no line voltage is present Completed Will be completed by requested date N/A Lumenpulse Systems with CBX controllers to be tested via press test button inside box Completed Will be completed by requested date N/A Appropriate personnel are available for training Completed Will be completed by requested date N/A Note: If the Field Service Technician arrives on site on the scheduled date and the site/system is not ready, a return visit is billable. Authorization Please sign above to confirm your understanding that all checklist items must be completed by the installing contractor before the Field Service Technician arrives onsite. End User Contact Information -The following representative of the End User will be responsible for signing off on the system once commissioning and training has been completed. End User Name End User Title End User Email End User Phone Number NOTE:● Please take into consideration the availability of these persons prior to scheduling the Commissioning visit. Aftersystem checkout is completed, a representative of the owner must be available to receive operation andmaintenance instruction. Arrangement for evening hour instruction must be made in advance.● Unless otherwise specified at the time of purchase, only one trip by a Field Service Technician will be made to thejob site for system commissioning and training.● It is important that all representatives of such parties as the owner, purchaser, installing contractor, and consultantbe available the day of system checkout to countersign the inspection records.● If the site representatives are not available for training on the specified date, then a return visit may be billable.● If a return visit is required for changes to the specified Sequence of Operations (SOO), the return visit may bebillable.
