IGBT D
IMMER
R
ACKS
Installation
& Operation
E
NGINEERING
C
HECK
-O
UT
R
EQUEST
F
ORM
Please review the
on the previous page.
Upon completion of the requirements outlined in the Notice, make a
copy of this form, complete all information and fax it to Genlyte Controls Technical Services (fax: +1-972-389-6175).
3 W
EEKS
OTICE IS
R
EQUIRED
!
REQUESTED E.C.O. DATE: _________________________________________________________________
Location of Job Site: _________________________________________________________________
_________________________________________________________________
Please include directions from the nearest Airport to the Job Site.
Job Name: _________________________________________________________________
Order #: ________________ Distr / P.O. #: ________________
Factory Representative: _________________________________________________________________
Contractor
Distributor: _________________________________________________________________
Address: _________________________________________________________________
_________________________________________________________________
Phone: _______________________ Fax: _______________________
By returning this form, you certify that the system is ready for Engineering Check-Out and energization in accordance with
the Notice To Contractor. This includes all DMX512, Ethernet, and Lytemode ILS control terminations.
You also certify that all personnel required for training by specification or contract will be available. At the completion of
training, all personnel required by specification or contract must be present to accept the system.
If the Field Service Representative arrives at the date and time you request, and the site is not ready, you will be
responsible for time and expense beyond what would have been required to complete the E.C.O. and/or for any
return visit(s).
Street
Street
Signature of
City
City
State
State
Zip
Zip
Contractor
Distributor: _________________________________________________________________
Print or Type Name: _________________________________________________________________
Title: _________________________________________________________________
Owner / Owner's Agent who will
be present to Accept the System: _________________________________________________________________
Phone: _______________________ Fax: _______________________
Make a copy of this page and fax completed form to Philps Controls Technical Services at +1-972-389-6175
