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AGENCIES LTD. 

CI2 PRECOMMISSIONING SIGN OFF FORM

Please take these seriously as it is a minimum $1000 fee for start-up not to be ready when start-up team arrives. 

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Please make sure forms are filled out accurately and work is done or start up team will have to reschedule but will require a 2nd PO prior to return. 

1. Form must be filled out completely and signed by the mechanical contractor. 

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 2. If commissioning agents find pre-commissioning work to be incomplete, the project commissioning will not proceed. Additional visits to the commission will require a Purchase Order or Payment in full, prior to site arrival.

Please complete all fields.

CI2 Pre-Commissioning Sign Off Form

Is PPE required on site? (Yes/No)
YES
NO
Is Site Orientation required prior to start-up? (Yes/No)
YES
NO

Boilers

Number of Boilers
1
2
3
4
5
6
7
8
Boiler Models (Please check all the apply):
BACNET / ModBus: (Yes/No)
YES
NO
BMS 0-10V Signal: (Yes/No)
YES
NO
System purged of Air: (Yes/No)
YES
NO
Is Combustion free of halogens (solvents & cleaning fluids) and dust (drywall): (Yes/No)
YES
NO
Are System Pumps operating: (Yes/No)
YES
NO
Is there a heat dump available to reject heat during commissioning: (Yes/No)
YES
NO
Gas Train leak test performed & documented: Yes/No
YES
NO

Controls

CANbus connected 91 Plug:
YES
NO
N/A
Outdoor sensor installed on cascade/lead boiler:
YES
NO
N/A
Common Supply sensor installed on cascade/lead boiler
YES
NO
N/A
DHW Tank Sensor installed on cascade/lead boiler:
YES
NO
N/A

Venting

Is Venting Fully installed:
YES
NO

Gas

Fuel: (N/G or L/P)
N/G
L/P
If L/P, has fuel conversion been done:
YES
NO
Gas Line Purged: (Y/N)
YES
NO

Safetys & System Components

Boiler PRV Installed & Tested:
YES
NO
LWCO Installed:
YES
NO
No Evidence of Leaks:
YES
NO
Power connected to each boiler :
YES
NO
Boiler pump(s) wired to Contact in boiler:
YES
NO
DHW pump(s) wired to cascade control:
YES
NO
Pump(s) installed in correct direction of flow:
YES
NO
Condensate neutralization kit installed:
YES
NO
Is each boiler condensate connected:
YES
NO
Is condensate line vented:
YES
NO
Is condensate line sloped to drain:
YES
NO

Mixing Valves

Are there any Viessmann controlled mixing valves:
YES
NO
N/A
Are mixing valves wired back to cascade control:
YES
NO
N/A
Has direction been confirmed for operation:
YES
NO
N/A
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