5000KIT | 5000KIT AUTOMATION SET 89
COMMISSIONING CERTIFICATE
13. COMMISSIONING CERTIFICATE
Serial number and production date ________________________________________________
data from the product label
Information on the organisation, authorised to perform mounting and maintenance
_____________________________________________________________________________
_____________________________________________________________________________
name, address, phone
Installation date _______________________________________
day, month, year
LS Signature of the person,
in charge of installation _____________ ___________________
signature full name
The consumer (Client) has checked the content of the set, is informed on and agrees with the
warranty period, and has no complaints about the external look of the product. The product is
mounted and adjusted according to the established requirements and is approved for operation.
The user was instructed on the existing hazards and risks, and informed about operation rules.
Information about the client (consumer) ____________________________________________
_____________________________________________________________________________
name, address, phone
Client’s (customer’s)
signature ____________________ ________________________
signature full name
14. INFORMATION ON REPAIRS DURING WARRANTY PERIOD
Information about repairing organisation ___________________________________________
List of repairs __________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Repair date ___________________________________________
day, month, year
LS Signature of the person
in charge of repair____________ _________________________
signature full name
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Information about repairing organisation ___________________________________________
List of repairs __________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Repair date ___________________________________________
day, month, year
LS Signature of the person
in charge of repair____________ _________________________
signature full name
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