Form I-ADF, Page 28
Installer:
Name ________________________________________________________
Company ________________________________________________________
Address ________________________________________________________
________________________________________________________
________________________________________________________
Phone _________________________________
Distributor (company from which the unit was purchased):
Company ________________________________________________________
Contact ________________________________________________________
Address ________________________________________________________
________________________________________________________
________________________________________________________
Phone _________________________________
Model ________________ Serial No.______________________________Date of Installation ____________
SPECIFIC INSTALLATION NOTES: (i.e. Location, Amps, Gas Pressure, Temperature, Voltage, Adjustments,
Warranty, etc.)
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
BUILDING OWNER OR MAINTENANCE PERSONNEL:
For service or repair
• Contact the installer listed above.
• If you need additional assistance, contact the Distributor listed above.
• For more information, contact your Factory Representative.
INSTALLATION RECORD - to be completed by the Installer:
Specications & illustrations subject to change without notice and without incurring obligations.
©Nortek Global HVAC, LLC 2015. All rights reserved.
All marks are the property of their respective organizations.
O’Fallon, MO I Printed in U.S.A. (12/15)
Form I-ADF (12-15), PN 131805R6