Statement Of Compliance - A.O. Smith VB/VW 500/750/1000 Start-Up Instructions

I, the undersigned, certify that the product listed and described above has been started in accordance with this
form and the literature provided, (Instruction Manual part number 212800) and that all measured values and
requirements are within the manufacturer's specifications. If this unit does not meet all start-up criteria in this
document, DO NOT LEAVE UNIT IN OPERATION. SEVERE PERSONAL INJURY, PROPERTY DAMAGE OR
EQUIPMENT DAMAGE MAY OCCUR. If the boiler is damaged due to any criteria not being met, WARRANTY may
not cover damaged parts or any labor allowances.
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Required Signature of Start-up Agent
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Required Signature of Owner, contractor or installer
For additional information please refer to the User's Manual supplied with the boiler or contact:
Our Internet Site is another source of information 24 hours a day.

STATEMENT OF COMPLIANCE

A.O. Smith Technical Services at 1-800-527-1953
7 a.m. to 7 p.m. Central Time
http://www.aosmithwaterheaters.com
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