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Customer:
Addess:
Street:
City, zip code:
Phone num:
Email:
Company:
Addess:
Street:
City, zip code:
Phone num:
Email:
Device:
Serial number:
Power:
Bivalent source:
Location of out. unit
"
I confirm that device was installed by conventional and by both sides accepted technical dispositions.
Flawless functionality was tested and I was acquained with basic service and maintenance.
Date
Installation protocol
Company representative signature
This part belongs to installation company
HANDOVER CONFIRMATION
in:
signature:
43
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