Please complete this form and return to ThermFlo at startups@thermflo.com so that the start-up can be scheduled. IMPORTANT: At the time of start-up, it is required that: Liebert manuals must be used to ensure proper installation and start-up of the unit, then given to the end-user as reference for proper maintenance and operation in the future. The installing contractor must be on site and ready to respond as needed. The installing contractor must supply refrigerant and POE oil. The End-User/Owner of the Liebert equipment should be present, so our technician can provide training on their new Liebert equipment. Please schedule accordingly. If the equipment is not ready for the scheduled start-up (see checklist on pg. 2), there may be a $500.00 charge to reschedule. A purchase order or credit card information must be provided before the start-up can be rescheduled.

Requested Start-Up Date:

Start-ups must be scheduled with a start time of 8:00 A.M., Monday through Friday, with at least 72 hours notice. Overtime rates will apply for start-ups performed outside of business hours.

Model No. Serial No.

Installing Contractor Information (Required)

Company Name: Requested By Name: Requested By Phone No.:

Company Address: On-Site Contact Name: On-Site Contact Phone No.:

City, State, Zip: On-Site Email:

LIEBERT START-UP REQUEST FORM

Site/Owner Information and Location of Unit (Required for Warranty Registration and Maintenance))

Site Company Name: Unit Location:

Site Address: Contact Name: Contact Phone No.:

Site City, State, Zip: Contact Email:

Inspect and Confirm the Following:

Air-Cooled Units: Glycol Units: Water-Cooled Units: Other Products Installed At This Site: Power wiring to units

and condensers is complete Power wiring to units, dry coolers

and pumps is complete Power wiring to unit

is complete AC4

Control wiring to condensers is complete

Control wiring to the units, dry coolers and pumps is complete

Water supply to unit is connected

Water Detection

Network Switch

Water supply to humidifier is connected

Supply, return piping and the dry coolers are filled with Glycol and vented

Drain piping is complete

Network Cabling

Unity Cards Site Scan/SiteLink MUST CALL EMERSON NETWORK POWER/ LIEBERT FOR START-UP 1-800-543-2378

Drain piping is complete Unit(s) installed per manual installation specifications

Refrigerant piping has been leak checked, evacuated and charged to at least 80%

Drain piping is complete

Water supply to humidifiers is connected

Unit(s) installed per manual installation specifications

Unit(s) installed per manual installation specifications

Other (explain)

Special Instructions:

Installing Contractor’s Signature: Date:

Thank You! ThermFlo Service Coordinators I Phone: 847-353-5353

Please send completed form to: startups@thermflo.com