Dunkirk Q95M-200 Modulating Condensing Boiler - Manual (Page 28)

11 - INSTALLATION AND CHECKOUT CERTIFICATE
Boiler Model: Boiler Serial Number: Date of Installation:
Measured BTUH Input: Boiler Location: Altitude of Location:
Honeywell AM Kit Installed? (Yes/No): Service Dates:
System Type (Give Brief Description):
Installation Instructions Have Been Followed
Checkout Procedure/Adjustments Performed
Maintenance/Service Issues Reviewed With Owner or Maintenance Person
Installation Manual Affixed Adjacent To or On Boiler
Installer/Technician’s Company:
Installer’s Name:
Company Address:
Company Phone Number:
Installer’s Signature: