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Fire Alarm and Emergency Communication System Record of Completion

Draper City Fire Department Fire Prevention Bureau

To be completed by the system installation contractor at the time of system acceptance and approval.
It shall be permitted to modify this form as needed to provide a more complete and/or clear record. Insert N/A in all unused lines.
Attach additional sheets, data, or calculations as necessary to provide a complete record

1. PROPERTY INFORMATION

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Name of property:

Address

City

Zip Code

Description of property:

Occupancy Type

Name of property representative

Address

City

Zip Code

Phone Number- Primary

Fax Number

Email- Property Information Contact

Authority having jurisdiction over this property:

Phone Number- Primary

Fax Number

2. INSTALLATION, SERVICE, AND TESTING CONTRACTOR INFORMATION

Installation contractor for this equipment:

Address

City

Zip Code

License or certification number:

Phone Number- Primary

Fax Number

Service organization for this equipment:

Address

City

Zip Code

License or certification number:

Phone Number- Primary

Fax Number

A contract for test and inspection in accordance with NFPA standards is in effect as of:

Contracted testing company:

Address

City

Zip Code

Phone Number- Primary

Fax Number

Contract Expires:

Contract number:

Frequency of routine inspections: