Fire Protection_amend_2_SemiAnnual Ansul 200518.pdf

Johnson ,k • Controls

Johnson Controls Fire Protection LP

Address

State, Zip

Range Hood Suppression Systems Report

Fax:

Customer: Date of Service: SI/S-20 SRP:

Contact:

Address: Inspection: El Installation: LI POP:

Installation Sign Off (If Applicable)

Phone:

Signature:

Date:

Fax:

System Information

Manufacturer

Model It

Serial tt

Cylinder Size & Qty.

Fusible Links 360°

450°

500°

Other * E'''''''' here then enter 14 in box to right

Fuel Shut-off Type:

Size:

System Information (Continued)

Manufacturer Hydro

Tank Pressure

Record Cartridge Weight in boxes to the right

Piranha System - Record PSI in boxes to the right

Cooking / Ventilating Equipment

Number of Duct(s) and Duct Sizes

Hood Size

Plenum Size

Filter Type and Size Qty.

List cooking appliance(s) type and size of cooking surface.

(NOTE: List appliances from left to right) (Size = Length x Width) (Fuel Source . E= Electric, G. Gas, SF= Solid Fuel) (Nozzle Type and Quantity)

Appliance Size Fuel

Source Nozzle Type Qty.

1.

2.

4.

Appliance Size Fuel

Source

7.

8.

9.

10.

11.

12.

3.

13.

All Appliances Properly Protected w/Correct Nozzles

Duct And Plenum Protected w/Correct Nozzles

All Nozzles Properly Aimed At Hazard/Unobstructed

Proper Seperation Between Fryer(s) and Open Flame

Nozzle Blow-off Caps Installed (Replace, If needed)

Hood/Duct Penetrations Sealed w/Weld or UL Device

Check Cartridge Weight (Replace If needed)

Test Detection System From Terminal Detector

Replace Fusible Links (Every 6 Months)

Test Remote Manual Pull Station

Test Mechanical Gas Shut-Off Valve

Test Electric Solenoid Gas Shut-off Valve w/Reset Relay

Test Electric Switch For Proper Operation

System Meets UL 300 Standards

Piping And Conduit Secured To Rigid Surface

18. Tamper Seal(s) Installed

Building Fire Alarm Connected / Activated

Actuation Line Vacuum Test Performed (Every 6 Months)

Blow-out Distribution Piping Network w/Dry Air or Nitrogen

Exhaust Fan(s) Operating

Make-up/return Air Fan(s) Shut Down

All Filters / Spacers Reinstalled ersonnel instructed in manual operation of system

Class K Extinguisher w/ Placard Present

System Returned to Normal Operation

Hydrostastic Test Date Enter Date Code in box to right (Month /Year(

7.

8.

LI

LI

LI

LI LI

LI LI

LI LI

No Yes N/A

LI 4.

15. LI System Installed In Accordance W/Mfg. UL Listing

Name of Activity:a-61%d 1\1151A\

NOTE DEFICIENCIES OR DISCREPANCIES

Clean Nozzles 29. Service and certification tag on system

Immo ILEX"- •

NFPA Standard: - 1U1 hc IMPORTANT NOTICE To CUSTOMER: Customer acknowledges and agrees that, ea the absence eta Service Agreement between parties, services hereunder are perforrned pursuallieSitlinibilndiAarzatta itaLAmme.filariknatmleakisimkr further agrees that the services have been completed with pursuant to the agreed upon scope of work and that the system is in good working order and repair, unless services performed were of a temporary nature, in whi case usto er acknowledges that part of customers system may have been bypassed or is othetwise inoperable until services can be completed CUSTOMER'S ATTENTION IS DIRECTED TO THE LIMITATION OF LIABILITY, WARRANTY, INDEMNITY AND OTHER CONDITIONS ON THE REVERSE SIDE.

Acceptance of customer or customer's representative

Service Technician Signature Date Time Customer's Authorized Agent Signature Date

Service Technician Print

AM [171

Customer's Authorized Agent Print

CUSTOMER COPY

0 2018 Johnson Controls All rights reserved

SG0720 R3 (12/18)

TERMS AND CONDITIONS

1. Limitation of Liability: Limitations of Remedy. It is understood and agreed by Customer that Company is not an insurer and that insurance coverage shall be obtain' Customer and that amounts payable to Company hereunder are based upon the value of the services and the scope of liability set forth in this agreement and are unrelated to the value of Customer's property and the property of others located on the premises. Customer agrees to look exclusively to Customer's insurer to recover for injuries or damage in the event of any loss or injury, and Customer releases and waives all right of recovery against Company arising by way of subrogation. Company makes no guaranty or warranty;

including any implied warranty of merchantability or fitness for a particular purpose that equipment or services supplied by Company will detect or avert occurrences or the consequences therefrom that the equipment or service was designed to detect or avert, ft is impractical and extremely difficult to fix the actual damages which may proximately result from failure on the part of Company to perform any of its obligations under this agreement. Accordingly, Customer agrees that; Company shall be exempt from liability for any loss, damage or injury arising directly or indirectly from occurrences: or the consequences therefrom, which the equipment or service was designed to detect or avert, Should Company be found liable for any loss, damage or injury arising from a failure of the equipment or service in any respect, Company's liability shall be limited to an amount equal to the agreement price (as increased by the price for any additional work) or where the time and material payment term is selected, Customer's time and material payments to Company. Where this agreement covers multiple sites, liability shall be limited to the amount of the payments allocable to the site where the incident occurred. Such sum shall be complete and exclusive. IN NO EVENT SHALL COMPANY BE LIABLE FOR ANY DAMAGE, LOSS, INJURY. OR ANY OTHER CLAIM ARISING FROM ANY SERVICING, ALTERATIONS, MODIFICATIONS, CHANGES, OR MOVEMENTS OF THE COVERED SYSTEM(S) OR ANY OF ITS COMPONENT PARTS BY CUSTOMER OR ANY THIRD PARTY. COMPANY SHALL NOT BE LIABLE FOR INDIRECT, INCIDENTAL OR CONSEQUENTIAL DAMAGES OF ANY KIND, INCLUDING BUT NOT LIMITED TO DAMAGES ARISING FROM LOSS OF USE OR LOST PROFITS, The limitations of liability set forth in this agreement shall inure to the benefit of all parents, subsidiaries and affiliates of Company, whether direct or indirect. Company's employees, agents, officers and directors.

2 Limited Warranty, COMPANY WARRANTS THAT ITS WORKMANSHIP AND MATERIAL FURNISHED UNDER THIS AGREEMENT WILL BE FREE FROM DEFECTS FOR A PERIOD OF NINETY (90) DAYS FROM THE DATE OF FURNISHING. Where Company provides product or equipment of others. Company will warrant the product or equipment only to the extent warranted by such third party, EXCEPT AS EXPRESSLY SET FORTH HEREIN, COMPANY DISCLAIMS ALL WARRANTIES, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO ANY IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE WITH RESPECT TO THE SERVICES PERFORMED OR THE

PRODUCTS, SYSTEMS OR EQUIPMENT, IF ANY, SUPPORTED HEREUNDER,

3. Indemnity. Customer agrees to indemnify, hold harmless and defend Company against any and all losses, damages. costs, incluthng experi fees and costs, and expenses including reasonable attorneys' fees, arising from any and all third-party claims for personal injury, death, property damage or economic lOSS, resulting from any act or omission of Customer or Company, including without !imitation damages resulting from the exposure of workers to Hazardous Conditions whether or not Customer pre-notifies Company of the existence of • Hazardous Conditions, whether such claims are based upon contract, warranty, tort (including but not limited to active or passive negligence), strict liability or otherwise, Company reserves me right to select counsel to represent it in any such action.

4 Hazardous Materials, Customer represents that, except to the extent that Company has been given written notice of the following hazards prior to the execution of this agreement to the best of Customers knowledge there is no:

• "permit confined spae," as defined by the Occupational Safety and Health Administration ("OSHA'):

• risk of infectious disease,

• need for air monitoring, respiratory n, or other medical risk: or

• asbestos, asbestos-containing material, formaldehyde or other potentially toxic or otherwise hazardous material contained in of on the surface of the floors, walls ceilings. insulation or other structural components of the area of any building where work is required to be performed under this agreement.

Al of the above are hereinafter referred to as "Hazardous Conditions,' Company shall have the right to rely on the representations listed above. if Hazardous Conditions are encountered by Company during the course of Company's work, the discovery of such materials shall constitute an event beyond Company's reasonable control, and Company shall have no obligation to further perform services in the area where the Hazardous Conditions exist until the area has been made safe by Customer as certified in writing by an independent testing agency. Customer shall pay disruption expenses and re-mobilization expenses as determined by Company. This agreement does not provide for the cost of capture, containment or disposal of any hazardous waste materials, or hazardous materials encountered during performance of the services. Said materials shall at all times remain the responsibility and property of Customer. Company shall not be responsible for the testing, removal or disposal of such hazardous materials.

5. Equipment Disconnections. This represents Company's notice to you that the systems/equipment/devices listed on the face of this agreement as temporarily or permanently disconnected are no longer in servicept*jyvvivial rttia .gablorrei and/or report occurrences or transmit signals. During any period of impairment, in the event of any occurrence which the fife prot esi .nen detecl &lavert,'MRFigir agrees to defend, indemnify and hold Company harmless from any and all claims arising out of or related to or resulting from that occurrence, including any claims arising out of the impaired condition of the system and/or the cause of such impairment.

.#33 6.General, Unless otherwise specified, work sTalinitabe between the hours of 8:00 AM and 5:00 PM, exciusae of Saturdays, Sundays and Company holidays. All work is subject to review and rebilling in accordance with the texe.an0 condi6tikels agreement/contract with Company, if one is in effect, Company shall not be responsible for failure to render services due to cau e.1,309ftP!4:81`41riad to ora te/al shortages, work stoppages, fires, civil disobedience or unrest, severe weather, fire or any other cause beyond the control of Company. Customer, is aware that the Limitation of debility and other provisions set forth in any existing agreementicontract, if one is in effect, or set forth above, apply to services pejlzu.LaLd materials sup: -d, The texitkigisfieernent shall govern notwithstanding any inconsistent or additional terms and conditions in any purchase order or other document submitted by Customer.

7. Payment Term, "To clarify payment si Report Company requires payment in full within thirty (30) days front the invoice date.

2019 Johnson Controls. All Rights Reserved

Date of Service:

SRit:

Inspection: Installation: CI POP:

Installation Sign Off (If Applicable)

Signature: Date:

0 Johnson 0/ Controls

Range Hood Suppression Systems Report

Johnson Controls Fire Protection LP

Address

State, Zip a:

Fax:

Customer:

Contact:

Address:

Phone:

Fax:

System Information

Manufacturer

Model It

Serial it

Cylinder Size & Qty.

Fusible Links

450'

500°

Other . E.', herethen enter P;r1 box to nght

Fuel Shut-off Type:

Size:

System Information (Continued)

Manufacturer Hydro

Tank Pressure

Record Cartridge Weight in boxes to the right

Piranha System - Record PSI in boxes to the right

Cooking / Ventilating Equipment

Number of Duct(s) and Duct Sizes

Hood Size

Plenum Size

Filter Type and Size Qty.

List cooking appliance(s) type and size of cooking surface.

(NOTE: List appliances from left to right) (Size = Lengths Width) (Fuel Source : E= Electric, Go Gas, SF= Solid Fuel) (Nozzle Type and Quantity)

Appliance Size Fuel

Source

1.

3.

4.

Appliance Size Fuel

Source

7.

8.

9.

10.

11.

12.

20.

All Appliances Properly Protected w/Correct Nozzles

Duct And Plenum Protected w/Correct Nozzles

All Nozzles Properly Aimed At Hazard/Unobstructed

Proper Seperation Between Fryer(s) and Open Flame

Nozzle Blow-off Caps Installed (Replace, if needed)

System Meets UL 300 Standards

Piping And Conduit Secured To Rigid Surface

Tamper Seal(s) Installed Year Year

Building Fire Alarm Connected / Activated

Actuation Line Vacuum Test Performed (Every 6 Months)

Li Li Li Li Li

Li Li

Li LI Hood/Duct Penetrations Sealed w/Weld or UL Device Li Blow-out Distribution Piping Network w/Dry Air or Nitrogen

3.

4.

S.

6.

111 Check Cartridge Weight (Replace If needed)

Test Detection System From Terminal Detector

Replace Fusible Links (Every 6 Months)

Test Remote Manual Pull Station

Test Mechanical Gas Shut-Off Valve

Test Electric Solenoid Gas Shut-off Valve w/Reset Relay

Exhaust Fan(s) Operating

Make-up/return Air Fan(s) Shut Down

All Filters / Spacers Reinstalled

Personnel instructed in manual operation of system

Class K Extinguisher w/ Placard Present

System Returned to Normal Operation

Li Li Li

7.

8.

9.

10.

11.

13. Test Electric Switch For Proper Operation

4. Clean Nozzles

15. System Installed In Accordance W/Mfg. UL Listing

Hydrostastic Test Date Enter Date Code in box to right (Month / Year)

29. Service and certification tag on system

NOTE DEFICIENCIES OR DISCREPANCIES

NFPA Standard:

IMPORTANT NOTICE TO CUSTOMER: Customer acknowledges and agrees that. in the absence of a Service Agreement between parties, services hereunder are performed pu cond :111:0 of this Service Request. Customer further agrees that the services have been completed with pursuant to the agreed upon scope of work and that the system is in good working order and repair, unless services performed were o Tn ystem may haw been bypassed or is otherwise inoperable until services can be completed. CUSTOMER'S ATTENTION IS DIRECTED TO THE UMITATION OF LIABILITY, WARRANTY, INDEMNITY AND OTHER CONDITIONS ON THE REVERSE SIDE.

Acceptance of customer or customer's representative

Service Technician Signature Date Time Customer's Authorized Agent Signature Date

Service Technician Print

AM 111

Customer's Authorized Agent Print

PM

2018 Johnson Controls All rights reserved

CUSTOMER COPY SG0720 R3 (12/18)

TERMS AND CONDITIONS

1. Limitation of Liability; Limitations of Remedy. It is understood and agreed by Customer that Company is not an insurer and that insurance coverage shall be obtaine Customer and that amounts payable to Company hereunder are based upon the value of the services and the scope of liability set forth in this agreement and are unrelated to toe value of Customer's property and the property of others located on the premises. Customer agrees to look exclusively to Customer's insurer to recover for injuries or damage in the event of any loss or injury, and Customer releases and waives all right of recovery against Company arising by way of subrogation. Company makes no guaranty or warranty, Including any implied warranty of merchantability or fitness for a particular purpose that equipment or services supplied by Company will detect or avert occurrences or the consequences therefrom that the equipment or service was designed to detect or avert.

It is impractical and extremely difficult to fix the actual damages which may proximately result from failure on the part of Company to perform any of its obligations under this agreement. Accordingly, Customer agrees that. Company shall be exempt from liability for any loss, damage or injury arising directly or indirectly from occurrences, or the consequences therefrom, which the equipment or service was designed to detect or avert, Should Company be found liable for any loss, damage or injury arising from a failure ef the equipment or service in any respect, Company's liability shall be limited to an amount equal to the agreement price (as increased by the price for any additional work) or where the time and material payment term is selected, Customer's time and material payments to Company, Where this agreement covers multiple sites, liability shall be limited to the amount of the payments allocable to the site where the incident occurred. Such sum shall be complete and exclusive, IN NO EVENT SHALL COMPANY BE LIABLE FOR ANY DAMAGE, LOSS, INJURY, OR ANY OTHER CLAIM ARISING FROM ANY SERVICING, ALTERATIONS. MODIFICATIONS, CHANGES, OR MOVEMENTS OF THE COVERED SYSTEM(S) OR ANY OF ITS COMPONENT PARTS BY CUSTOMER OR ANY THIRD PARTY. COMPANY SHALL NOT BE LIABLE FOR INDIRECT, INCIDENTAL OR CONSEQUENTIAL DAMAGES OF ANY KIND, INCLUDING BUT NOT LIMITED TO DAMAGES ARISING FROM LOSS OF USE OR LOST PROFITS, The limitations of liability set forth in this agreement shall inure to the benefit of all parents, subsidiaries and affiliates of Company, whether direct or indirect, Company's employees, agents, officers and directors.

2 Limited Warranty. COMPANY WARRANTS THAT ITS WORKMANSHIP AND MATERIAL FURNiSHED UNDER THIS AGREEMENT WILL BE FREE FROM DEFECTS FOR A PERIOD OF NINETY (90) DAYS FROM THE DATE OF FURNISHING, Where Company provides product or equipment of others. Company will warrant the product or equipment only to the extent warranted by such third party. EXCEPT AS EXPRESSLY SET FORTH HEREIN, COMPANY DISCLAIMS ALL WARRANTIES, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO ANY IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE WITH RESPECT TO THE SERVICES PERFORMED OR THE _

PRODUCTS, SYSTEMS OR EQUIPMENT, IF ANY, SUPPORTED HEREUNDER.

3. Indemnity. Customer agrees to indemnity, held harmless and --defend Company aoainst any and all losses, damages, costs, including expert fees and costs, and expenses including reasonable attorneys' fees, arising from any and all third-party claims for personal injury, death, property damage or economic loss, resulting from any act or omission Of Customer or Company, including without litnitation damages resulting from the exposure of workers to Hazardous Conditions Whether' or not Customer pre-notifies Company Of the existence of Hazardous Conditions, whether such claims are based upon contract, warranty, tort (including but not limited to active or passive negligence), strict liability or otherwise. Company reserves right to select counsel to represent it in any such action, 4 Hazardous Materials. Customer represents that, except to the extent that Company has been qiven ortilten notice of the following hazards prior .o the execution of this agreement, to the test of Customer's knowledge there is no:

• "permit confined space," as defined by the Occupational Safety and Health Administration (OSHA');

• risk of infectious disease;

• need for air monitoring, respiratory protection, or otner medical r

• asbestos, asbestos-containing material, formaldehyde or other potentially toxic or otherwise hazardous material contained iri or on the surface of the floors, walls, ceilings, insulation or other structural components of the area of any building where work is required to be performed under this agreement.

aboveA:l of the are hereinafter referred to as "Hazardous Conditions.' Company shall have the right to rely on the representations listed above. if Hazardous Conditions are encountered by Company during the course of Company's work, the discovery of such materials shall constitute an event beyond Company's reasonable control, and Company shall have no obligation to further perform services in the area where the Hazardous Conditions exist until the area has been made safe by Customer as certified in writing by an independent testing agency. Customer shall pay disruption expenses and re-mobilization expenses as determined by Company. This agreement does not provide for the cost of capture, containment or disposal of any hazardous waste materials, or hazardous materials encountered during performance of the services. Said materials shall at all times remain the responsibility and property of Customer. Company shall not be responsible for the testing, removal or disposal of such hazardous materials.

5. Equipment Disconnections. This represents Company's notice to you that the wstemsrequipmentidevic,es listed on the eee of this agreement as temporarily or permanently disconnected are no longer in service- airlih.iiihanVetec

_i 4.4iiik, and/or report occurrences or transmit signals. During any -period of impairment, in the event of any occurrence which the_fire proterrrsttt,, ,.03 dcdigtrd 9 e I grees to defend, indemnify and hold Company harmless from any and all claims arising out of or related to or resuifing from that occurrence, including any claims arising out of the impaired condition of the system and/or the cause of such impairment.

'3 33 6. General. Unless othermse specifier), wort shaft be 'Jute b't.,t ,rscri this f. Ours of 8:00 AM and 5:00 PM, exclusive of Saturdays. Sundays and Company holidays. Alt work rs subject to review and rebilling in accordanci with the terms and conditions of Customer's agreement/contract with Company, if one is in effect. Company shall not be responsible for failure to render services due to causes re.r„,-, 5 rp2.cnn=0,10 ,A443140 material shortages, work stoppages, fires, civil disobedience or unrest, severe weather; fire or any other cause beyond the control of Company. Customer is aware that the Limitation of Liability and other provisions set forth in any existing agreement/contract, if one is in effect, or set forth above, apply to services performed and materials supplied. The termsaisamment shall govern notwithstanding any inconsistent or additional terms and conditions in any purchase order or other document submitted by uustomer.

7. Payment Term. "To clarify payment term for Services pursuant to this Report. Company requires payment in lull t,thirty (30) days from the invoice date, Cf 2019 Johnson Controls. All Rights Reserved