This form must be submitted 30 days prior to the requested Startup date!

Date
Field is required!
Project/Job Title
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Project/Job Number
Field is required!
Electrical Contractor
Field is required!
Company Contact
Field is required!
Contact Phone Number
Field is required!
Electrical Distributor
Field is required!
Distributor Contact
Field is required!
Phone Number
Field is required!
Email Address
Field is required!

Please confirm the following tasks are complete:

Line Voltage terminated to the controller.
Field is required!
Line/Loads terminated to the relays/dimmers.
Field is required!
Lighting loads with 0-10v dimming wiring has been tested for proper polarity.
Field is required!
Control devices terminated to the controller and ready to be tested.
Field is required!
Specified communication cable properly installed, tested, and terminated.
Field is required!
Updated panel schedules or As-built information completed and sent into Lighting Solutions.
Field is required!
Times schedule information sent into Lighting Solutions.
Field is required!
Building Automation Systems Required?
Field is required!
Automation Company
Field is required!
Company Contact
Field is required!
Contact Phone Number
Field is required!
Please confirm Startup has been coordinated with ALL of the following parties:
Field is required!
Startup date requested?
Field is required!
Requested Date
Field is required!
Training date requested?
Field is required!
Requested Date
Field is required!
Requested Time
Field is required!
Additional Information
Is there anything else we should know?
Field is required!

Contact Information

Please enter your contact information.
First Name
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Last Name
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Your Company Name
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Title
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Phone Number
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Email Address
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Please Read & Sign

If all tasks are not completed as verified on the arrival of the Field Engineer, then the Field Engineer will leave the job site and the Contractor or Distributor will be charged the full cost of the scheduled visit. Another visit will need to be scheduled with Lighting Solutions at the Contractor's expense once all the above items have been completed.
Date
Field is required!