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SIEMENS <br />RECEIVED <br />JAN 282013 <br />FACILITES MANAGEMENT <br />System Acceptance Sign -Off Sheet <br />Project Name. <br />Project Number: <br />Siemens Industry, Inc <br />Building Technologies <br />BFL2 FIS Indian River County Jail. Fire Alarm <br />440P-106011 <br />This system has been fully demonstrated and explained in accordance with the <br />contract, and is approved for acceptance by the Customers Representative on <br />Date:' <br />F di" a 0011/ <br />by h{ Mary? ea, rel <br />This system is accepted with the full knowledge: that the installation must undergo a <br />token debugging period, and the understanding that all items (if any) on the following list <br />will be corrected in a timely manner from the above date. I accept this system with <br />exceptions (if any) as noted by the following detailed list <br />Customer. .Indian .River County <br />Signature: Q(f <br />Title: j t <br />Date:d14-(7.1 <br />• . <br />`re l onS. <br />Siemens Industry, Inc., Building <br />Technologies Division <br />Signature: <br />Title: <br />Date: <br />Exception List Attached No ❑ Yes <br />DocuirientNiunber. A03 :gg _FM0027 <br />Version: 1.3 <br />Docurhent Owner Charles Brown Data: 04/26/20.11 <br />Department:. Solutions Operations Standards Form page 1 of 1 <br />58 <br />