FIRE ALARM INSTALLATION LOG BOOK



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13 Whiteknights P O Box 235 Reading RG6 6BW FIRE ALARM INSTALLATION LOG BOOK FOR ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. PART OF M&E SERVICES DOCUMENT PACK DOCUMENT N02 5 In accordance with BS 5839- This installation log book must be handed to the Estates Services Department, complete and with all supporting documentation before Practical Completion. IMPORTANT NOTE: The design of all fire safety services must be in accordance with the University of Reading ッs Fire Safety Guide 34 and in conjunction with the Estates Services Department and the University ッs Fire Safety Adviser (Peter Lawther 0118 378 8282 ). Automatic fire alarm systems for academic and administration buildings not used for sleeping purposes, L3 standard. Automatic fire alarm systems in residential buildings with sleeping accommodation, L1 standard. Issued 11/05/05 V3 Revised 12/2011-1 -

13FIRE ALARM INSTALLATION LOG BOOK As recommended in Annex F LB It is recommended that this log book be maintained by a responsible person, who should ensure that every entry is properly recorded. This is necessary to satisfy the recommendations of BS 5839-1, compliance with which may be a requirement of legislation. If the premises are certificated under the Fire Precautions Act 1971, failure to keep a suitable log book may be a breach of the requirements of the certificate, which is a criminal offence. In order to satisfy the recommendations of BS5839-1, the following must be recorded: - The name of the responsible person - Brief details of the maintenance arrangements - Dates & times of all tests, including fire drills - Dates & times of all fires to which the system responds - Dates & times of all false alarms - Causes, circumstances surrounding, and category of all false alarms (if known) - The identity of any manual call point or automatic fire detector that triggers any of the above fire alarm signals (if known) - Dates & types of all faults & defects - Dates & types of all maintenance (e.g. service visit or non-routine attention) THE ABOVE INFORMATION IS RECORDED & HELD BY THE UNIVERSITY MAINTENANCE DEPARTMENT. PLEASE PRINT NAME BEFORE HANDOVER Address of protected premises: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ...... Responsible person: (Deputy Head of Maintenance) ュ ュ ュ ュ ュ. ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ... ュ ュ ュ ュ... The system was designed by: (Consultant) ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... The system was installed by: (Contractor) ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ.. ュ ュ ュ ュ ュ... ュ ュ ュ ュ... The system was commissioned by: (Gent Limited) ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Verification was undertaken by: (Consultant) ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ... The system was accepted by: (Estate Services Department) ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ... The system is maintained under contract by: (Gent Limited / DLO)... ュ ュ... ュ ュ ュ ュ ュ ュ... Issued 11/05/05, V3 Revised 12/2011-2 -

13FIRE ALARM DESIGN CERTIFICATE FD Certificate of design for the fire alarm system at: Address:...... I/we being the competent person(s) responsible (as indicated by my/our signatures below) for the design of the fire alarm system, particulars of which are set out below, CERTIFY that the said design for which I/we have been responsible complies to the best of my/our knowledge and belief with the recommendation of Section 2 of BS 5839- for the system Category described below, except for the variations, if any, stated in this certificate. Name in block letter: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Signature:... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Position:. ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ... Date: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ... For and on behalf of: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Address: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Postcode: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ... The extent of liability of the signatory is limited to the system described below. System Category (see BS 5839-1, Clause 5) ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Variation from the recommendations of Section 2 of BS 5839-1, Clause 7): ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Extent of system covered by this certificate:... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ... Brief description of areas protected (not applicable for Category M, L1 or P1 systems):... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ...... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ... Measures incorporated to limit false alarms. Account has been taken of the guidance contained in Section 3 of BS 5839- and, more specifically (tick as appropriate): The system is manual. Type & siting of manual call points takes account of the guidance contained in Section 3 of BS 5839-1. The system incorporates automatic fire detectors, and account has been taken of reasonably foreseeable causes of unwanted alarms, particularly in the selection and siting of detectors. An appropriate analogue system has been An appropriate multi-sensor system has been specified specified A time-related system has been specified (details) ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ... Fire signals from automatic fire detectors result initially in a staff alarm, which displays a general alarm/transmission of signals to an alarm receiving centre (delete as applicable) for ュ ュ ュ ュ. min Appropriate guidance has been provided for the user to enable limitation of false alarms Other measures as follows: ュ ュ ュ ュ ュ... ュ ュ ュ ュ... INSTALLATION AND COMMISSIONING. It is strongly recommended that installation and commissioning be undertaken in accordance with the recommendations of Section 4 & Section 5 of BS 5839- respectively. SOAK TEST In accordance with the recommendations of 35.2.6 of BS 5839-, it is recommended that, following commissioning, a soak period of ュ ュ ュ ュ ュ ュ ュ. should follow. (Enter a period of not less than 1 week). As the system incorporates no less than 50 automatic fire detectors, no soak test is necessary to satisfy the recommendations of BS 5839-:2002. VERIFICATION Verification that the system complies with BS 5839- should be carried out, on completion, in accordance with Clause 43 of BS5839-1: Yes No To be decided by the purchaser or user MAINTENANCE: It is strongly recommended that, after completion, the system is maintained in accordance with Section 6 of BS 5839-. USER RESPONSIBIITIES: The user should appoint a responsible person to supervise all matters pertaining to the fire alarm system in accordance with the recommendations of Section 7 of BS 5839-. Issued 11/05/05, V3 Revised 12/2011-3 -

13FIRE ALARM INSTALLATION CERTIFICATE FI Certificate of installation for the fire alarm system at: Address: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ. ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... I/we being the competent person(s) responsible (as indicated by my/our signatures below) for the installation of the fire alarm system, particulars of which are set out below, CERTIFY that the said installation for which I/we have been responsible complies to the best of my/our knowledge and belief with the recommendation of Section 4 of BS 5839- for the system Category described below, except for the variations, if any, stated in this certificate. Name: (in block letter): ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ... Signature: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ... ュ ュ... Position: ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ... Date: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ... For and on behalf of: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ... Address: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ. ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ... Postcode: ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Extent of installation work covered by this certificate: ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Specification against which system was installed: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ... Variations from the specification and/or Section 4 of BS 5839-1 (see BS 5839-1: Clause 7): ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ... Wiring has been tested in accordance with the recommendations of Clause 38 of BS 5839-. Test results have been recorded and provided to: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Unless supplied by others, the ョas fitted ッ drawings have been supplied to the person responsible for commissioning the system (see 36.2m) of BS 5839-. ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ...... Issued 11/05/05, V3 Revised 12/2011-4 -

13FIRE ALARM COMMISSIONING CERTIFICATE FC Certificate of installation for the fire alarm system at: Address: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ.. ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ.. ュ... I/we being the competent person(s) responsible (as indicated by my/our signatures below) for the commissioning of the fire alarm system, particulars of which are set out below, CERTIFY that the said work for which I/we have been responsible complies to the best of my/our knowledge and belief with the recommendations of Clause 39 of BS 5839-, except for the variations, if any, stated in this certificate. Name: (in block letter):... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Signature: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ... ュ ュ... Position: ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Date: ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... For and on behalf of: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ... Address: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ... Postcode: ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Extent of system covered by this certificate:... ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Variations from the recommendations of Clause 39 of BS 5839- (see BS 5839-, Clause 7) ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... All equipment operates correctly. Installation work is, as far as can reasonably be ascertained, of an acceptable standard. The entire system has been inspected and tested in accordance with the recommendation of 39.2c of BS 5839-. The system performs as required by the specification prepared by: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ. a copy of which I/we have been given. Taking into account the guidance contained in Section 3 of BS 5839-12002, I/we have not identified any obvious potential for an unacceptable rate of false alarms. The documentation described in Clause 40 of BS 5839- has been provided to the user. The following work should be completed before/after (delete as applicable) the system becomes operational. ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... The following potential causes of false fire alarms should be considered at the time of the next service visit:... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Before the system becomes operational, it should be soak tested in accordance with the recommendation of 35.2.6 of BS 5839- for a period of ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. (Enter a period of either 1 week, such period as required by the specification, or such a period as recommended by the signatory to this certificate, whichever is the greatest, or delete if not applicable). Issued 11/05/05, V3 Revised 12/2011-5 -

13FIRE ALARM VERIFICATION CERTIFICATE FV Certificate of verification for the fire alarm system at: Address: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... I/we being the competent person(s) responsible (as indicated by my/our signatures below) for the verification of the fire alarm system, particulars of which are set out below, CERTIFY that the said installation for which I/we have been responsible complies to the best of my/our knowledge and belief with the recommendations of Clause 43 of BS 5839-. Name: (in block letter):... ュ ュ. ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Position: ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Signature: ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Date:. ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ... For and on behalf of:.. ュ ュ.. ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ... Address: ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ... Postcode: ュ... ュ ュ ュ ュ ュ ュ... Extent of system covered by this certificate: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ ュ... Scope and extent of the verification work: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ ュ... In my/our opinion, that as far as can be reasonably ascertained from the scope of work described above, the system complies with, and has been commissioned in accordance with, the recommendations of BS 5839-1: 2002, other than in respect of variations already identified in the certificates of design, installation or commissioning. In my/our opinion, there is no obvious potential for an unacceptable rate of false alarms. The following non-compliances with the recommendations of BS 5839-, have been identified (other than those recorded as variations in the other certificates of design, installation or commissioning): ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ. ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ... Issued 11/05/05, V3 Revised 12/2011-6 -

13FIRE ALARM ACCEPTANCE CERTIFICATE FA Certificate of acceptance for the fire alarm system at: Address: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ.. ュ ュ. ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ ュ ュ ュ... I/we being the competent person(s) responsible (as indicated by my/our signatures below) for the acceptance of the fire alarm system, particulars of which are set out below, ACCEPT the system on behalf of: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ. ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ... Name: (in block letter: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ... Position: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ... Signature: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ... Date: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ... For and on behalf of:. ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ... Address: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Postcode: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ... ュ... Extent of system covered by this certificate: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ... All installation work appears to be satisfactory. The system is capable of giving a fire alarm signal. The facility for remote transmission of alarm to an alarm receiving centre operates correctly. (Delete if not applicable). The following documents have been provided to the purchaser or user: ョAs fitted ッ drawings. Operating and maintenance instructions. Certificates of design, installation and commissioning. A log book. Sufficient representatives of the user have been properly instructed in the use of the system, including, at least, all means of triggering fire signals, silencing and resetting the system and avoidance of false alarms. All relevant tests, defined in the purchasing specification, have been witnessed. (Delete as applicable). The following work is required before the system can be accepted: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ... Issued 11/05/05, V3 Revised 12/2011-7 -

13FIRE ALARM MODIFICATION CERTIFICATE FM Certificate of modification for the fire alarm system at: Address: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ. ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... I/we being the competent person(s) responsible (as indicated by my/our signatures below) for the modification of the fire alarm system, particulars of which are set out below, CERTIFY that the said modification work for which Iwe have been responsible has to the best of my/our knowledge and belief been carried out in accordance with the recommendations of 46.4 of BS 5839-, except for the variations, if any, stated in this certificate: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Name: (in block letter): ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ. ュ ュ... Position: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ. ュ... Signature: ュ ュ ュ ュ ュ.. ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Date: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ. ュ ュ ュ... For and on behalf of: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Address: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Postcode: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Extent of system covered by this certificate: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ ュ ュ ュ ュ. ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ ュ ュ ュ ュ ュ. ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ ュ ュ ュ ュ. ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ ュ... Variations from the recommendations of 46.4 of BS 5839-: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ.. ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ.. ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Following the modifications, the system has been tested in accordance with the recommendation of 46.4.2 of BS 5839-. Following the modifications, ョas fitted ッ drawings and other system records have been updated as appropriate. I/we the undersigned confirm that the modifications introduced no additional variations from the recommendations of BS 5839-, other than those recorded above: Signed: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Capacity: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... (e.g. maintenance organisation, system designer, consultant or user representative. Issued 11/05/05, V3 Revised 12/2011-8 -

13FIRE ALARM SERVICING CERTIFICATE FS Certificate of servicing for the fire alarm system at: Address: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ. ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ ュ ュ ュ... I/we being the competent person(s) responsible (as indicated by my/our signatures below) for the servicing of the fire alarm system, particulars of which are set out below, CERTIFY that the said modification work for which I/we have been responsible complies to the best of my/our knowledge and belief with the recommendations of Clause 45 of BS 5839- quarterly inspection of vented batteries/periodic inspection and test/inspection and test over a 12 month period (delete as applicable), except for the variations, if any, stated in this certificate. ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Name: (in block letter): ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ. ュ ュ... Position: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ. ュ... Signature: ュ ュ ュ ュ ュ.. ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Date: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ. ュ ュ ュ... For and on behalf of: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Address: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Postcode: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Extent of system covered by this certificate: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ.. ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ.. ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... Variations from the recommendations of Clause 45 of BS 5839- for periodic or annual inspection and test (as applicable): ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ.. ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ ュ ュ ュ ュ ュ ュ... Relevant details of the work carried out and faults identified have been entered in the system log book. During the past 12 months: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ false alarms have occurred. The above number of false alarms equates to: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュfalse alarms per 100 automatic fire detectors per annum (for Category M systems enter ョnot applicable ッ). The following work/action is considered necessary: ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ. ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ.. ュ ュ ュ ュ ュ ュ ュ ュ... ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ ュ.. ュ ュ ュ ュ ュ... Issued 11/05/05, V3 Revised 12/2011-9 -

13 Fire Protection Impairment Form All impairments to the Fire Detection and Protection system exceeding 8 hours are to be notified to the University of Reading insurers via the University Insurance Officer 0118 3788309 Impairments to the Fire Detection and Protection system are to be Planned Events, notification or requests are to be made 48 hours in advance. Any emergency works will be dealt with separately. Wren Number Fire Detection and Protection Impairment Location Impairment from Date: Time: Impairment to Date: Time: Equipment or areas effected Reason for Impairment Precautions to be taken (plant room, floor, room or service riser as an example) 1. Fire Brigade Notified 2. Cutting and welding banned 3. System reinstated overnight 4. Extra fire extinguishers provided in area 5. Extra security Patrols in area 6. Area of Impairment to be minimised (i.e. Room, part of floor or whole floor and not the whole building). 7. Hot work Permit issued and a copy added to this form. 8. Other Precautions (list): Yes No Number of Removed: Covered: Isolated: devices disabled: Type of (See overleaf for details of approved impairment systems) Yes No Impairment 1. Detector heads covered (state number ) 2. Disabled on fire panel (single device or whole loop) 3. Isolation of the fire panel Informing the University Insurance Officer Insurance officer notified by Name: Telephone No: Date: Building manager or Hall Name: Telephone No: Date: office notified System Restored System restored Date: Time: Checked: Name: Time Approved methods of isolating detector heads Issued 11/05/05, V3 Revised 12/2011-10 -

13Covering individual heads: Plastic detector head covers: These are specially designed covers that protect the head from dust and smoke ingress. Important: Make sure the cover is clean as putting a cover on that is dusty will risk dust getting on to the detector, causing a false alarm or stopping the alarm system form resetting Always number the covers if your putting on more then 2 (i.e. 1 of 6), this ensures that you have collected all the covers in after the job. Programmable Fire Panels: Fire Panels: When needing to isolate larger areas using the panel to isolate the loop or floor is a simple option. Important: You will still need to protect the head against dust by either removing the head or by covering it. When you come to reset the panel you may find it will not reset, this is normally down to dust ingress into one of the detector heads. Removing detector Heads: Detector heads: The removal of a detector head is also an acceptable policy for longer term works. However, the removed head must be kept clean and protected against the ingress of dust etc. as it will go to alarm as soon as it ッs replaced. Warning, using rubber gloves to cover devices is not permitted, as many of these have talcum powder inside and will cause the detector to activate requiring a service engineer to be called to clean the detector at your cost. Issued 11/05/05, V3 Revised 12/2011-11 -