Affiliate Partner: Marmic Fire & Safety
Instructions
1. Schedule visit with store manager. Identify yourself as an affiliate partner of
Commercial Fire. Record the name and title of the manager with whom you made the
appointment and the date and time of the appointment:
Name _______________ Title __________ Date __/__/__ Time __:__ am pm
2. Check in upon your arrival at the store. Call Commercial Fire IVR using the phone
and tracking number above. If there are any issues using IVR, call Commercial Fire at
800-241-1277.
The customer requires successful IVR call-in and call-out per the instructions
provided. is an essential part of this work order. IVR must be successfully completed
for this work order to be complete. Failure to successfully IVR will result in a 10%
penalty on the entire amount of the invoice for this work!
3. Scope Of Work:
Perform annual inspection of ALL BACKFLOW PREVENTION DEVICES LISTED ON
THE FOLLOWING SURVEY PAGE. IF THE PAGE IS BLANK, INSPECT ALL
DEVICES AT THE LOCATION.
If devices are listed on the survey page, ONLY those devices are to be inspected. Do
not inspect any devices not listed on the following page. If you believe that other
devices require inspection, you must receive authorization to complete an inspection.
A complete jurisdictionally approved inspection certification form must be completed
for each device inspected. One copy of each inspection report must be sent to
Commercial Fire with the signed/stamped work order, survey and deficiency form, and
invoice, and a second copy of the inspection report must be left on site with the store
manager.
4. Additional Work If you find additional work that can be repaired on site, call the
IVR phone number and hit option 2 to request authorization. If work is authorized,
record the work authorized and the authorization number in the adjacent space.
5. Complete survey forms in their entirety. You must complete the Technician
Statement and indicate whether any additional work remains. You must have
signature on the Work Order.
6. Check out before departing from the store. Call Commercial Fire IVR using the
phone and tracking number above. Enter the Closing Check Out number:
____________________.
Service Location:
Huck's #267
328 S Main St
O Fallon, MO 63366
US
Phone: (636) 272-3957
Work Authorized:
Back Flow
Inspection
4720867
Additional Work Authorization Number
Store Stamp
_________________________________
Customer Signature
_________________________________
Print Name
___________________ ___ / ___ / ____
Title Date
(use separate sheet if necessary)
Start Date: 5/1/22
Deadline: 5/31/22
IVR Phone: 844-325-8006
Tracking No: 201293371
Customer PO:
Commercial Fire, LLC
2465 St. Johns Bluff Road S, Jacksonville, FL 32246
800-241-1277 Fax 800-956-9789
Important Reminder:
CommercialFire Mobile App
is the preferred and fastest
method for check in/out
compliance!
Visit CommercialFire.com/CFConnect for
more information
Photos Required for
Deficiencies/Repairs
Wo002 3/16/2022
Job 24925258
Amber