RURAL-40
Assigned to Affiliate:
ON SITE Required Prior To:
MARMIC FIR
4/15/2022
Work Order Details
CFP WO#:
220401-0533
Customer PO:
546400 1 of 5
Priority Status:
Within 30 days
Account Rep:
LISSETTE R.
Customer Location Details
Rural King
Benton 40
618-439-4159
62 Rend Lake Plaza
Benton, IL 62812
Instructions For Technicians
1
TECH MUST CHECK IN and OUT OF IVR, FAILURE WILL RESULT IN DEDUCTION OF PAYMENT/NON-PAYMENT!! CFP IVR: 1-844-423-7487 AND ENTER
CFP WORK ORDER CUSTOMER & CFP FORM MUST BE SIGNED
***IF TECH HAS QUESTIONS WHILE ON SITE ABOUT ANYTHING CALL JEN O'DEE STARK @ 949-346-8015 OR EMAIL jodeestark@cfpfire.com, DO NOT
CALL RURAL KING CORPORATE***
2
Nature Of Problem
Please have techs complete the following inspection:
ALARM
PICTURE OF INSPECTION TAG REQUIRED FOR PAYMENT
NTE: contract pricing - Onsite deficiency work approved up to $750, cost is over please contact CFP while onsite. Photos of all deficient items are required as
well as part info for quotes.
QUOTES NOT APPROVED WITHOUT PART INFO AND PHOTOS.
******Please note that the technician needs to have the Rural King Store sign off form filled out for every trip, without this we are not able to invoice.
For any questions, please contact Liz Ramirez @ 949-346-8039
Customer's Signature & Store Stamp
3
Obtain customer's signature for proof of service:
Date on Location:
Manager's Signature:
Print Name:
Place the store stamp in this section:
Resolution Notes
4
5
TECH MUST CHECK OUT OF IVR. FAILURE TO CHECK OUT WILL RESULT IN INVOICE CHALLENGE
***IF TECH HAS QUESTIONS WHILE ON SITE ABOUT ANYTHING CALL JEN O'DEE STARK @ 949-346-8015 OR EMAIL jodeestark@cfpfire.com,, DO NOT
CALL RURAL KING CORPORATE***
Invoice Instructions
TERMS and CONDITIONS
1) By performing the work described herein. Technician and Technician's company and/or employee accept all terms and conditions of this work order.
2) If Technician is a CFP Affiliate, the terms and conditions of the Affiliate Contract apply to and are incorporated into this work order.
3) Technician and Technician's company and/or employer represent that they are covered by adequate worker's compensation, general liability, and automotive liability insurance policies.
4) Technician and Technician's company and/or employer represent that they are properly licensed/certified and trained to perform this work order.
5) No mechanic's or similiar lien will be recorded or asserted against Customer.
6) LIMITATION OF LIABILITY
The Contractor makes NO WARRANTIES, EXPRESS, OR IMPLIED, INCLUDING, WITHOUT LIMITATION, WARRANTIES OF PERFORMANCE OR WARRANTIES OF FITNESS FOR A PARTICULAR PURPOSE. No promise not
contained herein or affirmation of fact made by any employee, agent or representative of the Contractor shall constitute a warranty by the Contractor or give rise to any liability or obligation. Contractors liability to Customer for
personal injury, death, or property damage arising from performance under this contract shall be limited to the contract price. Customer shall hold Contractor harmless from any and all third party claims for personal injury, death or
property damage, arising from Customers failure to maintain these systems or keep them in operative condition, whether based upon contract, warranty, tort, strict liability or otherwise. In no event shall the Contractor be liable for any
special, indirect, incidental, consequential or liquidated, penal or any economic loss damages of any character, including but not limited to loss of use of the Customers property, lost profits or lost production, whether claimed by the
Customer or by any third party, irrespective of whether claims or actions for such damage are based upon contract, warranty, negligence, tort, strict liability or otherwise.
7) INDEMNITY Customer shall indemnify and hold CFP harmless from any and all third party claims for bodily injury, death, property, or economic loss arising from Customer's failure to maintain it's fire and alarm systems or to keep
them in operative condition.
153 Technology Drive, Ste. 200, Irvine, CA 92618 | 24 HOUR EMERGENCY SERVICE 1-866-556-4501 Fax 949-861-6889
5/2/22
Brady neal
Brady neal
Store#________
Incident # _________
rm Contractor Sign Off Form
Managers Signature Required for Payment
Work Performed
Number of Contractors onsite Working _________
_______________________________ ________________________
Time in Date Time Out Date
_______________________________ ________________________
Time in Date Time Out Date
_______________________________________
Manager Name Print Date
________________________________________
Manager Signature Date
All invoices must be sent into pmiller@ruralking.com with a completed signature form and pictures where applicable. No
Invoices will be accepted without assigned PO# listed clearly on your invoice. All invoices are required to be billed time and
material with for actual labor time onsite. Call our facilities team members below if you have questions.
Rural King Management
By your signature you are confirming that
you have checked the work performed and
that you are satisfied with the progress or
completion.
Number of service providers onsite
Labor hours listed are correct
If you have questions call into RK
Construction for support.
6:40 am
5/2/22
11:25am
5/2/22
Brady neal
5222
5222
Brady Neal
Fire System Inspection
Alarm System
Protected Property
Inspection Frequency
Annual
Semi-Annual
Quarterly
Other:
Site Name:
Address:
City: State: Zip:
Phone:
Date of Inspection:
Fire Alarm System Information:
Percentage of System Tested:
System Type:
Hardwired
Addressable
MultiPlex
Manufacturer:
UL Listed:
Model:
Panel Type:
YES
NO
Area Inspected:
Deficiencies Found:
Recommendations & Comments:
This certifies that our Representative has tested the above noted fire system, and has left the system in
good operating condition.
This acknowledges that our Representative has tested the above noted fire system, and that the system is not fully operational. In Addition,
all problems have been reviewed with the client. The system has been left in the same condition as it was prior to the inspection.
Customer Acknowledgment Date Service Technician Date
RED TAG
YELLOW TAG GREEN TAG
System Condition:
YES
NO
Page 1 of 6
Please see last page of the Alarm Inspection report for the deficiencies.
Address
City
State
Zip Code
Inspection Company Name:
Rural king
62 rend lake plaza
Benton
Il
62812
6184394159
5-2-22
100
DSC
Found 6 strobe that did not signal
12882 Pennridge Dr
Bridgeton
MO
63044
Marmic Fire
System Tests and Inspections
1) Field Devices Tested
A) Smoke Detectors
Quantity
Ionization
Photoelectric
Both
Satifactory
Unsatisfactory
Functional
Visual
Comments:
B) Manual Pull Stations
Quantity
Coded
Non coded
Addressable
Satifactory
Unsatisfactory
Functional
Visual
Comments:
Quantity
C) Heat Detectors
Fixed
Rate of Rise
Combination
Satifactory
Unsatisfactory
Functional
Visual
Comments:
Comments:
D) Duct Detectors
Quantity
Ionization
Photoelectric
Both
Satifactory
Unsatisfactory
Functional
Visual
Quantity
Comments:
E) Water Flow Switches
Paddle
Pressure
Satifactory
Unsatisfactory
Functional
Visual
F) Tamper Switches
Satifactory
Unsatisfactory
Quantity
Comments:
2) Emergency Communication System
Fireman Phones
Phone Jacks
Indicator Panel
Amplifiers
Satisfactory Unsatisfactory N/A Not Tested
Satisfactory Unsatisfactory N/A Not Tested
Satisfactory Unsatisfactory N/A Not Tested
Satisfactory Unsatisfactory N/A Not Tested
Comments:
3) Signaling Devices
Speakers
Bells Chimes
Strobes
Horns
Visual
Functional
Quantity
Quantity
Quantity
Quantity
Comments:
Page 2 of 6
0
1
0
0
1
1
6
1
Found 6 strobes that failed to signal
4) Supervisory Functions
System Tests and Inspections
Backup Power
Main Power
Trouble Silence Switch
Trouble Visual
Satisfactory Unsatisfactory
Satisfactory Unsatisfactory
Satisfactory Unsatisfactory
Satisfactory Unsatisfactory
Not Tested
N/A Not Tested
N/A
N/A Not Tested
N/A Not Tested
Trouble Audible
Ground Fault
Disconnect Switches
Fire Pump Running
Fan Status
Satisfactory Unsatisfactory
Satisfactory Unsatisfactory
Satisfactory Unsatisfactory
Satisfactory Unsatisfactory
Not Tested
N/A Not Tested
N/A
N/A Not Tested
N/A Not Tested
Satisfactory Unsatisfactory
N/A Not Tested
Comments:
5) Panel Operations
Signal Circuits
Initiating Circuits
Alarm Silence Switch
Lamp Test Switch
Satisfactory Unsatisfactory
Satisfactory Unsatisfactory
Satisfactory Unsatisfactory
Satisfactory Unsatisfactory
Not Tested
N/A Not Tested
N/A
N/A Not Tested
N/A Not Tested
Alarm Reset Switch
All Lamps/LED's
Printer
Satisfactory Unsatisfactory
Satisfactory Unsatisfactory
Satisfactory Unsatisfactory
Not Tested
N/A Not Tested
N/A
N/A Not Tested
Comments:
Comments:
6) Panel Operations
Elevator Capture
Door Release
Fan Control
Central Station
Satisfactory Unsatisfactory
Satisfactory Unsatisfactory
Satisfactory Unsatisfactory
Satisfactory Unsatisfactory
Not Tested
N/A Not Tested
N/A
N/A Not Tested
N/A Not Tested
City Tie
HVAC Shut Down
Remote
Annunciators
Satisfactory Unsatisfactory
Satisfactory Unsatisfactory
Satisfactory Unsatisfactory
Not Tested
N/A Not Tested
N/A
N/A Not Tested
7) Special Hazard Systems
Make Model Visual Device Operation Simulated Operation
Page 3 of 6
DeviceZone Location Comments FailPass
Page 4 of 6
Front door
1
Pull station
DeviceZone Location Comments Pass
Page 5 of 6
Fail
Alarm System
Fire System Inspection
System Tests and Inspections
Please List Deficiencies:
RED TAG
YELLOW TAG GREEN TAG
System Condition:
All Technicians MUST check one of these tags:
Page 6 of 6
Recommendations:
Found 6 strobe that failed to signal
Troubleshoot system to locate cause of strobes not working.