Hoyles Dorgard Fire Door Retainer - Manual (Page 19)

Commissioning Certificate
18
Certificate of commissioning for the electrically powered hold-open device(s) (please delete as
appropriate) at: Address:........................................................................................................................
..................................................................................................................................................................
..................................................................................................................................................................
I/we being person(s) responsible (as indicated by my/our signatures below) for the
commissioning of the above, particulars of which are set out below, CERTIFY that the
equipment and release arrangements I/we have commissioned complies to the best of my/our
knowledge and belief with the recommendations of BS 7273-4:2007 for the category of
actuation described below, except for the variations, if any, stated in this certificate.
Name (in block letters):.............................................................Position:...............................................
Signature:...................................................................................Date:....................................................
For and on behalf of:...............................................................................................................................
Address:...................................................................................................................................................
..................................................................................................................................................................
............................................................................................Postcode:......................................................
The extent of liability of the signatory is limited to the equipment and arrangements described
below.
(tick appropriate) O Category A (hardwired System X with Dorgard X)
O Category B (acoustically activated System X with Dorgard X)
O Category C (acoustically activated Dorgard)
Variations for the recommendations of BS 7273-4 (Clause 7).............................................................
..................................................................................................................................................................
..................................................................................................................................................................
Brief description of release mechanisms, method(s) of actuation (see 7273-4:2007, Clause 8)
and system design (see BS 7273-4:2007, Clause 10)............................................................................
..................................................................................................................................................................
..................................................................................................................................................................
O All equipment operates correctly.
O Installation work is, as far as can reasonably be ascertained, of acceptable standard.
O I/we have carried out commissioning in accordance with recommendations of
BS 7273-4:2007, 21.5)
O Suitability documentation has been completed before/after (delete as applicable) release
mechanisms become operational.......................................................................................................
..................................................................................................................................................................
..................................................................................................................................................................
..................................................................................................................................................................
Maintenance: It is strongly recommended that, after completion, Dorgard is maintained in
accordance with BS 7273-4:2007, Clause 22.
User Responsibilities: the user should appoint a responsible person to supervise routine testing
of release mechanisms in accordance with BS 7273-4:2007, 22.1 and to supervise all matters
pertaining to the associated fire detection and fire alarm system in accordance with
BS 5839-1:2002, section 7.