![](media/image1.png){width="0.8597222222222223in"
height="1.1034722222222222in"}Fire Alarm Record of Completion

and Acceptance Form

(Form FA-2)

**Date:**

**Time:**

**CONTRACTOR** **PARK INFORMATION**

Business Name: Park Name:

Address: Park Address:

Representative: Park Contact:

License No.: Contact Phone No.:

Telephone: Building Name/Number:

FMSS Asset ID No.:

Park District:

**MONITORING ENTITY**

Contact: Telephone: Monitoring Account Ref. No.:

**1. TYPE(S) OF SYSTEM OR SERVICE**

NFPA 72, Chapter 3 -- Local

If alarm is transmitted to locations (s) off premises, list where
received:

NFPA 72, Chapter 3 -- Emergency Voice/Alarm Service

Quantity of voice/alarm channels: Single: Multiple:

Quantity of speakers installed: Quantity of speakers zones:

Quantity of telephones or telephone jacks included in system:

NFPA 72, Chapter 6 -- Auxiliary

Indicate type of connection:

Local energy Shunt Parallel telephone

Location of telephone number for receipt of signals:

NFPA 72, Chapter 5 -- Remote Station

Alarm:

Supervisory:

NFPA 72, Chapter 3 -- Proprietary

If alarms are retransmitted to public fire service communications
centers or others, indicate location and telephone numbers of the

organization receiving alarm:

Indicate how alarm is transmitted:

NFPA 72, Chapter 5 -- Central Station

Prime Contractor:

Central Station Location:

Means of transmission of signals from the protected premises to the
central station:

McCulloh Multiplex Digital Alarm Communicator One-way Radio Two-way
Radio

Other

Means of transmission alarms to the public fire service communications
center:

\(a\)

\(b\)

System location:

Organization Name/Phone Representative Name/Phone

Installer

Supplier

Service Organization

Location of record (as-built) drawings:

Location of owners' manuals:

Location of test reports:

A contract, dated , for test and inspection in accordance with NFPA
standards(s) No(s). ,

dated , is in effect.

**2. RECORD OF SYSTEM INSTALLATION**

(Fill out after installation is complete and wiring checked for opens,
shorts, ground faults, and improper branching, but prior to

conducting operational acceptance tests.)

This system has been installed in accordance with the NFPA standards as
shown below, was inspected by

on , includes the devices shown below, and has been in service since .

NFPA 72, Chapters 1 2 3 4 5 6 7 (circle all the apply)

NFPA 70, *National Electrical Code,* Article 760

Manufacturer's instructions

Other (specify):

Signed: Date:

Organization:

**3. RECORD OF SYSTEM OPERATION**

All operational features and functions of this system were tested by on
, and

Found to be operating properly in accordance with the requirements of:

NFPA 72, Chapters 1 2 3 4 5 6 7 (circle all the apply)

NFPA 70, *National Electrical Code,* Article 760

Manufacturer's instructions

Other (specify):

Signed: Date:

Organization:

**4. FIRE ALARM CONTROL PANEL**

Manufacturer: Model: Serial No.:

Configuration: Access Code(s):

Location of Control Panel and Remote Annunciator(s):

**5. ALARM-INITIATING DEVICES AND CIRCUITS**

Quantity and class of initiating device circuits (*see* NFPA 72, *Table*
3-5) Quantity: Style: Class:

MANUAL

\(a\) Manual Stations Noncoded, activating Transmitters Coded

\(b\) Combination manual fire alarm and guard's tour coded stations

AUTOMATIC

Coverage: Complete: Partial:

\(a\) Smoke detectors Ion Photo

\(b\) Duct detectors Ion Photo

\(c\) Heat detectors FT RR FT/RR RC

\(d\) Sprinkler water flow switches Transmitters Noncoded, activating
Coded

\(e\) Other (list):

**6. ALARM-INITIATING DEVICES AND CIRCUITS**

GUARD'S TOUR

\(a\) Coded stations

\(b\) Noncoded stations, activating transmitters

\(c\) Compulsory guard tour system comprised of Transmitter stations and

intermediate stations

Note: Combination devices are recorded under 4(b) and 5(a).

SPRINKLER SYSTEM

\(a\) Coded valve supervisory signaling attachments

Value supervisory switches, activating transmitters

\(b\) Building temperature points

\(c\) Site water temperature points

\(d\) Site water supply level points

Electric-driven fire pump:

\(e\) Fire pump power

\(f\) Fire pump running

\(g\) Phase reversal

Engine-driven fire pump:

\(h\) Selector in auto position

\(i\) Engine or control panel trouble

\(j\) Fire pump running

Engine-driven generator:

\(k\) Selector in auto position

\(l\) Control panel trouble

\(m\) Transfer switches

\(n\) Engine running

Other supervisory functions(s) (specify):

**7. ALARM-INITIATING DEVICES AND CIRCUITS**

Quantity and class (*see* NFPA 72, *Table 3-7*) of notification
appliance circuits connected to the system:

Types and quantities of notification appliances installed: Quantity:
Style: Class:

\(a\) Bells Inch

\(b\) Speakers

\(c\) Horns

\(d\) Chimes

\(e\) Other:

\(f\) Visual signals Type:

with audible w/o audible

\(g\) Local annunciator

**8. SIGNALING LINE CIRCUITS**

Quantity and class (*see* NFPA 72, *Table 3-6*) of signaling line
circuits connected to system:

Quantity: Style: Class:

**9. SYSTEM POWER SUPPLIES**

\(a\) Primary (main): Nominal voltage: Current rating:

Overcurrent protection: Type: Current rating:

Location:

\(b\) Secondary (standby):

Storage battery: Amp-hour rating:

Calculated capacity to drive system, in hours: 24 60

Engine-driven generator dedicated to fire alarm system:

Location of fuel storage:

\(c\) Emergency or standby system used as backup to primary power
supply, instead of using a secondary power supply:

Emergency system described in NFPA 70, Article 700

Legally required standby system described in NFPA 70, Article 701

Optional standby system described in NFPA 70, Article 702, which also
meets the performance requirements of Article

700 or 701

**10. SYSTEM SOFTWARE**

\(a\) Operating system software revision level (s):

\(b\) Application software revision level(s):

\(c\) Revision completed by:

(name) (firm)

**11. COMMENTS:**

(signed) for central station or alarm service company or installation
contractor/supplier (title) (date)

Frequency of routine tests and inspections, if other than in accordance
with the referenced NFPA standard(s):

System deviations from the referenced NFPA standard(s) are:

(signed) for central station or alarm service company or installation
contractor/supplier (title) (date)

Upon completion of the system(s) satisfactory test(s) witnessed (if
required by the Regional Structural Fire Management Officer):

(signed) for central station or alarm service company or installation
contractor/supplier (title) (date)

**12. SIGNATURES:**

Contractor Representative/Technician:

(signature)

Date:

Regional Structural Fire Management Officer (or his designee):

> (signature)

Date: