Shields, Harper & Co. System Start-Up Program Site:

Responsible Party:____________________________________

Date:____________________

Name:______________________________________________

Company:___________________________________________

Fax:_____________________

Shields, Harper & Co. Order System:______________________

START-UP APPOINTMENT DATE:_________________________

TIME:____________________

Print this form, sign and Fax back within 24 hours to confirm start-up appointment (510)658-8448. The "System Start-Up Program" provides basic training as well as ensuring equipment is installed and registered in accordance with the manufacturer's specifications and requirements. This guarantees maximum system performance and warranty benefit.

The System Start-UP Program includes:

• Phone consultation prior to installation and start-up
• Check of all the wiring connections at start-up
• Application of power to the system (Application of power prior to start-up may void warranty)
• Adjustment of the pulse transmitters if needed + Installation of a modem if purchased from Shields, Harper & Co
• Initial operation and programming of the system.
• Operation check of the system and all hoses
• Basic instruction on operation and care of the systemCompletion of all warranty documentation
  
  

Phone support throughout the labor warranty period before a technician is dispatched, the following Pre-Start-Up requirements are to be completed:

• All system components are to be mounted or installed per manufacturer's specifications
• All conduits are to be run and wires or shielded cables pulled to system components per the manufacturer's specifications
• System electrical supply (ACH, ACC, and GROUND) are to be connected at the service panel per manufacturer's specification but remain deactivated
• Wire identification is to be used if the same color and gauge are repeated
• Commercial power is to be available at the site
• A separate dedicated Phone Line must be installed and active within 5 feet of Point-of-Sale Console such as the Verifone Ruby or Tokheim Columbus
• Network arrangements are customer's responsibility
• Keys necessary to gain access to equipment, service panels, storage tanks, etc. are to be on site
• All hoses and nozzles are to be installed
• Storage tanks are to contain product
• Personnel are to be available for training
• Magnetic or punch cards are to be available for testing the system and training

To schedule a start-up contact Shields, Harper & Co. central dispatch at 800-772-3208. Extra time, travel and mileage resulting from the site not being ready in accordance with the requirements listed above will be billed at a rate of $76.00 per hour and $.75 per mile, portal to portal. Cancellations are permitted up to 24 hours before appointment time. Cancellations less than 24 hours are subject to a charge of 4 hours minimum.

NOTE: FAILURE TO RETURN SIGNED FORM WITHIN 24 HOURS MAY RESULT IN CANCELLING YOUR START-UP APPOINTMENT.

I have read and understand the Pre-Start-Up requirements that are to be completed before a Shields, Harper & Co. technician arrives on site. If they are not completed I assume responsibility for additional charges that may occur.

CUSTOMER SIGNATURE:________________________________

DATE:_________________

Form M-400 Rev. 11/08