Information
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Client / Site
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Conducted on
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Prepared by
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Location
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Site Contact, Name, Email, Phone number
Scope and Services
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Provide a description of the equipment and the project scope:
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Please indicate the services that are requested
- DC Power Services
- Other
DC Power Services
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Indicate the Services that Vertiv will provide
- Battery Replacement (355)
- Battery Maintenance/PM (208)
- Battery Capacity Testing (208)
- Charger/UPS Maintenance (208)
- Charger/UPS Upgrades (215)
- Charger/UPS Replacement (215 or 356)
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Indicate the battery manufacturer
- Alcad
- Alpha
- BAE
- C&D
- Deka (East Penn)
- Eaton
- Energy Storage Systems
- Enersys
- Fiamm
- GNB (Exide)
- Hoppecke
- Laor
- Leoch
- Northstar
- Power Battery
- Power Sonic
- SAFT
- SBS
- Ultra Power
- Universal Battery
- Other
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Enter the battery model number
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Enter the battery type
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Indicate the battery system voltage
- 12VDC
- 24VDC
- 48VDC
- 125VDC
- 250VDC
- 288 VDC
- 360 VDC
- 384 VDC
- 480 VDC
- Other
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Enter the number of batteries in a string
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Enter the number of strings in the battery system
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What is the accessibility of the battery?
- Elevator
- Stairs
- A manlift is needed for personnel and tools
- Not accessible
- Ground Level
- Other
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Where are the batteries located?
- Basement
- Ground level
- 2nd floor
- 3rd floor
- 4th floor
- 5th floor
- Roof/Mezzanine
- Other
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Indicate the desired manufacturer for the new system
- Alcad
- Alpha
- BAE
- C&D
- Deka (East Penn)
- Eaton
- Energy Storage Systems
- Enersys
- Fiamm
- GNB (Exide)
- Hoppecke
- Laor
- Leoch
- Northstar
- Power Battery
- Power Sonic
- SAFT
- SBS
- Ultra Power
- Universal Battery
- Other
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Indicate the desired battery type for the new system
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Is there presently spill containment?
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Does the client want to reuse the spill containment system?
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Enter the type of rack (e.g. 2-step, 3-tier, etc.)
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Enter the rack dimensions (Width, Height, Depth)
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Is a Temporary battery required for replacement of the existing battery system?
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Include photos of battery system
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What does the customer require for the frequency of the Battery PM?
- 1 PM Per Year
- 2 PMs Per Year
- 4 PMs Per Year
- 12 PMs Per Year
- Other
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What is the customer wanting us to perform on the UPS, Inverter, Charger or Static Switch?
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Enter the existing UPS, Inverter, Charger or Static Switch manufacturer
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Enter the existing UPS, Inverter, Charger or Static Switch model number
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Enter the number of UPS, Inverter, Charger or Static Switch
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What is the accessibility of the UPS, Inverter, Charger or Static Switch?
- Elevator
- Stairs
- A manlift is needed for personnel and tools
- Not accessible
- Ground Level
- Other
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Where is the UPS, Inverter, Charger or Static Switch located?
- Elevator
- Stairs
- A manlift is needed for personnel and tools
- Not accessible
- Ground Level
- Other
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Take or attach photo of existing UPS, Inverter, Charger or Static Switch nameplates
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Enter the existing UPS, Inverter, Charger or Static Switch manufacturer
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Enter the existing UPS, Inverter, Charger or Static Switch model number
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Enter the number of UPS, Inverter, Charger or Static Switch
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Indicate the desired manufacturer, model number, and/or product family for the system. Enter Vertiv to specify if the client does not have a preference.
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What is the accessibility of the UPS, Inverter, Charger or Static Switch?
- Elevator
- Stairs
- A manlift is needed for personnel and tools
- Not accessible
- Ground Level
- Other
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Where is the UPS, Inverter, Charger or Static Switch located?
- Basement
- Ground level
- 2nd floor
- 3rd floor
- 4th floor
- 5th floor
- Roof/Mezzanine
- Other
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Is a Temporary system required for replacement of the existing system? This option may not always be possible to provide.
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Take or attach photo of existing UPS, Inverter, Charger or Static Switch nameplates
Other Services
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Indicate the requested services:
Additional information and notes
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When is the outage window or when is service requested? (Date)
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If an outage, how long is the outage duration (in Hours, Days or Weeks)?
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Notes
