Federal Buildings—Systems to Commission

Chapter 1
Project: _____________________________________________ Address: _________________________________
Owner: _____________________________________________ Email/Phone: ______________________________
Owner’s Project Manager: ______________________________ Email/Phone: ______________________________
Cx Provider: _________________________________________ Email/Phone: ______________________________
Date Initiated: ______________________ Date Revised: ______________________
System Integrated System

Chapter 2
Commissioning
Commissioning Commissioning
Item Equipment/System Completed—
Required— Required—
Date
Y/N Y/N
1. Air-conditioning and ventilation systems
2. Domestic hot-water systems

Chapter 3
3. Plumbing systems
4. Lighting and control systems
5. Electrical power systems
6. Energy monitoring and management systems
7. Outdoor air and energy recovery systems

Chapter 4
8. Landscape irrigation systems
9. Fire protection and fire sprinkler systems
10. Fire alarm systems
11. Vertical transportation (elevators, escalators)
12. Building enclosures
13. Roofing systems
14. Computer rooms and data systems
15. Security systems
16. Telephone and communication systems

Appendix A
17. Public address systems
18. Court systems
19. Detention areas and systems
20. Smoke control systems

Appendix B
21. Library systems
22. Humidity control systems
23. Fire prevention systems
24. Shops and special exhaust systems
25. Law enforcement and security systems
Appendix B
The approval section that follows can be used if applicable to the planning process.

I have reviewed the required items and plans and verified that they meet the project requirements:
Owner or Owner’s Representative Name: ____________________________________________________________
Company Name: _______________________________________________________________________________
Signature: _____________________________________________ Date: __________________________________
Appendix B

Revision:
Owner or Owner’s Representative Name: ____________________________________________________________
Company Name: _______________________________________________________________________________
Signature: _____________________________________________ Date: __________________________________