EXAMPLE

THIS FORM TO BE COMPLETED BY GENERAL CONTRACTOR GENERATOR

PREFUNCTIONAL CHECKLIST
NAME: ________________________________________________

Engine
Generator
Service Area All

Contractor Notes
ACCEPTANCE CRITERIA
Engine Generator
Ground bus(ses) have been installed and terminated to
1 DATE APPROVED
ground grid system
Permanent labels for bus, section, breakers and devices
2 DATE APPROVED
installed

Electrical equipment clean of construction debris, dust, and

3 moisture and egress routes from electrical room are DATE APPROVED
unobstructed.

All bolted connections securely fastened in accordance with

4 DATE APPROVED
recommended torque values
Generator neutral bus is solidly grounded by factory-installed
5 DATE APPROVED
bonding jumper as specified for a four-pole system

6 Generator frame and enclosure bonded to ground DATE APPROVED

Generator anchored in place according to manufacturer’s

7 DATE APPROVED
recommendations
All bolted electrical connections have been tightened to their
proper torque values. (Note: some connections will be
8 disconnected as part of the functional testing. These DATE APPROVED
connections will be field torqued to proper settings at the
conclusion of the field-testing.)
Manufacturer’s field service personnel have completed
9 DATE APPROVED
preliminary checkout and startup

10 Engine lube oil system is fully operational and free of leaks DATE APPROVED

11 Engine coolant system is fully operational and free of leaks DATE APPROVED

12 Fuel supply system tank is full and ready for operation DATE APPROVED

13 Engine exhaust is fully operational and free of leaks DATE APPROVED

14 Engine exhaust has rain cap installed at exterior outlet DATE APPROVED

15 Engine exhaust has condensate drain installed at silencer DATE APPROVED

16 Batteries are fully charged and in service DATE APPROVED

Generator remote annunciation panel is remotely installed,

17 electrically connected and fully operational to comply with DATE APPROVED
NFPA 110, Level 1 system.

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Prefunctional Checklist Page 1 of 2 E4 PFC EXAMPLE Generator.xls
 EXAMPLE
THIS FORM TO BE COMPLETED BY GENERAL CONTRACTOR GENERATOR
PREFUNCTIONAL CHECKLIST
NAME: ________________________________________________

Engine
Generator
Service Area All

Contractor Notes
ACCEPTANCE CRITERIA
Generator remote E-stop is remotely installed, electrically
18 connected and fully operational to comply with NFPA 110, DATE APPROVED
Level 1 system

Generator control wiring to building management control

19 DATE APPROVED
panel is installed, electrically connected and fully operational

All Overcurrent protective devices have been installed at the

20 proper ampere rating and all settings have been adjusted to DATE APPROVED
match the final approved system Coordination Study.

21 Utility Power is available and connected for system operation DATE APPROVED

All status and alarm indicators are installed and functioning

22 DATE APPROVED
properly.
All field and interconnecting wiring is completed and labeled
23 at each end with visible and readable tags, printed markings DATE APPROVED
on the conductors are NOT acceptable
Testing agency or manufacturer's representative has been
24 scheduled to perform the test and the commissioning DATE APPROVED
authority has been notified of the testing date.
Test equipment requirements have been reviewed with the
25 DATE APPROVED
testing agency or manufacturer's representative.

26 Power available for test equipment. DATE APPROVED

27 Installation is complete and ready for verification testing. DATE APPROVED

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Prefunctional Checklist Page 2 of 2 E4 PFC EXAMPLE Generator.xls
THIS FORM TO BE COMPLETED BY GENERAL CONTRACTOR EXAMPLE
NAME: ________________________________________________ AUTOMATIC TRANSFER SWITCH
PREFUNCTIONAL CHECKLIST

Automatic
Transfer Switch
Service Area All

Contractor Notes
ACCEPTANCE CRITERIA
Automatic Transfer Switch

1 Electrical room grounding system complete. DATE APPROVED

Ground bus(ses) have been installed and terminated to

2 DATE APPROVED
ground grid system
Doors to electrical room installed and locks or temporary
3 DATE APPROVED
security measures installed.

4 Electrical room clear of storage, temporary equipment, etc. DATE APPROVED

Permanent labels for bus, section, breakers and devices

5 DATE APPROVED
installed
Electrical equipment clean of construction debris, dust, and
6 moisture and egress routes from electrical room are DATE APPROVED
unobstructed.
All bolted connections securely fastened in accordance with
7 DATE APPROVED
recommended torque values
Working clearances meet NEC and contract documents and
8 DATE APPROVED
ATS has been installed on a level housekeeping pad

9 ATS anchored per manufacturer’s instruction DATE APPROVED

10 All enclosure panels and doors in place, fitted, undamaged DATE APPROVED

All field and interconnecting wiring is completed and labeled

11 at each end with visible and readable tags, printed markings DATE APPROVED
on the conductors are NOT acceptable
NORMAL and EMERGENCY sources are available for
12 DATE APPROVED
testing.
All settings have been adjusted to Engineer's provided
13 DATE APPROVED
settings.
Testing agency has been scheduled to perform the test and
14 the commissioning authority has been notified of the testing DATE APPROVED
date.
Test equipment requirements have been reviewed with the
15 DATE APPROVED
testing agency.

16 Installation is complete and ready for verification testing. DATE APPROVED

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Prefunctional Checklist Page 1 of 1 E5 PFC EXAMPLE Automatic Transfer Switch.xls
 EXAMPLE
VAV WITH REHEAT AND PERIMETER HEAT
FUNCTIONAL PERFORMANCE TEST

Passed 0
Tested 0 Pass?
Initial Test Date ?
Retest 1 ?
Retest 2 ?
VAV 0-067 VAV 1-025 VAV 1-061

Room(s) Served
Max Cooling CFM 2,400 1,100 2,400
Min Cooling CFM 1,200 1,050 1,200
Max Heating CFM 2,400 1,100 2,400
Min Heating CFM 1,200 1,050 1,200
Occupied Space Temperature Cooling Setpoint
Occupied Space Temperature Heating Setpoint

Notes
ACTION ACCEPTANCE CRITERIA
DEVICE LOCATIONS
Removable without removing
1 Observe VAV box Pass? Pass? Pass?
ductwork or piping.
Re-heat coil removable without
2 Observe reheat coil location. Pass? Pass? Pass?
removing ductwork or piping.
Observe reheat hot water valve Accessible for maintenance or
3 Pass? Pass? Pass?
location replacement
Observe perimeter radiation hot Accessible for maintenance or
4 Pass? Pass? Pass?
water valve location replacement
5 Observe temperature sensor location Temporary location Pass? Pass? Pass?
TEST INITIATION
Space temperature setpoint Insert Value Insert Value Insert Value
Space temperature Insert Value Insert Value Insert Value
VAV discharge temperature Insert Value Insert Value Insert Value
Record Initial Performance Supply airflow setpoint Insert Value Insert Value Insert Value
6
Parameters Supply airflow Insert Value Insert Value Insert Value
Damper position Insert Value Insert Value Insert Value
Reheat valve position Insert Value Insert Value Insert Value
Perimeter heating valve position Insert Value Insert Value Insert Value
OCCUPIED COOLING

Airflow increases to cooling

Pass? Pass? Pass?
maximum CFM.

Reheat valve is closed. Pass? Pass? Pass?

Perimeter heating valve is closed. Pass? Pass? Pass?

Override the space temperature to:
cooling setpoint plus 4 F. (Or adjust Record airflow setpoint Insert Value Insert Value Insert Value
7
control setpoints to achieve the same Record airflow Insert Value Insert Value Insert Value
system reaction.)
Record damper position Insert Value Insert Value Insert Value
VAV discharge temperature is
about equal to the AHU discharge Pass? Pass? Pass?
air temperature.
Record VAV discharge
Insert Value Insert Value Insert Value
temperature
Override the space temperature to: VAV airflow. Insert Value Insert Value Insert Value
cooling setpoint minus 1.5 F. (Or Reheat valve position. Insert Value Insert Value Insert Value
adjust control setpoints to achieve the
8 Perimeter heating valve position. Insert Value Insert Value Insert Value
same system reaction.) After 5 to 10
minutes, record the system VAV discharge temperature. Insert Value Insert Value Insert Value
parameters. Record damper position Insert Value Insert Value Insert Value

American University Cx Plan

Functional Performance Test Page 1 of 2 F1 FPT Terminal Units EXAMPLE.xlsx
 EXAMPLE
VAV WITH REHEAT AND PERIMETER HEAT
FUNCTIONAL PERFORMANCE TEST

Passed 0
Tested 0 Pass?
Initial Test Date ?
Retest 1 ?
Retest 2 ?
VAV 0-067 VAV 1-025 VAV 1-061

Room(s) Served
Max Cooling CFM 2,400 1,100 2,400
Min Cooling CFM 1,200 1,050 1,200
Max Heating CFM 2,400 1,100 2,400
Min Heating CFM 1,200 1,050 1,200
Occupied Space Temperature Cooling Setpoint
Occupied Space Temperature Heating Setpoint

Notes
ACTION ACCEPTANCE CRITERIA
OCCUPIED HEATING
Airflow at heating CFM. Pass? Pass? Pass?
Reheat valve opens to100%
before the perimeter heating
Pass? Pass? Pass?
Override the space temperature to: valve opens? Sequence of
heating setpoint minus 4 F. (Or operation is not clear.
adjust control setpoints to achieve the Perimeter heating valve opens to
Pass? Pass? Pass?
9 same system reaction.) Override the 100%.
outside air temperature to 39 F (or
Discharge air temperature
change perimeter heating lock-out Pass? Pass? Pass?
increases
setpoint).
Record airflow Insert Value Insert Value Insert Value
Record damper position Insert Value Insert Value Insert Value
Record VAV discharge
Insert Value Insert Value Insert Value
temperature

Override the outside air temperature

10 to 41 F (or change the perimeter Perimeter heating valve closes. Pass? Pass? Pass?
heating lock-out setpoint).

Override the outside air temperature

11 to 39 F (or change the perimeter Perimeter heating valve opens. Pass? Pass? Pass?
heating lock-out setpoint).

Perimeter heating valve closes to

0% open prior to the reheat valve
Pass? Pass? Pass?
closing? Sequence of operation
Override the space temperature to: is not clear.
heating setpoint plus 1.5 F. (Or
adjust control setpoints to achieve the VAV airflow Insert Value Insert Value Insert Value
12
same system reaction.) After 5 to 10
Record damper position Insert Value Insert Value Insert Value
minutes, record the system
parameters. Reheat valve position. Insert Value Insert Value Insert Value

Perimeter heating valve position. Insert Value Insert Value Insert Value

VAV discharge temperature. Insert Value Insert Value Insert Value

UNOCCUPIED MODE
13 Not applicable for this project.
ALARMS
Override the space temperature to 5
14 F below the space temperature Alarm to the operator's console. Pass? Pass? Pass?
setpoint.
Override the space temperature to 5
15 F above the space temperature Alarm to the operator's console. Pass? Pass? Pass?
setpoint.
TEST CONCLUSION
Deactivate any system over-rides Terminal unit resumes normal
16 Pass? Pass? Pass?
(setpoints, sensors, modes). operation

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Functional Performance Test Page 2 of 2 F1 FPT Terminal Units EXAMPLE.xlsx
 EXAMPLE
LIGHTING CONTROL SYSTEM
FUNCTIONAL PERFORMANCE TEST

TEST EQUIPMENT REQUIRED

Test Name Equipment Description
Light Level Light Level Meter

Action Expected Result Status Comments Notes/Reference Initial Date

INSTALLATION
Prior to functional testing, for best lamp life, verify installed fluorescent lamps have a logged 100 hours of operation prior to any dimming or testing of dimming.
Ultrasonic ceiling mounted occupancy sensors are
a mounted a minimum of six (6) feet from HVAC Pass?
supply/return vents
Sensors mounted over doorways are placed one
b Pass?
(1) foot inside threshold.
1.1 Verify Installation of lighting control devices. All occupancy and daylight photo sensors are Record results in applicable sensor
c easily accessible for adjustment, repair, and Pass? worksheets when checking function of
replacement. those sensors
Outdoor photocell is mounted facing northern sky
d Pass?
and pointed away from nighttime light sources.
Lighting Controller located and mounted in a
a Pass?
location where audible noise is acceptable
Lighting Controller voltage wiring is at least six (6)
b Pass?
feet from sound and electronic equipment wiring.
Clearance on left and right side of the relay
c Pass?
1.2 Verify installation of lighting controllers cabinets is 1 1/2 " or greater
Lighting Control cabinets are easily accessible for
d Pass?
adjustment, repair, and replacement.
Cabinets are cleaned of all dust, debris, metal
e Pass?
particles.
Relay cabinet anchored and supported per
f Pass?
manufacturer's recommendations

Check the lighting circuit breakers to ensure that Circuit breaker shall be rated for switching
1.3 a Pass?
they are duty rated. functions “SWD”

OPEN OFFICE SPACE LIGHTING CONTROL

Verify that the occupancy sensing devices installed
Correct occupancy sensing devices have been
2.1 match with drawings, shop drawings and a Pass?
installed.
specifications.
Lighting in open office spaces comes on at __ am Record results for each Open Office space
a Pass?
Time controller function controls lighting in Open and turns off at __ pm. in Time Clock worksheet
2.2
Office Spaces as expected A blink warning occurs 5 minutes prior to lighting
b Pass?
shut off.

Lighting in each zone turns ON when initiating

a Pass?
override

2.3 Verify override control for each lighting zone.

American University Cx Plan Lighting Control

Functional Performance Test Page 1 of 6 F2 FPT EXAMPLE Lighting Controls.xls
 EXAMPLE
LIGHTING CONTROL SYSTEM
FUNCTIONAL PERFORMANCE TEST

Action Expected Result Status Comments Notes/Reference Initial Date

2.3 Verify override control for each lighting zone.
2.4 Verify daylighting control within open office spaces.
Verify occupancy sensor control of lighting during
2.5
evening and weekend hours.
2.6 Review system programming options
Return all changed control parameters and
2.7
conditions to their pre-set values.
Lighting in other zones (not pressed) remains OFF -
b until the zone override is initiated for each Pass?
particular zone.
Lighting override times out after _____ minutes and
c Pass? Verify time in minutes of override control.
lighting turns OFF.
Light level setpoint for Open Office Spaces
to be verified prior to initiating this test -
Verify daylight photosensor controls - record test confirm that light level meets or exceeds
a data for each daylight photosensor in Daylight Pass? IES recommended standards at the task
Photosensor worksheet surface (50 fc assumed). Record results for
each photosensor in Daylight Photosensor
worksheet
Record results for each sensor in
Before __ am or after __ pm and after lighting in a
Occupancy Sensor worksheet. Note that
particular zone has automatically turned off, walk
a Pass? time ON may be user selected at time other
by occupancy sensor and confirm that lighting
than __am to __pm. Record actual time
controlled by the occupancy sensor turns on.
settings.
Note that sensors can be set to shorter
After a time delay of __ minutes, lighting in area
b Pass? timeout settings for these test, but must be
controlled by occupancy sensor turns off
set back to original setting - see worksheet
Confirm that schedules can be re-assigned and
a confirm that modified schedules respond as Pass?
expected.
Confirm that holiday schedule is programmed as
b Pass?
required.
Time of day schedule, occupancy sensor timeout
a delay and photosensor light level setpoints are Pass?
returned to initial settings.

American University Cx Plan Lighting Control

Functional Performance Test Page 2 of 6 F2 FPT EXAMPLE Lighting Controls.xls
 EXAMPLE
LIGHTING CONTROL SYSTEM
FUNCTIONAL PERFORMANCE TEST

Action Expected Result Status Comments Notes/Reference Initial Date

HALLWAYS AND LOBBY LIGHTING CONTROL
Verify that the occupancy sensing devices installed
3.1 match with drawings, shop drawings and
specifications.
Time controller function controls lighting in Hallways
3.2
and Lobbies as expected
Correct occupancy sensing devices have been
a Pass?
installed.
Lighting in Hallways and Lobbies comes on at __ Record results for each Hallway and Lobby
a Pass?
am and turns off at __ pm. space in Time Clock worksheet
A blink warning occurs 5 minutes prior to lighting
b Pass?
shut off.

a Lighting in Lobby turns on when initiating override Pass?

3.3 Verify override control for Lobby lighting zone.
b Lighting in other zones (not Lobby) remain off. Pass?
Lighting override times out after _____ minutes and
c Pass? Verify time in minutes of override control.
Lobby lighting turns off.
Record results for each sensor in
Before __ am or after __ pm (same as Open Office
Occupancy Sensor worksheet. Note that
space time settings) and after lighting in Hallways
time on may be user selected at time other
a have automatically turned off, walk by occupancy Pass?
than __am to __pm but should be same as
sensor and confirm that Hallway lighting controlled
Verify occupancy sensor control of Hallway Lighting Open Office Space. Record actual time
3.4 by the occupancy sensor turns on.
during evening and weekend hours. settings.
Note that sensors can be set to shorter
After a time delay of __ minutes, lighting in Hallway
b Pass? timeout settings for these test, but must be
controlled by occupancy sensor turns off
set back to original setting - see worksheet
Time of day schedule, occupancy sensor timeout
Return all changed control parameters and
3.5 a
delay and photosensor light level setpoints are Pass?
conditions to their pre-set values.
returned to initial settings.
BATHROOM/RESTROOM, STORAGE CLOSETS AND ENCLOSED CORRIDORS - OCCUPANCY SENSOR VERIFICATION
Verify that the occupancy sensing devices installed
Correct occupancy sensing devices have been Record each room in Occupancy Sensor
4.1 match with drawings, shop drawings and a Pass?
installed. (OS) worksheet
specifications.

Ceiling mounted occupancy sensing devices have

Verify all ceiling mounted occupancy sensing
4.2 a been installed in the locations show on the design Pass?
devices.
drawings.
Upon entering the room, the light fixtures will switch
4.3 Verify that lighting turns on when motion is sensed a Pass?
ON.
Light fixtures will remain on for __ minutes in Note that sensors can be set to shorter
Remain motionless for occupancy sensor timeout Restroom/Bathrooms, __ minutes in timeout settings for these tests, but must be
4.4 a Pass?
setting storage/mechanical closets and __ minutes for set back to original setting - see Occupancy
enclosed corridors Sensor Worksheet
Return all changed control parameters and Occupancy sensor timeout delays are returned to
4.5 a Pass?
conditions to their pre-set values. initial settings.

American University Cx Plan Lighting Control

Functional Performance Test Page 3 of 6 F2 FPT EXAMPLE Lighting Controls.xls

Action
PRIVATE OFFICES AND CONFERENCE ROOM - LIGHTING CONTROL VERIFICATION
Verify that the occupancy sensing devices installed
5.1 match with drawings, shop drawings and
specifications.
5.2 Verify all occupancy sensing devices.
5.3 Verify that lighting turns on when motion is sensed
Remain motionless for occupancy sensor timeout
5.4
setting
After lighting has turned off, turn on again with
5.5
motion.
5.6 Verify override control switch operation
Return all changed control parameters and
5.7 a.
conditions to their pre-set values.
MECHANICAL/ELECTRICAL ROOMS AND COMPUTER ROOMS
Verify that the ON/OFF switches installed match
6.1
with drawings, shop drawings and specifications.
6.2 Verify ON operation of ON/OFF digital switches
6.3 Verify OFF operation of room lighting control
After lighting has turned OFF, turn on again with
6.4
ON/OFF digital switch.
After "blink warn" has occurred, but before 5
6.5
minutes are up, press digital switch
Return all changed control parameters and
6.6
conditions to their pre-set values.
American University Cx Plan
Functional Performance Test
EXAMPLE
LIGHTING CONTROL SYSTEM
FUNCTIONAL PERFORMANCE TEST
Expected Result Status Comments Notes/Reference Initial Date
Correct occupancy sensing devices have been Record each room in OS w override
a Pass?
installed. worksheet
Occupancy sensing devices PIR/Ultrasonic and
a have been installed in the locations show on the Pass?
design drawings.
Upon entering the room, the light fixtures will switch
a Pass?
ON.
Note that sensors can be set to shorter
Light fixtures will remain on for __ minutes in
timeout settings for these tests, but must be
a Private Offices, and __ minutes in Conference Pass?
set back to original setting - see Occupancy
Rooms
Sensor Worksheet
Upon movement detected, the light fixtures will
a Pass?
switch ON.
By pressing low voltage override switch, lighting is
a turned off by tenant even though movement is Pass?
being detected by occupancy sensor.
Occupancy sensor timeout delays are returned to
Pass?
initial settings.
a Correct switches have been installed. Pass? Record rooms tested
a Pressing switch turns lighting ON. Pass?
Note that sensors can be set to shorter
Light fixtures will blink after __ minutes (5 minute timeout settings for these tests (greater
a "blink warn") and then will turn OFF automatically Pass? than 5 minute blink warn), but must be set
after 5 minutes. back to original setting - see ON/OFF
Worksheet
a Pressing switch turns lighting ON. Pass?
Lighting remains ON for an additional ___ minutes
a before turning OFF automatically. Confirm that 5 Pass?
minute "blink warn" again initiates.
a OFF timeout delays are returned to initial settings. Pass?
Lighting Control
Page 4 of 6 F2 FPT EXAMPLE Lighting Controls.xls
 EXAMPLE
LIGHTING CONTROL SYSTEM
FUNCTIONAL PERFORMANCE TEST

Action Expected Result Status Comments Notes/Reference Initial Date

BOARD ROOM LIGHTING CONTROL
Verify that Multizone Dimmer/Controller and
7.1 accessories installed per manufacturer's
recommendations.
7.2 Verify operation of Multizone Dimmer/Controller.
Only appropriate electronic dimming ballasts in use
a Pass?
for fluorescent lamps.
Controller wired with copper or copper clad wire
b only. If aluminum wire used, only use devices Pass?
marked CO/ALR or CU/AL.
c Load types are not mixed on any single zone Pass?
The insulation of the Class I (line voltage) field
d Pass?
wiring must be rated no less than 75°C.
No more than two (2) 12 AWG wires installed on
e Pass?
each screw terminal.
Both fluorescent lighting fixtures and dimmer are
f Pass?
grounded per manufacturer's recommendations.
Note- this FPT developed around
Test each named scene ("Presentation,” Leviton D3206 Multizone
"Chandelier", "Lunch", etc.) and confirm operation Controller/Dimmer. Modify based on
a Pass?
and naming. Named scenes will appear in the actual dimming system provided.
display (LCD) when the button is pressed. Required Scenes to be reviewed with
Owner's representative as required.
Test MAX button and confirm that all Loads are set
b Pass?
to maximum BRIGHT
Test OFF button and confirm that all Loads are
c Pass?
turned OFF.
Test OFF button and confirm that all Loads are
d Pass?
turned OFF.
Test "Dim Scene" function. This button dims or
e Pass?
brightens the selected scene.
Test "Dim/Bright" function and confirm that manual
f Pass?
control of light level for selected zone is enabled.
Confirm that proper date and time have been
g Pass?
programmed.
If applicable, confirm timer trigger operation as
h expected (i.e. specific timer triggers a SCENE, Pass?
MAX, OFF or Auto OFF).
Confirm that Holiday schedule has been set up if
i Pass?
applicable.
Verify Auto OFF as been programmed for energy
savings (if applicable). Confirm that lights
j Pass?
automatically turn OFF at the programmed time
after a warning blink to maximum.

American University Cx Plan Lighting Control

Functional Performance Test Page 5 of 6 F2 FPT EXAMPLE Lighting Controls.xls