Form SH-1

BLUE STAR
Ducted System Handing Over Report
(From PAD Installation to Customer)

S6o 0 5o1 Inv. Date: UO E1

Customer Name / Address (Billing Address)

Name:
Address.

Pincode. S C D Tel.OOD O Mobile: 5 5 02sO

Customer Name/Address (lnstallation / Site Address)

Name: D Te1dT UPIIAUOOOOOOOO

Address: CID5 3 KDCENTen 2DHD
Kt mm DODODOOODOODOODODO
Pincode: o Tel. OOODOOMobile: 55024DOO
Customer Email lds

Sales. OOOOOOOOOOOOOOOOOOOOOOOOO
Service
Accounts: OOOOOOOOOOOODDOOODOOOOOOO
Dislance from Dealer Office: <60km 60-200km 200km
Usage: 8 hours 1 2 hours 24 hours
Due Dates of Free Preventive Maintenance Service
Date of handing over 2 First U
1 montm from dalte of

Warrantystarts from 2
h n9nhsS Hm date of

Second ancing ovar

8 months Irom dale ol
Third
VWarranty ends on
B 22 handing over)
11 mohs rom date of
Fourth

1 We have handed over the AC system described below today for beneficial use by you

Equipment installed Achieved conditions

Description of space RH
Model Qty Temp
DSA 1021 23 2
CATH
Ic324Ve1u 22 SS

Outside conditions 21
P.T.O.
2 We have ralned yoursrenyepasaikwaneoanyarensresareshwsbnvhelueesngandre
On howto start/stop the ACunits.

3We have handed over one User Manual for each Packaged / Ducted Spit Airconditioner The manual contains
useful intormation. We request you to read the same.

Warranty dates have been established earlier in this document. Warranty conditions are explained in the User
Manual.
5 Youare requested to complete the foilowing works, so that the AC plant delivers ful capacity

Please contact us at the following number for after-sales service. And please check with us for our good
value-for-money Annual Maintenance Contracts when the warranty is coming to a close.

Our 24x7 Call Desk

Toll Free No.: 1860 266 6666

Handed over by Accepted y

SaYihu.
Signature of BSL representative
M
clel
Signature of Customer repprésentative

For internal use oniy

Instructions for distribution: PAD Installation/PAD Dealer to
hand over to B81. Commercial after filling. Commercial to take
4photocopies and dstribute as follows Origmal Customer mer Name
cr CBg Serice CRO: cC Dealer dealer saia)
Cc Copirmercar teE

To be filied in by BSL Commercial

a) SH form received on'
Distibuted on
b Ertered control register

Signature (lor Bst Commercial) Company Seal

 BLUE STAR Form SH-2
(Use extra Annexure sheets
tor every 4 Units)

CustomerIMaNIOOOOOOOOOO No: OOOOO

BSL Code

Stick/ Staple Stick/ Staple

Product Barcode Sticker Product Barcode Sticker

Commissioning Tests and Trials-Check List

Parameters Unit No. OO Unit No.O0

Model
DSAID 21 D3 DSATO2 27
Sr No DS1O1 23 1 A KUF o0336 DSA102D3 -tAKU fo63u
LOcatiopn
re g Ofice Reception Area CATH LAB CATH LAB
& Conference Hal etc)

Compressor Sr. No

- Circuit 1 AFDATUF Oo 0 OAKUF 0oSy

Circuit,2
Circuit 3

Operating Voltage u20 2 phele 20,3 ph<se

Opereting Current 16 AmPS I AmPS
Operating Pressure Suction 20 psig Suction120 psig

Discharge 14D psig Discharge psig

Supply Air
(canvas temp) Temperature 12 CF Temperature

Returm Air (at grille) 21C CF Temperature c CF

Temperature
CFM 3400 CFM
Drain Tray checked
for iree fiow es No Yes No

Sooul
Use reverse if needed. Signature of PAD Installation Engineer PAD Dealer
See overeaf for distribution instructions.
 BLUE STAR Form SH-2
REVERSE

Stick/Staple Stick/ Staple

Product Barcode Sticker Product Barcode Sticker

Commissioning Tests and Trials-Check List

Parameters Unit No.OO Unit No. OO

Model LC32 VgTU
Sr. No Tc32vOTUHUA D23 13
LOcation
egofioè Reckpion Ares Bclley Room
& Conference Hal etc)

Compressor s No.

- Circuit 1

Circuit 2
-Circuit 3

Operating voltage 20 Sugfe phase.

Operating Current
Amps
Operating Pressure Suction psig suCion psig
Discharge 70 psig Discharge psig

Supply Air
Canvas temp) Temperature C'FTemperature CPF

Return Atr (at grile) Temperature CFTemperature CPF

CFM CFM
Drain Tray checked
for free fiow es No Yes No

instructions for distribution: PAD Instaflation/PAD Dealer to

hand over to BSL Commerclal after iling. Commercial to take
2 photocopies and distribule as follows. Qriginal PAD S6rvice
alongwith SH1 cc. Dealer (if dealer sale) co. Commercial File.
Notto be handed overto customer Signature of PAD Installation Engineer PAD Dealer
 Page 4105

x i BLUE STAR

QUOTATION KHAMMAM DISTRICTHOSPITAL

IAncillary worksfor Air Conditioners QTY UNITS RATE AMOUNT EXECUTED AMOUNT
Galvanized Iron sheet Rectangle Type Ducting

a24 G 70.00 Sgmt 1100.00 77000.00 82500.00

b22G 38.00sqmt 1200.00 45600.00 39000.000
2Canvass Connection at the outletofthe indoor units 6.00 No's 1800.00 10800.00 3600.00
3Aluminium powder coated Supply / Return Air Gril 2.40 Sqmt 6500.00 15600.00 26000.00
4Collar Damper 1.20 Sqmt 4800.00 5760.00 4800.00
Thermal Insultion of ducts with self athesive 13mm Thick
120.0 sqmt 590.00 70800.00 108 63720.00
insulation of duc
6Hard Drawn Copperrefrigerant piping for8.5 TR DuctableUnit 30.00 Rmt 1200.00 36000.00 20 24000.00
Control cabling interconnecting evaporating unit and condensing 35.00 Rmt 165.00 5775.00 25 4125.00
unit.
Installation, Testing and commissioning of air conditioning 2.00 Nos. 8500.0 17000.00 17000.00
system 8.5 TR Ductable Unit
Installation, Testing and commissioning of air conditioning
1.00 Nos 1800.0 1800.00 1800.00
system 2.0 TR Split Unitfor UPS Room
10 R410A Refrigerant Gas 15.00 Kgs 800.00| 12000.000 12000.00
1PVC Drain Piping 25MM DIA 20.00 Rmt 120.00 2400.00 2400.00
12MS Stand For Ductable Outdoor Unit 2.00 No's 4500.00 9000.00 9000.00
134outdoor stand for 2.0 TR Split Unit 1.00 Nos 1700.00 1700.00 1700.00
14 Supply and Installtion of 6KW Strip Heater 1.00 No's 18000.00| 18000.00 18000.00
15 Supply and Installation of Control Panel for heating arrangement 1.00 No's 32000.00 32000.00 32000.00
16 Supply and Installtion of Auto Sequential Times to Switch over|
1.00 No's 18000.00 18000.00 18000.00
eauipments automatically_
17Supply and Installtion of GI Volume Control Damper to control Air
1.00 sqmt 5400.00 5400.00 5400.00
Flow
18-Supply and Installtion of Non Back Draft Louvers 1.00 Sqmt 6200.00 6200.00 6200.00
19 Supply&Installation of SS drain tray insulatedd 2.00 Nos. 11000.00 22000.00 0.00
SUBTOTAL 412835.00 371245.00
GST 18% Extra On Low Side 74310.30 66824.1
TOTAL-ANCILLARY 487145.30 438069.10

98152o