Installer:
Name ________________________________________________________
Company ________________________________________________________
Address ________________________________________________________
________________________________________________________
Phone ________________________________________________________
Distributor (company from which the unit was purchased):
Company ________________________________________________________
Contact ________________________________________________________
Address ________________________________________________________
________________________________________________________
Phone ________________________________________________________
Model ________________ Serial No.______________________________Date of Installation ____________
SPECIFIC INSTALLATION NOTES: (i.e. Location, Amps, Gas Pressure, Temperature, Voltage, Adjustments,
Warranty, etc.)
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
BUILDING OWNER OR MAINTENANCE PERSONNEL:
For service or repair
• Contact the installer listed above.
• If you need additional assistance, contact the Distributor listed above.
• For more information, contact your Factory Representative.
INSTALLATION RECORD (TO BE COMPLETED BY INSTALLER)
Specifications and illustrations subject to change without notice or incurring obligations.
©2021 Nortek Global HVAC LLC, O’Fallon, MO.
All rights reserved.
I-UBX-UBZ-UDX-UDZ (03-21) 1034344-0
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