Install Instructions

Installation and Service Certifi cate
Boiler Data
Boiler Model / Series Evergreen ________ / Series ____ Date installed _____________________
CP Number ________________ FUEL: Natural ______ LP ______ Btu Input ___________________
CERTIFIED THAT: ❏ Installation instructions have been followed.
❏ Check-out sequence has been performed.
❏ Information on next two pages is certifi ed to be correct.
❏ Information received and left with owner/maintenance person.
Installer
(Company) (Address) (Phone) (Installer’s Signature)
Part number 550-100-191/0917
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gas-fired water boiler — 70/110/155 Boiler Manual