Pre-installation Checklist: SafeTrack™ This checklist may be completed and submitted online to request a SafeTrack™ installation. Completion of the checklist will assure that the job site is ready for our crew upon their arrival, and avoid unnecessary back charges to you. You may save the form and return later if unable to finish. Please have your Safe-Grain, Inc. job number ready. Step 1 of 3 33% Contact InformationYour Name* First Last Your Company*Email* Enter Email Confirm Email Your best contact phone number*Safe-Grain, Inc. Job Number*Customer Company*Installation Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Pre-Installation ChecklistAll bin(s) are 100% finished with temperature cables hung in correct locations?*NoYesAll leadwires are identified and pulled thru the Myers Hub located near the roof peak?*NoYesAll ladders and catwalks are complete, accessible, and meet OSHA safety standards?*NoYesIs all Millwright work completed above all work areas where our crew will be working and we do not have to worry about falling objects or welding splatter etc. ?*NoYesAll 120 VAC true earth ground power wiring is pulled to and ready for termination at all scanner and relay radio locations.*NoYesA computer is installed, with Windows Ver. 7, 8 or 10.*NoYesThe computer has Microsoft Excel software loaded.*NoYesThe computer is on site at the final location*NoYes Important NotesSafe-Grain SafeTrack installation does not cover repairs to any bin erector or millwright leadwire or cable damages. Any repairs to the leadwire or cables will be billed to customer.* Agreed Payment for your SafeTrack project is due at the completion of Safe-Grain installation. Any additional repairs will be on separate time and material invoicing. Labor by Safe-Grain to install the above material excludes any 120VAC wiring and 120VAC wire conduit.* Agreed Safe-Grain installation prices are based upon: The bin erector must hang our cables from the bin manufacturer's cable supports (supports by other) and bring all lead wires through a Safe-Grain supplied Myers Hub to be installed by the bin erector near the roof peak.* Agreed Our installation will begin on the outside of the roof peak at the Myers Hub and is based on the bin having an outside roof and wall ladder with OSHA safety cage or safe access to the catwalk located over the peak.* Agreed I understand that Internet access and Microsoft Excel software is required to fully utilize all the functions of the SafeTrack Software.* I understand All bins are to be ready for our crew for installation in the quantity of trips quoted. Return trips caused by other's actions or inactions will result in additional travel charges and billed on a separate time and material basis.* Agreed If possible we prefer that you forward any safety training materials in advance for completion prior to our arrival on the job site. Would you like to upload training materials?* Yes No File Drop files here or Accepted file types: jpg, gif, tif, doc, docx, pdf. By my eSignature below, I certify that I have read, fully understand and accept all terms of the foregoing statement. Please signify your acceptance by entering the information requested in the fields below. Please enter your full name:* First Last Identifier*Please enter your identifier - your first initial and the last four digits of your phone number.