Installation Certificate - Dräger Interlock 5000 Gebrauchsanweisung

11

Installation certificate

I, the undersigned:
certify that the installation of the breath-alcohol-controlled vehicle immobilizer described below has been
carried out by myself pursuant to the fitting instructions supplied by the manufacturer of the system.
Description of the vehicle:
Make:
Type:
Serial Number:
Registration Number:
Description of the breath alcohol controlled vehicle immobilizer:
Make:
Type:
Approval number:
Installation:
Installer's full address (and stamp, if appropriate):
Signature:
Position:
Place:
Dräger Interlock 5000 / 7000
Dräger
®
Dräger Interlock 5000 / 7000
10 R - 057310
Installation certificate
Date:
19