AE Solutions Application / Specification Form for Safety-Instrumented Fire and Gas System Complete this form and click the request pricing button below to receive a quotation.1   SI-FGS Type FGS 1100 Safety-Instrumented Fire & Gas System based on Siemens Quadlog FGS 1400 Safety-Instrumented Fire & Gas System based on Siemens S7-400 HF Safety Instrumented Fire & Gas System based on Select OptionAllen-Bradley Control LogixSiemens QuadlogTriconex TriconTriconex Trident   PLC Processors Simplex Processor Redundant Processors   PLC I/O Modules Centralized I/O Modules Distributed Remote I/O Modules (FGS 1400 Only) Number of Zones # of Zones   Initiating Devices # Initiating Device Circuits per Zone (Up to 20 devices per circuit max) # of 2-wire dry contact inputs # of 4-wire dry contact inputs # of Analog Inputs   Notification Appliances # Notification Appliance Circuits Zone (Each circuit can support up to 10 Amps) Specify Notification Device control voltage or contact closure (cc)   Suppression Devices # Suppression Device Circuits per Zone Specify Suppression Device control voltage or contact closure (cc)   Fire Safety Function Circuits # Fire Safety Function Circuits per Zone   Gas Detection Cicruits # Gas Detection Circuits in Zone   Gas Detection Functionality IR Flame Detectors Combustible Gas Detectors Toxic Gas Detectors Specify Other   Battery Backup System 24 Hours Battery Backup with FM Approved Battery System 4 Hours Battery Backup with FM Approved Battery System Batterry Backup System Provided By Others (Requires re-certification by FM)   Unit Operation Offshore Processing Facility Onshore Processing Facility Refinery Semi-Conductor Petro-Chemical Facility Specify Other   Enclosure Wall Mount NEMA 12 Painted Carbon Steel Enclosure Wall Mount NEMA 4X Stainless Steel Enclosure Specify Other   Enclosure Environmental Conditioning None Electrical Heater Pneumatic Cooling Electrical Cooling   Area Classification (Where FGS Panel will be mounted) General Purpose Class I, DIV 2 Class I, DIV 1 – Type Z Purge   Field Wiring Design None: Will use existing field wiring General Purpose Explosion Proof Intrinsically Safe - Requires Factory consultation   Operator Interface Local Mounted Flat Panel – Siemens TP370 (FGS 1100 only) Local Flat Panel PC with Safety Matrix Specify Other   Field Device Voltage 24 VDC Other – Requires Factory consultation   Design Engineering Options2 None AE Solutions to Specify and Supply Field Devices – Fire / Gas Sensors and / or Final Elements AE Solutions to Provide Electrical / Controls Engineering Design for Installation of field devices   Safety Instrumented System Engineering Options None Onsite Safety Instrumented System Training Hazards Analysis / Safety Integrity Level Selection Safety Requirements Specification Safety Integrity Level Verification Calculations Functional Test Plans SI-FGS Configuration provided by AE Solutions - Required for FM approval   Product Certifications FM - NFPA 72 FM - Gas Certification None Name*   Title*   Company*   Email*   Phone*   Project Reference*   Requesting*   Select RequestBudgetary QuoteFormal Proposal Project Type*   Select TypeNew ProjectUpgrade Project Purchase Date*   Select Term0-3 Months3-6 Months6 Months - 1 YearMore Than 1 Year Nuisance Trip Cost*   The cost of a nuisance trip is a determining factor on the degree of FGS redundancy. Expensive down time can easily justify the cost of redundant architecture. Select Nuisance Trip Cost$0 - $10,000 a Day$10,000 - $50,000 a Day$50,000 - $100,000 a Day> $100,000 a Day Questions/Comments       (After submitting this form you will be prompted to print this page for your records.)     * Required Fields 1 Client to provide I/O List, P&ID, or Wiring Diagram(s) along with request for quotation in order to allow AE Solutions to confirm extended pricing. 2 AE Solutions shall contact client to obtain additional information to support developing pricing for this requested option.