PERHATIAN / ATTENTION :
Borang permohonan hendaklah diisi dengan lengkap dan diserahkan beserta tiga (03) set dokumen-dokumen yang diperlukan/ Application form must be completely filled and submitted with three (03) sets of required documents
Permohonan yang tidak lengkap akan dikembalikan dan/ atau tarikh permohonan akan dikemaskini mengikut pembetulan yang telah dibuat/ Incomplete application shall be returned and/ or the application date shall be amended following the date of a satisfactory submission
DOKUMEN-DOKUMEN DIPERLUKAN/ SUPPORTING DOCUMENTS : Sila Petak/ Please Box
Salinan Persijilan/ Copies of Certificates (Salinan disahkan Benar/ Certified True Copy)
ISO 9001
ISO 14001 *Required for any chemical products
Certification Mark
Salinan Laporan Ujian yang lengkap daripada Pihak Makmal Ketiga dan/ atau Sijil daripada Kilang dalam tempoh tidak melebihi tiga (3) tahun dari tarikh permohonan/ Copies of Test Reports from a Third-Party Laboratory and/ or Mill Certificate with validity of not more than three (3) years (Salinan disahkan Benar/ Certified True Copy)
Salinan Sijil Pendaftaran Syarikat Pembekal, Kementerian Pembangunan/ Supplier Registration Certificate, Ministry of Development
Salinan asal Brosur / Katalog / Spesifikasi Produk yang dipohonkan/ Original copy of Product Brochure / Catalogue / Specification
Senarai projek-projek yang telah dan/ atau akan menggunakan produk termasuk projek diperingkat Nasional / Serantau / Antarabangsa/ List of past and/ or future National / Regional / International projects in which the product is/ will be used
Salinan Sijil Persijilan Produk yang telah diluluskan oleh Kementerian Pembangunan - Untuk Permohonan Membaharui Sahaja/ Copy of previously approved Product Certificate – For Renewal Application Only
*Nota/ Note : Salinan Persijilan dan Laporan-Laporan Ujian hendaklah disahkan sebagai Salinan yang Benar oleh Syarikat Pembuatan atau Badan yang Disahkan atau Notari Awam dan bukanlah disahkan sendiri oleh Syarikat Pemohon
All copies of Certificate and Test Reports must be Certified as True Copies by the Product Manufacturer or a Certified Body or the Public Notary but not the Applying Company itself
KETERANGAN SYARIKAT/ COMPANY DETAILS |
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Nama Syarikat/ Company Name : |
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Alamat Syarikat/ Company Address : |
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Pegawai/Kakitangan yang membuat permohonan/ Officer/Staff responsible for making application |
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Nombor telefon/ Telephone number : |
Nombor fax/ Fax number : |
Emel/ E-mail : |
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KETERANGAN PERMOHONAN/ APPLICATION DETAILS |
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Permohonan Baru/ New Application |
Permohonan Membaharui/ Renew Application |
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Sila lampirkan senarai yang berasingan jika ruang ini tidak mencukupi/ Please attach a separate list if space is limited
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Nama Produk/ Product Name
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Harga bagi satu Unit/ Price per Unit |
Tajuk dan Bilangan Spesifikasi Piawaian/ Title and Number of Standard Specification |
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Nama Syarikat Pembuatan/ Name of Manufacturer |
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Alamat Kilang/ Factory Address |
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Jenis Skim Persijilan yang diperlukan/ Type of Certification Scheme required
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Scheme 1: A valid compliance certificate of ISO 9000 Standard on Quality System and a valid Certification Mark from any foreign Standards Organisation recognised by ABCi Scheme 2: A valid compliance certificate of ISO 9000 Standard on Quality System recognised by ABCi Scheme 3: Local Product – Product has a valid test report from an accredited laboratory or any foreign Standards Organisation recognised by ABCi. There shall be certificates verified by any of the approved third party quality agencies for authenticity and validity (if required by ABCi). Any fees incurred shall be borne directly by the applicant. Scheme 4: Product has a valid Certification Mark from any foreign Standards Organisation recognised by ABCi |
PENGAKUAN/ DECLARATION |
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Jika diluluskan sebagai Pembekal Produk, Syarikat hendaklah mematuhi segala syarat keperluan yang ditetapkan oleh Kementerian Pembangunan / If approved as a Products Supplier, the Company must comply with all the requirements set by the Ministry of Development Jika didapati bahawa Syarikat tidak mematuhi mana-mana syarat keperluan dan/ atau jika produk itu telah dibuktikan tidak berkesan secara teknikal, pihak ABCi berhak untuk menarik balik sijil yang berkenaan/ If the Company has failed to comply with any of the requirements and/ or the product has been proved to be technically ineffective, the approval certificate can be withdrawn by ABCi
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Nota/
Note:
Kesahihan sijil adalah tertakluk kepada tarikh mansuh Sijil
ISO 9000
atau
Certification
Mark
bagi produk yang berkenaan
The
validity of the certificate is according to the expiry date of the
ISO
9000 Certificate or
Certification Mark
of the product
Page
STD 3/003 Rev. No. 13
Date : 30/11/2017
Tags: attention :, permohonan, perhatian, hendaklah, attention, borang