REQUEST FOR PRODUCT CERTIFICATION IMPORTANT THIS FORM SHOULD BE

STUDENT ID DUPLICATE CREDENTIAL REQUEST FEE CHARGED
(JAWAPAN PADA SLAID) 1 A MANAGER REQUEST HIS
048B DATE OF BIRTHADDRESS CHANGE REQUEST FORM

2 REQUEST FOR NCG FUNDING FOR RITUXIMAB
2 REQUEST FOR URGENT CITIZENSHIP CEREMONY –
APPLICATION TO THE REGISTRAR TO REQUEST THE PRODUCTION


Request for Product Certification

IMPORTANT: this form should be utilized in order to apply for a quotation; it is required for a valuable job of our experts, that require info are properly submitted and specified. Any generic data may generate a wrong understanding with consequent mistake in evaluation and pricing. If more space is needed, additional sheets may be attached.

Completed form should be returned to: [email protected]

Company Information
Company name
Address
VAT no.
Contact person
Function
Email
Phone
Applicant is	 Manufacturer	 Dealer / supplier	 Importer

Service requested
Certification of products for following Countries / Markets:
 Russian Federation	 Ukraina		 Kazakistan			 Other ( Specify )

Other Services:
 Safety product certification		 Fire safety product certification			 Atex product certification
 Custom Union Hygienic Register.		 RTN Permit			 Medical registration
 Other ( Specify )

Requested Schemes
 Batch (one contract / shipment)				 Serial (from one to five years)

Product information ⁽¹⁾
Description ⁽²⁾
Product model / Type / Code
Manufacturer
Production countries site
HS Code

⁽¹⁾in case of multiple products fill in table at point 8

⁽²⁾as invoice and/or according to data sheet

Shipment information
Country of delivery
Expected shipment date
Contract number and date
Client
End User⁽³⁾
Intended use⁽⁴⁾

⁽³⁾ in case company client will export or re-export goods

⁽⁴⁾ i.e. Medical, Oil & Gas, Mining, etc.

Document enclosed
 Contract	 Test reports	 Conformity declaration
 Management system certificates	 Product certificates	 Copy of packaging, labels and information for consumer
 Data sheet, manuals, lay-out / drawing	 Other, please indicate:

Note, comments

Specific notes:

AENOR nor QSA are not obliged by the receiving of this form to produce a formal quotation

The submission of the proposal after the receipt of this application has not to be considered as the output of a consultancy process for the identification of applicable standards and certification required for a specific product, field of application, country.

Advised terms of quotation are based on our experience and are indicative.

Signature
Name		Position
Signature		Date

REQUEST FOR PRODUCT CERTIFICATION IMPORTANT THIS FORM SHOULD BE

Product information
Product	Code / article⁽⁵⁾	Category / family	HS Code	Country of origin	Manufacturer	Standards reference

⁽⁵⁾as invoice and/or data sheet

450780.doc – November 2012 2 / 2

CHAIRMAN PHIL MENDELSON AT THE REQUEST OF THE
FREEDOM OF INFORMATION ACT REQUEST PLEASE REVIEW
FRESNO COUNTY EMPLOYEES’ RETIREMENT ASSOCIATION REQUEST FOR PROPOSAL

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