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1、中國(guó)質(zhì)量認(rèn)證中心CHINAQUALITYCERTIFICATIONCENTRECB測(cè)試證書(shū)申請(qǐng)書(shū)ApplicationforCBTestcertificateCQC/QPCPO9.04(1/1）Ourreference申請(qǐng)書(shū)編號(hào)Date申請(qǐng)日期SCHEMEOFTHEIECEEFORRECOGNITIONOFRESULTSOFTESTINGTOSTANDARDSFORSAFTYOFELECTRICALEQUIPMENT(CB-SCHEME).國(guó)際電工委員會(huì)電工產(chǎn)品合格測(cè)試認(rèn)證組織IECEE-關(guān)于電工產(chǎn)品測(cè)試證書(shū)相互認(rèn)可體系A(chǔ)pplicantname申請(qǐng)人名稱:Applicanta
2、ddress申請(qǐng)人地址:Tel.電話號(hào)Fax傳真號(hào)E-mailContactpersonname/Tel./E-mail聯(lián)系人姓名及電話/E-mailManufacturer’sname/address制造商名稱及地址Tel.電話號(hào)Fax傳真號(hào)E-mailFactoriesnameandaddress:工廠名稱及地址:Productname產(chǎn)品名稱Trademark產(chǎn)品商標(biāo)Modelandspecification型號(hào)規(guī)格RelevantStandard標(biāo)準(zhǔn)號(hào)/版本號(hào)及增補(bǔ)件2005-12-26Page3of3中國(guó)質(zhì)量認(rèn)證中心CHINAQUALITYCERTIFICATIONC
3、ENTREThecountrywhichtheproductwillbeexportto擬出口國(guó)家:Components/sparepartsusedintheappliance整機(jī)的安全元器件清單:Object/part元器件名稱ManufacturerTrademark制造廠/商標(biāo)Type/model型號(hào)規(guī)格Technicaldata技術(shù)數(shù)據(jù)Standard采用標(biāo)準(zhǔn)Markofconformity認(rèn)證標(biāo)志OtherinformationofvaluetotheNCBs(suchasbusinesslicense,catalogues,pricelists,advertisi
4、ngmaterial,informatorypamphlets,listsofcomponentsorspareparts,instructionsformaintenanceandrepair,photographs,drawings,circuitdiagrams)isenclosed(preferablyinquadruplicate)andislistedbelow:提供給NCB的其它有價(jià)值的信息（企業(yè)注冊(cè)復(fù)印件,產(chǎn)品目錄、價(jià)格表、宣傳材料、小冊(cè)子、元件或備件表、維修指南、照片、圖紙、線路圖）作為申請(qǐng)書(shū)附件（一式二份）備注Note：1.我們申請(qǐng)進(jìn)行現(xiàn)場(chǎng)測(cè)試，測(cè)試形式為T(mén)
5、MPWMTWewouldliketoapplyforon-sitetesting測(cè)試實(shí)驗(yàn)室名稱：編號(hào)：NameofLab:CodegivenbyCQC:2.我們同意本產(chǎn)品獲得CB證書(shū)后將證書(shū)內(nèi)容作為公共信息公布在IECEE網(wǎng)站上，所有人員均可查閱。Weagreethat,afterobtainingCBcertificatesfortheproductsinvolvedinthisapplication,contentofthecertificatewillbepublishedontheIECEEwebsiteaspublicinformation,withoutanyacc
6、essrestrictions.同意不同意AgreeNotagree2005-12-26Page3of3中國(guó)質(zhì)量認(rèn)證中心CHINAQUALITYCERTIFICATIONCENTREWedeclarethatwewillfollowtherulesoftheCBSchemeandCQC’srelevantregulationandprocedure.Andmakepaymentforthefeesarisingfromtheapplication,testingandotheritemsrelatedtothecertification.CQCwillnotbeheldliab
7、leforanyresponsibilitythatshouldbetakenbythecertifiedmanufacturerofsalesagent.我們聲明愿意遵守CB體系的規(guī)則及CQC的規(guī)則程序.并支付所需費(fèi)用.中國(guó)質(zhì)量中心(CQC)將不承擔(dān)獲得CB測(cè)試證書(shū)的制造廠或銷售商應(yīng)承擔(dān)的任何法律責(zé)任.Signature簽字2005-12-26Page3of3
