ANNEX V
Approval certificate for products in accordance with appendix 1B/1C
Chapter III of Appendix 2 ‘III. Approval certificate for products in accordance with Appendix IB’ is replaced by the following:
‘III. Approval certificate for products in accordance with appendix 1B/1C
( 1 )
Once the Contracting Party has effected an approval it issues the applicant with an approval certificate, drawn up in accordance with the model below. Contracting Parties use copies of this document in order to communicate to other Contracting Parties approvals granted or any withdrawals.
Approval certificate for products in accordance with appendix 1B/1C
( 1 )
Name of the competent administration
Communication concerning ( 2 ) :
Approval
Withdrawal of an approval
Of a control device model
Of a control device component ( 3 )
Of a driver card
Of a workshop card
Of a company card
Of an inspector's card
Approval No …
(1)
Manufacturing or commercial mark
(2)
Name of model
(3)
Name of manufacturer
(4)
Address of manufacturer
(5)
Submitted for approval on
(6)
Test laboratory or laboratories
(7)
Date and No. of reports
(8)
Date of approval
(9)
Date of withdrawal of approval
(10)
Model (s) of component(s) of control device with which the component is intended to be used
(11)
Place
(12)
Date
(13)
Descriptive documents annexed
(14)
Remarks (including the affixing of seals if required)
…
(Signature)
( 1 ) Specify Appendix 1B or 1C
( 2 ) Tick the relevant boxes
( 3 ) Specify the component concerned in the communication’
’