| RoHS整合报告申请表 | |||||||||||||||
| Company Name & Address Shown On Final Report 报告抬头之公司名称及地址 | (*******内部专用) | ||||||||||||||
| Applicant Name (*即报告抬头) | Rpt. No. | ||||||||||||||
| *Add. (地址) | Quo. No. | ||||||||||||||
| Rec. Date | |||||||||||||||
| Contact Person (联系人) |
| Dept. (部门) | R.R. Date | ||||||||||||
| *Tel. (电话) | *Fax (传真) | 测试费用 已付 未付 | |||||||||||||
| E-mail (电邮) | 邮政编码 | Sales/CSO: | |||||||||||||
| 付款公司 (*即抬头) |
| *联络人 | |||||||||||||
| 地址 | |||||||||||||||
| 币 种 | |||||||||||||||
| 电 话 | 传 真 | ||||||||||||||
| Following product information will be shown on the report. Item marked with * must be provided. 以下资料将显示在报告上, 打*标记为必须填写项目. | |||||||||||||||
| *Sample Description *样品名称(中/英文品名) | |||||||||||||||
| Ref.No. 参考号码 | Item No. 型号 | ||||||||||||||
| Factory 工厂名称 | Buyer’s Name 买家 | ||||||||||||||
| Country of Origin 原产国 | |||||||||||||||
| Other Requirement (Please Specify) 其它要求 (请注明) : Report in 报告语种: English 英文 Chinese 中文 | |||||||||||||||
| Turnaround Time 服务周期: | 5-7 working days with compliant application 收到符合要求的申请表后5-7个工作天 | ||||||||||||||
| *报告送递 (可多选): | 传真 Email 自取 快递到付 | ||||||||||||||
| *报告寄至: | 中文地址: | ||||||||||||||
*所有资料请确实填写，报告完成后如需修改报告内容，将收取报告修改费 | *公司盖章及代表签名 : Authorized Signature and Company Chop of the Applicant | ||||||||||||||
| *日期 | |||||||||||||||
CONSOLIDATED TEST DATA:
整合报告测试数据:
| ITEM NO. | PART NO. | Component Description | TEST SAMPLE | TEST LAB | REPORT NO. ISSUED DATE | TEST DATA (ppm) |
| 编号 | 料号 | 零部件名称 | 检测样品 | 报告发出机构 | 报告编号及发出时间 | 检测数据 (ppm) |
disclaimers:
The test data obtained and the test reports issued by laboratories other than ******* are provided by the applicant to ******* for data consolidation purposes.
This is a summary consolidating THE test data AND THE TEST REPORTS provided by the applicant to ******* and hence this consolidated test datA report shall in no event be treated or deemed to be a formal test report.
******* will not verify and be responsible for the accuracy, completeness, adequacy and/OR genuineness of all or any of the test data and the test reports submitted by the applicant to *******.
in no event shall ******* or any of its officers be or deemed to be liable for any LOSS OR DAMAGES, WHETHER direct, incidental or consequental LOSS OR damages (including without limitation damages for loss of profits and business interruption) arising out of OR IN CONNECTION WITH the use, quote, reliance or whatsoever of any information provided in this consolidated test data REPORT, or any claim attributable to errors, omissions or other inaccuracies in thIS consolidated test data REPORT or the interpretations thereof.
IN CASE THERE IS ANY CONFLICT BETWEEN THE DISCLAIMERS STATED HEREIN AND THE APPLICABLE TERMS AND CONDITIONS OF *******, THE DISCLAIMERS SHALL PREVAIL.
声明:
1.整合报告不等同于测试报告的效力。
2.整合报告中所列的数据都由申请者提供，*******对所列数据未经确认，对其真实性不负责任，申请者应对所整合内容的真实性负责。
3.申请者同意承担由整合报告所引起的所有法律责任。
4.如果此声明与*******的条款有任何不符或冲突，应以此声明为准。
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