APPLICATION FORM FOR ISSUE OF

SK TECHNICAL ASSESSMENT

referred to in Act declared by the National Council of the Slovak Republic
No. 133/2013 Coll. on construction products and to change and amend certain Acts
as amended by the Act No. 91/2016 Coll.

No.–––––––––––––––––––––––––––––––

(To be filled by approved body for technical assessment)

(Framed parts to be filled in by the applicant for issue ofSK Technical Assessment)

  1. Applicant for issue of SK Technical Assessment:
1.1 Identification data
Business name:…………......
Address:…………......
Comp. reg. No.:...... VAT reg. No.:......
1.2 Statutory body
Name:….…...... Position:......
Telephone (fax):……………..……………………... e-mail……………………………………….
1.3 Contact person
Name:….…...... Position:......
Telephone (fax):……………..……………………... e-mail………………………….……………
  1. Manufacturer:
(If different from the applicant)
2.1 Identification data
Business name:…...………......
Address:…………......
Comp. reg. No.:……...... VAT reg. No.:......
2.2 Statutory body
Name:….…...... Position:......
Telephone (fax):…………….……………………... e-mail……………………………………….
2.3 Contact person
Name:….…...... Position:......
Telephone (fax):…………….……………………... e-mail……………………………………….
  1. Construction product
3.1Identification data
Trade name……………......
(Detailed identification name according to valid standard, internal documentation, catalogue etc.)
…………………………………………………………………………………………………………….
Variants of the product (names of variants):......
(Detailed identification name according to valid standard, internal documentation, catalogue etc.)
…………………………………………………………………………………………………………….
Construction product suitability for use in construction (building) and declared characteristics
of the product:……..…………………………………………………………………………………….
…………………………………………………………………………………………………………….
3.2Information about product manufacture
Place of manufacture:….…......
Has been issued a certificate of quality management system in compliance with EN ISO 9001 for the manufacturing plant? (tick the appropriate)
□ yes – please state the number of the certificate ...………………..…………………………..
□ no
If not, briefly describe factory production control…………………………………………………..
(especially managing of production control, staff and technical equipment of production control)
…………………………………………………………………………………………………………….
…………………………………………………………………………………………………………….
  1. Information about process of technical assessment
Technical specification which contains declared characteristics of construction product:
…………………………………………………………………………………………………….……...
No. of group of construction products:…………………………….………………………………….
(In compliance with Decree of the Ministry of Transport, Construction and Regional Development of the Slovak Republic
No. 162/2013 Coll., establishing a list of groups of construction products and systems of assessment and verification
of constancy of performance. Approved Body and Ministry of Transport and Construction of the Slovak Republic may help to determine the appropriate group of your construction product.)
Has been issued SK Technical Assessment, or Technical Approval before validity of Act declared by the National Council of the Slovak Republic No. 133/2013 Coll.?
(tick the appropriate)
□ yes – please state the number:………………………………………………………………..
□ no
  1. Statement of the manufacturer/applicant

The product is fully developed as atype andinformation stated in this application form, submitted documentation as well as other data are complete and giving a true picture of the product state on the date of producing this application form. Manufacturer/applicant declares that he has not made any request for SK Technical Assessment for the construction product referred to in clause 3 of this application form to any other Approved Body for technical assessment, or the manufacturer/applicant has made such request, but the request was rejected/withdranw because of following reason:

Falsehood of this statement is disciplinable according to valid legislation.

  1. Obligations of the applicant for issue of SK Technical Assessment

Applicant for isse of SK Technical Assessmenthas to:

-submit att the documents necessary for execution of technical assessment in language which is understandable for Approved Body for technical assessmentFIRES, s.r.o.(i.e.Slovak, Czech, English orPolish language);

-cooperate with the Approved Body for technical assessment during execution of technical assessment in the range required by Approved Body for technical Assessment, including ensure that the manufacturing places can be visited by representative of Approved Body for technical assessment in relation to issue of SK Technical Assessment;

-settle the full costs arising from the technical assessment process to Approved Body for technical assessment stated in the head of this application form;

-submit following documents as annexes of this application form for issue of SK Technical Assessment:

  1. detailed technical description of construction product;
  2. drawings of construction product;
  3. test reports and classification reports related to the particular construcion product,resolutions or calculations of other testing laboratories or approved/notified bodies about particular construction product which are relevant during technical assessment process;
  4. quality management system certificates or document issued by inspection body expressing positive result of inspection of the manufacturing plant and of factory production control if they were issued for the manufacturing plant;
  5. documents about factory production control, especially managing of production control, staff and technical equipment of production control, if neither quality management system certificate nor document of competent institution expressing positive result of inspection of the manufacturing plant and of factory production control has been issued for the manufacturing plant;
  6. copy of statement of trade register or copy of trade licence.
  1. Notes

-application form has to be filled in for each product manufactured in this country or imported and for each place of manufacture separately;

-enclosed documents according to clause 6, related to several products simultaneously required for technical assessment can be enclosed to one application form, while references are made in the other application forms;

-application form has to be sent together with enclosed documents in one copy, all as aregistered letter to the address shown in the heading of this application form;

-trade and legal relations will be dealt in a separate contract, enclosed according to § 591 and others of Commercial Code. Separate contract will be elaborated on the basis of this application form.

Information

Employees of the executor (of the Approved Body for technical assessment) are bound with secrecy about any facts gained during the certification proceedings. These facts shall not be given to a third party without the sponsor’s consent.

Abbreviations used in this application form:

MDV SR – Ministry of Transport and Construction of the Slovak Republic

Registration of the application form
on behalf of Approved Body No. TP01:

(To be filled in by the TP01)

......

date......

Signature:......

Records of theApproved Body for technical assessment or MVD SR:

Removal of the application form from evidence was made by:…….……………......

Reason for removal of application form from evidence:…………………………………………………………

In Batizovce, date…………………………… Signature:…………………………………………..

FIRES 202/OTP-31/01/2017-E1/3