Application
about assessment parametersof construction product
No.......

(filled in by the Approved / Notified Body)

Applicant / manufacturer requires about: (it marks by mark)

certificationof constancyof product – system 1+ (I+), 1 (I)

certification of conformityofproduction control system – system 2+ (II+)

specificationof product type – system 3 (III)

technical assistance at assessment of productparameters – system4(IV)

pursuant to provisions: (it marks by mark one case)

Regulation(CPR)No. 305/2011, whichare determinedconditions of introducing of construction productson the market and which cancelguidelineof council 89/106/EHS (further only „regulation“)

Act.No. 133/2013 Coll.onconstruction products and about change and completing some acts as amended by Act No. 91/20166 Coll. (further only „Act“)

1.Applicant:

Company name(according registerat company register,trade certificate)

Address(street,community, P.O.Box – including address for service)

IBAN: VAT reg. No.: SWIFT:

Representative for subject act: (name, position, phone, fax, e-mail)

Authorised person:(name, position, phone, fax, e-mail)

Bank connection:seat bank:IBAN:

seat account:BIC/SWIFT:

2.Producer: (fill, if applicant is not hereby manufacturer)

Company name(according registerat company register,trade certificate)

Address(street,community, P.O.Box – including address for service)

IBAN: VAT reg. No.: SWIFT:

Representative for subject act: (name, position, phone, fax, e-mail)

Authorised person: (name, position, phone, fax, e-mail)

Place (s) of manufacture(name of manufacturing plant, street, city, state):

3.Product

Generic name, trade name:

Type (s)(detailed identificationof all the types and variants of the product according to a valid standard, a corporate documentation or a catalogue, that are produced by the same technology):

The product of this type andkindis manufacturedin...... designs (variants)

Type brands of all kinds of the product included in the type tested:

Technicalspecification (whereare referred declared properties of the product):

The marking of group product by addition No. 1 regulation MDVRR SR No. 162/2013Col.l as amended by regulation
No. 177/2016 Coll.:

Purpose and method of using productinbuilding, method of his permanent and fixed installationto building, relevantlimitof hisusing:

Additional information about the product(if applicable)

Class of reaction to fire:

(according toEN 13501-1)

Class of fire characteristicsof roofs /of sliding roofsby subjected external fire, while is it relevant to:

(accordingEN 13501-5)

In productionare used substancesfor reduction of flammability:yesno

4.The product is available to take over for assessment of parameters since:

  1. Was already on construction productissued assessment of parameters

under regulationoract (or documented conformity under Act No. 90/1998 Coll.as amended later regulations)?

yes(specifyNo. certificate or other document):

yes, I applyaboutextention stated(specify No. certificateor other document):

no

  1. Enclose auxiliary documents to Application

Information on the product

-detailed technical description and drawings, data sheets, structural analysis;

-data on intended use;

-list of other technicalspecifications and instructions validfor product and production;

-brief description of production process;

-copiesof reportsof performed tests in other testing laboratories, issued of certificates, reports fromaudit of qualityor reports
about performedinspection above control system of production.Annex No......

Copy of actual Abstract of the Companies Registeror Trade CertificateAnnex No......

In the case, that Application presentrepresentative of manufacturer(according point 2 of Application) originalorauthenticated copy of agreementif you like authorizationof manufacturer for applicantwith intorducing of range representation Annex No......

7.Declaration of the applicant / manufacturer

The product is developmentally completed and data contained in this application, the documentation and other data are complete and represent the state of the product at the date of this application.

Applicant/manufacturer present, thathe have not appliedsame applicationfor productreffered in the Art. 3 otherApproved/NotifiedBody, if you likeThe application was not accepted.

(Untrueness of this declarationisdisciplinable according the Act.)

8.Other requirements for the applicant / manufacturer

To deliver documents needed to assess the performance of the product in Slovak language (unless otherwise agreed).

To allow for the taking a sample, if you like provide a sample of the product for performance testing of the product in due time.

To allow the performance of initial inspection of the factory and factory production control and continous controlabove factory production control and control tests in due time.

To ensure cooperation during the assessment of parameters to the extent required by the approved /notified body.

9.Commercial and legal relationships

Will be addressed in a separate contract concluded pursuant to § 591 at seq. Commercial Code, in relation to this application.

If the procedure of issuing SK technical assessment would stop prematurely, the applicant agrees to pay the approved body incurred costs of works even done before the conclusion of the contract.

In on

Representative of the applicant:On behalf of the approved/notifiedbody registered:

name: on

signature: ...... signature: ......

Stamp of the applicant

The notes to filling of application

The application are filling separatelyfor every brand of productproduced by one manufacturer inmember state or in abroad.

Accompanying papers according point 6,which concerning at the same time several products required for assessment of parameters of product, do to addto one application and in otherto introduce heritage.

Application you send in two works,accompanying papers 1xby registered post to address presented in top application.

We urge,that by register of application not confirm its allness.Process of assessment parameters of product, can be begun till after completing by specified data andby delivery all required accompanying documents in terms off § 21 Section 2) and Section. 3) of Act.

Informations for applicant / manufacturer.

By assessment of parameters maybeto verify only properties of construction productstated in technical specifications by defined by direction or act.Because obligationto assess parameters of these requirements is it relevant to all manufacturers and all products the same products,is for successful of product in the market possible to show by per independent body also other properties of product, these, which are different from competing products and that are important for selection of product his incoming users.

For applicant is financially and timely advantageous together with assessment of parameters to realize too certification of others properties of product andto obtain so certification of Accredited certification body for certification of products VÚSAPL, a.s., reg. No. P-011, eventually to verify properties of productby tests in competent accredited laboratory VÚSAPL, a. s., reg. No. S-043.

In the case of your interest you introduce, which other properties of product you inquire to verify by certification if you like by tests.

Certificationif you like tests perform VÚSAPL, a.s. on the basis of particular contracy. Particular informations you offer at address listedin the head-line of this application.

Application _PPSV-SK-englpage1from3OCV-002-0118-V10