BRE Global, Garston, Watford, WD25 9XX, UK

ASSESSMENT OF MODIFICATIONS

1.PRODUCT

For which product is the modification proposed?LPCB Reference No(s).

......

2.MODIFICATION DETAILS

Please state the exact nature of the proposed modification(s), and reason for the change(s) using the Table 1. Please submit a copy of the old and the new drawings which details the change, and associated parts lists.

Please provide a brief outline of the modifications in Table 1 on Page 2, or on a separate

sheet as necessary.

3.EQUIPMENT PERFORMANCE

Has the modified equipment been examined and tested for conformance to any recognised equipment specifications or standards? YES/NO

If 'YES', please enclose two copies of the test report and complete the following.

Test Specification / Test Authority / Test Report Reference / Date

4.CERTIFICATION AND APPROVAL INFORMATION

In order to meet and continue to meet the requirements for approval and certification it is important that listed companies understand the following:

All approvals and certifications are subject to our terms and conditions (ref PN101, available from )
Failure to comply with our approval or certification requirements for quality systems and products may be grounds for suspension or withdrawal of the certification or approval.
Entries in the LPCB Red Book will incur listing and promotional fees - these fees are charged to cover the following: an entry in the Red Book(s), inclusion in our Website ( at exhibitions, events and promotional literature. The LPCB Red Book(s) are distributed Worldwide and used by Clients, Insurers, specifiers and building owners.

Delays may be experienced if applications are not complete and correct. Please check that all the requisite documents specified in this form are included and inform us of any document detailed but not submitted at this stage.

F318-6.2Page 1 of 3© BRE Global, 2011

TABLE 1. MODIFICATION DETAILS.

Component / Old Drawing or Document No. / Issue / Date / New Drawing or Document No. / Issue / Date / Modification(s) / Reason(s) / LPCB Use
only

F318-6.2Page 2 of 3© BRE Global, 2011

5.DECLARATION

Please sign below to confirm that:

The information contained in this documentation has been subjected to technical review to ensure that it is fullycomplete andcorrect; and
All specimens provided for testing are representative of current production methods, produced in accordance with the drawings and specifications provided with this application, comply with any specific requirements of the test standard and will be supplied free of all duties and charges.

If prototype tick here 

Signed on behalf of ______

Name:Position:

(Authorised representative of Applicant)

Signature:Date:

CONTRACT REVIEW

LPCB USE ONLY

Reviewed by …………………………………. Date ………………….. Accepted: Yes  No
If not accepted details of action taken: