DECLARATION OF PERFORMANCE
according Annex III of the Regulation (EU) No 305/2011
amended by Commissions delegated Regulation (EU) No 574/2014

No[XYZ-123-abc]
[Unique reference number of the declaration of performance (DoP).
This Nocan be chosen by the manufacturer.
The reference number of the DoP can be the same as the unique identification code of the product-type.]

Unique identification code of the product-type:[XYZ-123-abc]

[The unique identification code of the product-type can be chosen by the manufacturer.
This could be for example the brand name[1)]or another unique code clearly linked with the product.
It must be ensured thatvia the unique identification code of the product-type there is clear link between the single product and the relevant DoP.]

Intended use/es:

Synthetic resinscreed for internal uses

[The intended use of the product shall be described using the wording of the hEN]

Manufacturer:

[name and address of the manufacturer]

System/s of AVCP:

System 4 (for internal uses)

System 4(for internal uses subject to reaction to fire regulations)

Harmonised standard:

EN 13813: 2002

Notified body/ies:

Not relevant

[For this case (only AVCP system 4) the point „notified body/ies” can be omitted]

Declaredperformance/s:

Essential characteristics / Performance / System of assessment and verification of constancy of performance / Harmonisedtechnicalspecification
Reactiontofire / Efl a) / System 4 / EN 13813:2002
Release ofcorrosivesubstances / SR
Waterpermeability / NPD
Wearresistance / ≤ AR1
Bond strength / ≥ B1,5
Impact resistance / ≥ IR4
Sound insulation / NPD
Sound absorption / NPD
Thermal resistance / NPD
Chemical resistance / NPD

Appropriate Technical Documentation and/or Specific Technical Documentation:

Appropiate Technical Documentation: No. [12345]

Performance without further testing: reaction to fire class Efl

Fulfilled requirements[Maximum layer thickness: 10 mm]
[Organic content: < 75 % in weight]

The performance of the product identified above is in conformity with the set of declared performance/s. This declaration of performance is issued, in accordance with Regulation (EU) No 305/2011, under the sole responsibility of the manufacturer identified above.

Signed for and on behalf of the manufacturer by:

[authorised representative of the manufacturer]

(name)

[place, date]……………………………………………..

(place and date of issue)(signature)

Annex[Option: if necessary to be deleted]

According to Art. 6 (5) of the Regulation (EU) No. 305/2011 a Safety Data sheet according Regulation (EU) No. 1907/2006 (REACH), Annex II is attachedto this Declaration of Performance.

Deutsche Bauchemie e.V.
Edition: June 2014

[1)][If the brand name of the product will be used as unique identification code of the product-type it should be considered, that the brand name of the product must be changed if the product-type has been changed. If this is not intended,another unique code should be used as identification code of the product-type.]