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BLANK FORM FOR THE APPLICATION TO ISSUE
A EUROPEAN TECHNICAL ASSESSMENT
UNDER ARTICLE 26 OF REGULATION (EU) No. 305/2011
1. To
Deutsche Institut für Bautechnik (DIBt), Kolonnenstr. 30 B, 10829 Berlin
2. Applicant
a) Manufacturer (*):
b) If need be, additional designation of an authorised representative (based in the European Union):
according to the attached written mandate, dated
3. Type of construction product
4. Trade name(s) of the product, which shall be included in the European Technical Assessment:
5. Description of the construction product, the intended use or the intended uses and the essential characteristics of the product:
6. Assessment of essential characteristics of the product with methods and criteria used in other harmonised technical specification(s) (**)
Case 1: The construction product is covered by the following European Assessment Document (EAD):
Reference number and version of the EAD:
Case 2: The construction product is covered by the following European technical approval Guideline (ETAG) (transitional arrangement referred to in Article 66(3) of Regulation (EU) No 305 / 2011):
No. of the ETAG:
Case 3: The construction product is partially covered by an existing harmonised standard (hEN) or a European Assessment Document (EAD).
hEN or reference number of the EAD and version:
Case 4: For the construction product there are no applicable harmonised methods and criteria for assessing the performances of the product under an hEN, an EAD or an ETAG.
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(*) According to Article 2(19) of the Regulation the 'manufacturer' means any natural or legal person who manufactures a construction product or who has such a product designed or manufactured, and markets that product under his name or trademark. The indication of the manufacturing plant(s) to DIBt is performed under 8. An Assessment is generally issued for one applicant each.
(**) Mark with a cross where applicable
7. Documents required for application
In cases 1 and 2 of Section 6.:
Additional techncial documentation shall be presented to allow a judgement that the said EAD or the said ETAG can be applied in full.
In cases 3 and 4 of Section 6.:
For a complete application a technical file shall by all means be submitted by the manufacturer (**).
The technical file, dated , is enclosed.
The technical file is expected to be submitted to DIBt by
DIBt will be pleased to be at your disposal for consultations in connection with the preparation of the manufacturer's file.
8. Manufacturing plant(s):
9. Declaration of the applicant
I hereby declare that (***)
I have not filed an application for a European Technical Assessment for the construction product with any other Technical Assessment Body;
I have filed an application
With
………………………………………………………………………………………………………
(Name of the Technical Assessment Body)
for the issue of a European Technical Assessment; this application was denied.
Furthermore, I declare that I
- will bear the costs of issuing the European Technical Assessment according to the scale of fees of DIBt (Annex 1 of the Statutes of Deutsches Institut für Bautechnik of 24.09.1993, as amended),
- will provide the necessary support in the process of issuing the European Technical Assessment,
- will ensure that the manufacturing plant(s) can be visited at any time during the operating times by representatives of DIBt and
- agree that the European Organisation for Technical Assessment (EOTA) and the European Commission shall be informed about the content of this application;
- I further declare that I am prepared to inform DIBt without delay of the first making available of the product on the market with CE marking.
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(***) Mark with a cross where applicable
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(Place and date) (Stamp/Signature)
Form sheet application ETA according to CPR