Service Required*(**Minimum Report Charge HKD200 in HK / RMB200 in China )
Regular (Standard Pricing) Urgent (40% Surcharge) Emergency (100% Surcharge)
(5-7 Working days) (3 Working Days) (1-2 Working Days)
* Special requests or unique testing may require additional time
Quotation required before testing (testing only starts upon confirmation to accept the quotation), pls tick the box as “X”
Sample Return. Tick the “YES” box if require”Yes- Self Collect Tested Samples .Default as “No”

Applicant Information: ★Please type in ENGLISH & BLOCK LETTERS★

Submitting For Company Name: HOME RETAIL GROUP (JDE No.179479) Program: HABITAT
Submitter Company Name:
Address :
Contact person : / Tel NO.： / Fax No.： / E-mail:
Billing Information
Habitat PO#
Lab will NOT commence testing unless Habitat has provided the lab with a PO.
Report To: / Submitter (report sent by email to the same contact of “Submitter” stated above) / Email to other Contact as below:
Company Name:
Contact Person:
Address:
Tel: Fax:
Email:
SAMPLE INFORMATION:
Sample Description / No. of Cartons
Color / No. of Samples
CAT No./ Article No. / PO No.
Manufacturer / Order type: / DI DS Domestic
Country of Distribution / Country of Origin
If flammability test is requested, please fill below information :
Fabric batch no# / Foam batch no#
Fabric composition / Foam composition
Fabric weight / Foam density
Fabric manufacturer
If this is a Retest for a previous non-compliance, please provide the previous Technical Report No.
Test Requested:
Indoor Furnitrue Testing
Fpr EN 12520:2009
BS EN 4875 Part 5 Level
BS EN 4875 Part 7 Level
EN 1022
Other:
Outdoor Furnitrue Testing
BS EN 581-1
BS EN 581-2 Level
BS EN 581-3 Level
EN 1022
Other: / Flammability test
BS5852
Polyurethane foam in slab or cushion form (Schedule 1 Part 1, BS 5852-2:1982 I.S 5)
Polyurethane foam in crumb form (Schedule 1 Part II, BS 5852-2:1982 I.S 2)
Latex rubber foam (Schedule 1 Part III, BS 5852-2:1982 I.S 2)
Non-foam filling materials singly (Schedule 2 Part 1, BS 5852-2:1982 I.S 2)
Interliner (Schedule 3, BS 5852-2:1982 I.S 5)
Visible part of upholstery (Schedule 4 Part I, BS 5852-2:1979 I.S 0)
Non-Viisble part of upholstery (Schedule 4 Part II, BS 5852-1:1979 I.S 0)
Visible Cover (Schedule 5 Part I, BS 5852-1:1979 I.S 1)
Stretch cover (Schedule 5 Part II, BS 5852-1:1979 I.S 1)
Non-visible cover (Schedule 5 Part III, BS 5852-1:1979 I.S 1)
BS 7177
Others：
Analytical Testing
PCP DIN 53313
Azo Dyes BS EN 14362-1/2
Formaldehyde BS EN ISO 14184-1
Release Formaldehyde BS EN ISO 14184-2
Others: / Physical Testing for Fabric
Light BS EN ISO 105 B02
Rubbing BS EN ISO 105 X12
Water Staining BS EN ISO 105 E01
Bursting Strength BS EN ISO 13938-1
others: / EU Food Grade Test :
Ceramic Plastic 请注明具体材料:
Metal请注明具体材料:
Others:
OtherTest Requirement
Test in accordance with Quotation sheet as attached
All services of Bureau Veritas Consumer Products Services Division are strictly offered, and can only be accepted, under the CPS Conditions of Service. Any party that requests said services, confirms said services, or makes any payment for said services does so agreeing automatically that: (a) it irrevocably accepts and agrees to the CPS Conditions of Service; (b) it waives all rights to change or challenge the CPS Conditions of Service; and (c) the CPS Conditions of Service are final and, unless expressly agreed otherwise by Bureau Veritas, any additional conditions sought to be imposed on any service or payment shall be invalid. The CPS Conditions of Service can be accessed through this link:

Date / Authorized Signature and Company Chop：

CPSD-HL-TRFS-SZ-LOCAL TRF-V4 Page3of 3 Creation Date:FEB 04, 2009