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Applicationfortestwork

PO BOX 14372
LYTTELTON 0140
Tel: (012) 644-0997/8
Fax: (012) 644-0991
APPLICATION FOR TEST WORK
Please complete all relevant sections of this document. The information is required to enable SAEx to accurately assess the
type and cost of test work. For assistance in completing this form, please contact Roelof Viljoen on 083 235 5256.
Do you require a free initial meeting (up to 30 minutes)?
THE APPLICANT:
Technical Contact
Commercial Contact
Position
Company Name

Postcode

Telephone No.
E-mail address
Web site URL
Commercial details:
Key dates
Day / month / Year
Estimated date by which certificate / report is required?
VAT Registration NO.?
Company / CC Registration No.?
Quotation Type /Requested.
Type of quotation Explanation of Quotation Produced
Budgetary Estimate Budgetary purpose only – Fixed price quotation must be requested before work begins Fixed price quotation – All relevant sections of this form must be completed fully.
THE PRODUCT:
Product Information and Type of Certification Required.
Is the application for:
Instruction
A new product(s) to be certified?
Description of product
A variation(s) to an existing SAEx certificate
A batch for which prototype certification exist
Other (please state)
Product details (Supporting documents may be attached)
If applicable, give details of range, which may differ in Certification code sought (if known) e.g. Ex de IIB T4
Ambient temp application (if not -20°C to 40°C) Was it previously certified? (Certificate No.) Product Status Supporting Information Required
At what stage is product e.g. pre-production or fully Fully designed, /in production / already certified
designed? (Underline the applicable) If yes, are the samples to be returned or rejection of this quotation? (NOT FOR
* Please advise
SAEx ACCOUNT)

Zones, Groups & Product Classification – Intended Use

SANS or IEC
approval?
Enter Product type

Existing Certification
(If a new product then ignore this section)
Please state any existing certificate number covering this product and indicate any changes to the product. Please provide marked up copies of the drawings showing any changes. ADDITIONAL INFORMATION

Please state any additional information, which may be relevant to this application. If necessary attach additional sheets.
……………………………………………………………………………………………………………………….… …………………………………………………………………………………………………………………….……
Are the following included with your application? (some of these may be requested at a later stage)
Enter X for all
which have
been included
Certificates of product/components incorporated into your product Signature of Applicant. Please sign this form and return to SAEx via the address details at the top of this

NB: Please note that products may be damaged during the test and certification process. SAEx will

not repair/replace or compensate the client for damaged products.
In signing this form the applicant attest that a contract In signing this form, the applicant accepts the right to any has not been placed with another Test Laboratory for certificate issued shall be vested in the actual manufacturer the certification of the product listed herein. stated above.
Signature: …………………………………………. .
Position:
Name: ……………………………………. …….
Quality/forms/appl-test-work(31/10/05)

Source: http://www.saexpl.co.za/applicationfortestwork.pdf

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