Distributor’s Contact Details (ref #2 below) Contact Person: Company Name: Address: Telephone: Manufacturer’s Contact Details (ref #1 below) Original Classification Report(s) Manufacturer’s Product Distributor’s Product Description(s) / Contact Person: Number(s) Description(s) / Reference(s) Reference(s) (ref #3 below) (ref #4 below) (ref #5 below) Company Name: Address: Telephone: Email: Completion Advice: (#1) the details of the technical contact at the original Manufacturer (this should be the person responsible for holding and maintaining the test and classification reports). (#2) Enter the details of the technical contact at the Distributor (this should be the person responsible for holding and maintaining the classification reports). (#3) Enter the reference number(s) of the BASEC Classification Report(s) covering the cable(s) or families of cables in question. Do not include Test Report numbers. (#4) Enter the original Manufacturer’s reference number(s) or product description(s) of each individual cable or family of cables that have been type tested. (#5) Enter the Distributor’s reference number(s) or product description(s) of each individual cable or family of cables that are intended to be classified. Manufacturer & Distributors Declaration
Manufacturer’s Contact Details (ref #1 below) Contact Person: Company Name: Address: Telephone: Email: Distributor’s Contact Details (ref #2 below) Contact Person: Company Name: Address: Telephone: Original Classification Report(s) Number(s) (ref #3 below) Manufacturer’s Product Description(s) / Reference(s) (ref #4 below) Distributor’s Product Description(s) / Reference(s) (ref #5 below) Completion Advice: (#1) the details of the technical contact at the original Manufacturer (this should be the person responsible for holding and maintaining the test and classification reports). (#2) Enter the details of the technical contact at the Distributor (this should be the person responsible for holding and maintaining the classification reports). (#3) Enter the reference number(s) of the BASEC Classification Report(s) covering the cable(s) or families of cables in question. Do not include Test Report numbers. (#4) Enter the original Manufacturer’s reference number(s) or product description(s) of each individual cable or family of cables that have been type tested. (#5) Enter the Distributor’s reference number(s) or product description(s) of each individual cable or family of cables that are intended to be classified. Manufacturer & Distributors Declaration
BSF410-CPR-Distributor-System-1-Application-Form-Issue-2.docx