APPLICATION FORM FOR SYSTEM 1 CONSTANCY OF PERFORMANCE

FOR UKCA AND/OR “CE+UK(NI)” CONSTRUCTION PRODUCTS

All fields are mandatory except the blue field. Incomplete forms will be returned to the applicant and must be revised before the application can be progressed further.

Please tick this box if you already have UKCA and/or “CE+UK(NI)” certification from another approved body for this product Please advise who the approved body is that you already have UKCA and/or “CE+UK(NI)” certification with (if applicable): Please tick this box to confirm that you do not already hold certification for this product with another approved body: If selected, the certification must be withdrawn before we can process this application

SPECIFY THE APPLICATION TYPE

New application UKCA: Has the product been previously CE Marked by Warringtonfire? If so, please provide the CE Marking Certificate Number New application “CE+UK(NI)”: *if you already have CE marking then you cannot apply for “CE+UK(NI)” for the same product	Modification to existing certificate: Renewal: Existing certificate number:
Amendment to existing application: If yes, please specify the ID or job number:

2. Company to hold certification:
3. Address:	4. Telephone Number:
5. Main e-mail address:
6. Are the invoices to be issued in this company name and address? YES/NO Other (please specify) -
7. Contact Name(s): E-mail: Position:	7.1)	7.2)
8. Brand Name:
9. Scope of Certification: Describe the Product(s), Process(es) or Service(s) for which certification is to be granted: (please include product type and intended use of the product) Relevant designated product standard, UKAD, and UKTA: (If the responsible UK TAB is not Warringtonfire, see section 18 for requirements)
Name and Address of manufacturing site where the product is manufactured: Name: Address:	11. Number of employees involved in the manufacturing process _____ OR For certificate modifications or renewals, please tick if there has been no change in the manufacturing process since the last issue of your existing certificate [ ]
12. CERTIFIRE Certificate number if relevant:
13. Manufacturer contact details Name: e-mail: Telephone Number:	14. Do you authorise Warringtonfire Testing and Certification Limited to contact the manufacturer directly to organise Factory Production Control and Sampling visits? YES/NO
15. Please list any additional sites involved in the distribution or modification of the product and provide details of the process followed for each site. a) Type: Warehouse [ ] Manufacturing site [ ] Other [ ] Name: Address: Details: Please tick this box [ ] and continue on an additional page, if required.

16. Quality Systems Certification Body: Reference Number:
17. Do you currently have sampled test data to support your application? YES/NO If YES, please send the test report with the completed application form. If NO, are you currently in contact with a test lab to organise testing? YES/NO If YES, which lab:
18. If the responsible UK TAB is not Warringtonfire then we require you to submit the following information with this application form: Final UKTA and Evaluation report, these must have been circulated for 30-day period Sample report Written confirmation from the responsible UK TAB to confirm that sampling has been done to support the UKTA, this must be on letterheaded paper Declaration from the manufacturer (form EWC-QU-FT-623)

19. Certification Agreement

We hereby apply for Warringtonfire Testing and Certification Limited Certification of Conformity certification/extension of existing certification for the above mentioned product(s).

We understand that the application will be evaluated against the requirements of the technical specifications for UKCA and/or “CE+UK(NI)”.

We give our permission for Warringtonfire Testing and Certification Limited to liaise directly with the body certifying our quality system, with any bodies conducting tests in support of this application and any bodies certificating our factory production control system. We understand that any testing body may submit new test reports associated with this certification directly to Warringtonfire Testing and Certification Limited, at our request.

We are aware that it is our responsibility to send the supporting final test reports through to Warringtonfire Testing and Certification Limited and understand that certification will not be granted without the correct documentation being received.

In the event of certification being granted, we undertake to conform to the relevant product standard(s) or UKADs, including audit testing and factory production control auditing.

For details of Warringtonfire Testing and Certification Limited accreditation and locations of approval, please refer to the quality section of our website (www.warringtonfire.com).

Please note: If this certificate is linked to any mirror certificates, you must ensure that the mirror applicant is aware of any changes to the original certificate. If their certificate needs to be updated, please ask them to submit an application form for their certificate to be modified or renewed.

Authorised signatory of the above company:	Position:
Print Name:	Date: