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ICR Polska Sp. z o.o. / ICR Polska Co., Ltd.
ICR Polska Sp. z o.o. / ICR Polska Co., Ltd.

Data wydania:
发布日期:

Date of issue:
发布日期:

18.01.2021

Application for Verification of Conformity
符合性验证申请

Wydanie nr:
问题编号:

Edition No.:
电子编号:

1.01

F-P-00-01

Please mark and fill out fields below:
请标记并填写以下字段:

Type of service inquired
咨询的服务类型

Verification of TCF
TCF 验证

Testing
测试

Inspection
检查

APPLICANT INFORMATION
申请人信息

Company name:
公司名称:

HOLOWITS TECHNOLOGIES PTE. LTD.
HOLOWITS TECHNOLOGIES 私人有限公司有限公司。

Address:
地址:

1 HARBOURFRONT AVENUE,#14-08,KEPPEL BAY TOWER,SINGAPORE 098632 
1 HARBOURFRONT AVENUE,#14-08,吉宝湾大厦,新加坡 098632
    

VAT number:
增值税号:

     

e-mail:
电子邮件:

     

MANUFACTURER INFORMATION (to be filled if the applicant is not the manufacturer)
制造商信息(如果申请人不是制造商,则需要填写)

Company name:
公司名称:

HOLOWITS TECHNOLOGIES PTE. LTD.
HOLOWITS TECHNOLOGIES 私人有限公司有限公司。
   

Address:
地址:

1 HARBOURFRONT AVENUE,#14-08,KEPPEL BAY TOWER,SINGAPORE 098632
1 HARBOURFRONT AVENUE,#14-08,吉宝湾大厦,新加坡 098632
    

e-mail:
电子邮件:

         

PRODUCT DESCRIPTION
产品描述

Product Category:
产品类别:

  

Brand Name:
品牌:

HOLOWITS    

Product Name/Code:
产品名称/代码:

4MP Dual-Spectrum Thermal Imaging PTZ Camera
4MP 双光谱热成像 PTZ 摄像机
  

Product Type(s):
产品类型:

S9-4Z36A-Th190
编号 S9-4Z36A-TH190

Intended use:
有可能的使用:

Video Surveillance
视频监控
     

APPLICABLE DIRECTIVES/REGULATIONS (select relevant directives/regulations with applied product)
适用指令/法规(选择适用产品的相关指令/法规)

AIMD, 90/385/EEC
AIMD,90/385/EEC

CPR, (EU) 305/2011
CPR,(欧盟) 305/2011

ATEX, 2014/34/EU
ATEX,2014/34/EU

LIFTS, 2014/33/EU
电梯, 2014/33/EU

MDD, 93/42/EEC
MDD,93/42/EEC

RCD, 2013/53/EU
RCD, 2013/53/EU

RED, 2014/53/EU
红色, 2014/53/EU

GPSD, 2001/95/EC
GPSD,2001/95/EC

IVDD, 98/79/EC
体外诊断 dd,98/79/EC

SPV, 2014/29/EU
SPV,2014/29/EU

PED, 2014/68/EU
PED,2014/68/EU

RoHS, 2011/65/EU
RoHS 指令, 2011/65/EU

NNE, 2000/14/EC
NNE,2000/14/EC

LVD, 2014/35/EU
LVD,2014/35/EU

MARINE, 2014/90/EU
船舶, 2014/90/EU

REACH, (EC) 1907/2006
REACH,(EC) 1907/2006

MD, 2006/42/EC
MD,2006/42/EC

EMC, 2014/30/EU
EMC,2014/30/EU

MDR, (EU) 2017/745
MDR,(欧盟)2017/745

EKO, 2009/125/EC
ECO,2009/125/EC

TOYS, 2009/48/EC
玩具, 2009/48/EC

NAWI, 2014/31/EU
NAWI,2014/31/EU

IVR, (EU) 2017/746
IVR,(欧盟)2017/746

ECOL, 2010/30/EU
ECOL,2010 年 30 月/欧盟

TPQ, 2010/35/EU
TPQ,2010/35/EU

MID, 2014/32/EU
MID,2014/32/EU

PPE, (EU) 2016/425
个人防护装备,(EU) 2016/425

DRON, (EU) 2019/945
无人机,(欧盟) 2019/945

Other:
其他:

     

Other:
其他:

     

APPLICABLE STANDARDS
适用标准

ETSI EN 301 489-1 V2.2.3 ,ETSI EN 300 328 V2.2.0 ,EN IEC 62368-1:2020+A11:2020
ETSI EN 301 489-1 V2.2.3 ,ETSI EN 300 328 V2.2.0 ,EN IEC 62368-1:2020+A11:2020

  

DATA TO ISSUE THE PRO-FORMA INVOICE
开具形式发票的数据

Company name:
公司名称:

     

Address:
地址:

     

VAT number:
增值税号:

     

Please fill additional data on next page, carefully read information and obligatory confirm your commitments.
请在下一页填写额外数据,仔细阅读信息并强制确认您的承诺。

- 2 -

ADDITIONAL DATA - DOCUMENTATION
附加数据 - 文档

List of required technical documentation shall be agreed at the stage of application.
所需技术文件清单应在申请阶段商定。

the TCF is attached, including:
附加了 TCF,包括:

JAT-CE2703250122RE      

     

     

     

     

     

APPLICANT’S COMMITMENTS1)
申请人的承诺 1)

We commit to meet and follow requirements for the requested assessment and provide all necessary information needed to its conduct. Rules and requirements concerning product verification of conformity in ICR Polska Co., Ltd. are aware and clear2)
我们承诺满足并遵循所请求评估的要求,并提供其行为所需的所有必要信息。ICR Polska Co., Ltd. 中有关产品符合性验证的规则和要求是明确和明确的 2)
.

We agree to submit by ICR Polska Co., Ltd. the offer allowing the performance of some verification activities, including laboratory tests, by external entities with whom ICR Polska Co., Ltd. has appropriate agreements signed2)
我们同意 ICR Polska Co., Ltd. 提交报价,允许 与 ICR Polska Co., Ltd. 签署了适当协议的外部实体进行某些验证活动,包括实验室测试 2)
.

Name & Surname of person legally authorized to represent the Applicant
合法授权代表申请人申请人的姓名
:      

Position:
位置:
     

     ,

Date and signature: (company legal stamp if any)
日期和签名 (如有公司法定印章)

1) the declaration must be signed by a person legally authorized to represent the Applicant
1) 声明必须由合法授权代表申请人的人签署

2) this point of commitment must be chosen
2) 必须选择这个承诺点

All information contained in this document shall be considered confidential by ICR Polska Co., Ltd.
ICR Polska Co., Ltd. 应将本文档中包含的所有信息视为机密信息。

After the positive assessment of the completed application form the offer to perform verification process will be sent to you.
在对完成的申请表进行积极评估后,将向您发送执行验证过程的提议。