Jl. Kapuk Timur Blok F23 No. 11 AA
Lippo Cikarang, Delta Silicon III
Bekasi 17750, Jawa Barat – Indonesia
Ph: +62-21-89911467 Fax: +62-21-89911468
Website: E-mail:
PRODUCT LISTING PROCEDURES
Step 1Read the application (Form 2) completely. Fill in all spaces and sign and return the original. NOTE: You may also complete this application directly online on our website using our online application process, including uploading all of the necessary supporting documentation.
Step 2Complete the manufacturing information (Form 2A). For additional company names, please complete Form 2AA and submit a cross-reference list of models (for each name you wish to have listed).
Step 3Read the attached Listing and Licensing Agreement completely. Sign and date the signature page of the agreement and return to us. If you are a local companies with local tax ID number (NPWP), please also place your company stamp on top of your signature. If you currently have an existing active listing file with us, you can skip this step.
Step 4Please contact IAPMO Group Indonesia Staff if you have any question regarding listing process. Please submit the completed application forms, Listing and Licensing Agreement and fees to the IAPMO, along with the information and materials set forth in steps 5-11 as follows.
Step 5Refer to Exhibit "A" (attached) for the proper PT IAPMO Group Indonesia Certification Mark which is to be applied to the product under the terms of the Listing and Licensing Agreement.
Step 6Furnish one (1) copy of detailed, dimensioned engineering drawings of the product which includes the location, text and type of the required Certification Mark and all markings required by the product standard, i.e., etched, glass-over label, raised letters, etc.
Step 7Furnish one (1) copy of a test report(s) from our testing laboratory and/or an IAPMO Group owned testing laboratory. Test reports shall not be more than one year old and must be in the required format. If testing is not performed by our testing laboratory, some spot check testing may be required based on the recommendation of technical staff of PT IAPMO Group Indonesia to ensure compliance with local requirement. NOTE: If you choose to use our testing laboratory to perform the testing for this application, our testing laboratory will automatically forward the test report for evaluation upon conclusion of testing.
Step 8Deliver, prepaid and without charge to the attention of PT IAPMO Group Indonesia a sample or samples of the product (if required by PT IAPMO Group Indonesia Technical Staff). The exact number of samples will be determined by PT IAPMO Group Indonesia technical staff. Samples must bear prototype marking of the PT IAPMO Group Indonesia Certification Mark as determined in step 5. PT IAPMO Group Indonesia will not be responsible for loss or damage to any materials submitted. Unless samples are claimed within two weeks of notice of listing, PT IAPMO Group Indonesia may dispose of such materials. PT IAPMO Group Indonesia may, at its discretion, permanently retain any sample.
Step 9Furnish a normal size (approximately 3-1/2" x 5") photograph of each product submitted for listing(if required by PT IAPMO Group Indonesia Technical Staff). Each photograph should contain as much marking and identification detail as possible.
Step 10Furnish one (1) copy of the following: literature/brochures showing and describing the product, care & maintenance instructions, and installation instructions. Electronic copy is preferred. If hard copy is supplied, they shall be in color.
Step 11Furnish the street address, telephone number, name of the contact person at each plant and other information required by the Listing and Licensing Agreement for each location where the listed product is manufactured or is to be manufactured. This information is not required for component part manufacturing locations but only for final assembly locations.
Jl. Kapuk Timur Blok F23 No. 11 AA
Lippo Cikarang, Delta Silicon III
Bekasi 17750, Jawa Barat – Indonesia
Ph: +62-21-89911467 Fax: +62-21-89911468
Website: E-mail:
EXHIBIT A
“Certification Marks” as described in paragraph 3 of the Listing and Licensing Agreement, shall mean the following:
The use PT IAPMO Group Indonesia certification mark is mandatory upon product listing. Please choose the appropriate marking as noted on the following options:
Example of PT IAPMO Group Indonesia Certification Marks with Standard Designation
Jl. Kapuk Timur Blok F23 No. 11 AA
Lippo Cikarang, Delta Silicon III
Bekasi 17750, Jawa Barat – Indonesia
Ph: +62-21-89911467 Fax: +62-21-89911468
Website: E-mail:
APPLICATION FOR PRODUCT LISTING
Application Type (select one): New Product Listing Application (New Listing File)
Modification to Existing Listing File. Specify Listing File Number:
Check one or more of the following that applies to this application:
New Model Additions File Transfer
Additional Company Additions Manufacturing Plant Change
Technical Modification to Listed Products (i.e. design change, material change, component change, etc.)
Standard the product to be listed (if known to Applicant):
Brief Product Description:
Model Number(s) (you may submit a spreadsheet with list of model numbers):
Contact Name:
Company:
Company Legal Status:
Indonesian Tax ID Number/NPWP (if available):
Address:
City:
State/Province: Zip: Country:
Website: Email Address:
Phone: Fax:
Document Name: Listing Application PacketRevision: May 1, 2016
Is there a situation under which the product can lead to potential hazard? Yes No
Is your company ISO 9001 certified? Yes No
If yes, please provide a copy of your current ISO 9001 certificate and provide name of your registrar:
Which testing laboratory will you be utilizing to conduct the testing of your product(s)?
PT IAPMO Group Indonesia IAPMO R&T Lab (Ontario, CA-USA)* IAPMO R&T Lab (Guangzhou – China)*
*Please see step 7 on the page 1 of this application packet for additional information related to test report requirements.
- This Box is For PT IAPMO Group Indonesia Use Only -
APPLICATION FOR LISTING POLICIES
1.This is an application for listing.
2.Only one category of products (by standard) is permitted on one application. Listings are “Standard” specific. Example: Chimneys of various sizes, ducts of various sizes, Plumbing Fixtures - Vitreous China (i.e. water closets, lavatories), Bathtubs (Enameled Cast Iron) of various sizes, Bathtubs (Plastic) of various sizes, each will require a separate application per category depending on the standard for the product.
3.Applicant agrees to furnish all necessary drawings, test data, laboratory reports and product samples required PT IAPMO Group Indonesia Technical Staff. PT IAPMO Group Indonesia is not responsible for loss or damage to any materials submitted. Unless samples are claimed within two weeks of notice of listing, the IAPMO R&T may dispose of such materials. PT IAPMO Group Indonesia may, at its discretion, permanently retain any sample.
4.No freight collect product samples will be accepted by PT IAPMO Group Indonesia. The applicant must pay freight for all samples.
5.The application must be complete (including signatures) and all steps of Sheet 1 completed. If, after an application is first received, a period of three months elapses without the steps of Sheet 1 being completed, the application/file will be closed, unless otherwise instructed by Management of PT IAPMO Group Indonesia.
6.The feeis non-refundable.
7.Membership in IAPMO is not necessary for product acceptance, nor will membership in any way facilitate or confer product acceptance.
8.This application will be accepted for processing only if accompanied by an executed copy of the Listing and Licensing Agreement or if Listing and Licensing Agreement is already on file (for existing listee).
- For marking purposes, the appropriate certification mark shall be displayed on the product to indicate that it has been listed by PT IAPMO Group Indonesia and shall be visible on the product after installation. The only exception to this rule are for decorative or highly polished items, for items which are too small to accept the marking. In such cases, the certification mark and/or qualifying statements may be applied on the closest level of packaging to the product or other accompanying information. Listee shall contact PT IAPMO Group Indonesia to obtain PT IAPMO Group Indonesia’s consent to permit such deviation.
The undersigned certifies that he/she has read, understands, and, on behalf of applicant, approves and agrees to all the foregoing provisions of this application.
Signature of Applicant: Date:
Print or type name and title:
Jl. Kapuk Timur Blok F23 No. 11 AA
Lippo Cikarang, Delta Silicon III
Bekasi 17750, Jawa Barat – Indonesia
Ph: +62-21-89911467 Fax: +62-21-89911468
Website: E-mail:
MANUFACTURING PLANT LOCATIONS
The following information is required for each plant where your listed products are manufactured. Complete one sheet for each plant. Make photocopies of this sheet as needed.
COMPANY NAME: LISTING FILE NO. (If Known):
PLANT NAME:
PLANT STREET ADDRESS:
(City, State/ Prov., Postal Code, Country):
CONTACT PERSON:
PERSON RESPONSIBLE FOR QA SYSTEM:
PHONE NUMBER: FAX #
HOURS & DAYS OF OPERATION:
ANTICIPATED PLANT CLOSINGS, SHUTDOWNS OR HOLIDAYS:
Is this plant ISO 9001 Certified? No Yes (If yes, registrar’s name and provide a copy of certificate):
PLANT NAME:
PLANT STREET ADDRESS:
(City, State/ Prov., Postal Code, Country):
CONTACT PERSON:
PERSON RESPONSIBLE FOR QA SYSTEM:
PHONE NUMBER: FAX #
HOURS & DAYS OF OPERATION:
ANTICIPATED PLANT CLOSINGS, SHUTDOWNS OR HOLIDAYS:
Is this plant ISO 9001 Certified? No Yes (If yes, registrar’s name and provide a copy of certificate):
Which language can be used as the language for inspections: Bahasa Indonesia English Other
Signature of Applicant: Date:
Print or type name and title:
Jl. Kapuk Timur Blok F23 No. 11 AA
Lippo Cikarang, Delta Silicon III
Bekasi 17750, Jawa Barat – Indonesia
Ph: +62-21-89911467 Fax: +62-21-89911468
Website: E-mail:
ADDITIONAL COMPANY INFORMATION
Document Name: Listing Application PacketRevision: May 1, 2016
The following information is required for EACH Additional Company Name that currently appears on (or will be appearing on) your Listing Certificate.
Complete one sheet for each Additional Company Name (you may make photocopies of this sheet as needed).
Please provide all information as noted below for EACH ADDITIONAL COMPANY NAME that you are applying for or that currently appears on your certificate of listing:
LISTEE COMPANY NAME:
FILE NO.
PLEASE ATTACH LIST OF MODELS ON SEPARATE SHEET WITH CROSS-REFERENCE LIST OF CURRENTLY LISTED MODELS ON THE FILE.
ADDITIONAL COMPANY NAME:
CONTACT PERSON:
ADDRESS
CITY: STATE/PROVICE: ZIP: COUNTRY:
PHONE NUMBER: FAX #
EMAIL ADDRESS:
Applicant agrees, at the request of PT IAPMO Group Indonesia, to provide from any Additional Company named above written authorization and consent to have its name appear onApplicant’slisting, as well as any other information related to the Additional Company and reasonably required by PT IAPMO Group Indonesia.Applicant will promptly notify PT IAPMO Group Indonesia of any change to any of the information on this form.
Signature of Applicant: Date:
Print or type name and title:
IAPMO R&T : 8/1/992/99 DC#0003E
Rev.2/2008