Footwear & Recreation Technology Research Institute

No. 11,8th Rd., Industrial Park,Taichung, Taiwan Tel : +886-4-23590112 ext. 726 Fax : +886-4-23598903

Work Request Form Jan. 24, 2013

Date of application： Application No.：[ ] Date of receipt： Signature of receiver：
Applicant： / Contact：
(Report title) / Phone/Mobile：
Address： / Fax no.：
E-Mail addr.：
Mail address： / Registered No.：
Test fee payer： / Contact：
Phone/Mobile：
Address： / Fax no.：
E-Mail addr.：
□Same as applicant / Registered No.：
Manufacturer： / Case(s)：
Address： / Note：
Sample references： / Description：
Testing Item / Method / Condition / Estimated price
Notice / □Regular(7 working Days) / □Express(3 working Days) / □Urgent(24hrs) / □Estimated date：
□English report Copies□Chinese report Copies / □ Fax to Applicant[ ]
□Collect on completion / □Return tested and/or remaining
sample (within 7 days) / □ Fax to Manufacturer[ ]
□Post report to applicant (Adding NT$50) / □ E-Mail to Applicant[ ]
□Post report tested and/or remaining sample (Adding NT$100)
Authorized person
/Applicant
Title/Signature：
Date： / Company stamp： / Note：After signing this form, it means the clients does understand and agree with Terms and Conditions as following and acknowledge that all tests are destructive tests.
Samples confirmation：
Total price：〔 〕Registered No.：〔 〕

Verification： Signature of recipient： 4.4-M-4-N03-2

Terms and Conditions

  1. This Terms and Conditions is part of the Work Request Form, applicant should confirm the application, understand and agree with all test requests are following on this Terms and Conditions.
  2. Please prepare enough samples with Work Request Form and send to Footwear and Recreation technology Research Center (FRT). The test request is valid when the Work Request Form is filled out, including test methods and conditions and signed by the authorized person of client. If these application procedures have not been finished, the tests will not be undertaken.
  3. All tests are destructive tests. The period for the validity of the test reports is one year.
  4. The test report relates exclusively to the samples being tested and shall not apply to the lot of the original of the samples. The samples which has been tested will be destroyed at the expiration of a period of 30 days.
  5. If any requirements of deletion, division, modification of sample description, or additional notes for the test report, please request within one month of the finished date report, and an amount of surcharge would be added.
  6. The test report should not be used for public advertisement, commercial promotion or purchase specification. FRT accepts no responsibility if the client uses the test report without the prior written permission from FRT. If the above actions cause any damages to FRT, the client should be responsible for the legal liability.
  7. The liability of FRT in respect to of any claim for loss, damage or expense as a result of negligence or willful default of FRT test report shall in no circumstances exceed a total aggregate sum equal to 5 times the amount of the fee paid in respect of the testing service which gives rise to such claim.
  8. Before the service fee was totally paid by the client, FRT would not offer test report to the client.
  9. The Work Request Form and Terms and Conditions shall be governed, interpreted in accordance with the local laws of Republic of China (Taiwan), without regard to the conflicts of law principles.
  10. Base on the Personal Information Protection Act and relative regulation, FRT follows privacy protection policy to collect, process and use your personal information. Your information will be invalid for the period of two years after this request service is terminated. FRT will not notice the period of validation.
  11. Any matters have not been stated in this Terms and Conditions shall be governed by the civil law and related law of R.O.C.

(Where there is a conflict of interpretation of wording between the English and Chinese versions of this Terms and Conditions, the Chinese version shall prevail)