Product Evaluation Information for
NEBS Compliance Review
Complete this form when requesting Product Evaluation for NEBS Compliance. This information will be used by the NEBS evaluation team in determining the extent of individual NEBS requirements for your product. The information you provide will help us to better serve your specific needs.
Vendor:______/ Product:______Model(s):______
Your Name:______ / Project Tracking code:______
Phone Number:______
Type of Evaluation Requested:
Complete: Level One Level Two Ancillary
Preliminary:
Product Description (check all that apply):
Frame or Cabinet / Multi-Frame or CabinetSingle Shelf / Multi-Shelf
Circuit Pack / Switching Product
Transport Product / Loop Product
Customer Prem Product / Non-network Product
Describe the function of the equipment: ______
______
______
______
______
If this is part of a larger Project or Product Selection (RFQ), list related products that are also being submitted for NEBS evaluation: ______
______
______
prodeval.doc
Form ESP-001 (4/98)
EQUIPMENT ENGINEERING & SPACE PLANNING DATA
Equipment Systems (1)
Manufacturer: ______
Equip. Functional Description And Nomenclature: ______
Floor Plan Designation: ______Number of Frames Per System: ______
Names of Associated Frames: ______
PHYSICAL DATA (2)
Overall Dimensions Including Framework: Height: ______Width (3): ______Depth: ______
Equipment Weight: Shipping - ______lbs. Installed - ______lbs.
ENGINEERING DATA (2)
Framework Type/Description: ______
Manufacturer's Identifying Catalog/Part Number: ______
Minimum Aisle Spacing Requirements: Front: ______Rear: ______
Additional Space Requirements Between This Frame And An:
Adjacent Like Frame: ______End Guard: ______Other Frames Or Structure: ______
Equipment Locating Restrictions: None ____ Yes (Explain):
Maximum Heat Dissipation (watts per ft2): ______
120 V ac Required: Yes: ___ No: ___
Special dc Power Requirements: None ___ Yes (Explain):
EXTERNAL CABLING DATA (4)
Equipment Cabling Plan Reference/Drawing Number: ______
Fiber Optic Conductors (0.125 dia. each): Sq. inches ______
Fiber Optic Cable (0.75 dia. per 96 pair): Sq. inches ______
Coaxial Cable (0.25 dia. each) Sq. inches ______
Shielded Cable (0.70 dia. per 30 pair) Sq. inches ______
Other Cable/Wiring Except Power (0.60 dia. per 50 pair) Sq. inches ______
Do Special Cable Or Cabling Requirements Apply: No ___ Yes ___ (Describe):
(1) One form required per each frame of multi-frame system equipment.
(2) All dimensions to be expressed in FEET and INCHES.
(3) Width includes normal 1/16 inch space between adjacent frames.
(4) Use the values given in parenthesis when determining external cabling data for cables not furnished by you. Multiply the values by the known or expected number of cables required to provide the equipment's ultimate functionality.
Form ESP-002 (4/98)
ENGINEERING & SPACE PLANNING EQUIPMENT DATA
Shelf Level Equipment Units (1)
Manufacturer: ______
Unit Functional Description: ______
Product ID: ______Nomenclature (Acronym): ______
Names of Associated Units Per Function: ______
EQUIPMENT DATA
Overall Dimensions (inches): Height:____ Depth (2):_____ Width: 19” ____ 23” ____
Unit Weight: Shipping - ______lbs. Installed - ______lbs.
Unit Requires 120 V ac: Yes ____ No ____
Minimum Aisle Spacing Requirements (feet & inches): Front: ______Rear: ______
Power Requirements: ______
Heat Baffles Required: Yes ___ No ___ If Yes, Supplied With Unit: Yes ___ No ___
Maximum Heat Dissipation (watts): ______
UNIT TO FRAMEWORK MOUNTING DATA
Supported Mounting Flange Hole Patterns: 1 3/4 x 19" ___ 1 3/4 x 23" ___ 2 x 23" ___
Unit Mounts To Front of Framework Uprights: Yes ___ No ___
List Unit Locating Restrictions/Considerations If Any: ______
______
Distance Unit Extends From Framework Mounting Surface: _____ (in.)
EXTERNAL CABLING DATA (3)
Unit Cabling Plan Reference/Drawing Number: ______
Unit Is Cabled From The Rear: Yes ___ No ___ Front and Rear: ______
Fiber Optic Conductors (0.125 dia. each): Sq. inches ______
Fiber Optic Cable (0.75 dia. per 96 pair): Sq. inches ______
Coaxial Cable (0.25 dia. each) Sq. inches ______
Shielded Cable (0.70 dia. per 30 pair) Sq. inches ______
Other Cable Except Power (0.60 dia. per 50 pair) Sq. inches ______
Required Alarm Leads And Designations: ______
Do Special Cable Or Cabling Requirements Apply: No ___ Yes ___ (Describe):
(1) One form required per each unit of a multi-unit product/system.
(2) Overall depth includes cable and its supporting apparatus.
(3) Use the values given in parenthesis when determining external cabling data for cables not furnished by you. Multiply the values by the known or expected number of cables required to provide the equipment's ultimate functionality.
Form HWM-001 (4/96)
LETTER OF COMPLIANCE ATTESTING TO HAZARDOUS WASTE MATERIAL
The equipment detailed below does/does not contain mounted components which will be considered a hazardous waste material as defined by applicable Federal and State Laws, Ordinances, Rules and Regulations:
Product(s):
(Check one)
Equipment does not contain mounted components which will be considered a hazardous waste material.
Equipment does contain mounted components which will be considered a hazardous waste material.
List below the part numbers, components, description, circuit pack number/name where the component is mounted, and type of hazardous waste material.
______
Signature Printed Name
______
Title
______
Company
______
Date
FRM-001 (4/98)
LETTER OF COMPLIANCE ATTESTING TO FIRE RESISTANCE OF MATERIALS
Company ______Date ______
This statement of compliance applies to the following product(s) which are being considered for purchase:
The below individual having reasonable control over the fire resistance characteristics of materials and components used in the construction and manufacture of the above product(s) assures that:
1. ___ All materials and components, except those listed below, meet the fire resistance requirements contained in the current issue of ANSI T1.307 Fire Resistance Criteria - Part 1: Ignitability Requirements for Equipment Assemblies, and Fire Spread Requirements for Interconnection Wire and Cable Distribution Assemblies.
2. ___ Exposed non-metallic apparatus having a surface area £1 ft.2 (0.09 m2) have a fire resistance characteristic equivalent to or better than UL-94 V-0.
3. ___ Exposed non-metallic apparatus having a surface area >1 ft.2 (0.09 m2) and a thickness less than 0.25 inches (6 mm) have a fire resistance characteristic equivalent to or better than UL-94 5VA.
4. ___ Exposed non-metallic apparatus having a surface area 10 ft.2 (0.9 m2) have a fire resistance characteristic equivalent to or better than UL-94 5VA and a flame spread rating of 150 as determined by test methods equivalent to UL standard 723 Test For Surface Burning Characteristics Of Building Materials or the radiant panel test in UL standard 94.
5. ___ Items 2, 3 and 4 are not applicable to the product(s).
The below non-metallic components (other than LEDs, small cable ties and terminal lug insulators) do not or may not comply with Items 1 through 4 above. The combined weight of the listed components is ______grams.
______
Signature Printed name
______
Title
Form ESR-001 (7/98)
Level One
Equipment Supplier Response
TP 76200 MP Requirements
Item / Reference / Y / N / n/a / Att.# / Item / Reference / Y / N / n/a / Att.#Grounding / Shock and Vibration
6.01(a) / Conductors / 12.06 / Positive Latching
6.01(b) / Connectors / 12.08 / Seismic Frames
6.01(c) / DC Sys. / Conv. / 12.09 / Self Support Frame
6.01(d) / Rect. / Invert. Etc. / 12.12 / Floor Loading
6.01(e) / Transport Equip.
6.01(f) / Misc. Equipment / Fire Resistance
6.01(g) / Bay Ground Lead / 13.04 / Panels/Barriers
6.01(h) / Isolated Bonding / 13.05 / Dc Cable/Wire
6.01(i) / Elec. Equip. Encl. / 13.06 / Ac Cable/Wire
6.02 / Short Ckt. Test / 13.07 / Frame Level Test
6.03 / Bonding Environ / 13.08 / Shelf Level Test
6.04 / Battery Return
Spatial
dc Power / Rack Type Frameworks
8.04(b) / Noise Test Report / 14.12 / 7'-0" Seismic
8.13 / Fuse/Protection
Cabinets
14.18 / 7'-0 & Seismic
Heat Dissipation
9.01 / Heat Dissip. Data
GR-1089 Requirements
8 / Radiated Emissions / 54 / Class A1 Voltage9 / Radiated Emissions Obj. / 55 / Class A2 Voltage
10 / Radiated Emissions / 56 / Class A3 Voltage
11 / Radiated Emissions / 57 / Class A3 segregtd
12 / Conducted Emissions / 58 / Class A3 Labled
13 / Common Mode Emiss. / 59 / Class AB restrictd
14 / Unintentional Cond Em / 60 / Class AB inacces.
20 / Manuf. CO switching. / 61 / Rubber gloves ...
21 / Current Limiting Prot. / 62 / Eqpt pwrd by gen.
22 / Listing AC Power / 63 / Class B de-enrgzd
23 / Listing Inverters / 64 / Interruped/tripped v.
24 / Listng Cust Prem Equip / 65 / Voltage interrupted
25 / EUT damage / 66 / Int./Trpped include
29 / EUT Safety Hazard / 67 / Peak Voltage
33 / EUT Safety Hazard / 68 / Sources Com. Wire
34 / External Curr. Limit. Pr / 69 / Current - 100cm
36 / EUT Safety Hazard / 70 / Current - 1cm
37 / Series Type Network / 71 / Current measured
38 / EUT Safety Hazard / 115 / Continuous Source Volt
39 / EUT on Cust. Prem / 125 / EUT Safety Hazard
40 / EUT Safety Hazard
41 / EUT not meet require.
Form ESR-002(6/98)
Level Two
Equipment Supplier Response
TP 76200 MP Requirements
Item / Reference / Y / N / n/a / Att.# / Item / Reference / Y / N / n/a / Att.#Electromagnetic Compatibility & Electrical Safety / Grounding - Continued
2.03 / Equipment Type / 6.01(e) / Transport Equip.
2.04 / Rad. Emission / 6.01(f) / Misc. Equipment
2.05 / Cond. Emission / 6.01(g) / Bay Ground Lead
2.06 / Emission Measure / 6.01(h) / Isolated Bonding
2.07 / Immunity / 6.01(i) / Elec. Equip. Encl.
2.08 / Immunity Measure / 6.02 / Short Ckt. Test
2.09 / Test Report / 6.03 / Bonding Environ
2.10 / Lightning/AC Pwr. / 6.04 / Battery Return
2.11 / Fault Testing
2.12 / Test Report / Temperature and Humidity
2.13 / Steady State Pwr. / 7.02 / Operability
2.14 / Tests Performed / 7.03 / Test Report
2.15 / Test Report / 7.04 / 7.01 Test Report
2.16 / Electrical Safety / 7.05(a) / Normal Temp.
2.17 / Tests Performed / 7.05(b) / Short Term Temp.
2.18 / Test Report / 7.05(c) / Rate Of Change
2.19 / DC Potential / 7.05(d) / Normal Humidity
2.20 / Testing / 7.05(e) / Short Term Humid.
2.21 / Test Report / 7.05(f) / Transport Temp.
7.05(g ) / Transport Humid.
Acoustic Noise
3.01 / Meet GR-63 / dc Power
3.02 / Tests Performed / 8.01 / -48V dc
3.03 / Test Report / 8.02 / -42.0 to -56.7V dc
8.03 / -40Vdc Test
Physical Design / Reliability / 8.04 / Noise Test Report
4.01 / TR-78 Test Report / 8.05(a) / -75V Test Report
8.05(b) / 0V Test Report
Electrostatic Discharge / 8.06 / Power Drain Info.
5.01 / Normal Operation / 8.07 / Min. V Test Report
5.02 / Inst. and Repair / 8.08 / Cable Connr. Info.
5.03 / List Eqpt. Rqmts. / 8.09 / Depower M&P
8.10 / e/w Redundant Pwr
Grounding / 8.11 / Design Provided
6.01(a) / Conductors / 8.12 / Visual Alarm Device
6.01(b) / Connectors / 8.13 / Fuse/Protn. Info.
6.01(c) / DC Sys. / Conv. / 8.14 / OSP Power Alarm
6.01(d) / Rect. / Invert. Etc. / 8.15 / Pwr Documentation
Page 1 of 2
ESR-002
Item / Reference / Y / N / n/a / Att.# / Item / Reference / Y / N / n/a / Att.#Heat Dissipation / Spatial
9.01 / Heat Dissip. Data / 14.04 / Switch Entities
9.02 / Forced Air Cooled / 14.05 / Switch Adjuncts
9.03 / Req. Addnl. Space / 14.06 / Other Eqpt. 7'-0"
9.04 / Face Temperature / 14.08 / Min Aisle Rqmts
14.10(a) / Stnd ac materials
Altitude
10.01 / Meet Requirements / Equipment Units
Airborne Contaminants / 14.11 / 14.08 to 14.10
11.02 / Test Report / 14.11(a) / Frt Mt/Rear Cable
11.03 / Fans E/W Filters / 14.11(b) / Closed Slots/Hole
11.04 / 80% Arrestance / 14.11(c) / 1-3/4 x 23" Mtg
11.05 / CL-2 Fire Rating / 14.11(d) / 2 x 23" Mtg
11.06 / No Air Bypass
11.07 / Replace Schedule
11.08 / Replacement M&P
Shock And Vibration / Rack Type Frameworks
12.01 / Transport / 14.12 / 7'-0" Seismic
12.02 / Vibration / 14.13 / Alternate Anchors
12.03 / Shake Table Test / 14.14 / Base Access
12.04 / Approved Test Lab. / 14.15 / 5/8-11 Top Sup.
12.05 / Test Reports 6 mo. / 14.16 / Base ac
12.06 / Positive Latching / 14.17 / Fig.14-2 Holes
12.07 / Hard Drive Backup / Cabinets
12.08 / Seismic Frames / 14.18 / 7'-0 & Seismic
12.09 / Self Support Frame / 14.19 / Vert. Loading
12.10 / Office Vibration / 14.20 / Positive Latching
12.11 / Floor Loading / 14.21 / Alternate Anchors
14.21(a) / Base Access
Fire Resistance / 14.22 / 5/8-11 Top Sup.
13.03 / Electronics / 14.23 / Switch Mtg.
13.04 / Panels/Barriers
13.05 / Dc Cable/Wire / Engineering Documentation
13.06 / Ac Cable/Wire / 15(A) / Space Planning
13.07 / Frame Level Test / 15(B) / Office Condition
13.08 / Shelf Level Test / 15(C) / Equip. Cabling
Page 2 of 2
Form ESR-003(7/98)
Ancillary Equipment
Equipment Supplier Response
TP 76200 MP Requirements
Item / Reference / Y / N / n/a / Att.# / Item / Reference / Y / N / n/a / Att.#Electromagnetic Compatibility & Electrical Safety / dc Power
2.03 / Equipment Type / 8.01 / -48V dc
2.04 / Rad. Emission / 8.02 / -42.0 to -56.7V dc
2.05 / Cond. Emission / 8.03 / -40Vdc Test
2.06 / Emission Measure / 8.04 / Noise Test Report
2.07 / Immunity / 8.05(a) / -75V Test Report
2.08 / Immunity Measure / 8.05(b) / 0V Test Report
2.09 / Test Report / 8.06 / Power Drain Info.
2.10 / Lightning/AC Pwr.
2.11 / Fault Testing / Airborne Contaminants
2.12 / Test Report / 11.02 / Test Report
2.16 / Electrical Safety
2.17 / Tests Performed / Shock and Vibration
2.18 / Test Report / 12.02 / Vibration1
12.03 / Shake Table Test1
Physical Design / Reliability / 12.10 / Office Vibration1
4.01 / TR-78 Test Report
Fire Resistance
Electrostatic Discharge / 13.04 / Matl. Fire Resist.
5.01 / Normal Operation / 13.06 / Fire Tests Done
5.02 / Inst. and Repair / 13.08(a) / Shelf Ignite Ckt Bd