Application Form for Product Certification

PF020: Issue Date: 26 August 2014

Revised date: July 2015

Page 1 of 3

APPLICATION FORM FOR PRODUCT CERTIFICATION

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

1.Company to hold certification:
2. Address: / 3. Telephone Number:
4. Main e-mail address:
5. Are the invoices to be issued in this company name and address? YES/NO
If NO, we will contact you for further information.
6. Contact Name(s):
E-mail:
Position: / 6.1) / 6.2)
7. Brand Name:
8. Description of products (please include product type and application):
9. Please define the scope of certification required:
10. Address of manufacturing site where the product is manufactured: / 11. Number of employees involved in the manufacturing process:
12. CERTIFIRE product type (See page 3):
13. Existing certificate number (for modifications):
14. Manufacturers contact details:
Name:
e-mail:
Telephone Number: / 15. Please confirm if you authorise Warrington Certification Limited to contact the manufacturer directly to organise Factory Production Control and Sampling visits YES/NO
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:

Please complete the certification agreement on page 2 and return the completed application form along with any supporting documentation to

18. Certification Agreement

We hereby apply for CERTIFIRE certification/extension of existing certification for the above mentioned product(s).

We understand that the application will be evaluated against the requirements of the relevant Technical Schedules in accordance with the procedures given in CERTIFIRE’s Rules for Certification, TS00 - General Requirements for Certification of Fire Protection Products.

We give our permission for Warrington Certification Ltd to liaise directly with the body certifying our quality system and with any bodies conducting tests in support of this application.

In the event of certification being granted we undertake to conform to CERTIFIRE’s Rules for Certification, TS00 -General Requirements for Certification of Fire Protection Products.

Signed: / Date:
Print Name: / Position:

CERTIFIRE Product Types

aa. Cavity Barriers

ab. Ceilings

ac. Class 0 and Class 1

ad. Class B and Class C

ae. Concrete Blocks

af. Door Closers

ag. Door Hold Open Device

ah. Ductwork

ak. Fire Curtains

al. Fire Protection to Tunnels

am. Fire Upgrading System

an. Flame Retardant Panels

ao. Glass and Glazing

ap. Hinges

aq. Industrial Steel Fire Doors

ar. Insulation

as. Intumescent Air Transfer Grilles

at. Intumescent Seals

au. Intumescent Seals and Smoke Door Seals

av. Letterplates

aw. Linear Gap Seals

ax. Locks and Latches

ay. Panic Exit Devices & Emergency Exit Devices

az. Penetration Sealing

ba. Rigid Polyurethane Foam

bb. Separating Element

bc. Smoke Door Seals

bd. Steel Fire Doors

be. Steelwork Protection

bf.Temporary Protective Covering

bg. Timber Door

bh. Vertical and Horizontal Separating

bk. Wall Covering

bl. Door Modifiers

Warrington Certification Limited, Holmesfield Road, Warrington, Cheshire, UK, WA1 2DS

Tel: 01925 646777  e-mail: