3
Attachment B
(sample)
City (location) of the product acceptance __________________________________________
Name of the product recipient (company, facility)
_____________________________________
___________________________________________________________________________
Address and delivery information _______________________________________________
"_____"_____________201___
CERTIFICATE OF TECHNICAL CONDITION
The present certificate has been made ____________________________________________
(recipient representative, last name, title)
together with the representatives of ______________________________________________
(last name and title of manufacturer representative)
___________________________________________________________________________
or representative of company concerned, date and number of the document certifying
authorities of representatives for participation in inspection)
(Telegram requesting for the manufacturer representative
No. ___ dated "___"______201___)
to certify that during inspection of the product
___________________________________________________________________________
(product name)
manufactured by _____________________________________________________________
(name and address of manufacturer)
product factory number ________________ the following has been detected:
1.
Product storage conditions at the recipient warehouse:
___________________________________________________________________________
(specify product storage conditions)
1.
Condition of container and package
___________________________________________________________________________
(specify condition of external marking, date of container unpack, number of missing parts, their
cost, defects of container and package)
1.
The product is installed
___________________________________________________________________________
(specify conditions of product installation)
1.
Product assembly
___________________________________________________________________________
(specify who and when assembled the product, assembly quality)
1.
Product condition and complete set of supply
___________________________________________________________________________
(specify technical condition of product, electrical equipment, condition of their protection,
factory numbers, date of manufacturing)
1.
List of deficiencies (defects):
___________________________________________________________________________
