Training course completion declaration
The undersigned Mr.: ............................................................................................................................................
resident in: ...................................................................
postcode:
...........................
address: ......................................................................
no.: .......................................
phone / mobile:
..........................................................
fax / e-mail: .......................................................
AS:
❑
OWNER
❑
IN CHARGE OF THE COMPANY INSIDE SAFETY
❑
OPERATOR APPOINTED BY THE OWNER
❑
USER OF THE MACHINE
❑
..........................................................................................................................
DECLARE, UNDER ITS OWN RESPONSIBILITY:
to have attended the training course, to have received and understood the instructions for starting, operating,
stopping and keeping in perfect conditions the Covering System by
Marcolin Covering s.r.l.
Brand / Type: ..................................................................
Serial No.: ........................................................................
to have received the manual and to commit himself to understand its contents before using the machine for the first
time.
by the manufacturer:
Marcolin Covering s.r.l.
– Via Orefici Michelin, 3 – 33170
Pordenone
Tel +39 0434 570261
– Fax + 39 0434 572448
COMMIT HIMSELF ALSO TO THE TRAINING COURSE FOR NEW STAFF, IF APPLICABLE, WHO WILL USE THE
COVERING SYSTEM FOR ROLL-OFF CONTAINERS AND TIPPER BODIES.
SIGNATURE
SIGNATURE
MARCOLIN COVERING S.r.l.
Il legale rappresentante
Course contractor
(in case of sole owner of the following staff training)
...........................................................................
Date: .....................................
CUSTOMER COPY
