Template-Company
IQ / OQ
Template-SN
Page 7 of 29
Flexar Analytical / FX-10 UHPLC Pumps
IQ/OQ Rev. D June 2009
Approval Page
Preliminary Protocol Approval
This is to certify that the Installation Qualification and Operational Qualifications procedures for the
Flexar Analytical / / FX-10 UHPLC Pump
Serial number Template-SN
have been reviewed and both
PerkinElmer LAS and
Template-Company
have agreed to proceed with the procedures described in this
document.
Template-Company
Signature
Name
Title
Date
PerkinElmer LAS
Signature
Name
Title
Date
Final Approval
This is to certify that the Installation Qualification and Operational Qualifications procedures for the
Flexar Analytical / / FX-10 UHPLC Pump
Serial number Template-SN
have been performed and the
configuration installed
meets [ ] does not meet [ ]
the procedures and specifications described in
this document.
Template-Company
Signature
Name
Title
Date
PerkinElmer LAS
Signature
Name
Title
Date
