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Version 5.0 DUT-E Installation Manual
© 2007-2011, JV Technoton 26 of 30
Appendix 1. Act of the vehicle inspection
dated "___" ____________ 20___
We, the undersigned, representatives of the CUSTOMER
_____________________________________________________________________,
On one hand, and representatives of the CONTRACTOR
_____________________________________________________________________,
On the other hand, inspected the vehicle (device)
vehicle Type ___________________________________________________________
Make, Model _________________________________________________________
Reg. plate____________________________________________________________
if it meets the requirements for DUT-E installation and concluded as follows:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
representative of the CUSTOMER: representative of the CONTRACTOR:
_______________________
_______________________
name, signature
name, signature