46
Appendix 1
Disinfection certificate
Attention
: It is necessary to answer all questions in the table.
1. Has the instrument operated with material contaminated or suspected
of being infected with microorganisms of I-IV pathogenicity groups, in-
cluding:
Yes
No
components and blood substances
Yes
No
samples suspected of being infected with microorganisms of III-IV patho-
genicity groups
Yes
No
including hepatitis B and C viruses, HIV
Yes
No
samples suspected of being infected with microorganisms of I-II pathogenici-
ty groups
Yes
No
2. Has the instrument operated with toxic, carcinogenic or radioactive
substances?
Yes
No
If yes, please indicate types and quantities:
3.
the following kits were used with the instrument (list the names of the kits with the
manufacturer's indication):
_______________________________________________________________________________
________
_______________________________________________________________________________
________
_______________________________________________________________________________
________
_______________________________________________________________________________
________
4. the following decontamination methods were used prior to sending the instrument to repair a
manufacturer production site:
Company _________________ takes full responsibility for the biological, chemical and radi-
ological decontamination, disinfection and cleaning, as well as packaging of the instrument
serial number _______________.
We agree that in case if the instrument is damaged during transportation due to poor-quality
packaging, DNA-Technology R&P LLC assumes obligations to carry out maintenance / re-
pair procedures after written agreement with the Customer only.
Customer:
________________________________________
Company name
________________________________________
Signature
