普尼測(cè)試委托協(xié)議書(電子).doc

委托檢測(cè)/測(cè)試協(xié)議書 Test Application FormE注：欄目為委托單位必填項(xiàng)目 Note: Items marked withare mandatory 委托單編號(hào)(Application No.): 委托單位中文名稱(Client in Chinese)：委托單位英文名稱(Client in English): 付款單位名稱(Company of payment)： (付款單位名稱為發(fā)票抬頭，請(qǐng)準(zhǔn)確填寫。The invoice title is the Company Name of Payment, please complete accurately.)開(kāi)票種類(Type of invoice)：普通發(fā)票(General invoice) 專用發(fā)票(VAT special invoice) 聯(lián)系人(Contact Person)： 電話(Tel)： 傳真(Fax)： 電郵(E-mail) ：地址(Add)： 郵編(Post Code): 樣品信息(Sample Information)樣品名稱(Sample Name)： 樣品英文名稱（In English）： 樣品型號(hào)(Model No.)：產(chǎn)品制造商名稱（Manufacturer）：買家名稱（Buyer）：鍍層(Clad) 基材(Substrate) 混測(cè)(Mix testing) 整體均一材質(zhì)(Uniform composition throughout)樣品編號(hào)(Sample ID)(由實(shí)驗(yàn)室填寫Fill in by lab)樣品描述(Sample Description)：檢測(cè)/測(cè)試項(xiàng)目及方法(Test Items and methods) RoHS六項(xiàng)：鉛及其化合物（Lead and its compounds）；鎘及其化合物（Cadmium and its compounds）；汞及其化合物（Mercury and its compounds）；多溴聯(lián)苯（PBBs）；多溴聯(lián)苯醚（PBDEs）請(qǐng)選擇檢測(cè)/測(cè)試方法：IEC62321:2008；EPA Method；SJ/T 11365-2006六價(jià)鉻化合物（Hexavalent chromium compounds）請(qǐng)選擇檢測(cè)/測(cè)試方法：IEC62321:2008；ISO3613；EPA3060&EPA7196A；SJ/T 11365-2006備注：Cr（）六價(jià)鉻 如選用ISO3613，須提供樣品中鍍層重量或表面積，最好同時(shí)提供基材和鍍層的材質(zhì)以及鍍層的厚度。Note: if ISO3613 is to be used for Cr（）, the weight or surface area of the sample clad must be provided. It is better to provide the description of clad material and substrate material and the thickness of the clad layer as well.XRF； 鄰苯二甲酸酯Phthalates（6項(xiàng)）； 鄰苯二甲酸酯Phthalates（16項(xiàng)）； 鹵素（F/Cl/Br/I）；多環(huán)芳烴 PAHs； PFOS/PFOA； 其他項(xiàng)目檢測(cè)/測(cè)試依據(jù)(Test standard)申請(qǐng)人同意采用譜尼測(cè)試使用的檢測(cè)/測(cè)試方法(The applicant agrees to adopt the testing methods used by Pony Test) 申請(qǐng)人要求采用指定的檢測(cè)/測(cè)試方法(The applicant requires the use of the designated testing methods): 備注(Remarks)：服務(wù)類型及其他(Service Required and Others): 標(biāo)準(zhǔn)服務(wù)（Regular Service）: 57個(gè)工作日（5-7 business days）； 加急服務(wù)（Expedited Service）:3.5個(gè)工作日，加收40附加費(fèi) （3.5 business days, 40% surcharge)； 特急服務(wù)（Express Service）:1.5個(gè)工作日，加收100附加費(fèi) （1.5 business days, 100% surcharge）。請(qǐng)選擇報(bào)告形式 (Report language): 英文報(bào)告(English); 中文報(bào)告(Chinese) （任選一種，如需多選加收200-500元 You may select any one of them; if more than one is selected, additional fee RMB200-500 is to be charged）取報(bào)告方式及要求（Report pick up and requirements）:自取(Self pick-up) ; 國(guó)內(nèi)EMS(Domestic EMS); 國(guó)際EMS (International EMS)按重量及地區(qū)收費(fèi)(Charge according to weight and distance) 申請(qǐng)CQC RoHS認(rèn)證證書(Apply for CQC RoHS certificate) 原RoHS證書號(hào)(Number of existing RoHS certificate ): 大致完成時(shí)間 (Estimated finished date）：年(Y) 月(M) 日(D) 16:30以后 費(fèi)用(Charge)單價(jià)（Unit Price）： 加急費(fèi)用（Express Price）： 總費(fèi)用（Total Price）： 實(shí)收費(fèi)用（Actual Price）：請(qǐng)委托單位仔細(xì)閱讀本委托書背面的條款，正面與背面的內(nèi)容均系本委托書的組成部分。委托單位的簽字表明已看過(guò)并理解委托書背面條款，雙方同意履行。（The Client shall read the clauses as showed on the back of this letter of commitment. All contents on the front and back sides will form the full contract. Once signed by the Client, it will be deemed that the client has understood the clauses on the back and the two parties agree to carry out them.）委托單位聲明：對(duì)樣品及相關(guān)信息資料的真實(shí)性負(fù)責(zé)，并同意本協(xié)議背面“雙方約定條款”，保證樣品到達(dá)譜尼測(cè)試1個(gè)工作日內(nèi)支付費(fèi)用。 (Statement of the Client: to be liable for the truth of the sample and the related information and documents,agree on the back of this letter of commitment “clauses as agreed by the two parties” and ensure to pay the test charge within 1 business day after the sample delivered to PONY.)委托單位（蓋章） 檢測(cè)/測(cè)試單位（蓋章）Client (Stamp) Test organization (Stamp) 授權(quán)代表（簽字） 授權(quán)代表（簽字）Authorized representative (Signature) Authorized representative (Signature) 申請(qǐng)日期 受理日期(Date) (Date) 委托檢測(cè)/測(cè)試協(xié)議書雙方約定條款Clauses of the Test Application Form as agreed by the two parties 1.委托單位對(duì)結(jié)果如有異議，于報(bào)告完成之日起十五日內(nèi)向我單位書面提出，同時(shí)附上報(bào)告原件及預(yù)付復(fù)檢費(fèi)。If the trustor holds an objection to the result, the trustor shall propose a written objection to us within fifteen days after the completion of report, and present the original copy of report with retesting fee paid in advance.2.委托單位辦妥以上手續(xù)后，我單位將盡快安排復(fù)檢，不可重復(fù)性實(shí)驗(yàn)不進(jìn)行復(fù)檢。We shall arrange the retest as soon as possible after the foregoing procedure has been duly conducted, and be immune from conducting the recheck of the unrepeatable test.3.如委托單位與樣品生產(chǎn)單位不一致，委托單位需提供生產(chǎn)單位擁有樣品初始所有權(quán)并同意送檢的證明。If the trustor is not the manufacturer, the trustor shall submit the certificate which demonstrate the manufacturer possesses the initial ownership of such sample and agrees the presentation of sample.4.我單位僅對(duì)來(lái)樣負(fù)責(zé)，結(jié)果僅反映對(duì)該樣品的評(píng)價(jià)，結(jié)果的使用、使用所產(chǎn)生的直接或間接損失，我單位不承擔(dān)任何責(zé)任。We shall only be responsible for the presented sample. The result only reflects the evaluation of this presented sample. We shall be free from any liability arising from such result, or any direct or indirect loss incurred by usage of such result.5.對(duì)送檢樣品中包含的任何已知的或潛在危害，如放射性、有毒或爆炸性的樣品，應(yīng)事先聲明，否則后果由委托單位負(fù)責(zé)。The trustor shall inform us any known or potential hazard contained in the presented sample in advance, for instance, radioactivity, toxicity or explosivity of the presented sample, otherwise the trustor shall bear the legal consequence incurred by failure of such notice.6.如委托單位需要我單位外出采樣，則委托單位應(yīng)當(dāng)確保采樣場(chǎng)所不存在任何可能危及或影響我單位采樣人員人身、財(cái)產(chǎn)安全的危險(xiǎn)因素，否則，由此給采樣人員和/或我單位造成的一切損失(包括但不限于醫(yī)療費(fèi)用、工傷待遇、經(jīng)濟(jì)賠償)由委托單位承擔(dān)。If we will provide field sampling at the request of the trustor, the trustor shall ensure that there are no hazard factor which may be potential dangerous or adversely effective to the personal and property safety of our sample collectors on the sampling spot. Otherwise, the trustor shall assume all the damage caused to the sample collector and/or us (including but not limited to medical care expense, industrial injury fund and economic compensation).7.我單位可以在完成報(bào)告后按規(guī)定處置送檢樣品。We can dispose the presented sample pursuant to certain provisions after the completion of report. 8.委托單位應(yīng)認(rèn)真詳細(xì)填寫本協(xié)議書相關(guān)內(nèi)容，由于填寫不清造成報(bào)告修改，應(yīng)支付修改報(bào)告費(fèi)用。 The client should fill in the relevant contents of this agreement in detail accurately, and should pay the expenses for revising the report causing by not writing clearly. 9.在我單位CMA/CNAS認(rèn)證范圍內(nèi)的出具檢測(cè)報(bào)告，在認(rèn)證范圍外的則出具測(cè)試報(bào)告。We will issue the test report within the scope of CMA/CNAS certification we passed, and we will issue the data report outside of the scope of CMA/CNAS certification we passed. 10.在報(bào)告中的檢測(cè)項(xiàng)目左上角標(biāo)注“*”，則表示該項(xiàng)目不在我單位的CMA/CNAS認(rèn)證范圍內(nèi)。 If the test item in the report is marked with * in the upper left corner, then it shows that the test item is outside of the scope of CMA/CNAS certification we passed.付款方式及銀行賬號(hào)(Payment way and account No.)北京實(shí)驗(yàn)室人民幣賬號(hào) Bank account（RMB）：開(kāi)戶名(Account name)：譜尼測(cè)試科技股份有限公司 開(kāi)戶行(Deposit bank)：建行北京工商大廈支行 銀行帳號(hào)(Account No.)：11001085300059616767外幣帳號(hào) Bank account（$）：開(kāi)戶名(Account name):譜尼測(cè)試科技股份有限公司 Pony Testing Co., Ltd. 開(kāi)戶行(Deposit bank)：中國(guó)建設(shè)銀行北京市分行蘇州橋支行 CCB, Beijing Branch, Suzhouqiao sub-branch銀行賬號(hào)(Account No.)：11014350100220000023上海實(shí)驗(yàn)室人民幣賬號(hào) Bank account（RMB）：開(kāi)戶名(Account name)：上海譜尼測(cè)試技術(shù)有限公司 開(kāi)戶行(Deposit bank)：中國(guó)工商銀行上海市習(xí)勤路支行 銀行帳號(hào)(Account No.)：1001228109006747623廣州實(shí)驗(yàn)室人民幣賬號(hào) Bank account（RMB）：開(kāi)戶名(Account name)：廣州市譜尼測(cè)試技術(shù)有限公司 開(kāi)戶行(Deposit bank)：中國(guó)工商銀行廣州穗和支