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Attachment B
(sample)
City (location) of the product acceptance ______________________________________
Name
of
_____________________________________
_______________________________________________________________________
Address and delivery information ____________________________________________
"_____"_____________201___
CERTIFICATE OF TECHNICAL CONDITION
The present certificate has been made ________________________________________
together with the representatives of __________________________________________
_______________________________________________________________________
or representative of company concerned, date and number of the document certifying
authorities of representatives for participation in inspection)
(Telegram requesting for the manufacturer representative
No. ___ dated "___"______201___)
to certify that during inspection of the product
_______________________________________________________________________
(product name)
manufactured by _________________________________________________________
(name and address of manufacturer)
product factory number ________________ the following has been detected:
1.
Product storage conditions at the recipient warehouse:
_______________________________________________________________________
(specify product storage conditions)
1.
Condition of container and package
_______________________________________________________________________
(specify condition of external marking, date of container unpack, number of missing parts,
their cost, defects of container and package)
1.
The product is installed
_______________________________________________________________________
(specify conditions of product installation)
1.
Product assembly
_______________________________________________________________________
(specify who and when assembled the product, assembly quality)
1.
Product condition and complete set of supply
_______________________________________________________________________
the
product
(recipient representative, last name, title)
(last name and title of manufacturer representative)
recipient
(company,
facility)
5
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