普尼测试委托协议书(电子).doc

委托检测/测试协议书 Test Application FormE注：栏目为委托单位必填项目 Note: Items marked withare mandatory 委托单编号(Application No.): 委托单位中文名称(Client in Chinese)：委托单位英文名称(Client in English): 付款单位名称(Company of payment)： (付款单位名称为发票抬头，请准确填写。The invoice title is the Company Name of Payment, please complete accurately.)开票种类(Type of invoice)：普通发票(General invoice) 专用发票(VAT special invoice) 联系人(Contact Person)： 电话(Tel)： 传真(Fax)： 电邮(E-mail) ：地址(Add)： 邮编(Post Code): 样品信息(Sample Information)样品名称(Sample Name)： 样品英文名称（In English）： 样品型号(Model No.)：产品制造商名称（Manufacturer）：买家名称（Buyer）：镀层(Clad) 基材(Substrate) 混测(Mix testing) 整体均一材质(Uniform composition throughout)样品编号(Sample ID)(由实验室填写Fill in by lab)样品描述(Sample Description)：检测/测试项目及方法(Test Items and methods) RoHS六项：铅及其化合物（Lead and its compounds）；镉及其化合物（Cadmium and its compounds）；汞及其化合物（Mercury and its compounds）；多溴联苯（PBBs）；多溴联苯醚（PBDEs）请选择检测/测试方法：IEC62321:2008；EPA Method；SJ/T 11365-2006六价铬化合物（Hexavalent chromium compounds）请选择检测/测试方法：IEC62321:2008；ISO3613；EPA3060&EPA7196A；SJ/T 11365-2006备注：Cr（）六价铬 如选用ISO3613，须提供样品中镀层重量或表面积，最好同时提供基材和镀层的材质以及镀层的厚度。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； 邻苯二甲酸酯Phthalates（6项）； 邻苯二甲酸酯Phthalates（16项）； 卤素（F/Cl/Br/I）；多环芳烃 PAHs； PFOS/PFOA； 其他项目检测/测试依据(Test standard)申请人同意采用谱尼测试使用的检测/测试方法(The applicant agrees to adopt the testing methods used by Pony Test) 申请人要求采用指定的检测/测试方法(The applicant requires the use of the designated testing methods): 备注(Remarks)：服务类型及其他(Service Required and Others): 标准服务（Regular Service）: 57个工作日（5-7 business days）； 加急服务（Expedited Service）:3.5个工作日，加收40附加费 （3.5 business days, 40% surcharge)； 特急服务（Express Service）:1.5个工作日，加收100附加费 （1.5 business days, 100% surcharge）。请选择报告形式 (Report language): 英文报告(English); 中文报告(Chinese) （任选一种，如需多选加收200-500元 You may select any one of them; if more than one is selected, additional fee RMB200-500 is to be charged）取报告方式及要求（Report pick up and requirements）:自取(Self pick-up) ; 国内EMS(Domestic EMS); 国际EMS (International EMS)按重量及地区收费(Charge according to weight and distance) 申请CQC RoHS认证证书(Apply for CQC RoHS certificate) 原RoHS证书号(Number of existing RoHS certificate ): 大致完成时间 (Estimated finished date）：年(Y) 月(M) 日(D) 16:30以后 费用(Charge)单价（Unit Price）： 加急费用（Express Price）： 总费用（Total Price）： 实收费用（Actual Price）：请委托单位仔细阅读本委托书背面的条款，正面与背面的内容均系本委托书的组成部分。委托单位的签字表明已看过并理解委托书背面条款，双方同意履行。（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.）委托单位声明：对样品及相关信息资料的真实性负责，并同意本协议背面“双方约定条款”，保证样品到达谱尼测试1个工作日内支付费用。 (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.)委托单位（盖章） 检测/测试单位（盖章）Client (Stamp) Test organization (Stamp) 授权代表（签字） 授权代表（签字）Authorized representative (Signature) Authorized representative (Signature) 申请日期 受理日期(Date) (Date) 委托检测/测试协议书双方约定条款Clauses of the Test Application Form as agreed by the two parties 1.委托单位对结果如有异议，于报告完成之日起十五日内向我单位书面提出，同时附上报告原件及预付复检费。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.委托单位办妥以上手续后，我单位将尽快安排复检，不可重复性实验不进行复检。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.如委托单位与样品生产单位不一致，委托单位需提供生产单位拥有样品初始所有权并同意送检的证明。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.我单位仅对来样负责，结果仅反映对该样品的评价，结果的使用、使用所产生的直接或间接损失，我单位不承担任何责任。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.对送检样品中包含的任何已知的或潜在危害，如放射性、有毒或爆炸性的样品，应事先声明，否则后果由委托单位负责。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.如委托单位需要我单位外出采样，则委托单位应当确保采样场所不存在任何可能危及或影响我单位采样人员人身、财产安全的危险因素，否则，由此给采样人员和/或我单位造成的一切损失(包括但不限于医疗费用、工伤待遇、经济赔偿)由委托单位承担。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.我单位可以在完成报告后按规定处置送检样品。We can dispose the presented sample pursuant to certain provisions after the completion of report. 8.委托单位应认真详细填写本协议书相关内容，由于填写不清造成报告修改，应支付修改报告费用。 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.在我单位CMA/CNAS认证范围内的出具检测报告，在认证范围外的则出具测试报告。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.在报告中的检测项目左上角标注“*”，则表示该项目不在我单位的CMA/CNAS认证范围内。 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.付款方式及银行账号(Payment way and account No.)北京实验室人民币账号 Bank account（RMB）：开户名(Account name)：谱尼测试科技股份有限公司 开户行(Deposit bank)：建行北京工商大厦支行 银行帐号(Account No.)：11001085300059616767外币帐号 Bank account（$）：开户名(Account name):谱尼测试科技股份有限公司 Pony Testing Co., Ltd. 开户行(Deposit bank)：中国建设银行北京市分行苏州桥支行 CCB, Beijing Branch, Suzhouqiao sub-branch银行账号(Account No.)：11014350100220000023上海实验室人民币账号 Bank account（RMB）：开户名(Account name)：上海谱尼测试技术有限公司 开户行(Deposit bank)：中国工商银行上海市习勤路支行 银行帐号(Account No.)：1001228109006747623广州实验室人民币账号 Bank account（RMB）：开户名(Account name)：广州市谱尼测试技术有限公司 开户行(Deposit bank)：中国工商银行广州穗和支