Request for Quote - Hazloc - LabTest Certification Inc

Applicants Information for Hazloc

Company Name

Website

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Contact Name

Title

Email

Phone

Manufacturing Information

If different than Applicant Information

Company

Website

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Contact Name

Title

Email

Phone

Product Information

Product’s description and intended use/application

Type of Equipment

Model

Brief Description (electrical or not)

Overall Dimensions: Width

Overall Dimensions: Length

Overall Dimensions: Height

Uncrated Weight (kg)

Marks Requested

Approval Process

Other Mark - Please Describe

Electrical Ratings

Voltage

Phases

Current

Frequency

Hazardous Location Rating

Equipment Group

Group I (mining)
Group II (non-mining)

Hazardous Zone Ratings (Zone Markings)

Zones for Gas

Zone 0
Zone 1
Zone 2

Gas Protection Method

Please specify other

Gas Group

Zones for Dust

Zone 20
Zone 21
Zone 22

Dust Protection Method

Please specify other

Dust Group

IIIA
IIIB
IIIC

Temperature Classification

Ambient Temperature

Hazardous Zone Ratings (Division Markings)

North American Hazardous Ratings

Class II
(Group E
Group F
Group G)

Division 1
Division 2

Objective – Indicate applicable standards, if known

Quality System

ISO 9001 Certified

Please upload a copy of your certificate

QAR Currently Held

Please provide your QAR Report Number

List of Certified Products

Describe subcontract work

Requirement

Initial Application
Re-Certification
Transfer

Quality Module certificates are subject to periodic surveillance audits. According to IECEx rules, the surveillance audit frequency is every 12 months for Non-ISO 9001 registered companies and every 18 months for ISO 9001 registered companies. The QAR certificate is valid for 3 years. LabTest reserves the right to carry out audits at any time without notice.

Name

Date

To help us provide you with an accurate and quick proposal, provide as many of the following as possible

Product schematics • Product brochure • Operating manual • Wiring diagram • Previous test data & reports • Target completion date • Block diagram • Electrical rating • Operating frequency • Test budget • Installation manual • Product photograph(s)

File

How Did You Hear About Us*

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Email

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Applicants Information for Hazloc

Manufacturing Information

Product Information

Marks Requested

Electrical Ratings

Equipment Group

Hazardous Zone Ratings (Zone Markings)

Hazardous Zone Ratings (Division Markings)

Quality System

Head Office Contact

Get In Touch

Find what you need

RFQ – Hazloc

Applicants Information for Hazloc

Manufacturing Information

Product Information

Marks Requested

Electrical Ratings

Equipment Group

Hazardous Zone Ratings (Zone Markings)

Hazardous Zone Ratings (Division Markings)

Quality System

Head Office Contact

Get In Touch

Find what you need