(Doplnit adresu kancele ARIAL velikost 9)

Application for performing the activity of the Notified Body

The application is submitted by: Name of applicant ( pursuant to %o22ercial Re0ister or !rade Re0ister): Applicants seat: Company Registration Number/Tax Registration: Contact person/connection: Certification re uired for the follo!ing products: NB 1017 !"# $"D %&ec' s(r(o() Novodvorsk 99*) 1*+ +1 ,ra'a * (-. t'e o//ice listed in t'e 'eadin0) !a1 Re0istration Nu2-er3 %4569771+1

Lola Livnica $89, d(o(o(

Address3 :u0oslovenska +) ;ele&nik 11+<0) $er-ia

+0<<+76< 105196075 !o2as ,avlovi=
1 1 $teel (>elded) construction $teel (>elded) construction part Alu2iniu2 (>elded) construction Alu2iniu2 (>elded) construction part 8?%1 1 8?%+

8?%6

8?%*

The procedure of conformity evaluation Technical specification for conformity evaluation (8N) C$N) 8!A etc(): Name of producer: "lace of production:

@overn2ent Decree No( 190A+00+ $-( (%oll()) section <) para0rap' 1 e) (s.ste2 +B pursuant to 79A105A+$)
8valuation o/ t'e /actor. production control s.ste2 and supervision

C$N 8N 1090D1 C$N 8N 1090D6

C$N 8N 1090D+

Lola Livnica $89, d(o(o( :u0oslovenska +) ;ele&nik 11+<0) $er-ia

"roducers agent in #$: "roduction characteristics (-rie/ description): Eeldin0 o/ all t.pes o/ steel structures /or -uildin0s) pu-lic and industrial 'alls( 9anu/acturin0 o/ 2ac'ines and eFuip2ent /or ener0etic) 2inin0 and process industr.(

G <*0D0*7D108N (+01+D0+D1<) (196090+10(doc)

strana 1 & 6

Application /or certi/ication

The means of utili%ation in the construction: (includin0 special conditions o/ utili&ation)

&mplemented factory production control system (Fualit. certi/icate) Fualit. 2anual) ot'er docu2ents docu2entin0 t'e s.ste2 o/ 2ana0e2ent):

%erti/ied H9$ pursuant to 8N I$I 9001 %ert INd %erti/icate re0istration No( <666 % valid till3 0+(0<(+01< I$I 1*0013+00* $iste2 2enadJ2enta &aKtite Jivotne sredine 4a'tevi DIN 17700D7 Llasa 8 proi&vodnMa svi' vrsta NeliNni' konstrukciMa) NiMi su podreOeni standardiP valid until 60(01(+016( %ert INd certi/icate re0istration No( 6716A+ DIN 1<017 proi&vodnMa kranova i nose=i' NeliNni' konstrukciMa 8N 676*D+ valid until 60(01(+016( %ert INd certi/icate re0istration No( 10+0<<

Annex to the application: (lea/let) sectional dra>in0) 8!A) ot'er docu2entation and docu2ents) continuation /or lack o/ space in a /or2 etc() Applicants statement: I 'ere-. declare t'at I3 D Qave not applied /or certi/ication -. a di//erent -od.) D $'all -ear t'e costs o/ t'e certi/ication process accordin0 to t'e rules o/ !"# $"D %&ec') D $'all provide all t'e data necessar. /or product evaluation in certi/ication process) D A0ree t'at !"# $"D %&ec' can 'ave so2e tests 2ade -. approved su-Dsuppliers( In ;ele&nik on 0*(06(+016 Na2e o/ person in c'ar0e3 !o2as ,avlovi= $i0nature3
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Application /or certi/ication #xamination of application by T'( $') C%ech: !'e reFuire2ents /or certi/ication are set) an. disputes are resolved and t'e o//ice is capa-le o/ conductin0 t'e service !'e application 'as -een /or>arded to o//ice3 !'e application is not accepted /ro2 t'e /ollo>in0 reasons3

I/ t'e reasons /or reMection o/ t'e application cease to e1ist or are resolved) it is possi-le to su-2it a ne> application(

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