REQUEST FOR QUOTE AND INFORMATION REQUIRED FOR THE PURPOSE OF QUOTATION

Hazardous Locations (Ex) Equipment

For assistance in filling out this Form, please contact the sender of the form or customerservice@qps.ca

 After completing this RFQ, please forward it to the sender of the form or customerservice@qps.ca

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QSD-18HL-ATEX-UKEX-QuoteForm

QSD-18HL-ATEX-UKEX-QuoteForm

For assistance in filling out this Form, please contact the sender of the form or customerservice@qps.ca

 

After completing this RFQ, please forward it to the sender of the form or customerservice@qps.ca

1)  GENERAL INFORMATION

APPLICANT: A manufacturer or a person who applies for obtaining certification and will own the certification rights and files for the product in question.

Contact Name
Contact Name
First
Last

Title

Select Mobile, Landline, or Provide The Landline Extension
Select Mobile, Landline, or Provide The Landline Extension
Address
Address
City
State/Province
Zip/Postal
Country

Applicant Address

AGENT (if applicable): A person or company that provides a particular service, typically one that involves organizing transactions between two other parties. Click here if you are an Agent.

FACTORY: The site where final assembly and the required “Production Tests” (as outlined in the Certification Report) are conducted, and the QPS label is applied on complying products.

Contact Name
Contact Name
First
Last
Select Mobile, Landline, or Provide The Landline Extension
Select Mobile, Landline, or Provide The Landline Extension
Address
Address
City
State/Province
Zip/Postal
Country

MANUFACTURER: An organization, situated at one or more stated locations, that carries out or is responsible for controlling the design, manufacture, production, and storage of the product; and whose name may appear on the product.

Contact Name
Contact Name
First
Last
Select Mobile, Landline, or Provide The Landline Extension
Select Mobile, Landline, or Provide The Landline Extension
Address
Address
City
State/Province
Zip/Postal
Country

Please provide a listing of the additional facility locations.

Contact Name
Contact Name
First
Last
Select Mobile, Landline, or Provide The Landline Extension
Select Mobile, Landline, or Provide The Landline Extension
Address
Address
City
State/Province
Zip/Postal
Country
Add Another Facility Remove Last Facility - Note: Cannot Be Undone!