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Metric Importers of North America (MINA)


MINA designed; NIST approved format for section 280.5 (c) MANUFACTURERS CERTIFICATE OF CONFORMANCE.
English/German Language Version

This is an example of how another language may be a part of the certificate. However, English is the official language.

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CERTIFICATE OF CONFORMANCE
MANUFACTURERS CERTIFICATE OF CONFORMANCE
Werksbescheinigung
Per Section 280.5 (c) Fastener Quality Act

Manufacturer/Hersteller:

Address/Adresse:

Customer/Besteller:

Address/Adresse:
Product Description/Produkt: Purchase Order Number/ Bestellungsnummer:
Product Standard/Norm/Vorschrift:

Date of Manufacture/ Fabrikationsdatum:
Nominal Dimensions/Abmessunggen:

Finish/Oberflaeche:
Material Grade and Standard/Werkstoff/Festigkeitsklasse: Head Marking/ Kennzeichen(Hersteller,Festigkeit)
Mfg. Lot No./Fabrikationslos Nr:
Mark the appropriate box for either Part 1 or Part 2 of this certificate../ (not yet translated)
Part 1./Teil 1
 We certify that the above listed fasteners have been manufactured according to the requirements of the applicable standards and specifications and found to conform with its requirements and; have been inspected and tested by a laboratory accredited in accordance with the Fastener Quality Act.

Wir bestatigen, dass die oben angefuehrten Verbindungselemente entsprechend den angegebenen Vorschriften hergestallt wurden und; entsprechend den Anforderungen des FQA von einem akkreditierten Labor gepruefft wurden.
This lot or portion is accompanied by a laboratory test report with a serial number of:/Das entsprechende Pruefzeugnis, mit folgende Seriennummer, wird zur Verfuegung gestellt:

 Date of Issue:/
Ausstellungsdatum:

Mfg.'s Authorized Signature/Unterschrift des Herstellers:

Title/Funktion

Date/Datum:

 

Part 2./Teil 2
 We certify that the above listed fasteners have been manufactured according to the requirements of the applicable standards and specifications and; have NOT yet been inspected and tested by a laboratory accredited in accordance with the Fastener Quality Act.

 Wir bestatigen, dass die oben angefuehrten Verbindungselemente entsprechend den angegebenen Vorschriften hergestallt wurden und; entsprechend den Anforderungen des FQA von einem akkreditierten Labor NICHT gepruefft wurden.

Mfg.'s Authorized Signature/Unterschrift des Herstellers:

Title/Funktion:

Date/Datum:

 

The importer hereby assumes responsibility for the inspection and testing of the above listed lot or portion to be conducted by a laboratory accredited in accordance with the Fastener Quality Act.

 Der Importierer erklart sich dafur verantwortlich, dass die oben angefuhrten Verbindungselemente durch ein akkreditierten Labor gepruft wurden.

Importing Company Signature/Importierer Unterschrift:

Title/Funktion:

Date/Datum:
filename: conformg.doc rev 3 5/30/98 MINA

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