ANNEX III
DECLARATION OF PERFORMANCE
No. …
| 1. | Unique identification code of the product-type: … | ||
| 2. | Type, batch or serial number or any other element allowing identification of the construction product as required pursuant to Article 11(4): … |
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| 3. | Intended use or uses of the construction product, in accordance with the applicable harmonised technical specification, as foreseen by the manufacturer: … … |
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| 4. | Name, registered trade name or registered trade mark and contact address of the manufacturer as required pursuant to Article 11(5): … … |
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| 5. | Where applicable, name and contact address of the authorised representative whose mandate covers the tasks specified in Article 12(2): … … |
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| 6. | System or systems of assessment and verification of constancy of performance of the construction product as set out in Annex V: … … |
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| 7. | In case of the declaration of performance concerning a construction product covered by a harmonised standard: … (name and identification number of the notified body, if relevant) performed … under system … (description of the third party tasks as set out in Annex V) and issued … (certificate of constancy of performance, certificate of conformity of the factory production control, test/calculation reports – as relevant) |
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| 8. | In case of the declaration of performance concerning a construction product for which a European Technical Assessment has been issued: … (name and identification number of the Technical Assessment Body, if relevant) issued … (reference number of the European Technical Assessment) on the basis of …, (reference number of the European Assessment Document) performed … under system … (description of the third party tasks as set out in Annex V) and issued … (certificate of constancy of performance, certificate of conformity of the factory production control, test/calculation reports – as relevant) |
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| 9 | Declared performance Notes to the table. |
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| 1. Column 1 shall contain the list of essential characteristics as determined in the harmonised technical specifications for the intended use or uses indicated in point 3 above. | |||
| 2.For each essential characteristic listed in column 1 and in compliance with the requirements of Article 6, column 2 shall contain the declared performance, expressed by level or class, or in a description, related to the corresponding essential characteristics. The letters ‘NPD’ (No Performance Determined) shall be indicated where no performance is declared. | |||
| 3.For each essential characteristic listed in column 1, column 3 shall contain: | |||
| (a) dated reference of the corresponding harmonised standard and, where relevant, the reference number of the Specific or Appropriate Technical Documentation used; or |
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| (b)dated reference of the corresponding European Assessment Document where available and reference number of the European Technical Assessment used. | |||
| Essential characteristics (see Note 1) |
Performance (see Note 2) |
Harmonised technical specification (see Note 3) |
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| Where pursuant to Article 37 or 38 the Specific Technical Documentation has been used, the requirements with which the product complies: … … |
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| 10. | The performance of the product identified in points 1 and 2 is in conformity with the declared performance in point 9. This declaration of performance is issued under the sole responsibility of the manufacturer identified in point 4. Signed for and on behalf of the manufacturer by: … (name and function) …… (place and date of issue) (signature) |
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