Phone: +91-171-2441127 Email ID: cemark@qvccert.com Visit us: www.qvccert.

com
QVC CERTIFICATION SERVICES PVT LTD
CORPORATE OFFICE
2-B CIVIL LINES, YUKTI BUSINESS CENTRE, NEAR OLD SESSION COURT AMBALA CITY 134003 HARYANA INDIA
REGISTERED & HEAD OFFICE
# 9003/5, NEAR S.A. JAIN HIGH SCHOOL, AMBALA CITY HARYANA 134003 INDIA

1. Details about the Company and Contact Persons

Company Name:
Address:
Phone no.:
E-mail:
Web homepage:

Contact Person
Name:
Phone no.:
Fax no.:
E-mail:

Quality Manager
Name :
Phone no.:
Fax no.:
E-mail:

2. Details about the organization

Name and address of the headquarters

and subsidiaries / branches Departments Sum
Please fill the number of employees (approximately) W Ot
QC DD PU PR SL SE 
in the relevant departments H h

Please enclose an organigram of the headquarter as well as of the possible subsidiaries/branches

QC - Quality control DD - Design/Development PU - Purchasing WH - Warehouse

PR - Production SL - Sales SE - Service Oth - Other

Please specify the activities outsourced by you

Processes Name and location of the companies which took over activities
Design/
Development

Production

Packaging

Warehouse

Service

QVC/F/CQ/EMC/15.05.2020 Page 1 of 3 QVC_Certification Questionnaire_EMC

 Phone: +91-171-2441127 Email ID: cemark@qvccert.com Visit us: www.qvccert.com
QVC CERTIFICATION SERVICES PVT LTD
CORPORATE OFFICE
2-B CIVIL LINES, YUKTI BUSINESS CENTRE, NEAR OLD SESSION COURT AMBALA CITY 134003 HARYANA INDIA
REGISTERED & HEAD OFFICE
# 9003/5, NEAR S.A. JAIN HIGH SCHOOL, AMBALA CITY HARYANA 134003 INDIA

3. Details about the Products :

1. Equipment Name: ________________________________________________________

2. Model Number: __________________________________________________________

3. Standard to be used for testing: ______________________________________________

4. Highest frequency intentionally generated by the device: __________________________

5. Power source: Battery ________V or Mains Powered AC_______V / DC_______V

more than 1? No Yes If yes, identify _________________________________

6. Current rating of the equipment __________A

7. Does the equipment has auxiliary power supply No Yes

If yes, specify ______________________________________________________________

8. Size of the Equipment: _____cm(L) x ____ cm(B) x ____cm(H)

9. Are extra accessories required for monitoring of Equipment during testing No Yes
10. If yes, pls mention ________________________________________________________________________

11. How is the earthing provision made for the equipment ____________________________

12. Is there any software required for monitoring of equipment No Yes

13. Weight of the Equipment__________

4. Details about Existing Certification & Documentation :

Quality Management System Certification standard (ISO 9001, 16949
etc)
Please attach the list of products
(e.g. brochures/specifications/drawings)
Status of Critical Documentation ( Pls. tick the relevant column )
DESCRIPTION COMPLETE NOT COMPLETE
Overall Drawings

Full detail drawings, supporting calculations, test results,

as required to check conformity with essential
requirements
List of essential Health and Safety requirements
applicable to the machine

A description Risk Assessment and a list of standards

used.
Instructions for use

Internal procedures to ensure that the Product remains

in conformity with provision of the directive.

QVC/F/CQ/EMC/15.05.2020 Page 2 of 3 QVC_Certification Questionnaire_EMC

Phone: +91-171-2441127 Email ID: cemark@qvccert.com Visit us: www.qvccert.com
QVC CERTIFICATION SERVICES PVT LTD
CORPORATE OFFICE
2-B CIVIL LINES, YUKTI BUSINESS CENTRE, NEAR OLD SESSION COURT AMBALA CITY 134003 HARYANA INDIA
REGISTERED & HEAD OFFICE
# 9003/5, NEAR S.A. JAIN HIGH SCHOOL, AMBALA CITY HARYANA 134003 INDIA

5. Services Required :
Name of the Service Pls.(Tick if Required )
CE Marking Certification
Product testing

6. Time scheduling:
Please specify your desired dates for:
the product test / product documentation review: Onsite Audit:

Completed by (name & position):

QVC/F/CQ/EMC/15.05.2020 Page 3 of 3 QVC_Certification Questionnaire_EMC