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

3. Please specify the activities outsourced by you (if any):

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

Production

Packaging

Warehouse

Service

QVC/F/CQ/PPE/15.05.2020 Page 1 of 2 QVC _Certification _Questionnaire_PPE

 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

4. Details about the Products:

Product Name Model Description & Intended Use Any Approval

5. Accompanying documentation:
Category of the Personal Protective Equipment: category II category III*)
Required language versions of the documents issued English other ( )
Harmonized standards and other technical specifications applied at a PPE EN
design
Instructions for use, eventually assembly instruction:
Technical conditions (product and manufacture characteristics, risk analysis,
information for user, marking, illustrations, etc.)

Quality management system certificates (if any):

Reports by accredited testing laboratories:
Other documents and information:

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

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

Completed by: Name:

Position:
Dated:

QVC/F/CQ/PPE/15.05.2020 Page 2 of 2 QVC _Certification _Questionnaire_PPE