ANNEX 1 TO THE CERTIFICATE

VALID ONLY WITH CERTIFICATE

No 1434-MDD-300/2021
List of medical devices covered by the certificate:

Product Family Product Sub-Group Model/Type

Breathing and
Infant T-Piece Resuscitator nice 5020
Respiratory System

nice 3010
Infant Incubator Infant Incubator
nice 3010H

nice 5000

nice 2007S

Infant Radiant Warmer nice 2010

nice 2010B
Infant Radiant Warmers
nice 2010BC

nice 5000RP
Infant Radiant Warmer with
T-Piece Resuscitator and nice 5000R
Phototherapy
nice 5000P

Infant Transport
Infant Transport Incubator nice 3000
Incubator

Issued under the Contract No. MD-264/2019 Anna Elektronicznie

podpisany przez Anna
Application No: 825/2019 and 827/2019 Małgorzata Małgorzata Wyroba
Data: 2021.05.20
Certificate bears the qualified signature. Wyroba 10:55:28 +02'00'

Warsaw, 20/05/2021 Vice-President

Module H2/3/4/5

POLISH CENTRE FOR TESTING AND CERTIFICATION 02-844 Warsaw, 469 Puławska Street, tel. +48 22 46 45 200, e-mail:pcbc@pcbc.gov.pl