Document Reference LEEA-030.

1e6

EC Declaration of Conformity (1) / UK Declaration of Conformity (2)

(1) This certificate meets the requirements of the Machinery Directive 2006/42/EC Annex II 1. A
(2) This certificate meets the requirements of the Supply of Machinery (Safety) Regulations 2008

Name & Address of Manufacturer: Name & Address of person to compile

Technical File:
(Must be established (1) in the EU or (2) Not Applicable

Name & Address of Authorized Representative if one has been mandated by the manufacturer:
Note: for self-certified goods, the manufacturer can fulfil all of their legal obligations under SOM(S)R and in such a
case an authorised representative will not be required.

Name, Address, and identification number of the Notified Body (1) or Approved Body (2), where
applicable:

Description of the Equipment:

Should include – Generic Denomination; Function; Model; Serial Number; Type & Commercial Name; SWL or WLL
or WL or Rated Capacity.

The transposed harmonised standards (EN prefix) (1) or Designated Standards (BS prefix) (2)
(Specify):

The National standards (1) or British National Standards (2) and any technical specifications used
(Specify);

Place of Declaration:

Date of Declaration:

I declare that the above equipment meets the Essential Health and Safety requirements of the –
(1) The Machinery Directive 2006/42/EC Annex II 1.A
(2) Supply of Machinery (Safety) Regulations 2008 and Section 6 of the Health and Safety at Work Etc. Act 1974.

Name: Signature:

Position:

Version 2 February 2021 Document Originator K Tonge