P.O. Box 1980 Phone: 765.983.

5200
Richmond, IN 47375-1980 Fax: 765.983.5257

www.Belden.com

CERTIFICATE OF COMPLIANCE AND TEST REPORT

Customer: Anixter Chile Exports Date Issued: 6/8/2015
Customer P/N: 0 Belden P/N: 121492A 0105000
Purchase Order Number: 82L-001002-337 Date Shipped: 06/04/15
Belden Order No: 286686 Line 2 Lot Number: 783186
Date of Manufacture: 5/29/15 Standard: UL13
Plant of Manufacture: Canada Qty. Shipped: 4634 Feet / 1412.46 Meters

Cable Print Legend: BELDEN 121492A E34972-G 2PR16 1C22 SHIELDED (UL) CM 105C OR PLTC OR ITC SUN RES DIR BUR OR
C(UL) CM CANADA ROHS

CERTIFICATE OF COMPLIANCE:
This is to certify that the items listed below were tested, in accordance with product requirements, to the following standards, and with
the listed results of the said tests.

CERTIFIED TEST REPORT:

Attribute Test Standard Requirements Results

Min. Dielectric Withstand UL13 1500V AC or 2500V DC for 2s Pass
Continuity Test UL13 Confirmed Pass
Min. Insulation Spark Test UL13 1750 Pass
Min. Jacket Spark Test UL13 3000V Pass
Max. DC Resistance @ 20°C UL13 4.45 Ω/1000' Conforms
Insulation Resistance UL13 100 MΩ·1000' Conforms
Insulation Wall Min. Avg. UL13 0.014" Pass
Insulation Wall Abs. Min. UL13 0.013" Pass
Jacket Wall Min. Avg. UL13 0.04" Pass
Jacket Wall Abs. Min. UL13 0.032" Pass

Notes:
We hereby certify this to be a true and accurate copy of the results of tests conducted in accordance with orders and
specifications listed.

Signature:

Title: Quality Engineering Technician

DIVQAxxxx Issue 1 - Date 09/12/2013