APPLICATION FORM

APPOINTMENT OF 3RD PARTY INSPECTION BODY (TPIB) & FOREIGN/ LOCAL ACCREDITED LABORATORY

A. APPLICANT INFORMATION
1. Company Name & Address CCIE ENGINEERING (M) SDN. BHD.
UNIT NO. A33A04, SUASANA SENTRAL CONDOMINIUM, JALAN STESEN SENTRAL 5 50470 KUALA LUMPUR,
W.P. KUALA LUMPUR MALAYSIA

2. Business Registration No. 1212755-U 3. Contact Person GUO, JIANFENG

4. Tel. No +603-21610987 5. Fax. No +603-21610987 6. E-mail Address gjfboy111@126.com

7. Sampling Wucheng District, Jinhua Zhejiang, China

Location City

B. PRODUCT INFORMATION
Product Grade Standard HS Code Size/Diameter Total Quantity Usage
Prefabricated Steel Structure – MS EN 10025- Fabricated structure for
Angle Steel S235JR 7308909900 50mm*50mm*3mm 2.265 Tones building
2:2011
Prefabricated Steel Structure – MS EN 10025- Fabricated structure for
Angle Steel S235JR 7308909900 50mm*50mm*5mm 2.714 Tones building
2:2011
Prefabricated Steel Structure – MS EN 10025- Fabricated structure for
S235JR 7308909900 63mm*63mm*5mm 0.202 Tones
Angle Steel 2:2011 building
Prefabricated Steel Structure – MS EN 10025- Fabricated structure for
S235JR 7308909900 70mm*70mm*5mm 62.856 Tones
Angle Steel 2:2011 building
Prefabricated Steel Structure – MS EN 10025- Fabricated structure for
S235JR 7308909900 70mm*70mm*7mm 3.996 Tones
Angle Steel 2:2011 building
(Please use Annex A if insufficient space)/ (Attach Mill Certificate)

C. THIRD PARTY INSPECTION BODY (TPIB) (IF APPLICABLE)

1. Name and Address of TPIB Fuzhou Helmsman Quality & Technology Services Co., Ltd.
3/F., No.152, Jianxin North Road, Cangshan District, Fuzhou, Fujian, China

2. Website See attachment 3. Accreditation No. CNAS IB0132

(ISO 17020)
4. Scope Of Inspection 5. Attachments ✓ Accreditation certificate
List of accredited inspection
scope

D. FOREIGN / LOCAL ACCREDITED LABORATORY

1. Name and Address Nantong Product Quality Supervision& Inspection Institute

No.119, Guogiang Road, Gangzha District, Nantong, Jiangsu, China

2. Website See attachment 6. Accreditation No. CNAS L1166

3. Scope of Accreditation (ISO/IEC 17025)
4. Name of Accreditation Body 7. Attachments ✓ Accreditation certificate
5. Expiry Date List of accredited testing
scope

E. FOR CIDB USE

Scope of Accreditation License Validity Remark Approved by,

Third party inspection body

Foreign / Local accredited ………………………

laboratory ( )

Issue 1 Rev 0 Page 1 of 3

Effective date: 22 Ogos 2013
 APPLICATION FORM

APPENDIX 1: PRODUCT INFORMATION

Product Grade Standard HS Code Size/Diameter Total Quantity Application

Prefabricated Steel Structure MS EN 10025- 80mm*80mm*6m Fabricated structure for
– Angle Steel S235JR 7308909900 1.107 Tones building
2:2011 m
Prefabricated Steel Structure MS EN 10025- 90mm*90mm*8m Fabricated structure for
– Angle Steel S235JR 7308909900 5.886 Tones building
2:2011 m
Prefabricated Steel Structure MS EN 10025- 100mm*100mm*8 Fabricated structure for
– Angle Steel S235JR 7308909900 3.838 Tones building
2:2011 mm

Total 82.864 Tones

Remark :

Issue 1 Rev 0 Page 3 of 3

Effective date: 22 Ogos 2013