1、 检 验 申 请 合 同 书 Gn2012 Test Contract甲方 Party A：乙方 Party B：国家固定灭火系统和耐火构件质量监督检验中心China National Center for Quality Supervision and Test of Fixed Fire-Extinguishing Systems and Fire-Resisting Building Components产品名称Product型号规格Model & Spec委托单位Client生产单位Manufacturer送检单位Sample Delivered by生产厂址Factory Add.邮
2、政编码ZIP Code通讯地址Post Add.邮政编码ZIP Code联系电话Contacting Tel传真Fax抽样单位Sampled by抽样基数Sampling Base采样地点Sampling Place抽样日期Sampling Date申请等级Classification检验类别Type of Test检验依据Test Standard检验项目Test Items样品数量Sample Quantity甲方提供文件Documents Provided by Party A 甲方委托乙方拆封样品 甲方自行拆封样品（注：如甲方未填选该选项，则视为甲方委托乙方拆封样品。）甲方寄送样品时，
3、如委托乙方拆封验样，开箱时一旦发现因运输造成的样品损坏，乙方不予承担与此相关的一切责任，特此说明。样品情况Sample status 领回 Re-claim 不领回 Abandon报告领取方式Report Delivery 邮寄 by Post 自取 Personal Claim联系人手机Mobile phone备注Remark甲方需认真阅读并理解上述合同及补充条款的内容，保证所填写内容及提供资料准确无误，并愿承担由于上述内容不正确所产生的后果的责任。Party A should certify that he has read and understood all the provision
4、s set forth and the supplement in this contract and the answers he has furnished on this form are true and correct to the best of his knowledge and belief. Party A understands that he should undertake sole responsibility for any failure cause by any false statement of the contract.甲方代表（签字或盖章） 乙方代表（签
5、字或盖章）(Signature by Representative of Party A) (Signature by Representative of Party B)2012 年 月 日 2012 年 月 日检 验 申 请 合 同 书 补 充 条 款Supplement to the Test Contract1. 自取检验报告时，请出示“检验申请合同书”。Test contract (or its copy) is required for personal claim of the test report.2. 对于领回样品，自报告领取之日或报告邮寄之日起，乙方保存 60 天，超过保
6、存期后，如仍未领取样品，则视甲方将放弃对该样品的全部权利，由乙方按其规定处理。Tested samples will be kept by Party B for 60 days starting from the date of report is mailed or personally claimed. If the samples remain unclaimed when it preserved, Party A is regarded as having abnegated all rights over the samples, and Party B has the righ
7、t to dispose the samples as it deems appropriate.3. 甲方向乙方提供所需检测样品应符合检测要求，并应提供检测所需的各种配件及文本资料。Tested samples provided by Party A should meet the requirements of size and quantity in their standards. Accessories and data sheets may be required depending on the tests.4. 如样品因内在结构与设计具有腐蚀性、有毒、易爆等危险性因素，甲方应以
8、书面材料告知乙方，如因疏忽而未告知以上因素而使检测过程中发生事故，导致检测财产损失及检测人员伤亡，甲方应赔偿相应损失。Party A should inform Party B in written materials in case that the samples to be tested are potentially corrosive, toxic, explosive, etc. Due to the samples internal structure or design. If the potential dangers listed above are not informe
9、d by Party A out of neglect so that accidents occur during the testing process, Party A should compensate for the losses of testing equipments and the casualty involved.5. 自双方合同签订之日起，30 日内，如甲方未能按规定向乙方提供检测所需的样品及配件、文本资料、检验费用等，则视为双方自动解除合同，乙方将按取消合同处理。自合同解除之日起，甲方送检的样品，由乙方代为保存 15 日，逾期甲方未领回，则视甲方放弃对该样品的全部权利
10、，由乙方按其规定处理。The contract is automatically cancelled if Party A fails to provide the needed samples, accessories, data sheets, testing fees, etc. Within 30 days since the signing of the contract by the two parties. The tested samples will be kept for 15 days by Party B after the cancellation of the co
11、ntract. If Party A fails to claim the samples within those 15 days, Party A is regarded as having abnegated all rights over the samples, and Party B has the right to dispose the samples as it deems appropriate.6. 本合同仅限于送检样品，且不涉及对专利产品的说明与核实。The contract only addresses test samples. No explanation or
12、verification of any patents of the products will be concerned.7. 双方认为应补充的条款。Additional clauses will be supplemented as the two Parties deem necessary.检验中心地址：中国天津市西青区津涞公路富兴路 2 号 公安部天津消防研究所南河基地院内 Add. of CNCF: Tianjin Fire Research Institute Nanhe Campus, No.2, fuxing Road, Jinlai Highway, Xiqing Dist
13、rict, Tianjin, China 报告查询电话：022-58387800-8104 业务咨询电话：022-58387888 传真：022-58387878 邮政编码：300382Report Inquiry Hotline:86-22-58387800-8104 Business Hotline:86-22-58387888Fax:86-22-58387878 ZIP Code: 300382样品寄送地址：中国天津市西青区津涞公路富兴路 2 号 公安部天津消防研究所南河基地院内 样品库Samples mailing to: Sample Reception Office, Tianji
14、n Fire Research Institute Nanhe Campus, No.2, fuxing Road, Jinlai Highway, Xiqing District, Tianjin, China 样品库电话：022-58387889、022-58387800-2106，022-58387879（传真） 邮政编码：300382Tel of Samples Dept.:86-22-58387889/58387800-2105/58387800-2106，86-22-58387879(fax) ZIP Code: 300382开户单位：国家固定灭火系统和耐火构件质量监督检验中心帐号：02020101040001671 开户行：农行天津李七庄支行
