Scribd
Upload
45 views

Service Request Form!!

This document is a service request form from QVC Certification Services Pvt. Ltd., a testing laboratory. It requests information from the customer such as name, address, contact details, sample description, test parameters, and documents required. It outlines terms and conditions such as sample acceptance criteria, testing commencement upon payment, limitations of liability, additional testing charges, and sample retention policy. The customer signs accepting the terms and confirming technical details provided.

Uploaded by

cecertificateqvc1
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
45 views

Service Request Form!!

This document is a service request form from QVC Certification Services Pvt. Ltd., a testing laboratory. It requests information from the customer such as name, address, contact details, sample description, test parameters, and documents required. It outlines terms and conditions such as sample acceptance criteria, testing commencement upon payment, limitations of liability, additional testing charges, and sample retention policy. The customer signs accepting the terms and confirming technical details provided.

Uploaded by

cecertificateqvc1
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 2

QVC CERTIFICATION SERVICES PVT. LTD.

Ref: QVC/F/035
(TESTING LABORATORY) Issue no: 02
Amend no: 00
SERVICE REQUEST FORM

Date Date:

Customer Nam e & Addres s :

Manufacturer Name & Address:

Contact Person: Email Address:

Tele.No/Mobile no:

Sample Information:
S.no. Sample ID Sample Technical Specifications Quantity
(If any) Description
1.
2.

3.
4.

5.

Test Parameter’s:- Test Protocol/Standard:

Witness required: Yes No

If yes Name of witnessing authority/company/Person:

Test Report required for any certification: Yes No

If yes Regulator Name:

Page 1 of 2
QVC CERTIFICATION SERVICES PVT. LTD. Ref: QVC/F/035
(TESTING LABORATORY) Issue no: 02
Amend no: 00
SERVICE REQUEST FORM

Document Information:-
1. Drawing/Catalogues/Instruction Manual/User manual: Yes No

2. Transport intimation: Yes No

3. Transit insurance intimation: Yes No

4. Delivery Challan: Yes No

Other Information:
If Statement of conformity remarks required in the Report: Yes No
a) If No, then Only obtained results will be reported

b) If Yes, Select one of the following;

1b) Decision on Compliance to specification will be based on the tolerance mentioned in the standard
specification.
2b) For the tolerance specified by the customer, same will be considered for decision criteria.
(Note: Deviations requested by the customer shall not impact the integrity of the laboratory or the
validity of the results).
3b) If Measurement Uncertainty to be considered for decision on compliance, QVC calculated
Measurement Uncertainty at confidence level of approximately 95% will be acceptable.
(Decision criteria cannot be changed after preparation of job order)

Mode of payment Cash Cheque NEFT


r r r
e e e
Mode of collection of Report By Hand
r E-mailr Courier
r
e r r
r e e
Sample to be returned (Yes/No):-
r r
Comment

Customer Signature & Designation

For Laboratory use only


Sample condition:- Sample Quantity Sufficient
Not Sufficient
Job order no:- Test Completion date: -

I (Customer) hereby accepts terms and conditions mentioned below:-


 Sample shall be accepted only with proper name plate and marking label wherever applicable.
 Testing of sample will be commenced after submission of documents and payment.
 All possible care shall be taken in handling the sample, but the risk of damages in transit or during testing rests with the customer. QVC shall not be responsible for any
damage to the sample during loading, unloading, shifting and testing or due to any unforeseen act like fire, earthquake etc.
 QVC shall not be responsible, if a test has to be postponed because of non-availability of power, testing personnel, malfunctioning of equipment etc.
 If any additional test is required to be performed if requested after the job in progress, the same would be entertained only if sufficient sample would be available and will be
mentioned in the test reports after proper contract review. Charges would be charged extra.
 QVC will retain the samples as per the retention period expect for total perishable products. Test items will be disposed after 90 days from the date of issue of test report or
as per any regulatory authority. Customer shall hereafter collect the sample within 7 days after the retention period. QVC shall not be held responsible for the disposal of
the item after the said period.
 The technical details mentioned above are correct to best of my knowledge & belief. I abide by the same, and understand its importance. I fully agree upon for no change
whatsoever form our side and request to proceed for testing.

Page 2 of 2

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy