RCM Declaration

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A5W00004381-005

ACMA form – C02 / January 2018

Supplier’s declaration of conformity

As required by the following Notices:

 Radiocommunications (Compliance Labelling - Devices) Notice 2014 made under section 182 of the Radiocommunications Act 1992;

 Radiocommunications Labelling (Electromagnetic Compatibility) Notice 2017 made under section 182 of the Radiocommunications

Act 1992

 Radiocommunications (Compliance Labelling – Electromagnetic Radiation) Notice 2014 made under section 182 of the

Radiocommunications Act 1992 and

 Telecommunications (Labelling Notice for Customer Equipment and Customer Cabling) Instrument 2015 made under section 407 of

the Telecommunications Act 1997.

Supplier’s details (manufacturer, importer or authorised agent)

Company Name (OR INDIVIDUAL)

Siemens Ltd

Building Technologies Division

Street Address (AUSTRALIAN)

885 Mountain Highway

Bayswater, Victoria, 3153

ACN/ARBN

98 004 347 880

New Zealand IRDN

Product details and date of manufacture

Product description – brand name, type, current model, lot, batch or serial number (if available), software/firmware version (if applicable)

Product identification: Electromotoric damper actuators GAP..

Product number

Stock number

Additional information

[ASN]

[SEN, SSN, ASN or OEM ID]

GAP191.1E

GAP196.1E

GAP196.1E/DF

S55499-D453

GAP196.1E/MK

S55499-D678

GAP191.1E/09R

S55499-D710

GAP196.1E/09R

S55499-D711

GAP191.1E/25W

S55499-D799

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s Supplier’s declaration of conformity As required by the following Notices:     Radiocommunications (Compliance Labelling - Devices) Notice 2014 made under section 182 of the Radiocommunications Act 1992; Radiocommunications Labelling (Electromagnetic Compatibility) Notice 2017 made under section 182 of the Radiocommunications Act 1992 Radiocommunications (Compliance Labelling – Electromagnetic Radiation) Notice 2014 made under section 182 of the Radiocommunications Act 1992 and Telecommunications (
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s Compliance – applicable standards and other supporting documents Evidence of compliance with applicable standards may be demonstrated by test reports, endorsed/accredited test reports, certification/competent body statements. Having had regard to these documents, I am satisfied the above mentioned product complies with the requirements of the relevant ACMA Standards made under the Radiocommunications Act 1992 and the Telecommunications Act 1997.