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A5W00004371-008

ACMA form – C02

July 2021

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 GCA..

Product number

Stock number

Additional information

[ASN]

[SEN, SSN, ASN or OEM ID]

GCA121.1E

GCA121.1E/FW

S55499-D100

GCA121.1E/FW1

S55499-D143

GCA121.1E/FX

S55499-D753-A559

GCA121.1E/INN

GCA121.1E/IV1

S55499-D509

GCA121.1G/IV

S55499-D163

GCA121.1H/SW

S55499-D161

GCA126.1E

GCA126.1E/09H

S55499-D153

GCA126.1E/DF

S55499-D452

GCA126.1E/HA

S55499-D111

GCA131.1E

GCA135.1E

GCA151.1E/IV

S55499-D609

GCA161.1E

Summary of content (3 pages)

PAGE 1
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 (
PAGE 2
s Product number Stock number [ASN] [SEN, SSN, ASN or OEM ID] GCA161.1E/09H S55499-D154 GCA161.1E/102 S55499-D671 GCA161.1E/FW1 S55499-D777-A404 GCA161.1E/HA2 S55499-D150 GCA161.1E/MO S55499-D301 GCA161.1H S55499-D502 GCA163.1E GCA163.1E GCA164.1E GCA164.1E GCA166.1E GCA166.1E GCA166.1E/HA2 S55499-D151 GCA321.1A PAF 18/230.D S55499-D759-A479 GCA321.1E GCA321.1E GCA321.1E/INN GCA321.1E/INN GCA321.1E/SL S55499-D121 GCA321.1E/SW GCA321.1E/SW GCA326.1E GCA326.1E GCA326.
PAGE 3
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.