RCM Declaration

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A5W00004379-005

ACMA form – C02

June 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 GNA..

Product number

Stock number

Additional information

[ASN]

[SEN, SSN, ASN or OEM ID]

GNA126.1E/10

GNA126.1E/12

GNA126.1E/12A

S55499-D447

GNA126.1E/C10

GNA126.1E/C12

GNA126.1E/EP

S55499-D132

GNA126.1E/H12

S55499-D182

GNA126.1E/KA

GNA126.1E/MD

GNA126.1E/MP

GNA126.1E/SO1

GNA126.1E/SO2

GNA126.1E/SO3

GNA126.1E/SY1

GNA126.1E/T10

GNA126.1E/T12

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] GNA126.1E/TE S55499-D146 GNA126.1E/VK S55499-D126 GNA166.1E/T12 S55499-D496 GNA326.1E/10 GNA326.1E/10 GNA326.1E/12A S55499-D448 GNA326.1E/EP S55499-D133 GNA326.1E/KA GNA326.1E/KA GNA326.1E/MD GNA326.1E/MD GNA326.1E/MP GNA326.1E/MP GNA326.1E/SO1 GNA326.1E/SO1 GNA326.1E/SO2 GNA326.1E/SO2 GNA326.1E/SY1 GNA326.1E/SY1 GNA326.1E/T10 GNA326.1E/T10 GNA326.1E/T12 GNA326.1E/T12 GNA326.1E/TE S55499-D147 GNA326.
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.