RCM Declaration

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A5W00029694-006

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 GPC..

Product number

Stock number

Additional information

[ASN]

[SEN, SSN, ASN or OEM ID]

GPC121.1A

S55499-D233

GPC121.1A/09R

S55499-D655

GPC121.1A/09T

S55499-D659

GPC121.1A/FX

S55499-D751-A559

GPC121.1A/RW

S55499-D729

GPC126.1A

S55499-D234

GPC126.1A/09R1

S55499-D716

GPC126.1A/09T

S55499-D660

GPC126.1A/RW

S55499-D730

GPC131.1A

S55499-D235

GPC136.1A

S55499-D236

GPC161.1A

S55499-D237

GPC161.1A/09R

S55499-D714

GPC161.1A/09T

S55499-D684

GPC161.1A/RW

S55499-D731

GPC166.1A

S55499-D238

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] GPC221.1A/09R S55499-D657 GPC221.1A/09T S55499-D661 GPC221.1A/RW S55499-D726 GPC226.1A/09R1 S55499-D717 GPC226.1A/09T S55499-D662 GPC226.1A/RW S55499-D727 GPC261.1A/RW S55499-D728 GPC321.1A S55499-D239 GPC321.1A PAF 04/230.D S55499-D758-A479 GPC326.1A S55499-D240 GPC361.
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.