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© Siemens Switzerland Ltd, CH-6300 Zug
8000059930-007
ACMA form – C02
January 2018
I hereby declare that:
1. I am authorised to make this declaration on behalf of the Company mentioned above,
2. the contents of this form are true and correct, and
3. the product mentioned above complies with the applicable above mentioned standards and all products supplied under this declaration will be identical
to the product identified above.
Note: Under section 137.1 of the Criminal Code Act 1995, it is an offence to knowingly provide false or misleading information to a Commonwealth entity.
Penalty: 12 months imprisonment
CH-6300 Zug, 12.11.2020
Signed for and on behalf of:
Siemens Switzerland Ltd
i.V. ………………………………………………
Reiner Werner
Head of Systems and Room Automation
i.V. ……………………………………………..
Rico Jaeggi
Head of R&D Competence Center Zug
The Privacy Act 1988 (Cth) (the Privacy Act) imposes obligations on the ACMA in relation to the collection, security, quality, access, use and
disclosure of personal information. These obligations are detailed in the Australian Privacy Principles.
The ACMA may only collect personal information if it is reasonably necessary for, or directly related to, one or more of the ACMA’s functions or
activities.
The purpose of collecting the personal information in this form is to ensure the supplier is identified in the ‘Declaration of conformity’. If this
Declaration of Conformity is not completed and the requested information is not provided, a compliance label cannot be applied.
Further information on the Privacy Act and the ACMA’s Privacy Policy is available at www.acma.gov.au/privacypolicy. The Privacy Policy
contains details about how you may access personal information about you that is held by the ACMA, and seek the correction of such
information. It also explains how you may complain about a breach of the Privacy Act and how we will deal with such a complaint.
Should you have any questions in this regard, please contact the ACMA’s privacy contact officer on telephone on 1800 226 667 or by email at
[e-mail].
Digital signiert von Jaeggi Rico
DN: cn=Jaeggi Rico, o=Siemens,
email=[e-mail]
Grund: Ich stimme dem Dokument
zu
Datum: 2020.11.23 08:30:52 +01'00'
Jaeggi
Rico
Digital signiert von Werner Reiner
DN: cn=Werner Reiner,
o=Siemens,
email=[e-mail]
Datum: 2020.11.23 11:24:17
+01'00'
Werner
Reiner