Third Party Verification Claim

AUTHORIZATION TO MARK
Applicant: Manufacturer:
Address: Address:
Country: Country:
Contact: Contact:
Phone: Phone:
FAX: FAX:
Email: Email:
Standard(s):
Product:
Models:
This Authorization to Mark is for the exclusive use of Intertek's Client and is provided pursuant to the Certification agreement between Intertek and its Client. Intertek's responsibility and liability are
limited to the terms and conditions of the agreement. Intertek assumes no liability to any party, other than to the Client in accordance with the agreement, for any loss, expense or damage occasioned
by the use of this Authorization to Mark. Only the Client is authorized to permit copying or distribution of this Authorization to Mark and then only in its entirety. Use of Intertek’s Certification mark is
restricted to the conditions laid out in the agreement and in this Authorization to Mark. Any further use of the Intertek name for the sale or advertisement of the tested material, product or service must
first be approved in writing by Intertek. Initial Factory Assessments and Follow up Services are for the purpose of assuring appropriate usage of the Certification mark in accordance with the
agreement, they are not for the purposes of production quality control and do not relieve the Client of their obligations in this respect.
Intertek Testing Services NA Inc.
545 East Algonquin Road, Arlington Heights, IL 60005
Telephone [phone] or 847-439-5667 Fax [phone]
Household and Commercial Furnishings [UL 962:2014 Ed.4+R:12Jan2021]
Luminaires [CSA C22.2#250.0:2018 Ed.4]
LED mirror luminaire
KLR followed by A1, A2, A3, A4, A5 or A6; followed by E0, E1 or E2; may be followed by S1, S2, S3, S4
or S5; followed by 45 to 120; followed by 60 to 180; followed by H1, H2 or H3; followed by B0 or B1;
followed by P0 or P1; may be followed by D.
KLQA4 followed by E0, E1 or E2; may be followed by S1, S2, S3, S4 or S5; followed by 40 to 100;
followed by 40 to 100; followed by H1, H2 or H3; followed by B0 or B1; followed by P0 or P1; may be
followed by D.
KLFA4 followed by E0, E1 or E2; may be followed by S1, S2, S3, S4 or S5; followed by 60 to 90; followed
by 40 to 80; followed by H1, H2 or H3; followed by B0 or B1; followed by P0 or P1; may be followed by D.
Control Number:
5020102
Authorized by:
for L. Matthew Snyder, Certification Manager
This document supersedes all previous Authorizations to Mark for the noted Report Number.
[e-mail]
[e-mail]
Party Authorized To Apply Mark:
Same as Manufacturer
Report Issuing Office:
Intertek Testing Services Shenzhen Ltd. Guangzhou Branch
Jianfeng Guo
Jianfeng Guo
86-763-5302102
86-763-5302102
NA
NA
Qingyuan Jialan Sanitary ware Co., Ltd
Qingyuan Jialan Sanitary ware Co., Ltd
12 Hefeng Road, Foshan Chancheng
(Qingxin) Industrial transfer park, Heyun
Town Qingyuan City, Guangdong,
511875
12 Hefeng Road, Foshan Chancheng
(Qingxin) Industrial transfer park, Heyun
Town Qingyuan City, Guangdong,
511875
China
China
This authorizes the application of the Certification Mark(s) shown below to the models described in the Product(s)
Covered section when made in accordance with the conditions set forth in the Certification Agreement and Listing
Report. This authorization also applies to multiple listee model(s) identified on the correlation page of the Listing
Report.
This document is the property of Intertek Testing Services and is not transferable. The certification mark(s) may be
applied only at the location of the Party Authorized To Apply Mark.
Page 1 of 1 ATM for Report 210125140GZU-001
ATM Issued: 11-May-2021
ED 16.3.15 (15-Oct-20) Mandatory