EC Declaration of Incorporation

We (name of manufacturer)

of (address of manufacturer)

declare that:

Equipment (description of equipment)

Model name/number (brand name, model number)

Serial number (serial number, where applicable)

in accordance with Directive 98/37/EC (“The Machinery Directive”), has been

designed and manufactured to the following specifications:

(List of harmonised standards and their titles)

This machinery is incomplete and must not be put into service until the machinery
into which it is to be incorporated has been declared in conformity with the
provisions of the Directive.

Signed by: ............................................................................................................................

Name:

Position:

Done at (place)

On (date)

02D1793