Request For Certification (Republic of Iraq)

Service Request (SR) number: Trade parties & Place of Inspection Seller (Exporter) : name and address Buyer (Importer) : name and address Other S GS reference number:

Telephone: Email: Fax:

Telephone: Email: Fax:

C ontact name: Manufacturer / Supplier (if different from seller) : name and address

C ontact name: Place & Date where goods are available for Inspection and/or for further testing, if needed: name and address

Telephone: Email: Fax:

Telephone:

C ontact name:

C ontact name:

Email:

Fax:

Proforma Invoice / Contract Purchase Order Number : Date : Incoterm Product Information G oods Description: G oods conditions: Type of delivery: Please complete attached Declaration of Conformity New Total S econd hand/Used P artial Final C omplete C omplete knock down S emi knock down C urrency Total Value FOB Value

details: LC L : Bulk General C argo/C onventional S hipment method and P oint of E ntry: (information on point of entry is mandatory) Air S ea Road Bagdad airport Basra airport Najaf airport Mosul airport Umm Qasr port Khor Al-Zubair port Abu Falous port S yria Rabeeah (Mosul) S yria Al-Qaim (Ramadi) S yria Al-Waleed (Ramadi) Jordan Trebil (Ramadi) Kuwait S afwan (Basra) Iran S halamcheh (Basra) Iran Badra (Wasit) Iran Al-Muntheryah (Diyala) Ibrahim Al-Khalil Zahi (Turkey Kuridstan)

P acking FC L : x20 FC L

x40 FC L

Other point of entry (please detail) .. Additional Information IS O 9001 C ertificate Test Report provided Lab information Yes Yes No No Yes Other C ertification: . Testing done by No Own lab Third party Lab

IS O 17025 accreditation

Other: ..

IMPORTANT : P lease complete the above information and kindly return the form together with proforma invoice, copy of LC if applicable- and documents proving conformity such as detailed description of the goods with technical characteristics and properties, available test reports, quality management system certificates, marks of conformity, - e.g. C E declaration, technical data sheets, national approvals, franchise agreement or similar for supplying branded goods - , as well as health, hygienic, phytosanitary, fumigation certificates as applicable. As per requirements of our mandate, Final C ommercial Invoice and Transport documents are also required for issuance of C ertificates and should be submitted as soon as available. S G S remains available to provide additional information about the P roduct Conformity Assessment P rogram for the republic of Iraq.. If you have any comments/complaints/appeals regarding the certification service, please inform in writing to the GIS divisional manager; further to which (if applicable) an appeal form will be provided. http://www.sgs.com/lob/customers_feedback_request_for_information.htm?lobId=5549 This order is accepted according to the requirements of C OS QC and subject to the applicable S GS G eneral C onditions http://www.sgs.com/terms_and_conditions.htm