APPLICATION FOR TRADE AGENT

CERTIFICATES (ATEX & IECEx)

This form may be used for applications for a second EC type-examination certificate or Certificate of Conformity issued in the name of a Trade
Agent.

Item Details
1 Manufacturer: Name and address of original manufacturer: Name and address of Trade Agent required on
This should be the name of the certificates:
company that the original certificate is
held with.

2 Certificate number(s): Current certificate No: Trade agent certificate No: *

Several certificate numbers may be T.B.A
written here (including IECEx).
Additional certificates will be charged
an extra fee plus any IECEx levies
(Please see section 5).

3 Equipment description:

4 QAN/QAR: Please tick one of the following:

The designated trade agent certificate The trade agent requires an ATEX Quality Assurance Notification
holder is obliged to obtain product (QAN)/ IECEx Quality Assessment Report (QAR) or extension to.
Quality Assurance Approval with the The trade agent already maintains Quality Assurance Approval
relevant scope. through CSA Group-Sira/Another ExCB / Notified Body.
5 Estimated cost: GBP: USD:
Please calculate the cost based upon Cost of ATEX/IECEx Trade agent certificates for up to 5 £1480.00 $2,640.00
the number of certificates and the certificates
number of IECEx levies, as applicable. Cost of additional certificates (at £75/$150 per certificate)
Cost of IECEx levy (at £315/$630 per IECEx Certificate)
Total
6 Terms and conditions:
6.1 CSA Group standard terms and conditions apply, in addition to the following:
6.2 The client agrees to pay the cost specified in row 5 - Estimated cost. CSA Group will conduct an evaluation of the work involved and if it cannot be completed
for this sum, CSA Group-Sira will contact the client with a separate fixed price quotation before conducting any work.
6.3 This cost must include the cost of any IECEx charges per certificate – if appropriate, these fees will be added to the total invoice value sent.
6.4 The client is the manufacturer named on the prime certificate, or acting on behalf of and with permission of the manufacturer. Proof of ownership of intellectual
property may be requested.
6.5 Invoices will be sent 100% (payment net 30 days).
6.6 Prices valid until 31st December 2016
6.7 This form will not be accepted unless signed and dated by the client. A Purchase Order (P.O) number is also required. Without a P.O number, CSA Group cannot
start/progress the project.
6.8 In the event of a request for a Trade Agent certificate based upon an OEM certificate to earlier standards editions to that
which is current, the OEM certificate may require an update to latest standards before it is possible to issue a Trade Agent
certificate. If in doubt, please contact us prior to submitting an application.

Form 9115 Issue 6

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 APPLICATION FOR TRADE AGENT
CERTIFICATES (ATEX & IECEx)
7 Client signature: Signed: Date:
An electronic signature is acceptable,
otherwise please sign, scan and return as
a pdf.
Print name:
Company:
Email address:
Telephone no:
P.O number:
Please email this form & accompanying documentation to: ukinfo@csagroup.org

* The use of this certificate number is governed by the relevant sections of the Regulations Applicable to the Holders
of SCS certificates. It has been allocated prior to the issue of the actual certificate and, until the issue of this
certificate, the number or its suffixes may be subject to change and therefore it is for information purposes only. If
this certificate number is used for reasons such as, pre-production planning or label development, then this is
undertaken at the risk of the client. It is specifically prohibited to use the certification marks (certificate number, CSA
Group-Sira logo, UKAS logo, standards marking etc.) on products that are placed on the market or put into service,
prior the issue of the actual signed certificate.

It is essential that the following are provided to complete the project:

 An application form completed by the trade agent.

 A declaration from the original manufacturer that the products to be supplied to the trade agent will be the
same as that already certified.

 A declaration from the trade agent that the products to be put on the market will be identical to that already
certified and supplied and will not be modified in any form.

 A declaration from the trade agent that they agree to comply with the Regulations Applicable to the Holders of
CSA Group-Sira Certificates

 A copy of the contractual agreement or memorandum of understanding between the companies.

 A label drawing for the trade agent that shows the same information as on the label of original certified product,
except for the certificate number, the product reference (if different), and the ATEX trade agent’s name and
address.

 An extract or copy of the product instructions that comply with ATEX Directive, Annex II, Clause 1.0.6 the will be
supplied by the trade agent.

 Please note that the price quoted covers the issue of certificates only and does not include for any audit work
required. This will be quoted for separately upon application.

All work is undertaken in accordance with CSA Group standard terms and conditions.

Product/Production Quality Assurance

All manufacturers and trade agents are required to comply with the production control requirements defined in
article 8 of the ATEX Directive and the IECEx scheme.

In addition to holding an EC type-examination certificate and/or Certificate of Conformity in his own name, the trade
agent is also responsible for engaging a notified body to approve and carry out surveillance of the trade agent’s

Form 9115 Issue 6

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 APPLICATION FOR TRADE AGENT
CERTIFICATES (ATEX & IECEx)
quality management systems insofar as it relates to the production phase. It is this notified body whose number will
appear after the CE marking on the trade agent label.

The trade agent will need to satisfy CSA Group that it is in control of production by maintaining a Product/Production
Quality Assurance Notification of appropriate scope for the product(s) concerned.

An application to CSA Group by a prospective trade agent for a Product/Production Quality Assurance Notification
will require an audit at the trade agent’s premises.

Form 9115 Issue 6

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