淡水鮑pony委托協(xié)議書食品僅供填寫

1、委托檢測/測試Test Application FormF 注：欄目為委托必填項(xiàng)目 Note： Items marked wire mandatory(Application No.)：委托單委托中文名稱(Cnt in Chi)：湖南長沙喜地食品委托英文名稱(C nt in English)：付款(付款名稱(Company of payment)：湖南長沙喜地食品名稱為抬頭，請準(zhǔn)確填寫。Thetitle is the Company Name of Payment, please complete accura y.)開票種類(Type of聯(lián)系人(Contact)：)：普通(General)

2、(VAT spel傳真(Fax)：)電郵()：)：地址(Add)：湖南長沙寧鄉(xiāng)縣回龍鋪鎮(zhèn)新村組(t Code)：410606樣品及相關(guān)信息 (Sle and related information)(備注：此項(xiàng)填寫后不能改動，否則無效，請準(zhǔn)確填寫)(This item cannot be changed once filled in, or it will be deemed as invalid. Please fillheinformation correctly)樣品 ( 由 lab)(Sle ID)樣品名稱淡水鮑（河蚌肉）填寫 Fillinby(Sle name)委托 (Entrust

3、ed )監(jiān)督 (Supervi檢驗(yàn)類別(Test Category)產(chǎn)品等級(Product grade)商標(biāo)(Trade mark)味老藏?zé)o)生產(chǎn)日期和批號 (Manufacturing date and lot number)常溫(Room temperature)冷藏(Refrigeration)條件2015.6.25(Storage)冷凍(Freezing)避光(Ken dark place)樣品狀態(tài)及描述樣品屬性密封正常食品(Food)藥品(Drugs)品(Health products) (Sle sus&description)(Sle Property)樣品量樣品規(guī)格20 包

4、320 克凈含量：16 克/包 (Slety&amount)(Sle specification)檢測/測試項(xiàng)目(Test items)菌落總數(shù)、大腸菌群，酸價、過氧化值、水分申請人同意采用測試使用的檢測/測試方法 The applicant agrees to adopt the testing methods used by Pony Test申請人要求采用指定的檢測/測試方法The applicant requires the use of the designated testing methods：檢測/測試依據(jù)(Test standard)按DBS43/006 的要求檢測。水分 G

5、B5009.3、酸價 GB/T5009.37、過氧化值 GB/T5009.37、菌落總數(shù) GB4789.2、大腸菌群、GB4789.3估計(jì)含量范圍(Estimated content range)服務(wù)類型及其他(Service Required and Others)：標(biāo)準(zhǔn)服務(wù)(Regular Service)：7 個工作日(7 business days)；特殊樣品：10-15 工作日(spel sle：10-15 business days)加急服務(wù)(Expedited Service)：3.5 個工作日，加收 100附加費(fèi) (3.5 business days, 100% surchar

6、ge)；請選擇形式 (Report language)：英文(English)；中文(Chi) (任選一種，如需多選加收 200-500 元You may select any one of them； if moren one iected, additional fee RMB200-500 is to be charged)取方式及要求(Report pick up and requirements)：自取(Self pick-up) ； 國內(nèi)EMS(Domestic EMS)；國際EMS ( ernational EMS)按重量及地區(qū)(Charge according to weigh

7、t and distance)大致完成時間 (Estimated finished date)：年(Y)月(M)日(D) 16：30 以后（After 16：30） 是否加蓋資質(zhì)章： 是否費(fèi)用(Charge)單價(Unit Price)：加急費(fèi)用(Express Price)總費(fèi)用(Total Price)：500 元實(shí)用(Actual Price)：備注(Remarks)：加蓋 CMAF 資質(zhì)章請委托仔細(xì)閱讀本委托書背面的條款，正面與背面的內(nèi)容均系本委托書的組成部分。委托的簽字表明已看過并理解委托書背面條款，雙方同意履行。(The C nt shall read the clauses as

8、 showed on the back of this letter of commitment. All contents on the front and back sides will form the fullcontract. Onigned by the C nt, it will be deemed them.)t the c ns understood the clauses on the back and the two parties agree to carry out委托：對樣品及相關(guān)信息資料的真實(shí)性負(fù)責(zé)，并同意本協(xié)議背面“雙方約定條款”，保證樣品到達(dá)測試 1 個工作日

9、內(nèi)支用。(S ement of the C nt： to be liable for the truth of the sle and the related information ands,agree on the back of this letter of le delivered to PONY.)commitment “clauses as agreed by the two parties” and ensure to pay the charge within 1 business day after the s檢測/測試（蓋章）委托C nt (St（蓋章）湖南長沙喜地食品)T

10、estanization (St)代表（簽字） Authorized represen申請日期 2015.7.8 (Date)代表（簽字）Authorized represen ive (Signature)受理日期(Date)ive (Signature)委托檢測/測試雙方約定條款Clauses of the Test Application Form as agreed by the two parties1.委托對結(jié)果異議，于完成之日起十五日內(nèi)向我提出，同時附上原件及預(yù)付復(fù)檢費(fèi)。If the trustor holds an objection to the result, the tr

11、ustor shall proe a written objection to us within fifteen days after the completionof report, and present the original copy of report with retesting fee paid in advance.2.本委托檢測及本檢測檢測服務(wù)所涉及使用的“PONY”、“”字樣為本檢測的商標(biāo)，其受中民商標(biāo)法保護(hù)，任何本檢測的擅自使用和仿冒、變造“PONY”、“”商標(biāo)均為違法侵權(quán)行為，本檢測依法違法行為主體的全部。his agreement and during the t

12、esting service period are protected by theThe pattern and characters of PONY and usedtrademark law of the Peoples Republic of China. Any unauthorized usage, counterfeit, fery and alteration of trademarks ofPONY and are the violations of the law. The PONY has the right to pursue all legal liabilities

13、 of the subject of the delict.3.委托辦妥以上手續(xù)后，我將盡快安排復(fù)檢，不可重復(fù)性實(shí)驗(yàn)不進(jìn)行復(fù)檢。We shall arrange the retest as soon assible after the foregoing procedure has been duly conducted, and be immune fromconducting the recheck of the unrepeatable test.4.如委托與樣品生產(chǎn)不一致，委托需提供生產(chǎn)擁有樣品初始所并同意送檢的證明。If the trustor is not the manufact

14、urer, the trustor shall submit thewhich demonstrate the manufacturossesses the initialownership of such sle and agrees the presen ion of sle.5.我僅對來樣負(fù)責(zé)，檢測結(jié)果僅反映對該樣品的評價，檢測結(jié)果的使用、使用所產(chǎn)生的直接或間接損失，我不承擔(dān)任何責(zé)任。如因我過錯導(dǎo)致樣品的檢測結(jié)果有誤差，我對此檢測結(jié)果的誤差及檢測結(jié)果的使用承擔(dān)不超過此樣品此檢測項(xiàng)目的二倍檢測費(fèi)用金額范圍內(nèi)的賠償?shù)?。PONY is only responsible for the prov

15、ided sle. The test results only represent the evaluation of the tested sle. PONY will notbe responsible for usage of the test results and any direct or indirect losses generated from the usage of the test results. If due tomistakes of PONY, the test results of the sle contain errors,he case of error

16、s of the test results and usage of the test results,PONY wildertake the legal liability of compensation which is no moren twice of the test charge of the test item withhissle.6.對送檢樣品中包含的任何已知的或潛在危害，如放射性、或性的樣品，應(yīng)事先，否則由委托負(fù)責(zé)。The trustor shall inform us any known or potential hazard containedhe presented

17、sle in advance, for instance, radioactivity,toxicity or explosivity of the presented s notice.le, otherwise the trustor shall bear the legal consequence incurred by failure of such7.如委托全的位承擔(dān)。需要我外出采樣，則委托應(yīng)當(dāng)確保采樣場所不存在任何可能危及或影響我采樣人身、安，否則，由此給采樣和/或我造成的一切損失(包括但不限于醫(yī)療費(fèi)用、工傷待遇、經(jīng)濟(jì)賠償)由委托單If we will provide field

18、sling at the request of the trustor, the trustor shall ensuret there are no hazard factor whiay be ling spot.potential dangerous or adversely effective to theal and property safety of our sle collectors on the sOtherwise, the trustor shall ame all the damage caused to the sle collector and/or us (in

19、cluding but not limited to medical careexpense, industrial injury fund and economic compensation).8.我可以在完成后按規(guī)定處置送檢樣品。We can dise the presented sle pursuant to certain provis after the completion of report.9.委托應(yīng)認(rèn)真詳細(xì)填寫本相關(guān)內(nèi)容，由于填寫不清造成修改，應(yīng)支付修改費(fèi)用。The c nt should fillhe relevant contents of this agreement

20、in detail accura y, and should pay the expenses for revising thereport causing by not writing clearly.10.其他需計(jì)算或標(biāo)注的數(shù)據(jù)或參數(shù)及限值以附頁形式提供。Any other dahat need to calculate or label, and parameters and limits will provide in a form of attached sheet.在我 We will i scope ofAS 認(rèn)證范圍內(nèi)的出具檢測e the test report withhe

21、scope of AS certificationassed.，在認(rèn)證范圍外的則出具測試。AS certificationassed, and we will ie the data report outside of the12.在中的檢測項(xiàng)目左上角標(biāo)注“*”，則表示該項(xiàng)目不在我的AS 認(rèn)證范圍內(nèi)。If the test itemhe report is marked with *he upper left corner, then it showst the test item is outside of the scope ofAS certificationassed.付款方式及Pay

22、ment way and account No.賬號 B名(Account name)：account（RMB）：測試工商67廣州賬號 Baccount（RMB）：名(Account name)：廣州市測試技術(shù)廣州穗和3行(Deit b)：建行行(Deit b)：中國工商帳號(Account No.)：帳號(Account No.)：外幣帳號 Baccount（$）：賬號 Baccount（RMB）：科技化學(xué)名(Account name)：測試名(Account name)：Pony Testing Co.,.)：中國建設(shè)行(Deit b)：工行宗關(guān)行(Deit b市分行蘇州橋(Account

23、 No.)：8CCB, Beijing Branch, Suzhouqiao sub-branch(Account No.)：23車附所賬號 Baccount（RMB）：汽車車身附件名(Account name)：賬號 B名(Account name)：account（RMB）：測試行(Deit b)：工行宗關(guān)(Account No.)：5行(Deit b)：中國工商市習(xí)勤路3帳號(Account No.)：長春賬號 Baccount（RMB）：名(Account name)：吉林省測試科技賬號 B名(Account name)：account（RMB）：行(Deit b)：建行長春電臺街市測

24、試科技蛇口1(Account No.)：01行(Deit b)：中國工商帳號(Account No.)：大連賬號 Baccount（RMB）：測試科技外幣賬號 Baccount（$）：名(Account name)：大連名(Account name)：市測試科技行(Deit b)：中國建設(shè)大連高新技術(shù)產(chǎn)業(yè)園區(qū)86Shenzhen Pony Test Science and Technology Co.,帳號(Account No.)：行(Debranchit b)：中國工商分行 ICBC. SZ鄭州賬號 Baccount（RMB）：帳號(Account No.)：0名(Account name

25、)：鄭州測試技術(shù)行(Deit b)：建行鄭州開發(fā)區(qū)青島賬號 Baccount（RMB）：測試帳號(Account No.)：40名(Account name)：青島行(Deit b)：中國工商青島高科技工業(yè)園5杭州賬號 Baccount（RMB）：檢測科技杭州高新923帳號(Account No.)：名(Account name)： 杭州行(Deit b)： 交通寧波賬號 Baccount（RMB）：測試技術(shù)帳號(Account No.)：名(Account name)：寧波行(Deit b)：中國工商寧波高新區(qū)3廈門賬號 Baccount（RMB）：測試帳號(Account No.)：名(Account name)：廈門行(Deit b)： 工行廈門高