NPE Combined Certificate of Compliance & ESC

• Customer Name

• Customer Phone

• Installation Location
  Address

• Certificate No.

Work Details

• Tick if Certificate of Compliance relates to the Electrical Safety Certificate listed below

• Description of Work completed

• This Work is:

  Low Risk (refer to ESC below)

  General

  High Risk (ROI Required)

• This work has been done in accordance with:

  Part 2 of AS/NZS 3000

  Part 1 of AS/NZS 3000

  Certified Design

• Supply System this work is suitable for:

  230/240V MEN System

  Other (Please Specify)

• Other Supply System Details:

• Supporting Documents:

  Select Manufacturing Instructions Supplier DOC Test Sheets

  • Manufacturing Instructions
  • Supplier DOC
  • Test Sheets

• Other Standards this work complies with

• All Parts of this installation are safe to connect to a power supply

• All required testing has been carried out and all results are satisfactory

• Date on which the work was carried out

  Date

• I confirm that I am satisfied the work detailed in this Certificate of Compliance has been done lawfully and safely, and that the information contained in this certificate of compliance is correct and accurate. This certificate is issued by

  Sign

• Registration Number

• Phone/Email

• This work includes the supervision of

• Registration Number

• This work includes the supervision of

• Registration Number

• Tick if Certificate relates to Certificate of Compliance listed above

• Supporting Documents

  Select Test Sheets Other (Please Specify)

  • Test Sheets
  • Other (Please Specify)

• Other Supporting Documents

• Earth Continuity Result

• Earth Resistance Result

• Polarity Result

• Insulation Resistance Result

• Earth Fault Loop Impedance Result

• If part of, itemise what part of the installation is covered by this certificate

• I am satisfied the work detailed in this Electrical Safety Certificate and the installation (or part installation) to which it relates is connected to a power supply and is safe to use. The work described above was connected by:

  Sign

• Registration Number

• Date

  Date