NPE-Tech-Combined COC & ESC

• Reference/Certificate ID no:

• Location Details:

  Select

• Contact Details: ( Name and Address)

Electrical Worker Details:

• Name of Electrical worker

• Registration /Practicing licence number:

• Phone & Email

• Name and registration number of person(s) supervised:

Certificate of Compliance

• Type of work:

  Addition

  Alteration

  New Work

• The prescribed electrical work is:

  Low Risk

  General

  High-Risk (Specify)

• Means of Compliance:

  Part 1 of AS/NZS 3000

  Part 2 of AS/NZS 3000

• Additional Standards or electrical code of practice were required:

  Yes (Specify)

  No

• Date of range of dates that prescribed electrical work undertaken:

• Contains fittings that are safe to connect to a power supply?

  Yes

  No

• Specify type of supply system:

• The installation has an earthing system that is correctly rated (where applicable)

  Yes

  No

• Parts of the installation to which this certificate relates that are safe to connect to a power supply?

  All

  Parts (specify)

• The work relies on manufacturers instructions: ( if yes - identify the instruction manual including name , date and version. Also attach a copy of manufacturers design to this certificate.)

  Yes

  No

• The work has been done in accordance with a certified design: (if yes-identify the certified design including name, date and version. Also attach a copy of the certified design to this certificate.)

  Yes

  No

• The work relies on a Supplier Declaration of Conformity (SDoC): (if Yes- identify the SDoC including name, date and version OR EESS registration. Also attach a copy of the SDoC to this certificate.)

  Yes

  No

Test Results (provide values)

• The installation has been satisfactorily tested in accordance with the Electricity (Safety) Regulations 2010

  Yes

  No

• Polarity (Independent earth:

• Insulation resistance: Ohms

• Earth Continuity: Ohms

• Bonding: Ohms

• Fault Loop Impedance: Ohms

• Other (specify)

By signing this document I certify that the completed prescribed electrical work to which this Certificate of Compliance applies has been done lawfully and safely , and the information in the Certificate is correct:

• Certifier's Signature

  Sign

• Date:

  Date

Electrical Safety Certificate

By signing this document, I certify that the installation, or part of the installation, to which this Electrical Safety Certificate applies is connected to a power supply and safe to use

• Certifier's Name

• Registration/Practising licence number:

• Certifier's signature

  Sign

• Certification Issue Date:

  Date

• Connection Date:

  Date