Read CAL133_test_request_form.pdf text version

Customer Own Material (COM)

Before Getting Started

CAL 133

Please Complete This Form When Requesting that a COM Fabric be evaluated for CAL 133 Compliance.

1. Fabric being submitted must pass standard manufacturing feasability on model (s) specificed prior to submitting for CAL 133 testing. 2. Approval for CAL 133 is based on actual test results, or waived based on previous test results of a similarly constructed fabric/chair model combination 3. If fabric can not be waived based on prior test history a testing fee of $600 will be required if you request Haworth to test the fabric with an independent agency

Your Information

This information is need to track your request, load our data base and provides a contact. This information must be completed by a Haworth Dealer Name of Dealership Contact Information Contact Telephone Number Fax Number Street Address City, State, Zip E-Mail Client Name ,

Textile Information

This information is needed to load our database and process for waiver or full burn testing. Name of Fabric Supplier Pattern Number Backer type (if any) Fabric Content Treatment (IE Teflon) Color Name Fabric Weight Pattern Name Color Number Fabric Width

Product Information

In order to properly load our data base we need to know what products you would like us to test this material on. The easiest way to proceed is to check the Product category. We will test all fabric components listed in that Category Please list the product line this finish will be specified on. Product Product Product Product 1 2 3 4 : : : :

08/09

Haworth Will Advise Status of Test/Waiver Status

You will receive a letter from Haworth informing you of test results. If fabric is approved no further action is required. If fabric is rejected you will be given the option of having a burn test conducted. For the later, proceed to next step

Send This Form and Test Material To Haworth

Send completed form, check and sample yardage to Haworth, Inc. One Haworth Center Attention: COM Department Holland, MI 49423-9576 (616) 393.3000 or email: [email protected] (no test yardage is required at this time)

1. 5 yards are required for each model requested if a full burn test is required. 2. A check or purchase order for $600 dollars is required to proceed with agency testing. Haworth Will Advise Status of Test You will receive a letter from Haworth informing you of test results.

Internal Use Only Waiver approved Waiver not approved, additional testing needed

Authorized Signature:

Date:

08/09

Information

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