RCM Declaration

Frei verwendbar ACMA form – C02 Page 1 of 2 January 2018

Supplier’s declaration of conformity

As required by the following Notices:

 Radiocommunications (Compliance Labelling - Devices) Notice 2014 made under section 182 of the Radiocommunications Act 1992;

 Radiocommunications Labelling (Electromagnetic Compatibility) Notice 2017 made under section 182 of the Radiocommunications

Act 1992

 Radiocommunications (Compliance Labelling – Electromagnetic Radiation) Notice 2014 made under section 182 of the

Radiocommunications Act 1992 and

 Telecommunications (Labelling Notice for Customer Equipment and Customer Cabling) Instrument 2015 made under section 407 of

the Telecommunications Act 1997.

Instructions for completion

 Do not return this form to the ACMA. This completed form must be retained by the supplier as part of the documentation required

for the compliance records and must be made available for inspection by the ACMA when requested.

Supplier’s details (manufacturer, importer or authorised agent)

Company Name (OR INDIVIDUAL)

Siemens Limited, Australia

Street Address (AUSTRALIAN or NEW ZEALAND)

885 Mountain Hwy

Bayswater, Victoria, Australia POSTCODE 3153

Phone: +61 1300 773 948

ACN/ARBN

ABN 98 004 347 880

New Zealand IRDN

Product details and date of manufacture

Product description – brand name, type, current model, lot, batch or serial number (if available), software/firmware version (if applicable)

Fire detection products CERBERUS PRO including:

OP720, OH720, HI722, HI720, DB721, DBS720, FDCAI221, FDCI222, FDMH291-R, FDL241-9, FDCIO222, FDCH291, FDME221,

FDF241-9, FDFB291, FDF221-9, FDLB291, FDCL221, FDS221-R, FDUL221, FDLU291, FDS221-W, FDM225-RP, FDM225-RG,

FDM226-RG, FDM226-RP, FDMH295-R, FDMH295-S, FDUZ221, FDBZ292, FDS229-A, FDS229-R, FDCIO223, FDCI221,

FDCIO221, FDCH221, FDCL221-M, FDCL221-Ex, FDM223-Ex, FDM223, FDM224, FDS224-R/-W, FDS225-R/-W, FDS226-RR/-RW,

FDS226-WW/-WR, FDS227-RR/-RW, FDS227-WW/-WR, FDS227-RR-C/-RW-C, FDS227-WW-C/-WR-C, FDSB226-WR/-WW, FDSB227-

WR/-WW, FDSB227-WR-C/-WW-C

PAGE 1
Supplier’s declaration of conformity As required by the following Notices:     Radiocommunications (Compliance Labelling - Devices) Notice 2014 made under section 182 of the Radiocommunications Act 1992; Radiocommunications Labelling (Electromagnetic Compatibility) Notice 2017 made under section 182 of the Radiocommunications Act 1992 Radiocommunications (Compliance Labelling – Electromagnetic Radiation) Notice 2014 made under section 182 of the Radiocommunications Act 1992 and Telecommunications (La
PAGE 2
Compliance – applicable standards and other supporting documents Evidence of compliance with applicable standards may be demonstrated by test reports, endorsed/accredited test reports, certification/competent body statements. Having had regard to these documents, I am satisfied the above mentioned product complies with the requirements of the relevant ACMA Standards made under the Radiocommunications Act 1992 and the Telecommunications Act 1997.