RCM Declaration

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A5W00003843-016

ACMA form – C02 / 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.

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

Company Name (OR INDIVIDUAL)

Siemens Ltd

Building Technologies Division

Street Address (AUSTRALIAN)

885 Mountain Highway

Bayswater, Victoria, 3153

ACN/ARBN

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)

Product identification: Electromotoric damper actuators GDB..

Product number

Stock number

Additional information

[ASN]

[SEN, SSN, ASN or OEM ID]

GDB 161.1E/CA1

S55499-D572-A440

GDB111.1E/KN

S55499-D190

GDB111.1E/MO

S55499-D191

GDB111.9E/KN

S55499-D203

GDB111.9E/MO

S55499-D202

GDB131.1E

GDB131.1E/07H

S55499-D157

GDB131.1E/AB

GDB131.1E/FC

GDB131.1E/INN

GDB131.2E

GDB131.9E

Summary of content (5 pages)

PAGE 1
s 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 (
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s Product number Stock number [ASN] [SEN, SSN, ASN or OEM ID] GDB132.1E GDB132.1E GDB132.1E/EA GDB132.1E/EA GDB136.1E GDB136.1E GDB136.2E GDB136.2E GDB141.1E S55499-D184 GDB141.1E S55499-D377 GDB141.1E/09H S55499-D360 GDB141.1E/AB S55499-D590-A551 GDB141.1E/FC S55499-D591-A453 GDB141.1E/FX S55499-D746-A559 GDB141.1E/INN S55499-D574-A468 GDB141.9E S55499-D200 GDB141.9E S55499-D383 GDB141.9Y/101 S55499-D370-A101 GDB142.1E S55499-D185 GDB142.1E S55499-D378 GDB142.
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s Product number Stock number [ASN] [SEN, SSN, ASN or OEM ID] GDB161.9E GDB161.9E GDB161.9E S55499-D275 GDB161.9E S55499-D397 GDB161.9E/37 S55499-D285 GDB161.9E/6P S55499-D801 GDB161.9E/6W S55499-D784 GDB161.9E/MO S55499-D682 GDB161.9Y/101 S55499-D368-A101 GDB163.1E GDB163.1E GDB163.1E S55499-D267 GDB163.1E S55499-D394 GDB163.2E GDB163.2E GDB164.1E GDB164.1E GDB164.1E S55499-D268 GDB166.1E GDB166.1E GDB166.1E S55499-D269 GDB181.1E/3 GDB181.1E/3 GDB181.
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s Product number Stock number [ASN] [SEN, SSN, ASN or OEM ID] GDB331.1E/IVR GDB331.1E/IVR GDB331.1E/KF GDB331.1E/KF GDB331.2E GDB331.2E GDB331.9E GDB331.9E GDB332.1E GDB332.1E GDB336.1E GDB336.1E GDB336.1E/F2A S55499-D176-A534 GDB336.2E GDB336.2E GDB341.1E S55499-D187 GDB341.1E NES.590.220.5 S55499-D762 GDB341.1E/09H S55499-D361 GDB341.1E/FC S55499-D576-A453 GDB341.1E/INN S55499-D588-A468 GDB341.1E/INN S55499-D577-A468 GDB341.1E/KF S55499-D578-A479 GDB341.1E/KF PAS 05/230.
PAGE 5
s 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.