Pre-Export Verification of Conformity (Pvoc)

Pre-Export Verification of Conformity (PVoC) Request for Certification RFI No. (KCO Use): Exporter Details: Import Declaration Form (IDF) Name/Address: No.: Date:

Country of Contact Name: Origin: Tel: Fax: Country of E-mail: Supply: Importer Details: Location of Goods

Name/Address: Address:

Contact Name: Contact Name: Tel: Fax: Tel: Fax: E-mail: E-mail: Mode of Transport: Full Container Load  Yes  No  Air  Sea  Rail  Road Expected Shipment Date: Port of Port of Discharge: Loading: HS Quantity Product ICS Registration/ Standard Code (please include brand, model and description) Code License No. Ref.

Please note the following

1. Your Importer will need a Certificate of Conformity certificate to clear the goods from customs in Kenya. If you prefer the COC to be sent directly to the Importer, please state this clearly in a covering letter with this application. Otherwise, the original will be sent to the exporter. 2. Exporters should ensure that this form is completed correctly with the applicable ICS and HS codes stated accordingly. 3. This notice assumes that you have read our Terms and Conditions and are in possession of our Guidelines for Exporters and Importers. If not, copies of both are available from our website http:// www.intertek.com/government 4. Exporters should provide us with a copy of the final invoice when submitting this application to facilitate the certification process. 5. Your shipment may be subject to testing on a selective basis. 6. The declarations of HS codes and products descriptions are always the sole responsibility of the applicants. In case of incorrect declaration of HS codes and / or product descriptions leading to physical inspection and / or testing being performed on products not subject to Kenya PVoC, all consequences will be at the applicant's account and risk without any liability on Intertek's side. Any incorrect declaration of the HS codes or products description may result in corrective actions and / or penalties to be imposed by the Kenyan authorities upon arrival at the Kenyan entry points''

I……………………………… the undersigned importer/exporter agree to Intertek’s terms and conditions and the requirements referenced therein. I also confirm that the products listed in this RFC are genuine and not counterfeit. All legal, financial and other consequences that may arise due the inaccuracy of this statement will be the full responsibility of the applicant. I provide my consent that any of the data, results and documentation gathered and generated during the performance of this service may be shared with the Kenya Bureau of Standards (KEBS).

Signed……………………………….. Position………………………………..

Government Services March 2007, Revision 4 Page 1 of 2Appendix D

Visit www.kenyapvoc.com for further information on the PVoC.

Pre-Export Verification of Conformity (PVoC) Request for Certification RFI No. (KCO Use):

HS Quantity Product ICS Registration/License Standard Code (please include brand, model and Code No. Ref. description)

Government Services March 2007, Revision 4 Page 2 of 2Appendix D

Visit www.kenyapvoc.com for further information on the PVoC.