pony委托协议书食品仅供填写

1、委托检测/测试协议书Test Application FormF 注：栏目为委托单位必填项目 Note： Items marked withare mandatory委托单编号(Application No.)：委托单位中文名称(Client in Chinese)：永州舜源农业发展有限公司委托单位英文名称(Client in English)：付款单位名称(Company of payment)：永州舜源农业发展有限公司(付款单位名称为发票抬头，请准确填写。The invoice title is the Company Name of Payment, please complete ac

2、curately.)开票种类(Type of invoice)： 普通发票(General invoice)专用发票(VAT special invoice)联系人(Contact Person)：雷开宏电话(Tel)：传真(Fax)：电邮(E-mail)：地址(Add)：邮编(Post Code)：425600样品及相关信息 (Sample and related information)(备注：此项填写后不能改动，否则无效，请准确填写)(This item cannot be changed once filled in, or it will be deemed as invalid.

3、Please fill in the information correctly)样品编号(Sample ID)( 由实验室填写 Fill in by lab)样品名称(Sample name)香菇兔肉酱、麻辣兔肉酱、香辣兔肉酱检验类别(Test Category)委托 (Entrusted )监督 (Supervision)商标(Trade mark)舜毅兔了吧叽产品等级(Product grade)生产日期和批号 (Manufacturing date and lot number)2015贮存条件(Storage)常温(Room temperature) 冷藏(Refrigeration

4、)冷冻(Freezing)避光(Keep in dark place)样品状态及描述(Sample status&description)丁状样品属性(Sample Property)食品(Food) 药品(Drugs)保健品(Health products)样品量(Sample quantity&amount)6 瓶（每样 2 瓶）样品规格(Sample specification)200 克每瓶检测/测试项目(Test items)总酸、亚硝酸盐、食盐、菌落总数、大肠菌群、沙门氏菌、山梨酸、苯甲酸、铅、总汞、镉、总砷、感官（色泽、组 织与形态、香气与滋味、杂质）检测/测试依据(Test s

5、tandard)申请人同意采用谱尼测试使用的检测/测试方法The applicant agrees to adopt the testing methods used by Pony Test申请人要求采用指定的检测/测试方法The applicant requires the use of the designated testing methods：估计含量范围(Estimated content range)服务类型及其他(Service Required and Others)：标准服务(Regular Service)：7 个工作日(7 business days)；特殊样品：10-

6、15 工作日(special sample：10-15 business days)加急服务(Expedited Service)：3.5 个工作日，加收 100附加费 (3.5 business days, 100% surcharge)；请选择报告形式 (Report language)：英文报告(English)；中文报告(Chinese) (任选一种，如需多选加收 200-500 元You may select any one of them； if more than one is selected, additional fee RMB200-500 is to be charge

7、d)取报告方式及要求(Report pick up and requirements)：自取(Self pick-up) ； 国内EMS(Domestic EMS)；国际EMS (International EMS)按重量及地区收费(Charge according to weight and distance)大致完成时间 (Estimated finished date)：年(Y) 月(M) 日(D) 16：30 以后（After 16：30） 是否加盖资质章： 是否费用(Charge)单价(Unit Price)： 加急费用(Express Price) 总费用(Total Price)

8、：实收费用(Actual Price)：备注(Remarks)：请委托单位仔细阅读本委托书背面的条款，正面与背面的内容均系本委托书的组成部分。委托单位的签字表明已看过并理解委托书背面条款，双方同意履行。(The Client shall read the clauses as showed on the back of this letter of commitment. All contents on the front and back sides will form the full contract. Once signed by the Client, it will be deem

9、ed that the client has understood the clauses on the back and the two parties agree to carry out them.)委托单位声明：对样品及相关信息资料的真实性负责，并同意本协议背面“双方约定条款”，保证样品到达谱尼测试 1 个工作日内支付费用。 (Statement of the Client： to be liable for the truth of the sample and the related information and documents,agree on the back of th

10、is letter of commitment “clauses as agreed by the two parties” and ensure to pay the charge within 1 business day after the sample delivered to PONY.)委托单位（盖章）检测/测试单位（盖章）Client (Stamp)Test organization (Stamp)授权代表（签字）雷开宏授权代表（签字）Authorized representative (Signature)Authorized representative (Signature

11、)申请日期 2015.07.16受理日期 (Date)(Date)委托检测/测试协议书双方约定条款Clauses of the Test Application Form as agreed by the two parties1.委托单位对结果如有异议，于报告完成之日起十五日内向我单位书面提出，同时附上报告原件及预付复检费。If the trustor holds an objection to the result, the trustor shall propose a written objection to us within fifteen days after the compl

12、etion of report, and present the original copy of report with retesting fee paid in advance.2.本委托检测协议书及本检测单位检测服务所涉及使用的“PONY”、“谱尼”字样为本检测单位的注册商标，其受中华人民共和国商标法保护，任何未经本检测单位授权的擅自使用和仿冒、伪造、变造“PONY”、“谱尼”商标均为违法侵权行为，本检测单位有权依法追究违法行为主体的全部法律责任。The pattern and characters of PONY and 谱尼 used in this agreement and d

13、uring the testing service period are protected by the trademark law of the Peoples Republic of China. Any unauthorized usage, counterfeit, forgery and alteration of trademarks of PONY and 谱尼 are the violations of the law. The PONY has the right to pursue all legal liabilities of the subject of the d

14、elict.3.委托单位办妥以上手续后，我单位将尽快安排复检，不可重复性实验不进行复检。We shall arrange the retest as soon as possible after the foregoing procedure has been duly conducted, and be immune from conducting the recheck of the unrepeatable test.4.如委托单位与样品生产单位不一致，委托单位需提供生产单位拥有样品初始所有权并同意送检的证明。If the trustor is not the manufacturer,

15、 the trustor shall submit the certificate which demonstrate the manufacturer possesses the initial ownership of such sample and agrees the presentation of sample.5.我单位仅对来样负责，检测结果仅反映对该样品的评价，检测结果的使用、使用所产生的直接或间接损失，我单位不承担任何责任。如因我单位过错导致样品的检测结果有误差，我单位对此检测结果的误差及检测结果的使用承担不超过此样品此检测项目的二倍检测费用金额范围内的赔偿等法律责任。PONY

16、 is only responsible for the provided sample. The test results only represent the evaluation of the tested sample. PONY will not be responsible for usage of the test results and any direct or indirect losses generated from the usage of the test results. If due to mistakes of PONY, the test results o

17、f the sample contain errors, in the case of errors of the test results and usage of the test results, PONY will undertake the legal liability of compensation which is no more than twice of the test charge of the test item within this sample.6.对送检样品中包含的任何已知的或潜在危害，如放射性、有毒或爆炸性的样品，应事先声明，否则后果由委托单位负责。 The

18、 trustor shall inform us any known or potential hazard contained in the presented sample in advance, for instance, radioactivity, toxicity or explosivity of the presented sample, otherwise the trustor shall bear the legal consequence incurred by failure of such notice.7.如委托单位需要我单位外出采样，则委托单位应当确保采样场所不

19、存在任何可能危及或影响我单位采样人员人身、财产安全的危险因素，否则，由此给采样人员和/或我单位造成的一切损失(包括但不限于医疗费用、工伤待遇、经济赔偿)由委托单位承担。If we will provide field sampling at the request of the trustor, the trustor shall ensure that there are no hazard factor which may be potential dangerous or adversely effective to the personal and property safety of

20、 our sample collectors on the sampling spot. Otherwise, the trustor shall assume all the damage caused to the sample collector and/or us (including but not limited to medical care expense, industrial injury fund and economic compensation).8.我单位可以在完成报告后按规定处置送检样品。We can dispose the presented sample pu

21、rsuant to certain provisions after the completion of report.9.委托单位应认真详细填写本协议书相关内容，由于填写不清造成报告修改，应支付修改报告费用。The client should fill in the relevant contents of this agreement in detail accurately, and should pay the expenses for revising the report causing by not writing clearly.10.其他需计算或标注的数据或参数及限值以附页形

22、式提供。Any other data that need to calculate or label, and parameters and limits will provide in a form of attached sheet.在我单位AS 认证范围内的出具检测报告，在认证范围外的则出具测试报告。We will issue the test report within the scope ofAS certification we passed, and we will issue the data report outside of thescope ofAS certificat

23、ion we passed.12.在报告中的检测项目左上角标注“*”，则表示该项目不在我单位的AS 认证范围内。If the test item in the report is marked with * in the upper left corner, then it shows that the test item is outside of the scope of AS certification we passed.付款方式及银行账号Payment way and account No.北京实验室人民币账号 Bank account（RMB）：开户名(Account name)：

24、谱尼测试集团股份有限公司开户行(Deposit bank)：建行北京工商大厦支行广州实验室人民币账号 Bank account（RMB）：开户名(Account name)：广州市谱尼测试技术有限公司开户行(Deposit bank)：中国工商银行广州穗和支行银行帐号(Account No.)：67银行帐号(Account No.)：3外币帐号 Bank account（$）：开户名(Account name)：谱尼测试科技股份有限公司 Pony Testing Co., Ltd.开户行(Deposit bank)：中国建设银行北京市分行苏州桥支行CCB, Beijing Branch, Su

25、zhouqiao sub-branch武汉化学实验室人民币账号 Bank account（RMB）：开户名(Account name)：武汉谱尼科技有限公司开户行(Deposit bank)：工行宗关支行银行账号(Account No.)：8银行账号(Account No.)：23武汉车附所人民币账号 Bank account（RMB）：开户名(Account name)：武汉汽车车身附件研究所有限公司开户行(Deposit bank)：工行宗关支行上海实验室人民币账号 Bank account（RMB）： 开户名(Account name)：谱尼测试集团上海有限公司开户行(Deposit b

26、ank)：中国工商银行上海市习勤路支行银行账号(Account No.)：5银行帐号(Account No.)：3长春实验室人民币账号 Bank account（RMB）：开户名(Account name)：吉林省谱尼测试科技有限公司开户行(Deposit bank)：建行长春电台街支行深圳实验室人民币账号 Bank account（RMB）：开户名(Account name)：深圳市谱尼测试科技有限公司开户行(Deposit bank)：中国工商银行深圳蛇口支行银行账号(Account No.)：01银行帐号(Account No.)：1大连实验室人民币账号 Bank account（RMB

27、）：开户名(Account name)：大连谱尼测试科技有限公司开户行(Deposit bank)：中国建设银行大连高新技术产业园区外币账号 Bank account（$）：开户名(Account name)：深圳市谱尼测试科技有限公司 Shenzhen Pony Test Science and Technology Co.,Ltd开户行(Deposit bank)：中国工商银行深圳分行 ICBC. SZbranch支行银行帐号(Account No.)：86郑州实验室人民币账号 Bank account（RMB）：开户名(Account name)：郑州谱尼测试技术有限公司开户行(Depo

28、sit bank)：建行郑州开发区支行银行帐号(Account No.)：0青岛实验室人民币账号 Bank account（RMB）：开户名(Account name)：青岛谱尼测试有限公司开户行(Deposit bank)：中国工商银行青岛高科技工业园支行银行帐号(Account No.)：40杭州实验室人民币账号 Bank account（RMB）：开户名(Account name)： 杭州谱尼检测科技有限公司开户行(Deposit bank)： 交通银行杭州高新支行银行帐号(Account No.)：5宁波实验室人民币账号 Bank account（RMB）： 开户名(Account n

29、ame)：宁波谱尼测试技术有限公司开户行(Deposit bank)：中国工商银行宁波高新区支行银行帐号(Account No.)：923厦门实验室人民币账号 Bank account（RMB）：开户名(Account name)：厦门谱尼测试有限公司开户行(Deposit bank)： 工行厦门高科技园支行银行帐号(Account No.)：3天津实验室人民币账号 Bank account（RMB）：开户名(Account name)：谱尼测试科技（天津）有限公司开户行(Deposit bank)：中国农业银行天津长虹支行银行帐号(Account No.)：02190701040011150银行帐号(Account No.)：6苏州实验室人民币账号