淡水鲍pony委托协议书食品仅供填写

1、委托检测/测试Test Application FormF 注：栏目为委托必填项目 Note： Items marked wire mandatory(Application No.)：委托单委托中文名称(Cnt in Chi)：湖南长沙喜地食品委托英文名称(C nt in English)：付款(付款名称(Company of payment)：湖南长沙喜地食品名称为抬头，请准确填写。Thetitle is the Company Name of Payment, please complete accura y.)开票种类(Type of联系人(Contact)：)：普通(General)

2、(VAT spel传真(Fax)：)电邮()：)：地址(Add)：湖南长沙宁乡县回龙铺镇新村组(t Code)：410606样品及相关信息 (Sle 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. Please fillheinformation correctly)样品 ( 由 lab)(Sle ID)样品名称淡水鲍（河蚌肉）填写 Fillinby(Sle name)委托 (Entrust

3、ed )监督 (Supervi检验类别(Test Category)产品等级(Product grade)商标(Trade mark)味老藏无)生产日期和批号 (Manufacturing date and lot number)常温(Room temperature)冷藏(Refrigeration)条件2015.6.25(Storage)冷冻(Freezing)避光(Ken dark place)样品状态及描述样品属性密封正常食品(Food)药品(Drugs)品(Health products) (Sle sus&description)(Sle Property)样品量样品规格20 包

4、320 克净含量：16 克/包 (Slety&amount)(Sle specification)检测/测试项目(Test items)菌落总数、大肠菌群，酸价、过氧化值、水分申请人同意采用测试使用的检测/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：检测/测试依据(Test standard)按DBS43/006 的要求检测。水分 G

5、B5009.3、酸价 GB/T5009.37、过氧化值 GB/T5009.37、菌落总数 GB4789.2、大肠菌群、GB4789.3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：10-15 工作日(spel sle：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% surchar

6、ge)；请选择形式 (Report language)：英文(English)；中文(Chi) (任选一种，如需多选加收 200-500 元You may select any one of them； if moren one iected, additional fee RMB200-500 is to be charged)取方式及要求(Report pick up and requirements)：自取(Self pick-up) ； 国内EMS(Domestic EMS)；国际EMS ( ernational EMS)按重量及地区(Charge according to weigh

7、t 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)：500 元实用(Actual Price)：备注(Remarks)：加盖 CMAF 资质章请委托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 C nt shall read the clauses as

8、 showed on the back of this letter of commitment. All contents on the front and back sides will form the fullcontract. Onigned by the C nt, it will be deemed them.)t the c ns understood the clauses on the back and the two parties agree to carry out委托：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”，保证样品到达测试 1 个工作日

9、内支用。(S ement of the C nt： to be liable for the truth of the sle and the related information ands,agree on the back of this letter of le delivered to PONY.)commitment “clauses as agreed by the two parties” and ensure to pay the charge within 1 business day after the s检测/测试（盖章）委托C nt (St（盖章）湖南长沙喜地食品)T

10、estanization (St)代表（签字） Authorized represen申请日期 2015.7.8 (Date)代表（签字）Authorized represen ive (Signature)受理日期(Date)ive (Signature)委托检测/测试双方约定条款Clauses of the Test Application Form as agreed by the two parties1.委托对结果异议，于完成之日起十五日内向我提出，同时附上原件及预付复检费。If the trustor holds an objection to the result, the tr

11、ustor shall proe a written objection to us within fifteen days after the completionof report, and present the original copy of report with retesting fee paid in advance.2.本委托检测及本检测检测服务所涉及使用的“PONY”、“”字样为本检测的商标，其受中民商标法保护，任何本检测的擅自使用和仿冒、变造“PONY”、“”商标均为违法侵权行为，本检测依法违法行为主体的全部。his agreement and during the t

12、esting service period are protected by theThe pattern and characters of PONY and usedtrademark law of the Peoples Republic of China. Any unauthorized usage, counterfeit, fery and alteration of trademarks ofPONY and are the violations of the law. The PONY has the right to pursue all legal liabilities

13、 of the subject of the delict.3.委托办妥以上手续后，我将尽快安排复检，不可重复性实验不进行复检。We shall arrange the retest as soon assible after the foregoing procedure has been duly conducted, and be immune fromconducting the recheck of the unrepeatable test.4.如委托与样品生产不一致，委托需提供生产拥有样品初始所并同意送检的证明。If the trustor is not the manufact

14、urer, the trustor shall submit thewhich demonstrate the manufacturossesses the initialownership of such sle and agrees the presen ion of sle.5.我仅对来样负责，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，我不承担任何责任。如因我过错导致样品的检测结果有误差，我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。PONY is only responsible for the prov

15、ided sle. The test results only represent the evaluation of the tested sle. PONY will notbe responsible for usage of the test results and any direct or indirect losses generated from the usage of the test results. If due tomistakes of PONY, the test results of the sle contain errors,he case of error

16、s of the test results and usage of the test results,PONY wildertake the legal liability of compensation which is no moren twice of the test charge of the test item withhissle.6.对送检样品中包含的任何已知的或潜在危害，如放射性、或性的样品，应事先，否则由委托负责。The trustor shall inform us any known or potential hazard containedhe presented

17、sle in advance, for instance, radioactivity,toxicity or explosivity of the presented s notice.le, otherwise the trustor shall bear the legal consequence incurred by failure of such7.如委托全的位承担。需要我外出采样，则委托应当确保采样场所不存在任何可能危及或影响我采样人身、安，否则，由此给采样和/或我造成的一切损失(包括但不限于医疗费用、工伤待遇、经济赔偿)由委托单If we will provide field

18、sling at the request of the trustor, the trustor shall ensuret there are no hazard factor whiay be ling spot.potential dangerous or adversely effective to theal and property safety of our sle collectors on the sOtherwise, the trustor shall ame all the damage caused to the sle collector and/or us (in

19、cluding but not limited to medical careexpense, industrial injury fund and economic compensation).8.我可以在完成后按规定处置送检样品。We can dise the presented sle pursuant to certain provis after the completion of report.9.委托应认真详细填写本相关内容，由于填写不清造成修改，应支付修改费用。The c nt should fillhe relevant contents of this agreement

20、in detail accura y, and should pay the expenses for revising thereport 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式提供。Any other dahat need to calculate or label, and parameters and limits will provide in a form of attached sheet.在我 We will i scope ofAS 认证范围内的出具检测e the test report withhe

21、scope of AS certificationassed.，在认证范围外的则出具测试。AS certificationassed, and we will ie the data report outside of the12.在中的检测项目左上角标注“*”，则表示该项目不在我的AS 认证范围内。If the test itemhe report is marked with *he upper left corner, then it showst the test item is outside of the scope ofAS certificationassed.付款方式及Pay

22、ment way and account No.账号 B名(Account name)：account（RMB）：测试工商67广州账号 Baccount（RMB）：名(Account name)：广州市测试技术广州穗和3行(Deit b)：建行行(Deit b)：中国工商帐号(Account No.)：帐号(Account No.)：外币帐号 Baccount（$）：账号 Baccount（RMB）：科技化学名(Account name)：测试名(Account name)：Pony Testing Co.,.)：中国建设行(Deit b)：工行宗关行(Deit b市分行苏州桥(Account

23、 No.)：8CCB, Beijing Branch, Suzhouqiao sub-branch(Account No.)：23车附所账号 Baccount（RMB）：汽车车身附件名(Account name)：账号 B名(Account name)：account（RMB）：测试行(Deit b)：工行宗关(Account No.)：5行(Deit b)：中国工商市习勤路3帐号(Account No.)：长春账号 Baccount（RMB）：名(Account name)：吉林省测试科技账号 B名(Account name)：account（RMB）：行(Deit b)：建行长春电台街市测

24、试科技蛇口1(Account No.)：01行(Deit b)：中国工商帐号(Account No.)：大连账号 Baccount（RMB）：测试科技外币账号 Baccount（$）：名(Account name)：大连名(Account name)：市测试科技行(Deit b)：中国建设大连高新技术产业园区86Shenzhen Pony Test Science and Technology Co.,帐号(Account No.)：行(Debranchit b)：中国工商分行 ICBC. SZ郑州账号 Baccount（RMB）：帐号(Account No.)：0名(Account name

25、)：郑州测试技术行(Deit b)：建行郑州开发区青岛账号 Baccount（RMB）：测试帐号(Account No.)：40名(Account name)：青岛行(Deit b)：中国工商青岛高科技工业园5杭州账号 Baccount（RMB）：检测科技杭州高新923帐号(Account No.)：名(Account name)： 杭州行(Deit b)： 交通宁波账号 Baccount（RMB）：测试技术帐号(Account No.)：名(Account name)：宁波行(Deit b)：中国工商宁波高新区3厦门账号 Baccount（RMB）：测试帐号(Account No.)：名(Account name)：厦门行(Deit b)： 工行厦门高