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KWA
CERTIFICATION LISTING CONTRACT
Please
print this page, fill out the required information, and fax or mail
to KWA.
Ken Wilcox
Associates, Inc. has developed a web-site to promote the international
acceptance of KWA third-party certifications for leak detection
methods and to provide regulatory and other information on the leak
detection industry to interested parties. As a service to the leak
detection industry, KWA is publishing electronic copies of third-party
certifications on the KWA web-site. Completion of this agreement
authorizes KWA to publish electronic copies of third-party certifications
for the equipment named below as requested by the manufacturer.
KWA
Services
KWA will provide the following based on the vendor's requested format.
- Certification
Home page
- E-mail
links (May be updated periodically if information changes)
- Contact
Information (May be updated periodically if information changes)
- Adobe
Acrobat PDF files of certifications and/or evaluation reports
and/or EPA listings
Costs
Certifications will be posted at no charge to the vendor for up
to one year after the date on the certification. After the one year
initial time period, the fee to maintain the certification is $50
per year. The annual billing cycle will commence on January 1. Certifications
posted after January 1 will be billed pro-rated for the first year
based on the date of their initial posting. A one-time fee of $100
will be charged to setup the web-site if the web-site was not in
operation prior to January 1, 1999. A quotation of fees will be
provided to the vendor for approval prior to the posting of the
certifications.
Disclaimer
KWA, Inc. is an independent third-party testing organization that
provides evaluations and R&D facilities for manufacturers of
leak detection equipment. KWA certifications are used to meet regulatory
requirements in all 50 states and world-wide. The KWA web-site has
been developed to provide information related to the leak detection
industry. KWA does not endorse or recommend any leak detection manufacturers
or systems as is consistent with our third-party status. By completing
this form the vendor authorizes Ken Wilcox Associates, Inc. to post
third-party certifications to the KWA web-site according to the
guidelines and fees outlined in this agreement.
Vendor
Information
Table
1.
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Name:
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Title:
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Company:
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Address:
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City:
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State:
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Zip:
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Country:
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Phone
Number:
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Fax
Number:
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E-mail
Links:
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Date:
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Signature:
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Vendor
Listing Guidelines
Please check YES or NO for numbers 1 to 5 below.
Table
2.
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YES
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NO
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I
authorize posting all of the available third-party certifications
conducted on my company's equipment in accordance with the rest
of the YES/NO guidelines outlined on this form.
(If
no is checked, please list specific equipment name and versions
and dates of certifications in Table 3.)
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I
authorize posting full evaluation reports and all EPA certification
forms, including all tables. |
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I
authorize posting full evaluation reports and EPA certification
forms without report/EPA data tables. |
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I
authorize posting only EPA certification forms and EPA data
tables. |
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I
authorize posting only EPA certification forms with no EPA data
tables. |
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If
NO was selected for Number 1 in Table 2, please complete Table 3
for each certification to be posted. Certifications listed in the
Table 3 will be posted according to the vendor’s guidelines
in Numbers 2-5 in Table 2 unless the vendor notes otherwise.
Individual
Certifications
I authorize posting of the third-party certifications listed below:
Table
3. (Complete this table only if NO was marked for Number 1 in Table
2.
| Equipment
Name and Model |
Date
of Certification |
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| 10.
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| Please
attach additional sheets if necessary |
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Please
submit this agreement to KWA by mail or fax to the address/fax below.
Ken
Wilcox Associates, Inc.
1125 Valley Ridge Drive
Grain Valley, MO 64029
Phone (816) 443-2494
Fax (816) 443-2495
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