Supplier s declaration of conformity
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1 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 2008 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 Instructions for completion > Do not return this form to the ACMA. This completed form must be retained by the supplier as part of the documentation required for the compliance records and must be made available for inspection by the ACMA when requested. Supplier s details (manufacturer, importer or authorised agent) Company Name (OR INDIVIDUAL) Siemens Ltd. RC-AU DF FA ACN/ARBN OR New Zealand IRDN Street Address (AUSTRALIAN or NEW ZEALAND) 885 Mountain Highway Bayswater VIC POSTCODE 3153 Phone: 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) Distributed Input/Output Devices ET 200S ET 200S Anschaltungsbaugruppe / Interface Modules 6ES AA06-0AB0 6ES AB05-0AB0 6ES BA02-0AB0 6ES CA00-0AB0 6ES BA60-0AB0 6ES BB23-0AB0 6ES AA21-0AB0 6ES AB00-0AB0 103_RCM_ET_200_S_A3_12_2017_d_e.docx Page 1 of 6
2 6ES AA23-0AB0 6ES AB01-0AB0 6ES BA23-0AB0 Power Modul / Power Modules 6ES CA01-0AA0 6ES CA50-0AB0 6ES CA80-0AB0 6ES CB11-0AB0 6ES CA60-0AB0 Digitaleingabe-/Digitalausgabe-Module / Digital Input/Output Modules 6ES BB01-0AA0 6ES BB01-0AB0 6ES BD01-0AA0 6ES BD01-0AB0 6ES BD51-0AA0 6ES BF00-0AA0 6ES BF50-0AA0 6ES CD02-0AB0 6ES EB00-0AB0 6ES FB00-0AB0 6ES RD02-0AB0 6ES BB01-0AA0 6ES BB01-0AB0 6ES BB31-0AA0 6ES BB31-0AB0 6ES BD00-0AB0 6ES BD02-0AA0 6ES BD30-0AB0 6ES BD32-0AA0 6ES BD50-0AA0 6ES BF00-0AA0 6ES BF00-0AB0 6ES BF50-0AA0 6ES FB01-0AB0 Analogeingabe-/Analogausgabe-Module / Analog Input/Output Modules 6ES FB01-0AB0 6ES FB52-0AB0 6ES GB01-0AB0 6ES GB11-0AB0 6ES GB52-0AB0 6ES GB62-0AB0 6ES GD00-0AB0 6ES LB02-0AB0 6ES MB02-0AB0 6ES NB01-0AB0 6ES NB51-0AB0 6ES FB01-0AB0 6ES FB52-0AB0 6ES GB01-0AB0 103_RCM_ET_200_S_A3_12_2017_d_e.docx Page 2 of 6
3 6ES JB01-0AB0 6ES JB51-0AB0 6ES JD00-0AB0 6ES GB52-0AB0 6ES LB02-0AB0 6ES MB02-0AB0 Technologie-Module / Function Modules 6ES DA04-0AB0 6ES DB03-0AB0 6ES DC01-0AB0 6ES DD01-0AB0 6ES DF01-0AB0 6ES DF11-0AB0 6ES DL00-0AB0 6ES GA50-0AB0 6ES DE02-0AB0 Master-Interface Modul 6ES HA00-0AB0 Potenzialverteiler-Modul / Potential Distributor Modul 6ES FD00-0AA0 Reserve-Module / Reserve Modules 6ES AA01-0AA0 6ES AA11-0AA0 Terminalmodule / Terminal Modules 6ES CA20-0AA0 6ES CA30-0AA0 6ES CA40-0AA0 6ES CA50-0AA0 6ES CA70-0AA0 6ES CA80-0AA0 6ES CB00-0AA0 6ES CB10-0AA0 6ES CB20-0AA0 6ES CD20-0AA0 6ES CD30-0AA0 6ES CD70-0AA0 6ES CE00-0AA0 6ES CE10-0AA0 6ES CE60-0AA0 6ES CF40-0AA0 6ES CF50-0AA0 6ES CG20-0AA0 103_RCM_ET_200_S_A3_12_2017_d_e.docx Page 3 of 6
4 6ES CB30-0AA0 6ES CB60-0AA0 6ES CB70-0AA0 6ES CC20-0AA0 6ES CC30-0AA0 6ES CG30-0AA0 6ES CK20-0AA0 6ES CK30-0AA0 6ES CL20-0AA0 6ES CL30-0AA0 6ES CC70-0AA0 Abschlußmodul / Termination Modul 6ES JA00-0AA0 Relais-Modul / Relay-Modul 6ES HB01-0AB0 6ES HB50-0AB0 6ES HB12-0AB0 Zubehörteile wurden zusammen mit den Produkten Error! Reference source not found. getestet: Accessories tested together with the products Error! Reference source not found. : Steckerzusatz / Connection Element 6ES JB00-0AA0 6ES JB50-0AA0 103_RCM_ET_200_S_A3_12_2017_d_e.docx Page 4 of 6
5 ET 200S Compact Digitaleingabe-/Digitalausgabe-Modul / Digital Input/Output Modul 6ES CA00-3BL0 Digitaleingabe-Modul / Digital Input Modul 6ES CA00-1BL0 Terminalmodule / Terminal Modules 6ES DL00-0AA0 6ES DL10-0AA0 6ES FL00-0AA0 6ES FL10-0AA0 Date of manufacture or importation of the original/modified item 103_RCM_ET_200_S_A3_12_2017_d_e.docx Page 5 of 6
6 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 List the details of the documents the above statement was made, including the standard title, number and, if applicable, number of the test report/endorsed test report or certification/competent body statement EN : A1:2011 Declaration I hereby declare that: 1. I am authorised to make this declaration on behalf of the Company mentioned above, 2. the contents of this form are true and correct, and 3. the product mentioned above complies with the applicable above mentioned standards and all products supplied under this declaration will be identical to the product identified above. Note: Under section of the Criminal Code Act 1995, it is an offence to knowingly provide false or misleading information to a Commonwealth entity. Penalty: 12 months imprisonment SIGNATURE OF SUPPLIER OR AGENT POSITION IN ORGANISATION PRINT NAME DATE The Privacy Act 1988 (Cth) (the Privacy Act) imposes obligations on the ACMA in relation to the collection, security, quality, access, use and disclosure of personal information. These obligations are detailed in the Australian Privacy Principles. The ACMA may only collect personal information if it is reasonably necessary for, or directly related to, one or more of the ACMA s functions or activities. The purpose of collecting the personal information in this form is to ensure the supplier is identified in the Declaration of conformity. If this Declaration of Conformity is not completed and the requested information is not provided, a compliance label cannot be applied. Further information on the Privacy Act and the ACMA s Privacy Policy is available at The Privacy Policy contains details about how you may access personal information about you that is held by the ACMA, and seek the correction of such information. It also explains how you may complain about a breach of the Privacy Act and how we will deal with such a complaint. Should you have any questions in this regard, please contact the ACMA s privacy contact officer on telephone on or by at privacy@acma.gov.au. 103_RCM_ET_200_S_A3_12_2017_d_e.docx Page 6 of 6
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