LSPro DP OPS 08 Ed.0 Rev.0 2013 Letter of Coordinator Designation
BALAI SERTIFIKASI INDUSTRI
BADAN PENGKAJIAN KEBIJAKAN IKLIM DAN MUTU INDUSTRI
KEMENTERIAN PERINDUSTRIAN R.I.
SUPPORTING DOCUMENT
LETTER OF COORDINATOR
DESIGNATION
© Copyright Balai Sertifikasi Industri
Dokumen ini beserta informasi yang dikendalikan di dalamnya adalah hak milik Balai Sertifikasi Industri
Kementerian Perindustrian. Dokumen ini tidak boleh disalin atau dicetak baik sebagian maupun keseluruhannya,
atau diberikan kepada pihak lain tanpa adanya persetujuan tertulis dari Kepala Balai Sertifikasi Industri
Kementerian Perindustrian.
No. Dok.: LSPro/DPOPS-08
Edisi: 0 Revisi: 0
No. Halaman: 1 dari 4
BALAI SERTIFIKASI INDUSTRI
BADAN PENGKAJIAN KEBIJAKAN IKLIM DAN MUTU INDUSTRI
KEMENTERIAN PERINDUSTRIAN R.I.
Ditinjau Oleh,
Disahkan Oleh,
ttd
ttd
ADI IRFAN SHIDQY
Kepala Seksi Operasional
Sertifikasi
TRIYOGA I.W. NURJAYA
Kepala Balai Sertifikasi
Industri
Tanggal: 1 September
2013
Tanggal: 30 September
2013
© Copyright Balai Sertifikasi Industri
Dokumen ini beserta informasi yang dikendalikan di dalamnya adalah hak milik Balai Sertifikasi Industri
Kementerian Perindustrian. Dokumen ini tidak boleh disalin atau dicetak baik sebagian maupun keseluruhannya,
atau diberikan kepada pihak lain tanpa adanya persetujuan tertulis dari Kepala Balai Sertifikasi Industri
Kementerian Perindustrian.
No. Dok.: LSPro/DPOPS-08
Edisi: 0 Revisi: 0
No. Halaman: 2 dari 4
LETTER OF COORDINATOR DESIGNATION
No : year/month/date/Company initial
The undersigned belows,
Name
:
Company name
Company address
as “FIRST PARTY”
:
:
Name
:
Company name
:
Company address
Product
:
Brand
:
as “SECOND PARTY”
Name
:
Company name
Company address
Product
:
Brand
:
as “THIRD PARTY”
:
:
:
SECOND PARTY and THIRD PARTY are interest in the above products
with brands sold in Indonesia, whereas the products are manufactured by
FIRST PARTY
In terms of product certification of conformity with SNI/ST, FIRST PARTY
with the knowledge and consent of other parties designate the SECOND
PARTY as a coordinator in the arrangement of product certification in
Institute for Industrial Certification.
FIRST PARTY willing to be audited by an audit team from Institute for
Industrial Certification both within the framework of certification,
surveillance and / or expansion of all products and brands from those
contained in this agreement and are responsible for all obligations arising
therefore on behalf of the relevant parties in this agreement.
No. Dok.: LSPro/DPOPS-08
Edisi: 0 Revisi: 0
No. Halaman: 3 dari 4
Whereas in the future there is a change of this letter then the letter will be
updated by issuing a new letter of agreement.
................., ..............
.. 20..
FIRST PARTY
SECOND PARTY
Signature
Signature
(
name
)
(
name
)
THIRD PARTY
Signature
(
name
No. Dok.: LSPro/DPOPS-08
)
Edisi: 0 Revisi: 0
No. Halaman: 4 dari 4
Remarks :
The number of parties can be adjusted according to the number of applicants.
For example:
One company has four responsible Indonesian Company, than it has 5 parties
signatory :
First Party
Second Party
Third Party and more
No. Dok.: LSPro/DPOPS-08
: Producer
: Coordinator (Indonesian company)
: Other Indonesian companies
Edisi: 0 Revisi: 0
No. Halaman: 5 dari 4
BADAN PENGKAJIAN KEBIJAKAN IKLIM DAN MUTU INDUSTRI
KEMENTERIAN PERINDUSTRIAN R.I.
SUPPORTING DOCUMENT
LETTER OF COORDINATOR
DESIGNATION
© Copyright Balai Sertifikasi Industri
Dokumen ini beserta informasi yang dikendalikan di dalamnya adalah hak milik Balai Sertifikasi Industri
Kementerian Perindustrian. Dokumen ini tidak boleh disalin atau dicetak baik sebagian maupun keseluruhannya,
atau diberikan kepada pihak lain tanpa adanya persetujuan tertulis dari Kepala Balai Sertifikasi Industri
Kementerian Perindustrian.
No. Dok.: LSPro/DPOPS-08
Edisi: 0 Revisi: 0
No. Halaman: 1 dari 4
BALAI SERTIFIKASI INDUSTRI
BADAN PENGKAJIAN KEBIJAKAN IKLIM DAN MUTU INDUSTRI
KEMENTERIAN PERINDUSTRIAN R.I.
Ditinjau Oleh,
Disahkan Oleh,
ttd
ttd
ADI IRFAN SHIDQY
Kepala Seksi Operasional
Sertifikasi
TRIYOGA I.W. NURJAYA
Kepala Balai Sertifikasi
Industri
Tanggal: 1 September
2013
Tanggal: 30 September
2013
© Copyright Balai Sertifikasi Industri
Dokumen ini beserta informasi yang dikendalikan di dalamnya adalah hak milik Balai Sertifikasi Industri
Kementerian Perindustrian. Dokumen ini tidak boleh disalin atau dicetak baik sebagian maupun keseluruhannya,
atau diberikan kepada pihak lain tanpa adanya persetujuan tertulis dari Kepala Balai Sertifikasi Industri
Kementerian Perindustrian.
No. Dok.: LSPro/DPOPS-08
Edisi: 0 Revisi: 0
No. Halaman: 2 dari 4
LETTER OF COORDINATOR DESIGNATION
No : year/month/date/Company initial
The undersigned belows,
Name
:
Company name
Company address
as “FIRST PARTY”
:
:
Name
:
Company name
:
Company address
Product
:
Brand
:
as “SECOND PARTY”
Name
:
Company name
Company address
Product
:
Brand
:
as “THIRD PARTY”
:
:
:
SECOND PARTY and THIRD PARTY are interest in the above products
with brands sold in Indonesia, whereas the products are manufactured by
FIRST PARTY
In terms of product certification of conformity with SNI/ST, FIRST PARTY
with the knowledge and consent of other parties designate the SECOND
PARTY as a coordinator in the arrangement of product certification in
Institute for Industrial Certification.
FIRST PARTY willing to be audited by an audit team from Institute for
Industrial Certification both within the framework of certification,
surveillance and / or expansion of all products and brands from those
contained in this agreement and are responsible for all obligations arising
therefore on behalf of the relevant parties in this agreement.
No. Dok.: LSPro/DPOPS-08
Edisi: 0 Revisi: 0
No. Halaman: 3 dari 4
Whereas in the future there is a change of this letter then the letter will be
updated by issuing a new letter of agreement.
................., ..............
.. 20..
FIRST PARTY
SECOND PARTY
Signature
Signature
(
name
)
(
name
)
THIRD PARTY
Signature
(
name
No. Dok.: LSPro/DPOPS-08
)
Edisi: 0 Revisi: 0
No. Halaman: 4 dari 4
Remarks :
The number of parties can be adjusted according to the number of applicants.
For example:
One company has four responsible Indonesian Company, than it has 5 parties
signatory :
First Party
Second Party
Third Party and more
No. Dok.: LSPro/DPOPS-08
: Producer
: Coordinator (Indonesian company)
: Other Indonesian companies
Edisi: 0 Revisi: 0
No. Halaman: 5 dari 4