Quotation for Unintentional Radiator

Please fill out and submit the following request form. You will be contacted with a quotation for testing, reporting and certification services. This form is not applicable for FCC certification of transmitters; please refer to the transmitter quotation request form for those services.

Company Name:

Address 1:

Address 2:

City:

State:

Zip Code:

Phone:

Contact Person:

Email Address:

Product Name or Model

Objective

Equipment Class:

How would you like your testing documented: Data Only Formal Report

During Immunity Testing, the EUT will be exercised and the performance will be monitored. What is the time necessary for the EUT to update and response to the induced RF phenomena?

Cycle Time

How many different I/O ports and cables are to be tested?

What type of power does your equipment require?:

Single Phase 3 Phase DC

Other:

Is your equipment rated at greater than 16 Amps/phase? Yes No

If Yes:
Please Specify

Does your equipment require greater than 240VAC? Yes No

If Yes:
Please Specify

Does your equipment operate at a frequency other than 50 or 60Hz AC input? Yes No

If Yes:
Please Specify

Does your equipment weigh more than 150 lbs? Yes No

If Yes:
Please Specify

Is any physical dimension greater than 72"? Yes No

If Yes:
Please Specify

Special Requirements?

Multiple AC Inputs (i.e. Redundant Power Supplies) Air Vacuum Water

Other:

List all oscillator/clock frequencies generated:

Configurations/modes of operation to test:

Please give a brief description of the equipment:

Please attach any additional information (10mb limit):

Will you be scheduling:

Northwest EMC

EMC/EMI Testing, Support, and Certification Services

Quotation for Unintentional Radiator

(For devices other than transmitters)