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Appendix – declaration of conformity (sample)
Name and address of the company, which carried out the mounting of the installation duct
Construction project and building
Creation date
It is hereby confirmed that the fire-resistant installation duct (subject of approval) has been completed and
erected professionally with respect to all details and in compliance with all provisions of the general construction
test approval No. Z-19.30-2229 of Deutsches Institut für Bautechnik from 22.02.2017, as well as the mounting
instructions dated 07/2019.
Place, date
Stamp and signature
This confirmation must be given to the client for forwarding, if necessary, to the responsible construction super-
visory board.
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