Producer Certificate of subject content and levels Basis for assessment according to BVB:s criteria Company: Contact: Manufacturer Importer Phone no: Address: Homepage: Product name: Article no: E-mail: Certificate for assessment against criteria of Byggvarubedömningen, ver. 3.0 1. Certification of chemical composition The above specified products (with corresponding article numbers) are certified as follows: (Choose to certify either option A OR B) A) ☐ Concentrations of the substances have been declared down to 0.01 % by weight. This means that 100 % of the content is declared in the documents received by BVB. The documentation thereby is allowing assessment against Byggvarubedömningens criteria for the level of Recommended. (If this option is selected, continue to section 2.) ☐ Constituent substances are reported according to the instructions for BVD3 and thereby are allowing assessment against Byggvarubedömningens criteria for level of Accepted. (If this option is selected, continue to section 2.) B) ☐ It is hereby certified that the product/s specified above, with corresponding article numbers, do not contain substances with properties according to The Criteria1 in concentrations exceeding the limit for Recommended. ☐ We hereby inform that the specified products above, with corresponding article numbers, contain substances with properties according to criteria in concentrations that exceeds the limit for Recommended. Specification of substances that exceeds the limits for recommended are reported in Table 2. City and date: Signature: Title: Name: This certificate must be signed by a qualified person. Note that the certificate must be submitted with all 4 pages to be valid for an assessment. Link to BVBs website with criteria www.byggvarubedomningen.se 1 Byggvarubedömningen – Assessment Criteria 2015-04-30 Revised: 2015-04-27 1(4) Producer Certificate of subject content and levels Basis for assessment according to BVB:s criteria 2. Certification of chemical composition: - Substances of concern ☐ It is hereby certified that the specified product/s above, with corresponding article numbers, do not contain substances of concern according to Table 12. These have not been added during production and has not incurred by the reaction of substances in the product. ☐ We hereby inform that the above specified product/s contain substances of concern according to Table 12. These substances have been added during the production or have been incurred by the reaction between substances in the product, see our specification in Table 2. Table 1. Substances of concern Substance group/ Substance 1. Arsenic and its compounds3 Example of properties Tox, Harmful to the environment 2. Brominated flame retardants Pot. PBT/vPvB, PBT/vPvB 3. PFOA (perflouroctaneacids) Persistent, bio accumulating, probable Repr 4. PFOS (perfluorooctane sulfonate) Pot. PBT/vPvB, PBT/vPvB 5. Organotin compounds Pot. PBT/vPvB, PBT/vPvB, Tox, Harmful to the environment 6. Biocides added to the products (surface treatment) in order to achieve a disinfectant or antibacterial effect Tox, Harmful to the environment 7. Cadmium or cadmium compounds Tox, Harmful to the environment 8. Mercury or mercury compounds Tox, Harmful to the environment City and date: Signature: Title: Name: 2 3 Appendix 1 according to Byggvarubedömningens assessment criteria 2015-04-30. Arsenic, or arsenic compound, may not have been added to the product. Any impurities in the used raw material may not exceed 10 mg/kg. The concentration limit is set based on regulatory requirements for soil quality so that accepted products should not contribute to raise background levels during use or disposal (example; sewage sludge according to 1998:944 §20). The same threshold concentration found in the Environmental Protection Agency’s general guidance for less sensitive land use, MKM. Revised: 2015-04-27 2(4) Producer Certificate of subject content and levels Basis for assessment according to BVB:s criteria 3. Content of nanomaterials4 The information is mandatory in order to reach the level of “Recommended”, but does not affect the assessment. ☐ It is hereby certified that the specified product/s above, with corresponding article number, do not contain nanomaterials or nanoparticles. ☐ It is hereby certified that the specified product/s above, with corresponding article, do contain nanomaterials or nanoparticles, see our substance specification in Table 2. City and date: Signature: Title: Name: 4 According to EU-commission definition; http://ec.europa.eu/environment/chemicals/nanotech/faq/definition_en.htm Revised: 2015-04-27 3(4) Producer Certificate of subject content and levels Basis for assessment according to BVB:s criteria Substance specification Specification of: Substances that are found on the list of substances of concern according to Table 1. Substances that are exceeding Byggvarubedömningens criteria for the level Recommended (only relevant if alternative B) was selected in section 1. Nanoparticles. Table 2. Substance specification Substance CAS-no Properties Risk phrase / Hazard statement Criteria-no Concentration Undesirable substance (Weight %) (Yes/No) Comment ☐Table 2, and in the specified data, optionally classified. City and date Signature: Title: Name: Revised: 2015-04-27 4(4)