[paste to your company's letterhead]
[delete all comments in brackets prior to submission]
Product Evaluation Report
Date:
[replace with current date]
Application Number:
Project:
[replace if number is known, optional]
[replace with your project reference number or name]
Product Manufacturer: [replace with the product manufacturer name]
Manufacturer Address: [replace with product manufacturer address]
Product Name & Description:
[replace with product name & brief description]
Scope of Evaluation:
This Product Evaluation Report is being issued in accordance with the requirements of the Florida
Department of Business and Professional Regulation, Rule 61G20-3 and F.S. 553.8425 for Local Product
Approval. The product noted above has been tested and/or evaluated as summarized herein to show
compliance with the 2010 Florida Building Code and is, for the purpose intended, at least equivalent to
that required by the Code. Re-evaluation of this product shall be required following pertinent Florida
Building Code modifications or revisions.
Compliance Method:
(1) For local product approval, products or systems of construction shall demonstrate compliance with
the structural wind load requirements of the Florida Building Code through one of the following methods:
[include only one of the below as applicable]
(a) A certification mark, listing, or label from a commission-approved certification agency indicating
that the product complies with the code;
(b) A test report from a commission-approved testing laboratory indicating that the product tested
complies with the code;
(c) A product-evaluation report based upon testing, comparative or rational analysis, or a combination
thereof, from a commission-approved product evaluation entity which indicates that the product evaluated
complies with the code;
(d) A product-evaluation report or certification based upon testing or comparative or rational analysis,
or a combination thereof, developed and signed and sealed by a Florida professional engineer or Florida
registered architect, which indicates that the product complies with the code;
(e) A statewide product approval issued by the Florida Building Commission; or
(f) Designation of compliance with a prescriptive, material standard adopted by the commission by rule
under s. 553.842(15).
Substantiating Data:
[include all that are applicable, add others as needed]

RELATED PRODUCT APPROVALS
[list all applicable product approvals used to substantiate this product evaluation]

PRODUCT EVALUATION DOCUMENTS
Drawing number… titled… sheets … to…, signed and sealed by…. is an integral part of this Evaluation
Report.

TEST REPORTS
[list all test reports and referenced standards as applicable]

STRUCTURAL ENGINEERING CALCULATIONS [include as applicable:]
Structural engineering calculations have been prepared which evaluate the product based on
comparative and/or rational analysis to qualify the following design criteria:
1. Anchor Spacing
2. Maximum Allowable Size/Pressure Combinations
3. Glass Capacity
4. Anchor Capacity
[include as applicable:] No 33% increase in allowable stress has been used in the design of this product.
Impact Resistance:
[select one]
Large / Small Missile Impact Resistance has been demonstrated as evidenced in previously listed test
reports, and is accounted for in the engineering design of this product.
This product is NOT rated for large or small missile impact resistance. An approved large missile impact
protection devise IS REQUIRED over all openings pertaining to this evaluation.
Wind Load Resistance
This product has been designed to resist wind loads as indicated in the span schedule(s) on the Product
Evaluation Document (i.e. engineering drawing).
Installation
The product listed above shall be installed in strict compliance with the Product Evaluation Documents
noted above along with all components noted therein.
The product components shall be of the material specified in the Product Evaluation Documents noted
above.
Limitations & Conditions of Use:
[include all that apply, examples given below]

Use of this product shall be in strict accordance with the Product Evaluation Documents noted above.

All supporting host structures shall be designed to resist all superimposed loads and shall be of a
material listed in this product’s respective anchor schedule. Host structure conditions which are not
accounted for in this product’s respective anchor schedule shall be designed for on a site-specific
basis by a registered professional engineer.

All components which are permanently installed shall be protected against corrosion, contamination,
and other such damage at all times.

This product HAS / HAS NOT been designed for use within the High Velocity Hurricane Zone
(HVHZ).
Signed and Sealed:
[registered professional name]
[registered professional company]
[registered professional PE/AR # & C of A as applicable]
------------- delete this line and notes below -------------------------Note:
It is recommended this document be digitally signed. See http://FloridaLocalApprovals.com/digital for
instructions.
If the document is not digitally signed and sealed, a hardcopy of this evaluation report as well as the
evaluation documents is to be sent to the below prior to approval:
Product Approval Administrator
Ted Berman and Associates, LLC
925 41st Street
Suite 104
Miami Beach, FL 33140