ContactDetails:
(Nameandaddress)
Detailsofwork: Thewholeinstallation Partoftheinstallation
CUSTOMERCOPYTHISISANIMPORTANTDOCUMENTAND
SHOULDBERETAINEDFORAMINIMUMOF7YEARS


ELECTRICALSAFETYCERTIFICATE
REFERENCE/CERTIFICATEIDNO.:

ThisElectricalSafetyCertificateprovidesalegallyrecognisablestatementthattheconnected
installationorpartinstallation,oranyfittingthatsuppliesaninstallationorapartofaninstallation,
issafetousefollowingprescribedelectricalwork.
LocationDetails:
Descriptionof
work:
Dateof
connection:
By signing this document I certify that the installation, or part of the installation, to which the Electrical
SafetyCertificateappliesisconnectedtoapowersupplyandissafetouse.
Certi
f
ier’sname:
Registration/Practising
licencenumber:
Certifier’s
signature:
CertificateIssueDate:
Email:
Organisation/
Company:
ThiselectricalsafetycertificatealsoconfirmsthattheelectricalworkcomplieswiththebuildingcodeforthepurposesofSection19(1)(e)ofthe
BuildingAct2004.
click to sign
signature
click to edit