Energy Efficiency Standards Act

    Certification Form

    Product Type:

     

    Manufacturer's Information
    Manufacturer name:
    Manufacturer address:
    Manufacturer city:
    Manufacturer state:
    Manufacturer zip:
    Manufacturer’s point of contact name:
    Point of contact’s telephone number:
    Fax number:
    Point of contact’s email  address:

     

    Product Information
    Product name:
    Product identification number:

     

    Compliance Statement
    I assert that the product identified on this certification conforms to the standards to the efficiency standards contained in the Energy Efficiency Standards Act, State Government Article, Section 9-2006(e) Annotated Code of Maryland.
    Name:
    Title:
    Date:

     

    Testing Laboratory Information
    Testing laboratory’s or institution’s name:
    Address:
    City:
    State:
    Zip:
    Website:
    Contact Name:
    Telephone number:
    Fax number:
    Email address:
    Test method used:

     

    Labeling Information

    Brief discussion as to whether the product shall bear a Maryland label or if not what label it shall have that reflects that the products meets an efficiency standard equal to the one reflected in the Energy Efficiency Standards Act.