Unit 100, 10 Rockingham Street, London SE1 6PD
Tel : [phone] Fax : [phone]
Portable Appliance Testing Certificate
Certificate Number : 1234
Test Date :
Re-test Due By :
Site Name
Address
Town
Postcode
I certify, on behalf of ems, that the portable electrical equipment tested, as stated within
Report Number
at the above premises was carried out in accordance with the Institute of Electrical Engineers Code
of Practice for In-service Inspection and Testing of Electrical Equipment, and complies with the
 Health & Safety at Work Act 1974 , the  Provision and Use of Work Equipment Regulations 1998 ,
the  Management of Health & Safety at Work Regulations 1999 , and the Electricity at Work Act
1989
Signed
Operations Manager