Project No F942146 File E305164 Page 1 of 14 LABORATORY DATA PACKAGE ULS 00758 AVLV2 DataSheet 2001 Form Issued 2002 09 01 Form Page 1 Form Revised 2010 04 05 Copyright 2012 UL LLC Only those products bearing the UL Mark should be considered as being covered by UL Project No F942146 File E305164 Page 2 of 14 LABORATORY DATA PACKAGE ULS 00758 AVLV2 DataSheet 2001 Form Issued 2002 09 01 Form Page 2 Form Revised 2010 04 05 Copyright 2012 UL LLC Only those products bearing the UL Mark should be considered as being covered by UL Number of pages in this package 14 Fill in when using printed copy as record TEST LOCATION X UL or Affiliate WTDP CTDP TPTDP TCP PPP WMT TMP SMT Company Name UL CCIC Company Limited Address Suzhou CLIENT INFORMATION Company Name DONGGUAN BOLI ELECTRONIC CO LTD Address LONG YAN INDUSTRIAL AREA HUMEN DONGGUAN GUANGDONG 523000 CHINA AUDIT INFORMATION X Description of Tests Per Standard No X UL 758 Edition Revision Date Second 2010 07 15 X UL 1581 Fourth 2011 04 15 X CSA C22 2 No 210 Third 2011 CSA C22 2 No 127 Seventh 2009 09 Tests Conducted by Printed Name Signature UL Staff conducting or witnessing testing WTDP TMP WMT only UL Staff supervising UL Staff in training Authorized Signatory CTDP TPTDP SMT Printed Name Signature and include date for CTDP TPTDP WMT TMP SMT Reviewed and accepted by qualified Project Handler Jessie Wu Printed Name Signature Project No F942146 File E305164 Page 3 of 14 LABORATORY DATA PACKAGE ULS 00758 AVLV2 DataSheet 2001 Form Issued 2002 09 01 Form Page 3 Form Revised 2010 04 05 Copyright 2012 UL LLC Only those products bearing the UL Mark should be considered as being covered by UL TESTS TO BE CONDUCTED Test No Done Test Name Comments Parameters X Tests Conducted by 1 x PHYSICAL PROPERTIES Nery Zhang Nery Zhang Abel Wang Abel Wang 2 X HEAT SHOCK TEST Randy Wang Randy Wang 3 X COLD BEND TEST Randy Wang Randy Wang 4 X DEFORMATION Randy Wang Randy Wang 5 X DURABILITY OF PRINT TEST Abel Wang Abel Wang Project No F942146 File E305164 Page 4 of 14 LABORATORY DATA PACKAGE ULS 00758 AVLV2 DataSheet 2001 Form Issued 2002 09 01 Form Page 4 Form Revised 2010 04 05 Copyright 2012 UL LLC Only those products bearing the UL Mark should be considered as being covered by UL Instructions When all tests are conducted by one person printed name and signature can be inserted here instead of including printed name and signature on each page containing data Must indicate number of pages in the data package When test conducted by more than one person printed name and signature of person conducting the test can be inserted next to the test name instead of including printed name and signature on each page containing data Must indicate number of pages in the data package Use of this field is optional and may be employed differently Special Instructions X It shall be permitted to use a mandrel with a smaller size for Dielectric heat shock cold bend flexibility test If nonconforming results are obtained a mandrel as specified on these data sheets shall be used Unless specified otherwise in the individual Methods the tests shall be conducted under the following ambient conditions Confirmation of these conditions shall be recorded at the time the test is conducted Ambient Temperature C 23 5 Relative Humidity 70 RH Barometric Pressure mBar N A X No general environmental conditions are specified in the Standard s or have been identified that could affect the test results or measurements Refer to individual test method for the requirement of ambient condition To Lab Staff Refer to the below table for the unit conversion on the following datasheet 1 mm 0 03937 inch 1 KN 224 8089lbf Project No F942146 File E305164 Page 5 of 14 Tested by Date Printed Name Signature ULS 00758 AVLV2 DataSheet 2001 Form Issued 2002 09 01 Form Page 5 Form Revised 2010 04 05 Copyright 2012 UL LLC Only those products bearing the UL Mark should be considered as being covered by UL TEST EQUIPMENT INFORMATION Inst ID No Instrument Type Test Number Test Title or Conditioning Function Range Last Cal Date Next Cal Date If Test Number is used the Test Number must be identified on the data sheet pages or on the Data Sheet Package cover page The following additional information is required when using client s or rented equipment or when a UL ID Number for an instrument number is not used The Inst ID No below corresponds to the Inst ID No above Inst ID No Make Model Serial Number Asset No x UL test equipment information is recorded on Meter Use in UL s Laboratory Project Management LPM database TEST SAMPLE IDENTIFICATION The table below is provided to provide correlation of sample numbers to specific product related information Refer to this table when a test identifies a test sample by Sample No only Sample Card No Date Received x Test No Sample No Manufacturer Product Identification and Ratings 1286218 2012 01 17 1 5 W1 W11 Referred to the attached sample tag If Test Number is used the Test Number or Numbers the sample was used