Institute for testing materials a.d.

PT Provider IMS Institute - PIMS

Beograd, Bulevar vojvode Mišića 43
tel: +381 11 2650 322
fax: +381 11 3692 772, 3692 782
e-mail: provider@institutims.rs
www.institutims.rs

APPLICATION FORM FOR PARTICIPATION IN PROFICIENCY TESTING

1. Identity of the participant
Laboratory name ITM shpk
Parent company name
Country Place Zip code, street and number
Laboratory seat
Albania Tirane 1000
Parent company seat
ID/VAT/customs number
Phone Fax e-mail
Contacts
0697050320 laboratoritm@gmail.com
Accreditation
✘ status* yes no in procedure/preparation
Responsible person (first and last Asllan Bejleri
name, province and position in Phone Mobile e-mail
company) 0684660223
Country Place Zip code, street and number
Location for test item shipment
Albania Tirane 1000
We accept the terms from the Rules for participating in the Proficiency Testing Programme.*
*participant who applied for proficiency testing by sequential measurements, as well as simultaneous measuring of noise level,
but don’t appear, is charged 50% of the cost for applied property, if he don’t notify the Provider about the inability to access 3
working days prior to term of measurement

2. Participation goal (more then one option is acceptable)

Evaluation
✘ and monitoring of laboratories’ performance
Identification of problems in laboratory and initiation for improvement
Establishment of the effectiveness and comparability of test methods
Provision of additional confidence to customers
Validation of testing methods
Education of staff
Validation
✘ of uncertainty claims
Assignment of values to reference materials
3. Volume of participation (part/all of PT Provider IMS Institute Programme)**
Programme (scheme) code: PIO CEM/fm 02/18
Subject of testing/product: Cement
Testing methods: EN 196-1
Property/parameter
✘ 1 (compressive strength (after 2, 7 & 28 days))
...(for increasing a number of properties, copy this line and paste below)
We ✘dispose necessary equipment
We ✘dispose trained personal
We ✘dispose appropriate ambient conditions
We ✘have experiences in testing methods
We ✘prefer the Report in English language***
We ✘require the Report in paper form****
**in accordance with a number of properties, expand on next pages
***an English translation is charged 2 EUR per page of Report
****issuing the hard copy of the Report is charged by 25 EUR
We accept the fee amount for participation in the PT Provider IMS Institute Programme. We accept
distribution costs of the third party and the custom expenses for the test item.
Place and date Participant representative

PZ 07