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CUSTOMER CONTRACT REVIEW

Company Name(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Contact Person(Required)

First Last

Contact Phone(Required)

Contact Email(Required)

Calibration Interval

PO#(Required)

Regarding the PO# entered above, ISO 17025 requires that we ask what you would like us to use as a re-calibration cycle for your gages.

Due Date(Required)

No Due date

Every 6 Months

Every 12 Months

Every 18 Months

Other

Months

If other, please indicate how many months until the next calibration

If you would like this interval for only this job, please check here.

Only this job

Date

MM slash DD slash YYYY

If the above is acceptable for all future calibrations, please check here

All future calibrations

Date

MM slash DD slash YYYY

Procedure Acceptance

IMC will use internal calibration procedures CIMC-001 through CIMC-033, unless the customer specifies the following procedure for IMC to follow:

Procedure to follow:

If the above statement is acceptable for all future calibrations, please check here:

Acceptable for all future calibrations

Date

MM slash DD slash YYYY

Factoring Measurement Uncertainty

“When determining in or out of tolerance, measurement uncertainty is not factored. Only the tolerance is factored.”

If the above statement is acceptable for all future calibrations, please check here

All future calibrations

Date

MM slash DD slash YYYY

If you want measurement uncertainty added to the tolerance, please check here

Measurement uncertainty added to the tolerance

Date

MM slash DD slash YYYY

If you want measurement uncertainty subtracted from the tolerance, please check here

Measurement uncertainty subtracted from the tolerance

Date

MM slash DD slash YYYY

Outsourced Calibration – IMC will only outsource calibration for which we are not currently accredited

Customer approves IMC to outsource calibration to an accredited laboratory that A2LA mutually recognizes.

If the above is acceptable, please check here

Acceptable

Date

MM slash DD slash YYYY

If the above is NOT acceptable, please check here

NOT Acceptable

Date

MM slash DD slash YYYY

Calibration Certificates – Please choose one

I would like to receive hard copies of my calibration certificates, please check here

Yes I want a hard copy

Date

MM slash DD slash YYYY

I would like my calibration certificates to be e-mailed to me as a pdf file, please check here

Yes I want a PDF copy emailed

Date

MM slash DD slash YYYY

Signature

By checking the box below I am signing & approving the information contained in this form.

I agree

Title

Date

MM slash DD slash YYYY

These pages intended for the person or company named below and may contain information that is privileged and confidential. If you are not the intended recipient, you are hereby notified that dissemination or distribution of this information to other than the intended recipient is strictly prohibited. If you have received this in error, please notify IMC personnel immediately.

Inspection Measurement Company



2291 Byron Center Ave SW Wyoming, MI 49519 USA



(616) 531-3303

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send us an email

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Fax: 616-531-0153

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Mon – Thurs: 8AM – 4:30PM
Friday: 8AM-3:00PM

A2LA Accreditation
Catalog Request
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