DECLARATION of the WAGON KEEPER

Correction
DECLARATION of the WAGON KEEPER
1.WAGON KEEPER
Legal denomination: Kopalnie i Zakłady Chemiczne Siarki ,,Siarkopol’’S.A z siedzibą w
Grzybowie.
VKM (Vehicle keeper marking) code: PKPC KSG
(intormation trom the National Vehicle Register NVR)
Address
Street, NO: Grzybów
Town: Staszów
Country code ISO: PL
Postecode Alphanumeric code: 28-200
E-mail address: [email protected] [email protected]
VAT No: PL 866-000-13-69
2. DECLARATlON OF THE KEEPER
All wagons ot this keeper have certitied Entities in Charge ot Maintenance (ECMs) assigned to
them.
Tick or fili out where appropriate
Keeper is the ECM
x
..
Keeper is working with the tollowing certifed ECM (s):
..
x
Zakłady Produkcyjno-Naprawcze Taboru Maszyn i Urządzeń ,,TABOR’’
Ul. Sandomierska 39, 39-200 Dębica Cert No : 1034
Remark: both alternatives are possible at the same time
3. ADDITlONAL INFORMATlON
Date and Signature
31.12.2010 Ryszard Czerwiec
The intormation ot this declaration is deemed valid trom the date ot its signature until
withdrawal/replacement/updating by the keeper.