Form 1 Form No /1

ELECTRICAL INSTALLATION CERTIFICATE (notes 1 and 2)

(REQUIREMENTS FOR ELECTRICAL INSTALLATIONS - BS 7671 [IEE WIRING REGULATIONS])
DETAILS OF THE CLIENT (note 1)
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INSTALLATION ADDRESS
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..................................................................Postcode ......................................................................

DESCRIPTION AND EXTENT OF THE INSTALLATION Tick boxes as appropriate

New installation
Description of installation: .........................................................................................................

Extent of installation covered by this Certificate:............................................................................ Addition to an

....................................................................................................................................................... existing installation
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....................................................................................................................................................... Alteration to an
....................................................................................................................................................... existing installation
................................................................(use continuation sheet if necessary) see continuation sheet No: .....
FOR DESIGN, CONSTRUCTION, INSPECTION & TESTING
I being the person responsible for the Design, Construction, Inspection & Testing of the electrical installation (as indicated by my
signature below), particulars of which are described above, having exercised reasonable skill and care when carrying out the Design,
Construction, Inspection & Testing, hereby CERTIFY that the said work for which I have been responsible is to the best of my
knowledge and belief in accordance with BS 7671:2008 amended to .......... (date) except for the departures, if any, detailed as follows:

Details of departures from BS 7671 (Regulations 120.3 and 120.4):

The extent of liability of the signatory is limited to the work described above as the subject of this Certificate.

Name (IN BLOCK LETTERS): ................................................................................. Position:.........................................

Signature (note 3): ................................................................................................... Date: ..............................................
For and on behalf of:................................................................................................
Address:...................................................................................................................
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......................................................................................... Postcode........................ Tel No: ...........................................

NEXT INSPECTION
I recommend that this installation is further inspected and tested after an interval of not more than ............ years/months (notes 4 and 7)
SUPPLY CHARACTERISTICS AND EARTHING ARRANGEMENTS Tick boxes and enter details, as appropriate
Earthing arrangements Number and Type of Live Nature of Supply Parameters Supply
Conductors Protective Device
TN-C Characteristics
a.c. d.c.
TN-S Nominal voltage, U/Uo(1) .................................. V
Type: ..........................
TN-C-S 1-phase, 2-wire 2-pole
Nominal frequency, f (1) ................................... Hz ..........................
TT Rated current ............ A
1-phase, 3-wire 3-pole Prospective fault current, Ipf (2) ......................... kA
IT (note 6)
2-phase, 3-wire other
Alternative source External loop impedance, Ze (2)......................... Ω
of supply (to be detailed 3-phase, 3-wire
(Note: (1) by enquiry, (2) by enquiry or by measurement)
on attached schedules)
3-phase, 4-wire

Page 1 of (note 5)
 PARTICULARS OF INSTALLATION REFERRED TO IN THE CERTIFICATE Tick boxes and enter details, as appropriate
Means of Earthing Maximum Demand
Delete as appropriate
Distributor’s facility Maximum demand (load) ............................................ . kVA / Amps
Details of Installation Earth Electrode (where applicable)
Installation Type Location Electrode resistance to earth
earth electrode
(e.g. rod(s), tape etc)
................................ ................................ ................................ Ω
Main Protective Conductors
Earthing conductor: material ........................... csa ............................mm2 connection verified

Main protective bonding

conductors material ........................... csa ............................mm2 connection verified

To incoming water and/or gas service To other elements ........................................................………………………………….

Main Switch or Circuit-breaker
BS, Type ................................... No. of poles .............. Current rating ............A Voltage rating ..................V
Location ................................................................. Fuse rating or setting .............A
(Applicable only where an RCD is suitable
Rated residual operating current IΔn = .......... mA, and operating time of ....... ms (at IΔn) and is used as a main circuit-breaker.)

(In the case of an alteration or additions see Section 633)

COMMENTS ON EXISTING INSTALLATION:
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SCHEDULES (note 2)
The attached Schedules are part of this document and this Certificate is valid only when they are attached to it.
............ Schedules of Inspections and ............ Schedules of Test Results are attached.
(Enter quantities of schedules attached).

GUIDANCE FOR RECIPIENTS

This safety Certificate has been issued to confirm that the electrical installation work to which it relates has been designed, constructed, inspected and tested in accordance with
British Standard 7671 (The IEE Wiring Regulations).

You should have received an original Certificate and the contractor should have retained a duplicate Certificate. If you were the person ordering the work, but not the owner of the
installation, you should pass this Certificate, or a full copy of it including the schedules, immediately to the owner.

The "original" Certificate should be retained in a safe place and be shown to any person inspecting or undertaking further work on the electrical installation in the future. If you
later vacate the property, this Certificate will demonstrate to the new owner that the electrical installation complied with the requirements of British Standard 7671 at the time the
Certificate was issued. The Construction (Design and Management) Regulations require that for a project covered by those Regulations, a copy of this Certificate, together with
schedules is included in the project health and safety documentation.

For safety reasons, the electrical installation will need to be inspected at appropriate intervals by a competent person. The maximum time interval recommended before the next
inspection is stated on Page 1 under "Next Inspection".

This Certificate is intended to be issued only for a new electrical installation or for new work associated with an addition or alteration or to an existing installation. It should not
have been issued for the inspection of an existing electrical installation. A "Periodic Inspection Report" should be issued for such an inspection.

The Certificate is only valid if a Schedule of Inspections and Schedule of Test Results are appended.

Page 2 of (note 5)