25 Years System Warranty Registration Form

							                                              XHIBIT H

                            25 Years System Warranty Registration Form

From the warranty administrator:

Many thanks for installing an AMP NETCONNECT Open Cabling System. Please furnish all
information requested in this registration form. Before sending, please read the criteria for
registration found in your NDI information package. Furnishing the right and complete information
will reduce the process time for this application

Section A: ND&I Company Detail
              ND&I Number:
            Company Name:
                   Address:

Section B: Customer Detail
           Company Name:
         Company Address:
           Project Address:
                   Country:
   Customer Contact Name:
              Position/Title:
     Phone/Mobile Number:
             email address:
        Type Of Installation:      new    move    add , warranty certificate no:
         Type Of Warranty:         25 Year System Warranty    25 Year Component Warranty

Section C: Support Materials
(Put all soft copy file in to CD-ROM/DVD) and specific file name or folder name for each subject.
        AMP ACT Certificate:       yes   no   file/folder name :
               Bill of Material:   yes   no   file/folder name :
        Floor Layout (Outlet):     yes   no   file/folder name :
      Intra-Building Diagram:      yes   no   file/folder name :
      Inter-Building Diagram:      yes   no   file/folder name :
   Inter-Building Geography:       yes   no   file/folder name :
Inter/Intra Length Summary:        yes   no   file/folder name :
          Rack Arrangement:        yes   no   file/folder name :
   Port Summary each floor:        yes   no   file/folder name :

Section D: Test & Certification Document
The attached test documentation is 100% of the “certifiable” Links or Channel as described in the
attached “as built”. All ports are confirmed as meet the performance requirements described in the
current ANSI TIA/EIA-568C or ISO/IEC 11801 premises cabling standards
            Copper Tester: Please Select Brand, Model Other:
          Software version:
       RAW test report file:  yes    no file/folder name :
       OTDR Fiber Tester: Brand:         Model:
          Software version:
       RAW test report file:  yes    no file/folder name :
 Power Meter Fiber Tester: Brand:        Model:
          Software version:
       RAW test report file:  yes    no file/folder name :
Software to open report file:


Rev B, 2011
                                               XHIBIT H

                          25 Years System Warranty Registration Form

Section E: ND&I Registre Installation Personnel
The AMP ACT II accredited “Installation Supervisor” whose signature appears below confirms that
no less than 50% of the installation staff used to install this System was AMP ACT I accredited staff
employed by the NDI company
                    ND&I Installer Name:                                   AMP ACT Certificate No
1.
2.
3.
4.
5.
6.
7.
8.
9.

                                Installation Supervisor for This Project
           Supervisor Name:
              Position/Title:
                       Date:

                   Signature:




     -   Please indicate the date and revision number of the Warranted Parts Number List
         (AMP No. 114-44002) Date: 10 DEC 98 Rev-B
     -   All discs provided must be CD/DVD Rom for windows, application software used for creating
         files must be for DOS or Windows



Rev B, 2011