Application for Participation - National Flood Barrier Testing and Certification Program

National Flood Barrier Testing & Certification Program

This application for services is participation in the National Flood Barrier Testing and Certification Program managed by the Association of State Floodplain Managers, along with its partners FM Approvals, and the US Army Corps of Engineers. Testing (separate agreement and fee) will be scheduled upon receipt of application fee by the ASFPM.

Date *

Manufacturer Information

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Manufacturer Name *

Location Address (1) *

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Location Address (2)

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Manufacturer Technical Contact Information

Technical POC (TPOC)

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Manufacturer Billing Contact Information

Billing POC (PBOC)

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Testing/Certification Requested

Total Amount

$ 0.00

Consent to Share Certification & Testing Information

By entering into the testing and certification program, the manufacturer consents to share all submitted documentation and test results with FM Approvals, the ASFPM, and the US Army Corps of Engineers. It is understood and agreed to by the manufacturer that the results of all water related tests will be contained within a database maintained by the ASFPM and routinely posted on the program’s web site, nationalfloodbarrier.org.

Please sign below to indicate that this consent is understood.

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Date *