Nbic Form R 2 PDF Details

Creating a successful business is no easy feat, and taking the necessary steps for compliance with international standards can add to that challenge. One such step may be completing an Nbic Form R 2. This document sets forth the requirements for any business seeking licensure from the National Board of Insurance Commissioners (NBIC). To help guide you through this process, this blog post will discuss what an Nbic Form R 2 is, why it’s important, and how to complete one so that your business can become compliant with regulations and get off on the right foot.

QuestionAnswer
Form NameNbic Form R 2
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesform r 2, nbic r2 form, nbic forms, national board r2 form

Form Preview Example

Form R-2 Report of Alteration

in accordance with provisions of the National Board Inspection Code

(Form “R” Registration no.)

(P.O. No., Job No., etc.)

1a. Design performed by:

 

 

 

 

 

 

(name of “R” organization responsible for design)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(address)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1b. Construction performed by:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(name of “R” organization responsible for construction)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(address)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

Owner of Pressure Retaining Item:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(name)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(address)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

Location of Installation:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(name)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(address)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.

Item identiication:

 

 

 

 

 

 

 

Name of original manufacturer:

 

 

 

 

 

 

 

 

 

 

(boiler, pressure vessel, or piping)

 

 

 

 

 

 

 

 

 

 

 

 

 

5.

Identifying nos:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(mfg. serial no.)

 

 

 

(National Board No.)

(Jurisdiction No.)

 

 

 

 

(other)

 

 

(year built)

6.

NBIC Edition / Addenda:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(edition)

 

 

 

(addenda)

 

 

 

 

 

Original Code of Construction for Item:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(name / section / division)

 

 

 

 

 

 

 

(edition / addenda)

 

Construction Code Used for Alteration Performed:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(name / section / division)

 

 

 

 

 

 

(edition / addenda)

7a. Description of Design Scope:

Form R -4, Report Supplementary Sheet is attached

7b. Description of Construction Scope:

Form R -4, Report Supplementary Sheet is attached

Pressure Test, if applied

 

psi

MAWP

 

psi

8.Replacement Parts. Attached are Manufacturer’s Partial Data Reports or Form R-3’s properly completed for the following items of this report:

(name of part, item number, data report type or Certiicate of Compliance, mfg’s. name and identifying stamp)

NB-229, Rev. 6, (03/25/13)

FORM R-2 BACK

9. Remarks:

 

 

 

 

 

 

Design CeRtiFiCAtion

I,

 

 

 

 

, certify that to the best of my knowledge and belief the statements in this report are correct and that

the Design Change described in this report conforms to the National Board Inspection Code.

National Board “R” Certiicate of Authorization No.

 

 

 

expires on

 

 

Date

 

 

 

 

 

Signed

 

 

 

 

 

 

(name of design organization)

 

 

(authorized representative)

 

 

 

 

CeRtiFiCAte oF Design ChAnge Review

I,

 

, holding a valid Commission issued by The National Board of Boiler and Pressure Vessel

Inspectors and certiicate of competency, where required, issued by the jurisdiction of

 

and employed by

 

 

 

of

 

 

have reviewed the design change as described in

this report and state that to the best of my knowledge and belief such change complies with the applicable requirements of the National

Board Inspection Code.

By signing this certiicate, neither the undersigned nor my employer makes any warranty, expressed or implied, concerning the work described in this report. Furthermore, neither the undersigned nor my employer shall be liable in any manner for any personal injury,

 

property damage or loss of any kind arising from or connected with this inspection.

 

 

 

Date

 

 

 

 

Signed

 

 

 

 

 

 

Commissions

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(inspector)

 

 

 

 

 

(National Board and jurisdiction no.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ConstRuCtion CeRtiFiCAtion

 

 

 

I,

 

 

 

 

 

 

 

 

, certify that to the best of my knowledge and belief the statements in this report are

 

 

 

correct and that all material, construction, and workmanship on this Alteration conforms to the National Board Inspection Code.

 

 

National Board “R” Certiicate of Authorization No.

 

 

 

 

expires on

 

 

 

 

Date

 

 

 

 

 

 

 

 

 

 

 

Signed

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(name of alteration organization)

 

 

(authorized representative)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CeRtiFiCAte oF inspeCtion

 

 

 

I,

 

 

 

 

 

 

 

,holding a valid Commission issued by The National Board of Boiler and Pressure

 

 

 

Vessel Inspectors and certiicate of competency, where required, issued by the jurisdiction of

 

 

and employed

 

 

by

 

 

 

 

 

 

 

 

of

 

 

 

 

 

 

 

 

have inspected the work described

 

 

in this report on

 

 

 

 

 

 

and state that to the best of my knowledge and belief this work complies with the applicable

 

requirements of the National Board Inspection Code.

By signing this certiicate, neither the undersigned nor my employer makes any warranty, expressed or implied, concerning the work described in this report. Furthermore, neither the undersigned nor my employer shall be liable in any manner for any personal injury,

property damage or loss of any kind arising from or connected with this inspection.

Date

 

Signed

 

Commissions

 

 

 

 

(inspector)

 

(National Board and jurisdiction no.)

NB-229, Rev. 6, (03/25/13)

How to Edit Nbic Form R 2 Online for Free

You are able to complete nbic forms effortlessly with the help of our online PDF editor. The tool is constantly improved by our staff, receiving powerful functions and turning out to be more versatile. All it requires is just a few basic steps:

Step 1: Hit the "Get Form" button at the top of this webpage to open our PDF tool.

Step 2: With the help of our state-of-the-art PDF editor, you may do more than merely fill out forms. Express yourself and make your docs look great with custom textual content put in, or modify the file's original input to perfection - all supported by an ability to incorporate your own pictures and sign it off.

As a way to complete this form, make sure that you enter the right details in each and every field:

1. To get started, when filling out the nbic forms, beging with the part that includes the subsequent blanks:

Stage number 1 in completing form r 2

2. Now that the last section is complete, you're ready add the needed particulars in Identifying nos, mfg serial no, NBIC Edition Addenda, National Board No, Jurisdiction No, other year built, edition, addenda, Original Code of Construction for, name section division, edition addenda, Construction Code Used for, name section division, edition addenda, and a Description of Design Scope so you're able to move on to the next step.

Part number 2 of filling out form r 2

3. This next part will be straightforward - fill out all the form fields in Form R Report Supplementary Sheet, Pressure Test if applied, psi, MAWP, psi, Replacement Parts Attached are, completed for the following items, name of part item number data, and NB Rev in order to finish the current step.

Stage number 3 of submitting form r 2

4. The following subsection needs your details in the subsequent parts: Remarks, Design CeRtiFiCAtion, I the Design Change described in, Signed, expires on, certify that to the best of my, name of design organization, CeRtiFiCAte oF Design ChAnge Review, I Inspectors and certiicate of, holding a valid Commission issued, and employed by, and have reviewed the design change as. Be sure you provide all of the needed info to go onward.

form r 2 completion process clarified (portion 4)

5. To finish your document, this last subsection features some extra fields. Filling in have reviewed the design change as, Commissions, Signed, inspector, National Board and jurisdiction no, ConstRuCtion CeRtiFiCAtion, I correct and that all material, certify that to the best of my, expires on, Signed, name of alteration organization, CeRtiFiCAte oF inspeCtion, holding a valid Commission issued, I Vessel Inspectors and certiicate, and and state that to the best of my is going to conclude everything and you will be done before you know it!

Completing part 5 of form r 2

As to certify that to the best of my and Commissions, ensure that you take a second look in this section. The two of these are considered the key fields in the PDF.

Step 3: Right after taking another look at the filled out blanks, press "Done" and you're all set! Go for a free trial subscription with us and get instant access to nbic forms - with all transformations kept and accessible inside your FormsPal account page. FormsPal is devoted to the privacy of all our users; we make sure all personal data coming through our editor remains secure.

Nbic Form R 2 isn’t the one you’re looking for?

Related Documents