EU DECLARATION OF CONFORMITY

No. DECL-000067 Rev. G om Ron 9ti EU DECLARATION OF CONFORMITY 1. Product Models/Products: Mat Controller Models: MC3. MC4 to be used with Safety Mats (UM Series): UM. UMM. UMQ. UMMQ (black) UMY. UMYM. UMYQ. UMMYQ (yellow) 2. Name and address of the manufacturer: OMRON Scientific Technologies Incorporated 6550 Dumbarton Circle. Fremont. CA 94555-3605. U.S.A 3. This Declaration of Conformity is issued under the sole responsibility of the manufacturer. 4. Objects of the declaration: Pressure Sensitive Protective Devices to detect the presence of persons - consisting of a Safety Mat Controller in conjunction with universal pressure sensitive safety mats. Not suitable for the detection of children 5. The objects of the declaration described above are in conformity with the relevant Union harmonization legislation: Machinery Directive 2006/42/EC. EMC Directive 2014/30/EU. RoHS Directive 2011/65/EC (on MC3 only) 6. References to the relevant harmonized standards used or references to the other technical specifications in relation to which conformity is declared: Machinery Directive: EN ISO 13856-1 :2013, EN 62061 :2005+AC:201 O+A 1 :2013+A2:2015. EN ISO 13849-1 :2015. IEC 61508, Parts 1-7:2010. EN 50178:1997. EN 60204-1 :2006+A 1 :2009+AC:201 0 (in extracts) 7. Name, address, and identification number of Notified Body, Number of EC Type Examination Machinery Directive: Notified body: TUV Rheinland lndustrie Service GmbH Address: Alboinstr. 56. 12103 Berlin/Germany Notified Body identification No. :0035 Certificate for EU Type Examination: Registration No.: 01/205/0676.01/15 plus "TUV Rhineland Statement about the further validity of certificates" by Martin Kiontke. 2017-05-29 112

No. DECL-000067 Rev. G Signed and on behalf of: OMRON Scientific Technologies Incorporated Place of issue: Fremonl, CA, 94555, USA Date of issue: ::r: f ~ Signature: \~e<~~ C ~ Name: Vanessa Chen Function: Quality Manager, OMRON Scientific Technologies Incorporated ::>--I ' ~ I r Name and address of contact in EU OMRON Europe B.V. Quality & Environment Department Attn : J.J.P.W. Vogelaar, European Quality & Environment Manager Zilverenberg 2, 5234 GM, 's-hertogenbosch, The Netherlands 2/2

EC Type-Examination Certificate Reg.-No.: 01/205/0676.01/15 Product tested Pressure Sensitive Protective Certificate holder Devices to detect the presence of persons consisting of Safety Mat Controller in conjunction with universal pressure sensitive safety mats Type designation Mat Controllers: MC3, MC4 Safety Mats: UM, UMM, UMQ, UMMQ Codes and standards EN ISO 13856-1:2013 EN 62061 :2005 + AC:201 0 + A1 :2013 EN ISO 13849-1 :2008 + AC:2009 Intended application The mat controllers comply with the requirements of the relevant standards (Cat. 3/ PL dace. to EN ISO 13849-1, SIL CL2 ace. to EN 62061 /IEC 61508). They can be used in combination with the safety mats in applications up to PL dace. to EN ISO 13849-1 and SIL 2 ace. to EN 62061 / IEC 61508. Specific requirements The instructions of the associated Installation and Operating Manual shall be considered. Not suitable for the detection of children. OMRON Scientific Technologies, Inc. 6550 Dumbarton Circle Fremont, CA 94555-3605 USA IEC 61508 Parts 1-7:2010 EN 50178:1997 EN 60204-1 :2006 + A 1:2009 + AC:201 0 (in extracts) It is confirmed that the product under test complies with the requirements for machines defined in Annex I of the EC Directive 2006/42/EC. Valid until2020-05-12 Berlin, 2015-05-12 Dipl.-lng. Eberhard Frejno www.fs-products.com www.tuv.com /;;;!.. TUVRheinland Precisely Right.

TÜV Rheinland Industrie Service GmbH Postfach, 51101 Köln OMRON Scientific Technologies Inc. Mr. Doug Barnett 6550 Dumbarton Circle Fremont, CA 94555-3605 United States of America Martin Kiontke Kst. 968 / ki-nie Tel. +49/221/806-4506 Fax +49/221/806-1539 Mail martin.kiontke@de.tuv.com Web: www.tuv.com 2017-05-29 Statement about the further validity of certificates Dear Mr. Barnett, The presumption of conformity of the EN ISO 13849-1:2008 with its Annex AC:2009, as well as EN 62061:2005 + AC:2010 + A1:2013 as harmonized standards under the European Machinery Directive have been expired. These standards are superseded by new editions EN ISO 13849-1:2015 and EN 62061:2005 + AC:2010 + A1:2013 + A2:2015, whose status as harmonized standards under the Machinery Directive have become effective. On the following actually still valid certificates for type approved and certified products of the company OMRON Scientific Technologies Inc. the EN ISO 13849-1:2008 + AC:2009 and EN 62061:2005 + AC2010 + A1:2013 are listed as standards forming the basis for the examination and certification: Safety Light Curtains Certificate No. MS4800 Series 01/205/0705.01/15 PA4600 Series 01/205/0733.01/16 Safety Mat Controller Certificate No. MC-3, MC-4 01/205/0676.01/15 Safety Laser Scanner Certificate No. OS32C Series 01/205/5005.02/14 We performed a comparison of the requirements in the new EN ISO 13849-1:2015 / EN 62061:2005 + AC:2010 + A1:2013 + A2:2015 with the requirements in the previous editions. This comparison came to the conclusion that the certified products meet the requirements of the new edition EN ISO 13849-1:2015 as well as EN 62061:2005 + AC:2010 + A1:2013 + A2:2015. The modifications in these standards do not have any impact on the design of the devices and the requested tests for the assessment of conformity. These certified products further meet the essential safety and health requirements of Annex A1 of the Machinery Directive. A re-issue of the certificates is considered as not necessary at this context. The certificates will be updated within the next assessment of modifications and new products versions respectively latest when the validity of the certificates is going to expire. Best regards Automation - Functional Safety Business Unit FS Products TÜV Rheinland Industrie Service GmbH Am Grauen Stein 51105 Köln Geschäftsführung: Dirk Fenske i. A. Dipl.-Ing. Martin Kiontke Aufsichtsratsvorsitzender Dr. Michael Fübi Köln HRB 26876 www.tuv.com

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Supplier's declaration of conformity No. DECL-000147 Rev. A om Ron As required by the following Notices: > Radiocommunications (Compliance Labelling- Devices) Notice 2014 made under section 182 of the Radiocommunications Act 1992; > Radiocommunications Labelling (Electromagnetic Compatibility) Notice 2008 made under section 182 of the Radiocommunications Act 1992 > Radiocommunications (Compliance Labelling- Electromagnetic Radiation) Notice 2014 made under section 182 of the Radiocommunications Act 1992 and > Telecommunications (Labelling Notice for Customer Equipment and Customer Cabling) Instrument 2015 made under section 407 of the Telecommunications Act 1997. Supplier's details (manufacturer, importer or authorised agent) OMRON ELECTRONICS Ply. Ltd. Manufacturer: OMRON Scientific Technologies Incorporated UNIT 6, 108 SILVERWATER ROAD SILVERWATER SYDNEY NSW 2128 AUSTRALIA Phone: 61-2-9878-6377 6550 Dumbarton Circle, Fremont, CA 94555-3605, U.S.A ABN: 46 003 259 390 Product details MC3 Mat Controller to be used with Safety Mats (UM Series), Pressure Sensitive Protective Devices to detect the presence of personsconsisting of a Safety Mat Controller in conjunction with universal pressure sensitive safety mats. Not suitable for the detection of children Compliance- applicable standards and other supporting documents Applicable standards: IEC 61 000-6-3:2006+A1 :2010 (part of EN ISO 13856-1: 2013) Test Reports: TUV Rhineland Technical Report No.: 968/M 102.02/15 (Reference EMT Test Labs "EMC Report Test Data File: 150415C1") for EU Type Examination Certificate: Registration No.: 01/205/0676.01/15 Declaration I hereby declare that: 1. I am authorised to make this declaration on behalf of the Companies mentioned above, 2. the contents of this form are true and correct, and 3. the product mentioned above complies with the applicable above mentioned standards and all products supplied under this declaration will be identical to the product identified above. Signature p{ }a/~ Name: Hideaki Takiguchi Position in organisation: Industrial Automation Company, Safety Division, General Manager Date: rfo. 9iJf..26 I 7_ Additional information: N/A Page 1 of 1 IAB-SSG-024

Certificate of Compliance Certificate: 1165614 Master Contract: 156365 (LR 90200) Project: 70041145 Date Issued: 2015-09-30 Issued to: OMRON Scientific Technologies Inc 6550 Dumbarton Cir Fremont, California 94555-3605 USA The products listed below are eligible to bear the CSA Mark shown with adjacent indicators 'C' and 'US' for Canada and US or with adjacent indicator 'US' for US only or without either indicator for Canada only. Issued by: Dan Petrulian Dan Petrulian PRODUCTS CLASS - C321107 - INDUSTRIAL CONTROL EQUIPMENT-Miscellaneous Apparatus CLASS - C321187 - INDUSTRIAL CONTROL EQUIPMENT-Miscellaneous Apparatus - Certified to US Standards PART A: Safety Mat Controller/Power Supply, Models SMC-2-120, SMC-2-230, SMC-2-24, SMC-1-24, and Pressure Sensitive Mat-Switch to be used as Floor-Level Guarding System, rated 115 V ac/ 100 ma, 230 V ac/50 ma, 50/60 Hz, or 24 V dc/250 ma, 6 VA. PART B: PART C: PART D: Safety Mat Controller, Model designation MC3, DIN-rail mount, rated 24 V dc, 0.092 A, 2.2 VA max. Power consumption, suitable for use with ELV presence sensing/pressure sensitive mat. Safety Mat Controller, Model designation MC4, wall-mount, steel enclosure, rated 100-240 V ac, 0.2 A, 50/60 Hz or 24 V dc, 3 W, suitable for use with ELV presence sensing/pressure sensitive mat. Safety Mat Controller, Model designation MC6, wall-mount, steel enclosure, rated for universal input 100 V ac to 240 V ac, 20 VA, 50/60 Hz or 24 V dc, 2.0 A, suitable for use with ELV presence sensing/pressure sensitive mat. DQD 507 Rev. 2012-05-22 Page 1

Certificate: 1165614 Project: 70041145 Master Contract: 156365 Date Issued: 2015-09-30 Notes: PART A: 1. Numbers in the model designation SMC-X-XXX denotes the following: First X: 1= 35 mm Din Box. 2= Nema 12 rated steel enclosure Second XXX: 120= 120 V ac, 230= 230 V ac, 24= 24 V dc 2. The above certification covers electrical safety only. PARTS B, C AND D: 1. Safety Mat Controller model designation MC3, MC4 and MC6 are certified as components where the suitability of combination is to be determined by the end use application. 2. Maximum rating for relay outputs contact on safety Mat Controller Model MC4 is 250 V ac, 6 A max. 3. Maximum rating for relay outputs contact (K1 & K2) on safety Mat Controller Model MC6 is 250 V ac, 7 A and maximum relay output contact (K3) on safety Mat Controller Model MC6 is 120 V ac, 0.6 A. 4. The above certification covers electrical safety only. APPLICABLE REQUIREMENTS CAN/CSA-C22.2 No 14 (12 th Edition) - Industrial Control Equipment UL 508 (17 th Edition) - Industrial Control Equipment DQD 507 Rev. 2012-05-22 Page 2

Supplement to Certificate of Compliance Certificate: 1165614 Master Contract: 156365 The products listed, including the latest revision described below, are eligible to be marked in accordance with the referenced Certificate. Project Date Description Product Certification History 70041145 2015-09-30 Update Report 1165614 to correct class 3211-07 / 3211-87. 1881507 2007-02-16 Update report 1165614 to Include Company Name Change. 1795923 2006-05-31 Update report 1165614 to change model MC4 ratings to 100-240 Vac, 0.2 A, 50/60 Hz or 24 Vdc, 3 W (C/US) History 1437917 2003-05-14 Update to change the input voltage rating of Model MC6. 1288491 2002-02-06 Update to include 24 V dc version of the controller Models MC4 and MC6. 1165614 2001-02-01 Original Certification. (Reissue Report LR 90200-14 and update to include model MC6). DQD 507 Rev. 2012-05-22 Page 1

OMRON AUTOMATION AND SAFETY THE AMERICAS HEADQUARTERS Chicago, IL USA 847.843.7900 800.556.6766 www.omron247.com OMRON CANADA, INC. HEAD OFFICE Toronto, ON, Canada 416.286.6465 866.986.6766 www.omron247.com OMRON ELECTRONICS DE MEXICO HEAD OFFICE México DF 52.55.59.01.43.00 01-800-226-6766 mela@omron.com OMRON ELECTRONICS DE MEXICO SALES OFFICE Apodaca, N.L. 52.81.11.56.99.20 01-800-226-6766 mela@omron.com OMRON ARGENTINA SALES OFFICE Cono Sur 54.11.4783.5300 OMRON CHILE SALES OFFICE Santiago 56.9.9917.3920 OTHER OMRON LATIN AMERICA SALES 54.11.4783.5300 OMRON ELETRÔNICA DO BRASIL LTDA HEAD OFFICE São Paulo, SP, Brasil 55.11.2101.6300 www.omron.com.br OMRON EUROPE B.V. Wegalaan 67-69, NL-2132 JD, Hoofddorp, The Netherlands. +31 (0) 23 568 13 00 www.industrial.omron.eu Authorized Distributor: Automation Control Systems Machine Automation Controllers (MAC) Programmable Controllers (PLC) Operator interfaces (HMI) Distributed I/O Software Drives & Motion Controls Servo & AC Drives Motion Controllers & Encoders Temperature & Process Controllers Single and Multi-loop Controllers Sensors & Vision Proximity Sensors Photoelectric Sensors Fiber-Optic Sensors Amplified Photomicrosensors Measurement Sensors Ultrasonic Sensors Vision Sensors Industrial Components RFID/Code Readers Relays Pushbuttons & Indicators Limit and Basic Switches Timers Counters Metering Devices Power Supplies Safety Laser Scanners Safety Mats Edges and Bumpers Programmable Safety Controllers Light Curtains Safety Relays Safety Interlock Switches J89I-E-01 11/14 Note: Specifications are subject to change. 2014 Omron Electronics LLC Printed in U.S.A. Printed on recycled paper.