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1、Part Submission WarrantPart NameCust. Part NumberShown on Drawing No.Org. Part NumberEngineering Change Level DatedAdditional Engineering Changes DatedSafety and/or Government RegulationPurchase Order No. Weight (kg)Checking Aid No.Checking Aid Engineering Change LevelDatedORGANIZATION MANUFACTURING
2、 INFORMATIONCUSTOMER SUBMITTAL INFORMATIONOrganization Name & Supplier/Vendor CodeCustomer Name/Division Street AddressBuyer/Buyer Code CityRegionPostal CodeCountryApplicationMATERIALS REPORTINGHas customer-required Substances of Concern information been reported?Submitted by IMDS or other custo
3、mer format:Are polymeric parts identified with appropriate ISO marking codes?REASON FOR SUBMISSION(Check at least one)REQUESTED SUBMISSION LEVEL (Check one)SUBMISSION RESULTSThe results forThese results meet all drawing and specification requirements: (If NO - Explanation Required)Mold / Cavity / Pr
4、oduction ProcessDECLARATIONI hereby affirm that the samples represented by this warrant are representative of our parts which were made by a process that meets all Production PartApproval Process Manual 4th Edition Requirements. I further affirm that these samples were produced at the production rat
5、e of /hours.I also certify that documented evidence of such compliance is on file and available for review. I have noted any deviations from the declaration below.EXPLANATION/COMMENTS:Is each Customer Tool properly tagged and numbered?Organization Authorized SignatureDatePrint NamePhone No.Fax No.Ti
6、tleE-mailFOR CUSTOMER USE ONLY (IF APPLICABLE)Part Warrant Disposition:Customer SignatureDatePrint NameCustomer Tracking Number (optional)March2006CFG-1001YesNoYesNon/aInitial SubmissionTooling: Transfer, Replacement, Refurbishment, or additionalTooling Inactive than 1 yearChange to Optional Constru
7、ction or MaterialEngineering Change(s)Correction of DiscrepancySupplier or Material Source ChangeChange in Part ProcessingOther - please specify belowParts Produced at Additional Location Level 1 - Warrant only (and for designated appearance items, an Appearance Approval Report) submitted to custome
8、r. Level 4 - Warrant and other requirements as defined by customer. Level 2 - Warrant with product samples and limited supporting data submitted to customer. Level 3 - Warrant with product samples and complete supporting data submitted to customer. Level 5 - Warrant with product samples and complete
9、 supporting data reviewed at organizations manufacturing location.Yes dimensional measurementsmaterial and functional testsappearance criteriastatistical process packageYesNoYesNon/aApprovedRejectedOtherYesNon/aPart Submission WarrantP art N am eP art N um berSaf ety and/orGovernm ent R egulationE n
10、gineering D raw ing C hange LevelD atedAdditional E ngineering C hangesD atedShow n on D raw ing N o.P urchase Order N o.Weight (kg)C hecking Aid N o.E ngineering C hange LevelD atedSU PPLIE R MAN U FACTU R IN G IN FOR MATIONSU B MISSION IN FOR MATIONSupplier Nam e & Supplier CodeC ustom er N am
11、 e/D ivisionBuyer/Buyer C odeSt reet A ddressApplicationCit ySt at eZipN ote:D oes this part contain any restricted or reportable substancesAre plastic parts identified w ith appropriate ISO m arking codesR E ASON FOR SU B MISSIONR E QU E STE D SU B MISSION LE VE L (Check one)SU B MISSION R E SU LTS
12、The results fo r dimensio nal measurements material and functio nal tests appearance criteria statistical pro cess packageThese results meet all drawing and specificatio n requirements: (I f N O - E xplanation R equired)M old / C avity / P roduction P rocessD E CLAR ATIONI hereby affirm that the sam
13、ples represented by this warrant are representative o f o ur parts, have been made to the applicableP ro ductio n P art A ppro val P ro cess M anual 3rd Editio n Requirements. I further warrant these samples werepro duced at the pro ductio n rate o f / 8 ho urs. I have no ted any deviatio ns fro m t
14、his declaratio n belo w.E XP LAN ATI ON /C OM M E N TS: Dim ensionalMaterials/FunctionalAppearanceInitial Subm issionEngineering Change(s)Tooling: Transfer,Replacem ent, Refurbishm ent or additionalCorrection of DiscrepancyTooling Inactive 1 yearChange to Optional Construction or MaterialSub-Supplie
15、r or Material Source ChangeChange in Part ProcessingPart Produced at Additional LocationOther - Please specifyLevel 1 - Warrant only (and for designated appearance item s, an Appearance Approval Report) subm itted to custom er.Level 2 - Warrant with product sam ples and lim ited supporting data subm itted to custom er.Level 3 - Warrant with product sam ples and com plete supportin
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