零件提交保证书(100120).xlsVIP

PSW 安全和/或政府法规： 日期： 城市 （若为“否”请解释） 这些结果满足所有图纸和规范要求： 声明： 解释/说明： 印刷体姓名： 电话： 传真： 零件名称： 图纸号： 采购订单号： 重量 (kg)： 提交顾客信息： 供应商名称/供应商代码 顾客名称/部门 街道地址 采购员/采购员代码 邮编 提交原因（至少选择一项）： 首次提交 工程设计更改 工装：转移、代替、整修或添加 工装停止使用期超过一年 其他－－请说明 要求的提交等级（选择一项）： 等级 1 - 只向顾客提交保证书（若指定为外观项目，还应该提交外观件批准报告） 等级 2 - 向顾客提交保证书及产品样品以及有限的支持数据 提交结果： 结果： 材料和功能试验 外观标准 统计过程数据 通过IMDS或其它顾客规定格式提交： 工程更改等级： 经授权的供方代表签字： 顾客拥有的工装是否都已适当地加标签和编号： 供方制造场所信息： 适用范围 Part Name Cust. Part Number Shown on Drawing Number Orig. Part Number Engineering Change Level Dated Additional Engineering Changes Organization Name Supplier/Vendor Code Street Address City Region Postal Code Country Application ORGANIZATION MANUFACTURING INFORMATION CUSTOMER SUBMITTAL INFORMATION MATERIALS REPORTING Are polymeric parts identified with appropriate ISO marking codes? REASON FOR SUBMISSION (Check at least one) Tooling: Transfer, Replacement, Refurbishment, or additional Initial submission Engineering Change(s) Tooling Inactive than 1 year Correction of Discrepancy Change in Part Processing Parts produced at Additional Location REQUESTED SUBMISSION LEVEL (Check one) Level 1 - Warrant only (and for designated appearance items, an Appearance Approval Report) submitted to 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 4 - Warrant and other requirements as defined by customer. Level 5 - Warrant with product samples and complete supporting data reviewed at organizations manufacturing location. SUBMISSION RESULTS Safety and/or Government Regulation Purchase Order No. Weight (kg) Submitted by IMDS or other customer format: The results for These results meet all design record requirements: Mold / Cavity / Production Process DECLARATION I affirm that the samples represented by this warrant are representative of our parts, which were made by a process that meets all Production Part Approval Process M