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Part Submission Warrant

Part Name Customer Part Number Engineering Drawing Change Level Rev. If applicable Tool PO Number Additional Engineering Changes Shown on Drawing Number Checking Aid Number Purchase Order No. Engineering Change Level SUBMISSION INFORMATION Dated Dated Weight (kg) Dated

ORGANIZATION MANUFACTURING INFORMATION

Organization name and Code

Customer Name/Division

Street Address

Customer Contact

City Note:

State

Zip

Application

Does this part contain any restricted or reportable substances? Are plastic parts identified with appropriate ISO marking codes?

Yes Yes

No No

REASON FOR SUBMISSION (check at least one) Initial submission Engineering Change(s) Tooling: Transfer, Replacement, Refurbishment, or additional Correction of Discrepancy Tooling inactive > than 1 year 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. 1 (check) Level 5 - Warrant with product samples and complete supporting data reviewed at supplier's manufacturing location. DECLARATION I affirm that the samples represented by this warrant are representative of our parts and have been made to the applicable customer drawings and specifications and are made from specified materials on regular production tooling with no operations other than the regular production process. I also certify that documented evidence of such compliance is on file and available for review. EXPLANATION/COMMENTS 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Change to Optional Construction or Material Sub-Supplier or Material Source Change Change in Part Processing Parts produced at Additional Location Other - please specify below

List Molds / Cavities / Production Processes Organization Authorized Signature Print Name Title Phone No. e-mail Fax Date

FOR CUSTOMER USE ONLY PPAP Warrant Disposition:

Approved Rejected Interim Approval
Date

Comment:

Customer Signature Print Name

Volvo PSW 4th Edition PPAP

Application: 17. I also certify that documented evidence of such compliance is on file and available for review. Refurbishment. Shown on Drawing N ORGANIZATION MANUFACTURING INFORMATION SUBMISSION INFORMATION 12 Organization name and Code Customer Name/Division 14 13 Street Address Customer Contact 15 Purchase Order Num Part weight: Checking Aid No: Checking Aid's Eng 16 City Note: State Zip Application ORGANIZATION MANUF 12. The responsible supp 21 List Molds / Cavities / Production Processes Organization Authorized Signature Print Name Title 22 Phone No.please specify below 15. Tool Purchase Orde 5. Organization Name 13.Part Submission Warrant Part Name Completion of the Part Su Rev. Part Name: 2. DECLARATION I affirm that the samples represented by this warrant are representative of our parts and have been made to the applicable customer drawings and specifications and are made from specified materials on regular production tooling with no operations other than the regular production process. 9. Level 2 . Contact Name: 16.Warrant with product samples and complete supporting data reviewed at supplier's manufacturing location. Part Revision Level: 4. Organization Manuf Yes No No Does this part contain any restricted or reportable substances? 17 Are plastic parts identified with appropriate ISO marking codes? REASON FOR SUBMISSION (check at least one) Initial submission Engineering Change(s) Tooling: Transfer. Level 3 . Explanation/Comme 20 21. Customer Name/ Div Yes 18 Change to Optional Construction or Material Sub-Supplier or Material Source Change Change in Part Processing Parts produced at Additional Location Other . Replacement. 10. EXPLANATION/COMMENTS 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 DECLARATION 20. 8 11 Weight (kg) Dated 9 Additional Engineer 7. Check the appropria REASON FOR SUBMISS 18. 8. Identify the submiss Level 1 .Warrant only (and for designated appearance items. 1 (check) Level 5 . 1 Customer Part Number Engineering Drawing Change Level 2 3 If applicable Tool PO Number 4 5 Dated Dated Additional Engineering Changes Shown on Drawing Number Checking Aid Number 6 7 10 Purchase Order No. e-mail Fax Date FOR CUSTOMER USE O Leave blank FOR CUSTOMER USE ONLY PPAP Warrant Disposition: Approved Rejected Interim Approval Date Comment: Customer Signature Print Name .Warrant with product samples and limited supporting data submitted to customer. Customer Part Num 3. Level 4 . 11. Enter the number or c 22. or additional Correction of Discrepancy Tooling inactive > than 1 year SUBMISSION LEVEL (Check one) SUBMISSION INFORMAT 14. Check the appropria 19 REQUESTED SUBMISSI 19. Engineering Drawin 6.Warrant with product samples and complete supporting data submitted to customer. an Appearance Approval Report) submitted to customer. Engineering Change Level PART INFORMATION 1.Warrant and other requirements as defined by customer.

vehicle name. Material. Identify the submission level requested by your customer. transmission. (Volvo PVR number. and/or production process used to manufacture the sa mple parts. Application: Enter the model year. Performance Test Results. Control Plan. If not otherwise agreed Volvo request level 4. additional information may be attached as appropriate. 13. Add explanatory details in the "other" section. Checking Aid No: Enter the checking aid number. Volvo 3P. Shown on Drawing Number: The design record that specifies the customer part number being submitted. 18. (Supplier Name and Volvo supplier No. 9. 10.Completion of the Part Submission Warrant PART INFORMATION 1. Contact Name: Enter the name of your customer contact. Tool Purchase Order Number: if applicable. after verifying that the results show conformance to all customer requirements and th at all required documentation is available shall approve the declaration and provide Title. 11. Mandatory for Volv o Powertrain. REQUESTED SUBMISSION LEVEL 19. The minimum required mandatory documents are: 6. 17. etc. (Volvo SQA and/or Volvo purchaser.RTS). Enter the number or code that identifies the specific mold. Part Revision Level: if applicable.) 15.) 16. Additional Engineering Changes: Include all authorized engineering change documents and approval dates not yet incorporated on the drawing but which are incorporated in the part. Part weight: Enter the actual weight in kilograms to four significant places. 9. Process FMEA. 7. Purchase Order Number: Enter this number as found on the purchase order. Email Address. 22. Phone Number. ORGANIZATION MANUFACTURING INFORMATION 12. (Volvo purchasing company. 17. REASON FOR SUBMISSION 18. Customer Part Number(s): Engineering released finished end item part number. Customer Name/ Division: Show the corporate name and division or operations group. Part Submission Warrant (PSW). 21. etc.g. Appearance Approval Report (if applicable).) 4.) 8. Check the appropriate box to indicate Substances of Concern (Volvo black list STD 1009. or engine. Part Name: Engineering released finished end item part name. FOR CUSTOMER USE ONLY Leave blank .) 6.1)/ISO marking reporting. 10. 5. All other documents shall be submitted to Volvo upon request. (Volvo drawing No. Dimensional Results including Marked Drawing. Check the appropriate box. Explanation/Comments: Provide any explanatory details on the submission results. and Fax Number. Organization Name and Code: Show the code assigned to the manufacturing location on the purchase order. The responsible supplier official. (See Volvo Part Version Report. if one is used for dimensional inspection. (Volvo drawing issue. Engineering Drawing Change Level & Approval Date: Show change level and date for submission. DECLARATION 20. e. see PVR and drawing. Organization Manufacturing Address: Show the complete address of the location where the product was manufactured. (Volvo PVR Version. 7. SUBMISSION INFORMATION 14. Records of Compliance with Volvo Specific Requirements (Review of Technical Specification .) 2.) 13. Check the submission items if a level 4 is requested. Checking Aid's Engineering Change Level and Approval Date. Volvo Powertrain. see PVR and drawing. cavity.) 3.

Records of Compliance with Volvo Specific Requirements (RTS). Check the submission items if a level 4 is requested. Contact Name: Enter the name of your customer contact. Checking Aid No: Enter the checking aid number.) 4. Add explanatory details in the "other" section.) 15. see PVR and drawing. vehicle name. Mandatory for Volvo Powertrain. (See Volvo Part Version Report.) 13. Control Plan. All other documents shall be submitted to Volvo upon request. Organization Name and Code: Show the code assigned to the manufacturing location on the purchase order. Customer Part Number(s): Engineering released finished end item part number. (Volvo PVR number. Identify the submission level requested by your customer. REQUESTED SUBMISSION LEVEL 19. (Volvo SQA and/or Volvo purchaser. Additional Engineering Changes: Include all authorized engineering change documents and approval dates not yet incorporated on the drawing but which are incorporated in the part. (Volvo PVR Version. The minimum required mandatory documents are: 6. 7. if one is used for dimensional inspection. Customer Name/ Division: Show the corporate name and division or operations group. 13. (Volvo purchasing company. . Shown on Drawing Number: The design record that specifies the customer part number being submitted.) 16. (Supplier Name and Volvo supplier No. 17. SUBMISSION INFORMATION 14. Part Revision Level: if applicable.1)/ISO marking reporting. or engine. REASON FOR SUBMISSION 18.g. Check the appropriate box to indicate Substances of Concern (Volvo black list STD 1009. (Volvo drawing No.) 3.) 6. 9. Part Name: Engineering released finished end item part name. Checking Aid's Engineering Change Level and Approval Date. ORGANIZATION Manufacturing Address: Show the complete address of the location where the product was manufactured. 18. ORGANIZATION MANUFACTURING INFORMATION 12. Tool Purchase Order Number: if applicable. etc. Material. Part weight: Enter the actual weight in kilograms to four significant places. Dimensional Results including Marked Drawing. 7. Part Submission Warrant (PSW). 11. Process FMEA. (Volvo drawing issue. see PVR and drawing. Application: Enter the model year. Appearance Approval Report (if applicable). transmission. Check the appropriate box.New 4th Edition PSW Completion Instruction Wording Appendix A Completion of the Part Submission Warrant PART INFORMATION 1. e. Purchase Order Number: Enter this number as found on the purchase order. If not otherwise agreed Volvo request level 4.) 2. Performance Test Results. Engineering Drawing Change Level & Approval Date: Show change level and date for submission.) 8. 10. 5. 17. 10. Volvo Powertrain. Volvo 3P. 9. etc.

after verifying that the results show conformance to all customer requirements and that all required documentation is available shall approve the declaration and provide Title. Enter the number or code that identifies the specific mold. additional information may be attached as appropriate. 21. FOR CUSTOMER USE ONLY Leave blank . cavity. Phone Number. Email Address. Explanation/Comments: Provide any explanatory details on the submission results. The responsible supplier official. 22. and/or production process used to manufacture the sample parts.DECLARATION 20. and Fax Number.

DATE AUTHORIZED CUSTOMER REPRESENTATIVE SIGNATURE DATE March 2006 CFG-1002 .APPEARANCE APPROVAL REPORT PART NUMBER PART NAME ORGANIZATION NAME REASON FOR SUBMISSION PART SUBMISSION WARRANT PRE TEXTURE DRAWING NUMBER BUYER CODE MANUFACTURING LOCATION SPECIAL SAMPLE FIRST PRODUCTION SHIPMENT RE-SUBMISSION ENGINEERING CHANGE E/C LEVEL APPLICATION (VEHICLES) DATE SUPPLIER/VENDOR CODE OTHER APPEARANCE EVALUATION ORGANIZATION SOURCING AND TEXTURE INFORMATION PRE-TEXTURE EVALUATION CORRECT AND PROCEED CORRECT AND RESUBMIT APPROVED TO ETCH/TOOL/EDM AUTHORIZED CUSTOMER REPRESENTATIVE SIGNATURE AND DATE COLOR EVALUATION TRISTIMULUS DATA Da* Db* DE* CMC HUE RED YEL GRN BLU COLOR SUFFIX DL* MASTER NUMBER MASTER DATE MATERIAL MATERIAL TYPE SOURCE VALUE LIGHT DARK CHROMA GRAY CLEAN GLOSS HIGH LOW METALLIC BRILLIANCE HIGH LOW COLOR SHIPPING SUFFIX PART DISPOSITION COMMENTS ORGANIZATION SIGNATURE PHONE NO.

DATE AUTHORIZED CUSTOMER REPRESENTATIVE SIGNATURE 25 DATE March 2006 CFG-1002 .APPEARANCE APPROVAL REPORT PART NUMBER PART NAME ORGANIZATION NAME REASON FOR SUBMISSION 1 4 8 PART SUBMISSION WARRANT PRE TEXTURE DRAWING NUMBER BUYER CODE MANUFACTURING LOCATION SPECIAL SAMPLE FIRST PRODUCTION SHIPMENT 2 5 9 RE-SUBMISSION ENGINEERING CHANGE E/C LEVEL APPLICATION (VEHICLES) 3 6/7 DATE SUPPLIER/VENDOR CODE OTHER 10 11 APPEARANCE EVALUATION ORGANIZATION SOURCING AND TEXTURE INFORMATION 12 PRE-TEXTURE EVALUATION CORRECT AND PROCEED CORRECT AND RESUBMIT APPROVED TO ETCH/TOOL/EDM 13 AUTHORIZED CUSTOMER REPRESENTATIVE SIGNATURE AND DATE COLOR EVALUATION 14 COLOR SUFFIX DL* 21 20 METALLIC BRILLIANCE HIGH LOW 22 PART DISPOSITION 15 TRISTIMULUS DATA Da* Db* DE* CMC 16 MASTER NUMBER 17 MASTER DATE 18 19 HUE RED YEL GRN BLU MATERIAL MATERIAL TYPE SOURCE VALUE LIGHT DARK CHROMA GRAY CLEAN GLOSS HIGH LOW COLOR SHIPPING SUFFIX COMMENTS 23 ORGANIZATION SIGNATURE 24 PHONE NO.

Pre-Texture Evaluation: To be completed by authorized customer representative (not used by GM). Part Disposition: To be determined by customer (approved or rejected). Value. Authorized Customer Representative Signature & Date: Authorized Customer Representative approval signature. Comments: General comments by the organization or customer (optional). 5. Reason for submission: Check box(es) explaining the reason for this submission. Chroma.. paint/ABS). Material Source: Identify first surface and substrate suppliers. 24./7. Application: Enter the model year(s) and vehicle or other program on which the part is used. E/C Level & Date: Engineering change level and E/C date for this submission. & Date: Organization certification that the document information is accurate and meets all requirements specified. 12. 25.Appendix B Report 1. THE AREAS INSIDE THE BOLD LINES ARE FOR CUSTOMER USE ONLY. 16. 21. graining source(s).g. Color Suffix: Use alphanumeric or numeric color identification Tristimulus Data: List numerical (colorimeter) data of submission part as compared to the customer-authorized master. 14. 18. Buyer Code: Enter the code for specific buyer or part. Organization Signature. 23. 17. 9. 15. 8. Master Date: Enter the date on which the master was approved. Part Name: Use the finished part name on the part drawing. grain type(s). 19. 2. 4. Color Evaluation. Phone No. 10. Organization Name: Organization responsible for submission (include supplier if available). Hue. 13. . Drawing Number: Use the number of the drawing on which the part is shown if different from the part number. 6. 11. Supplier/Vendor Code: Customer-assigned code for organization location where the part was manufactured or assembled. 22. Gloss and Metallic Brilliance: Visual assessment by customer Color Shipping Suffix: Color part number suffix or color number. 3. Master Number: Enter alphanumeric master identification (not used by Ford). - Completion of the Appearance Approval Customer part number: Engineering released customer part number. Example: Redspot/Dow. Material Type: identify first surface finish and substrate (e. and grain and gloss masters used to check part. Organization Sourcing & Texture Information: List all first surface tools. Manufacturing Location: Location where part was manufactured or assembled. 20.

Appendix C Results - Production Part Approval. Production Part Approval Dimensional Test Results Dimensional ORGANIZATION: SUPPLIER/VENDOR CODE: INSPECTION FACILITY: PART NUMBER: PART NAME: DESIGN RECORD CHANGE LEVEL: ENGINEERING CHANGE DOCUMENTS: ITEM DIMENSION / SPECIFICATION SPECIFICATION / LIMITS TEST QTY. DATE TESTED ORGANIZATION MEASUREMENT RESULTS (DATA) OK NOT OK Blanket statements of conformance are unacceptable for any test results. March 2006 CFG-1003 SIGNATURE TITLE DATE .

/ REV / DATE OK Blanket statements of conformance are unacceptable for any test results. DATE TESTED PART NUMBER: PART NAME: DESIGN RECORD CHANGE LEVEL: ENGINEERING CHANGE DOCUMENTS: NAME OF LABORATORY: SUPPLIER TEST RESULTS (DATA) NOT OK MATERIAL SPEC.Appendix D Results - Production Part Approval. NO. include the supplier (Source) & Customer assigned code SPECIFICATION / LIMITS TEST QTY. March 2006 CFG-1004 SIGNATURE TITLE DATE . Production Part Approval Material Test Results Material Test ORGANIZATION: SUPPLIER/VENDOR CODE: MATERIAL SUPPLIER: *CUSTOMER SPECIFIED SUPPLIER/VENDOR CODE: *If source approval is req'd.

DATE TESTED PART NUMBER: PART NAME: DESIGN RECORD CHANGE LEVEL: ENGINEERING CHANGE DOCUMENTS: TEST SPECIFICATION / REV / DATE SUPPLIER TEST RESULTS (DATA) / TEST CONDITIONS OK NOT OK Blanket statements of conformance are unacceptable for any test results. Production Part Approval Performance Test Results Performance Test ORGANIZATION: SUPPLIER/VENDOR CODE: NAME OFLABORATORY: *CUSTOMER SPECIFIED SUPPLIER/VENDOR CODE: *If source approval is req'd.Appendix E Results - Production Part Approval. March 2006 CFG-1005 SIGNATURE TITLE DATE . include the supplier (Source) & Customer assigned code SPECIFICATION / LIMITS TEST QTY.