BUREAU VERITAS CONSUMER PRODUCTS SERVICES FOR LABORATORY USE ONLY

Plot #130, Dhaka Export Processing Zone Extension Area, Ganakbari, Savar, Dhaka, DATE RECEIVED:
Bangladesh. REVIEWED BY:
Tel:88-02-7789464-6 DUE DATE:
Fax:88-02-7789463 REPORT NO:
Email:Bvcps.CustomerService@bd.bureauveritas.com

LEVI'S TEST REQUEST FORM (FABRIC & GARMENT TEST)

TRF Number TRF003059562

APPLICANT INFORMATION
Company: SILVER COMPOSITE TEXTILE MILLS LTD (UNIT 3 TEXTILE)

Address: MIRZAPUR, GAZIPUR SADAR

Contact Person: RAMESHBABU GOWRISHANKAR Email Address: rameshbabu.rnd@silverglobalfashion.com

Tel No: 029852881 Fax No: 029880606

SERVICE REQUIRED:
REGULAR (5 working days) EXPRESS (40% SURCHARGE) (3 working days) EMERGENCY (100% SURCHARGE) (2 working days)

(Turn around time exclude day of sample receipt. For some test services, it may be subjected to special test nature) * = Mandatory
SUBMITTER INFORMATION
*Applicant Name: RAMESHBABU GOWRISHANKAR/MD. TOUHIDUZZAMAN

*Company Name: SILVER COMPOSITE TEXTILE MILLS LTD (UNIT 3 TEXTILE)

Address: B.K Bari, Taltoly, Monipur, MIRZAPUR, GAZIPUR SADAR

*Country: BANGLADESH
Zip Code:
*Phone: 029852881 Fax: 029880606
*E-mail: rameshbabu.rnd@silverglobalfashion.com,touhid.lab@silverglobalfashion.com

*Email Addresses For Test Completion (for report receipt) (Email addresses to be separated with COMMA)
touhid.lab@silverglobalfashion.com, alamin.mkt3@silverglobalfashion.com, rameshbabu.rnd@silverglobalfashion.com, nazrul.lab@silverglobalfashion.com,
karthikeyan.hoqa3@silverglobalfashion.com, shahriar.mkt3@silverglobalfashion.com,esheta.development@silverglobalfashion.com,jayanto.chemist@silverglobalfashion.com

INVOICE INFORMATION
*Invoice To submitter: YES NO Pls Specify payer company:

*Invoice Contact Email: rameshbabu.rnd@silverglobalfashion.com,touhid.lab@silverglobalfashion.com

*Invoice Contact Name: RAMESHBABU GOWRISHANKAR/MD. TOUHIDUZZAMAN

*Invoice Contact Phone: 029852881

MARKET INFORMATION
Finish Product Export to ( Market ) *:

Global (All countries includes China)

Global (excludes China)

Include India Include Turkey

Include Indonesia Include Saudi Arabia

Include India and Include Indonesia NA

Page 1 of 5
TEST STANDARD & METHODS / PROGRAM NAME
Primary Test Standard:
Supplementary Test Standard:
RSL - Pls specify accessories / Screen Print from

Centrally Source
Not Centrally Source (Contractor Source) (pls specify)
Screen Print previous report no.

SUPPLIER INFORMATION
*Supplier Type: Direct Contractor

Agent (Name & Location):

Country: -

Region:

SUBMISSION INFORMATION
Submitted Date: 04-Feb-2022
*Sample Description: SSR 221462, 16X12/116X58,PEACH,TWILL

*Full Test: YES NO

Additional RSL Test: YES NO

(Refer to RSL Manual)

*Test Type: Commercial Samples

*Re-test: NO Yes ( If yes , Please advise previous report no.)

*Any Reference/ Previous Report related to this application: NA

Requisition Remarks/ Special Request:

Return Retained Sample To Applicant: YES No

*Test Group: Fabric

*Test Nature: FABRIC GARMENT SUNDRIES ACCESSORIES

Corduroy Fabric Corduroy Garment Care Label Packaging Bags Gloves
Denim Fabric Denim Garment Graphic Prints Pocketing Belts Shawl
Knit Fabric Knit Garment Heat Transfer Snaps Caps Suspenders
Leather Fabric Leather Garment Hoop & Loop Fasteners Sticker Scarves Underwear
Non-Denim Garment Shoes Miscellaneous
Non-Denim Fabric Labels, Badges & Patches Stretch Inserts, Elastics, Internal Textile Trims
Non-Woven Fabric Outerwear Garment Lining Tapes, Drawstring, External Trims Hats
Sweater Metal Buttons Thread Socks
Non-Woven Garment Metal Hardware Waistband (Pre-constructed) Face coverings
Non-Metal Buttons Jewelry
Zipper
Non-Metal Hardwares Bodywear

*Consumer Group: Men's

*Brand: Dockers

*End Use: Bottoms (Shorts)

*Season: 2022 H2

*No. of Sample (Set): 1

Stretch Properties: NO

Size: 3YDS

FA Code:
Test Group Category: OTHER

Page 2 of 5
MAIN INFORMATION (For Fabric and Garment only)
*Fabric Mill (Name): Silver Composite Textile Mills Ltd.

Other Fabric Mill (Name):

*Fabric Mill Country: BANGLADESH

Fabric Mill Region: SAS

*Mill Style (only alphanumeric, no space, no symbols): SLG6008PGPTG

*Purchase Fabric Weight (oz/sq.yd ): 8.4

*Fabric Type (pls select the appropriate one): Twill

Fabric Weight After 3HL (oz/sq.yd) (for denim only):

Fabric Finish (including Performance Claims, can select multiple): Peached

Other Fabric Finish Details:

*Fabric Stretch Center point: NA

*Fabric Dimensional Stability Center point: Warp: 0.0 to -4.00%, Weft: -4.00%

*Fiber Content (Integer- no decimal place)

Product Component % Fibre name % Fibre name % Fibre name % Fibre name
Main 100 Cotton - - -

- - - - -

- - - - -

- - - - -

- - - - -

*Dye Type (e.g., indigo/sulphur/reactive/pigment etc.): Reactive

*Print Type (Pigment / Reactive print): Discharge Print

*Dyeing Method: Yarn Dye

Piece (fabric )Dye
Garment Dye
Garment Over Dye
Ready for Dyeing (RFD/PFD)
Others: Base Reactive +Discharge Print

FABRIC SUBMISSION (including lining or pocketing)

Fabric Color Name: D34703 VELOSO TWILL OTTER

Shipment Yardage/Unit: 50 Kgs Meters Pieces Yards

*Fabric PO Number: SPO 2717

Remark for Fabric Submission:

Page 3 of 5
GARMENT SUBMISSION
*Garment Vendor: -

Other Garment Vendor Name:

(input when Garment Vendor is chosen “other vendor”)

*Garment Vendor Country: -

Garment Vendor Region:

Garment Weight (For Sweater Only):

*Garment Color Name:

*Garment Finish Category: Rigid Rinse Others Bleach & Local Abrasion Destructed

*Garment Finish Details (e.g enzyme wash, stone wash, type of bleaching, etc)

*Finish Name:

*Product Code (9 digits, in format #####-####):

*Product Style (5 digits):

FFC/C (must 5 or 6 characters):

*PO Number (Garment):

*PO Quantity (Garment):

*Country of Origin: -

Remark for Garment Submission:

SUNDRIES SUBMISSION (excluding lining or pocketing)

*Sundry Supplier: -

Other Sundry Supplier Name:

*Sundry Item Location/Country: -

Sundry Item Region:

Material Code:
*Sundry Reference Code:

*Sundry Color Name:

Remark for Sundries Submission:

ACCESSORIES SUBMISSION
*Accessories Supplier: -

Other Accessories Supplier Name:

*Accessories Supplier Country: -

Accessories Supplier Region:

Accessories Style No:
Remark for Accessories Submission:

Page 4 of 5
COMPETITIVE SUBMISSION
*Study Name:

*Competitor Brand:

Remark for Competitive Submission:

RESTRICTED SUBSTANCE LIST (RSL) TESTING SUBMISSION

(A)RESTRICTED SUBSTANCE LIST (RSL) TESTING PACKAGE (Material Type)

Please select the appropriate test package(s)
Test package, method & requirement will base on Levis RSL Manual with corresponding version (can select multiple)

Natural textile Synthetic textile Natural & Synthetic textile Natural leather
Synthetic leather PU coated Natural Leather Resin / Easy Care Finish Tinted Finish

Overdye Coating Non-metallic Embellishment & Trims Metallic Embellishment & Trims
Jewelry Plastisol/ Glitter/ Puff / Foil/ Digital/ Graphic prints Water-based Prints Flock prints
Heat Transfer Foam Plastics (including soles)
Others (write in attribute):

(B)RESTRICTED SUBSTANCE LIST (RSL) TESTING ITEMS

Please select the appropriate test item(s): * only certain test parameter
Test method & Requirement will base on Levis RSL Manual with corresponding version (can select multiple)

Aromatic amines Disperse dyes Other dyes Isocyanate Phthalates

APs & APEOs Formaldehyde Organotins Total Lead Total Cadmium
Chromium (VI) Nickel Release Chlorinated Paraffins PCP/Tecp/TriCP Dimethylfumarate (DMFu)
Metals Extractable Heavy Metal N,N-Dimethylformanide PAH
Others (pls specify):

Date: 04-Feb-2022 Authorized Signature and Company Chop:

Page 5 of 5
All services of Bureau Veritas Consumer Products Services Division are strictly offered, and can only be accepted, under the CPS Conditions of Service. Any party that requests said services, confirms said services,
or makes any payment for said services does so agreeing automatically that: (a) it irrevocably accepts and agrees to the CPS Conditions of Service; (b) it waives all rights to change or challenge the CPS Conditions
of Service; and (c) the CPS Conditions of Service are final and, unless expressly agreed otherwise by Bureau Veritas, any additional conditions sought to be imposed on any service or payment shall be invalid. The
CPS Conditions of Service can be accessed through this link:

https://www.cps.bureauveritas.com/terms-conditions

I ACCEPTED CPS TERMS AND CONDITIONS OF SERVICE.

rameshbabu.rnd@silverglobalfashion.com (RAMESHBABU GOWRISHANKAR)
Order Reference : TRF003059562
Date & Time : 04-02-2022 04:13:28