Part Submission Warrant

Part Name TWO POST LIFT (400 SERIES LIFT)

Part Submission Warrant
Cust. Part Number LP60026
Shown on Drawing No. Org. Part Number

Engineering Change Level REV P Dated 9-Apr-20

Part Name
Additional Engineering Changes N/A Part Number Dated

Safety and/or
Safety and/or Government Regulation Ye
s
✘ No
Purchase Order No. N/A Weight (kg) 730 KG
Checking Aid No. N/A Checking Aid Engineering Change Level N/A Dated
Government Regulation Engineering Draw ing Change Level Dated
ORGANIZATION MANUFACTURING INFORMATION CUSTOMER SUBMITTAL INFORMATION
Additional Engineering Changes Dated
TECNORAMPA S.A. de C.V. DOVER
Show n on Draw ing No.
Organization Name & Supplier/Vendor Code Customer Name/Division Weight (kg)
Checking Aid No.
AUTOPISTA MEXICO-QRO. KM 175+494 Engineering Change Level Dated
Street Address Buyer/Buyer Code

SUPPLIER MANUFACTURING INFORMATION

QUERETARRO, PEDRO ESCOBEDO, CP76729
City Region Postal Code Country Application
SUBMISSION INFORMATION
MATERIALS REPORTING
Has customer-required Substances of Concern information been reported?
Dimensional
✘ No
n/
a
Submitted by IMDS or other customer forma N/A
Supplier Name & Supplier Code
Customer Name/Division
Are polymeric parts identified with appropriate ISO marking codes? n/
✘ No
a
REASON FOR SUBMISSIO (Check at least one)
Change to Optional Construction or
✘ Initial Submission
Material Buyer/Buyer Code
Engineering Change(s) Supplier or Material Source Change
Street Address
Tooling: Transfer, Replacement, Refurbishment, or
Change in Part Processing
additional Parts Produced at Additional
Correction of Discrepancy
Location
Tooling Inactive > than 1 year Application
Other - please specify below
City State
REQUESTED SUBMISSION LEVEL (Check one)
Zip
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
Note: Does this part contain any restricted or reportable substances
✘
customer.
Level 4 - Warrant and other requirements as defined by
customer.
Level 5 - Warrant with product samples and complete supporting data reviewed at organization's
manufacturing
SUBMISSION Are plastic parts identified with appropriate ISO marking codes
location.
RESULTS
The results for dimensional ✘
material and functional appearance statistical process
These results meet allmeasurements tests
drawing and specification requirements: Ye criteria
(If "NO" package
- Explanation Required)
No
Mold / Cavity / Production Proces s
REASON FOR SUBMISSION
DECLARATION
I hereby 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 Manual 4th Edition Requirements. I further affirm that these samples were produced at the production rate / 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? ✘ Yes No n/a

Organization Authorized Signature Date

Print Name Phone No. Fax No.

REQUESTED SUBMISSION LEVEL (Check one)

Title E-mail
FOR CUSTOMER USE ONLY (IF APPLICABLE)
Part Warrant Disposition: Approve
d Rejected Other

Customer Signature Date

Print Name Customer Tracking Number (optional)

March
2006 CFG-1001
 Part Submission Warrant

Part Name TWO POST LIFT (400 SERIES LIFT)

Part Submission Warrant
Cust. Part Number LP60026
Shown on Drawing No. Org. Part Number

Engineering Change Level REV P Dated 9-Apr-20

Part Name
Additional Engineering Changes Part Number Dated

Safety and/or
Safety and/or Government Regulation Ye
s
No
Purchase Order No. Weight (kg)
Checking Aid No. Checking Aid Engineering Change Level Dated
Government Regulation Engineering Draw ing Change Level Dated
ORGANIZATION MANUFACTURING INFORMATION CUSTOMER SUBMITTAL INFORMATION
Additional Engineering Changes Dated
Show n on Draw ing No.
Organization Name & Supplier/Vendor Code Customer Name/Division Weight (kg)
Checking Aid No. Engineering Change Level Dated
Street Address Buyer/Buyer Code

SUPPLIERRegion
City
MANUFACTURING INFORMATION
Postal Code Country Application
SUBMISSION INFORMATION
MATERIALS REPORTING
Has customer-required Substances of Concern information been reported? Ye
s
Dimensional
No
n/
a
Submitted by IMDS or other customer forma
Supplier Name & Supplier Code
Customer Name/Division
Are polymeric parts identified with appropriate ISO marking codes?
Ye n/
s No
a
REASON FOR SUBMISSIO (Check at least one)
Change to Optional Construction or
Initial Submission Buyer/Buyer Code
Material
Engineering Change(s) Supplier or Material Source Change
Street Address
Tooling: Transfer, Replacement, Refurbishment, or
Change in Part Processing
additional Parts Produced at Additional
Correction of Discrepancy
Location
Tooling Inactive > than 1 year Application
Other - please specify below
City State
REQUESTED SUBMISSION LEVEL (Check one)
Zip
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
Note:
customer. Does this part contain any restricted or reportable substances
Level 4 - Warrant and other requirements as defined by
customer.
Level 5 - Warrant with product samples and complete supporting data reviewed at organization's
manufacturing
SUBMISSION Are plastic parts identified with appropriate ISO marking codes
location.
RESULTS
The results for dimensional material and functional appearance statistical process
These results meet allmeasurements tests
drawing and specification requirements:Ye criteria
(If "NO" package
- Explanation Required)
No
Mold / Cavity / Production Proces s
REASON FOR SUBMISSION
DECLARATION
I hereby 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 Manual 4th Edition Requirements. I further affirm that these samples were produced at the production rate / 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? ✘ Yes No n/a

Organization Authorized Signature Date

Print Name Phone No. Fax No.

REQUESTED SUBMISSION LEVEL (Check one)

Title E-mail
FOR CUSTOMER USE ONLY (IF APPLICABLE)
Part Warrant Disposition: Approve
d Rejected Other

Customer Signature Date

Print Name Customer Tracking Number (optional)

March
2006 CFG-1001