Compliance Statement

For Contract _____________

This statement certi es that Haining Huanjin Plastics Co., Ltd uses the materials in
manufacturing that comply with the material and workmanship requirements and
regulations. Furthermore, it certi es that Haining Huanjin Plastics Co., Ltd products
have undergone local material safety, physical, or chemical tests. These test
requirements are part of the speci cations, that the manufacturer has performed
the necessary quality control to substantiate this certi cation.

Material Description:

Manufacturer: _________________

Model: ________________________

Serial number (if applicable): _______________

Quantity to be supplied: ____________

Signed by: _____________

Company: _____________

Date: __________________
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