SUPPLIER CERTIFICATE OF CONFORMANCE Purchase order Line Item No (s) Data Part Number Revision Quantity Purchase Description & Serial No (s) Lot Data Lot No(s) Serial Sampling Inspection Sampling Plan Data Yes No ACL Sampling Reference Specification: Data Country of Origin Specification CERTIFICATION I do hereby certify that the products and/or services listed above are of the quality specified and conform to all requirements of the purchase Order, including: Quality Control Clauses, Design specifications, drawings, preservation, packaging, packing, marking, and physical identification requirements. Company Name Address City State Zip Data Name & Title Of Company Quality Representative Supplier (Please Print Or Type Name & Title) Signature Of Company Quality Representative Date CF 6-193B
SUPPLIER CERTIFICATE OF CONFORMANCE Purchase Data Purchase order Line Item No (s) Part Number Revision Quantity Description Serial & Lot Data Serial No (s) Lot No(s) Sampling Data Sampling Inspection Sampling Plan Yes No ACL Specification Data Reference Specification: Country of Origin CERTIFICATION I do hereby certify that the products and/or services listed above are of the quality specified and conform to all requirements of the purchase Order, including: Quality Control Clauses, Design specifications, drawings, preservation, packaging, packing, marking, and physical identification requirements. Supplier Data Company Name Address City State Zip Name & Title Of Company Quality Representative (Please Print Or Type Name & Title) Signature Of Company Quality Representative Date CF 6-193B
CF%206-193_0.docx