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DAIMLERCHRYSLER Part Submission Warrant

Part Name Cust. Part Number

Shown on Drawing No. Org. Part Number

7/5/2021
Engineering Change Level Dated 6/23/2021

Additional Engineering Changes Dated N/A

Safety and/or Government Regulation ✘ Yes No Purchase Order No. N/A Weight (kg) 0.4500

Checking Aid No. N/A Checking Aid Engineering Change Level N/A Dated N/A

ORGANIZATION MANUFACTURING INFORMATION CUSTOMER SUBMITTAL INFORMATION

Eaton Industries S. de R.L. de C.V. Eaton Automotive Components Sp. z o.o., Tczew, Polska
Organization Name & Supplier / Vendor Code Customer Name/Division

Mike Allen #500. Reynosa Industrial Park


Reynosa, Mx. Karol Stopa
Street Address Buyer/Buyer Code

Reynosa Tam. 88780 Mx. 965/0 Tonale


City Region Postal Code Country Application

MATERIALS REPORTING
Has customer-required Substances of Concern Information been reported? ✘ YES NO n/a

Submitted by IMDS or other customer format:

Are polymetric parts identified with appropriate ISO marking codes? YES ✘ NO N/A

REASON FOR SUBMISSION (Check at least one)


Initial Submission Change to Optional Construction or Material
✘ Engineering Change (s) Sub-Supplier or Material Source Change
Tooling: Transfer, Replacement, Refurbishment, or additional Change in Part Processing
Correction of Discrepancy Parts produced at Additional Location
Tooling Inactive > than 1 year Other - please specify below

REQUESTED 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 define by customer.
Level 5 - Warrant with product samples and complete supporting data reviewed at organization's manufacturing location.

SUBMISSION RESULTS
The results for ✘ dimensional measurements ✘ material and functional tests appearance criteria ✘ statistical process package
These results meet all design records requirements: ✘ YES NO (If "NO" - Explanation Required)
Mold / Cavity / Production Process Assembly Process

DECLARATION
I affirm that the samples represented by this warrant are representative of our parts 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 of 4,800 pcs / 8 hours. I also certify that documented evidence of such compliance is on file and
available for review. I have noted any deviations from this declaration below.

EXPLANATION/COMMENTS:

Is each Customer Tool properly tagged and numbered? YES NO ✘ n/a


Organization Authorized Signature Date 03/30/2022

Print Name Phone No. Fax No. N/A


Title APQP Engineer E-mail

FOR CUSTOMER USE ONLY (IF APPLICABLE)


Part Warrant Disposition: Approved Rejected Other
Customer Signature Date

Print Name Customer Tracking Number (Optional)

SFF-7.3.6.3-002 REV.A SFWI-7.3.6-002


SEP 11, 2006 TIEMPO DE RETENCION: TODA LA VIDA DEL PRODUCTO MAS 1 AÑO

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