PPAPSubmissionWarrantPARTINFORMATIONPartNameCust.PartNumberShownonDrawingNumberOrganizationPartNumberEngineeringChangeLevelDatedAdditionalEngineeringChangesDatedSafetyand/orGovernmentRegulationPurchaseOrderNo.Weight(kg)CheckingAidNumberCheckingAidEngineeringChangeLevelDatedORGANIZATIONMANUFACTURINGINFORMATIONCUSTOMERSUBMITTALINFORMATIONOrganizationNameandSupplier/vendorCodeCustomerName/DivisionStreetAddressBuyer/BuyerCodeCityRegionPostalcodeCountryApplicationMATERIALSREPORTINGHascustomer-requiredSubstancesofConcerninformationbeenreported?SubmittedbyIMDSorothercustomerformat:IfsubmittedbyIMDS,enterModuleIDnumber,versionanddatetransmittedArepolymericpartsidentifiedwithappropriateISOmarkingcodes?REASONFORSUBMISSION(Checkatleastone)REQUESTEDSUBMISSIONLEVEL(Checkone)Level2-Warrantwithproductsamplesandlimitedsupportingdatasubmittedtocustomer.Level4-Warrantandotherrequirementsasdefinedbycustomer.SUBMISSIONRESULTSTheresultsforTheseresultsmeetalldesignrequirementsMold/Cavity/ProductionProcess(es)DECLARATIONIaffirmthatthesamplesrepresentedbythiswarrantarerepresentativeofourpartswhichweremadebyaprocesswhichmeetsallProductionPartApprovalProcessManual4thEditionrequirementsincludingallFord-specificrequirements.Ifurtheraffirmthatthesesampleswereproducedattheproductionrateof__________/_______hoursusing_________productionstreams.Ialsocertifythatdocumentedevidenceofsuchcomplianceisonfileandisavailableforreview.Ihavenotedanyexceptionsfromthisdeclarationbelow.EXPLANATION/COMMENTSOrganizationAuthorizedSignaturePrintNameDateInitialToolOrderWebQuoteTitlePhoneNo.Fax:EmailCPA(CommercialandProgramAgreement)SAL(SourcingAgreementLetter)IseachCustomerToolproperlytaggedandnumbered?Other(specifyindetailatright)CapacityRequirementsSourceoftheProgramApprovalrequirementsDetail/DateProgramApproval(
)RequirementsAPWMPWIfProgramApproval()requirementsarenotmet,indicatedatewhentherequirementswillbemetDateAmendedorsubsequentToolOrderWebQuoteSourceoftherevisedrequirementsafterDetail/DateCPA(CommercialandProgramAgreement)RevisedrequirementsafterAPWMPWSAL(SourcingAgreementLetter)Iftherevisedrequirementsafterarenotmet,indicatedatewhentherequirementswillbemetDateOther(specifyindetailatright)DemonstratedCapacity(recordedinFordCapacitySystem(GCPorMCPV)asPurchasedPartCapacity)EnterCapacityAnalysisReport"PredictedGoodPartsperWeek"APW,MPWanddateAPWMPWDateInterimStatus(tobecompletedbytheOrganization)InterimStatus(tobecompletedbytheOrganization)FORFORDUSEONLYPPAP.Non-PPAPa/.PhasedPPAPWarrantStatus:InterimAcceptedEngineeringAuthorizationAlertorAlertReportSTASignature.Namee-mailDateP.D.Signature.NameDescription:(IncompletePPAPRequirements)e-mailDatea/Non-PPAPindicatesthepartdoesnotsatisfyoneormorePPAPrequirementsandisincompleteFordGPPSS1October2010Theoriginalcopyofthisdocumentshallremainatthesupplier'slocationwhilethepartisactiveA4papersizeformatCustomerTrackingNumber(optional)Instructions:1Allfieldsofthisformaretobecompleted:eitherentertheappropriatevalueorenter"notapplicable"2Completetheformbyeithertyping(preferred)orclearlyprintingtherequiredinformation.零件提交保证书(PSW)零件信息零件名顾客零件号图纸所示件号供应商零件号工程变更等级日期其他工程变更日期安全和/或政府法规项采购订单号重量(kg)检具编号检具工程变更等级日期供应商制造现场信息顾客信息供应商名称及供应商代码顾客名称/部门街道地址采购/采购代码国家省城市邮编是否适用材料
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报告如果是通过IMDS报告提交,输入报告ID号码/版本/版本日期塑胶件是否已标注相应的ISO标注编码?提交原因（至少选一项）要求的提交等级(选择一项)等级2—向顾客提交保证书及产品样品以及有限的支持数据等级4—保证书及顾客规定的其它要求提交结果结果:这些结果满足所有设计要求成形模/多腔模/生产过程声明我声明：随本保证书提交的样品能代
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我们的零件，其生产过程满足生产件批准程序手册第四版本的所有要求及福特特殊要求。同时，我保证这些样品是___条生产线以_____件/___小时的生产节拍制造的。此外，我确认符合以上要求的证明性文件都已妥善归档，以供评审。与以上声明有偏差的内容如下：解释/说明：授权的供应商代表签名印刷体签名日期初始工装订单WebQuote职务电话号码传真邮箱CPA(商务和项目
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)顾客的每件工装模具都已按要求贴上标签并编号？其它（请在右边详细说明）产能要求项目批准要求的来源细节/日期项目批准()的要求APWMPW如果项目批准()的产能要求未满足，说明将满足的日期日期修改的或后续的工装订单WebQuote后产能要求修改的来源细节/日期CPA(商务和项目协议)后修改的产能要求APWMPWSAL(选点协议书)如果后修改的产能要求未满足，说明将满足的日期日期其它（请在右边详细说明）展示的产能(作为采购的零件产能记录在福特产能系统GCP或MCPV中)输入产能分报告"预测每周良品"APW,MPW及日期APWMPW日期InterimStatus(tobecompletedbytheOrganization)临时状态(由供应商完成)仅供福特使用PPAP.PPAP-拒绝a/.阶段性PPAP提交结果:拒绝临时接受工程授权Alert或Alert报告STA签名.姓名邮箱日期P.D.签名.姓名描述:(未完成的PPAP要求)邮箱Datea/PPAP-拒绝表示零件没有满足一项或多项PPAP要求,且未完成。福特GPPSS12010年10月在零件有效期内，此文档的原件应该保留在供应商处。A4纸格式顾客跟踪编号（可选）说明：1表格中的所有区域都要填写：填写适当值或者填写"n/a"；2用电子版（推荐）或清晰打印所要求的信息来完成此表。
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