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Part Submission Warrant

Part Name Customer Part Number Engineering Drawing Change Level Rev. If applicable Tool PO Number Additional Engineering Changes Shown on Drawing Number Checking Aid Number Purchase Order No. Engineering Change Level SUBMISSION INFORMATION Dated Dated Weight (kg) Dated

ORGANIZATION MANUFACTURING INFORMATION

Organization name and Code

Customer Name/Division

Street Address

Customer Contact

City Note:

State

Zip

Application

Does this part contain any restricted or reportable substances? Are plastic parts identified with appropriate ISO marking codes?

Yes Yes

No No

REASON FOR SUBMISSION (check at least one) Initial submission Engineering Change(s) Tooling: Transfer, Replacement, Refurbishment, or additional Correction of Discrepancy Tooling inactive > than 1 year 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 defined by customer. 1 (check) Level 5 - Warrant with product samples and complete supporting data reviewed at supplier's manufacturing location. DECLARATION I affirm that the samples represented by this warrant are representative of our parts and have been made to the applicable customer drawings and specifications and are made from specified materials on regular production tooling with no operations other than the regular production process. I also certify that documented evidence of such compliance is on file and available for review. EXPLANATION/COMMENTS 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Change to Optional Construction or Material Sub-Supplier or Material Source Change Change in Part Processing Parts produced at Additional Location Other - please specify below

List Molds / Cavities / Production Processes Organization Authorized Signature Print Name Title Phone No. e-mail Fax Date

FOR CUSTOMER USE ONLY PPAP Warrant Disposition:

Approved Rejected Interim Approval


Date

Comment:

Customer Signature Print Name

Volvo PSW 4th Edition PPAP

Part Submission Warrant


Part Name

Completion of the Part Su


Rev.

Customer Part Number Engineering Drawing Change Level

3
If applicable

Tool PO Number

Dated Dated

Additional Engineering Changes Shown on Drawing Number Checking Aid Number

6
7 10
Purchase Order No. Engineering Change Level

PART INFORMATION 1. Part Name: 2. Customer Part Num 3. Part Revision Level: 4. Tool Purchase Orde 5. Engineering Drawin
6.

8
11

Weight (kg) Dated

Additional Engineer

7.
8. 9. 10. 11.

Shown on Drawing N

ORGANIZATION MANUFACTURING INFORMATION

SUBMISSION INFORMATION

12
Organization name and Code Customer Name/Division

14

13
Street Address Customer Contact

15

Purchase Order Num Part weight: Checking Aid No: Checking Aid's Eng

16
City Note: State Zip Application

ORGANIZATION MANUF 12. Organization Name 13. Organization Manuf


Yes No No

Does this part contain any restricted or reportable substances?

17
Are plastic parts identified with appropriate ISO marking codes? REASON FOR SUBMISSION (check at least one) Initial submission Engineering Change(s) Tooling: Transfer, Replacement, Refurbishment, or additional Correction of Discrepancy Tooling inactive > than 1 year SUBMISSION LEVEL (Check one)

SUBMISSION INFORMAT 14. Customer Name/ Div

Yes

18
Change to Optional Construction or Material Sub-Supplier or Material Source Change Change in Part Processing Parts produced at Additional Location Other - please specify below

15. Contact Name: 16. Application: 17. Check the appropria

REASON FOR SUBMISS 18. Check the appropria

19

REQUESTED SUBMISSI 19. Identify the submiss

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 defined by customer. 1 (check) Level 5 - Warrant with product samples and complete supporting data reviewed at supplier's manufacturing location. DECLARATION I affirm that the samples represented by this warrant are representative of our parts and have been made to the applicable customer drawings and specifications and are made from specified materials on regular production tooling with no operations other than the regular production process. I also certify that documented evidence of such compliance is on file and available for review. EXPLANATION/COMMENTS 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

DECLARATION 20. Explanation/Comme

20

21. Enter the number or c 22. The responsible supp


21

List Molds / Cavities / Production Processes Organization Authorized Signature Print Name Title

22
Phone No. e-mail Fax

Date

FOR CUSTOMER USE O Leave blank

FOR CUSTOMER USE ONLY PPAP Warrant Disposition:

Approved Rejected Interim Approval


Date

Comment:

Customer Signature Print Name

Completion of the Part Submission Warrant PART INFORMATION 1. Part Name: Engineering released finished end item part name. (See Volvo Part Version Report.) 2. Customer Part Number(s): Engineering released finished end item part number. (Volvo PVR number.) 3. Part Revision Level: if applicable. (Volvo PVR Version.) 4. Tool Purchase Order Number: if applicable. 5. Engineering Drawing Change Level & Approval Date: Show change level and date for submission. (Volvo drawing issue, see PVR and drawing.) 6. Additional Engineering Changes: Include all authorized engineering change documents and approval dates not yet incorporated on the drawing but which are incorporated in the part. 7. Shown on Drawing Number: The design record that specifies the customer part number being submitted. (Volvo drawing No, see PVR and drawing.) 8. Purchase Order Number: Enter this number as found on the purchase order. 9. Part weight: Enter the actual weight in kilograms to four significant places. 10. Checking Aid No: Enter the checking aid number, if one is used for dimensional inspection. 11. Checking Aid's Engineering Change Level and Approval Date.
ORGANIZATION MANUFACTURING INFORMATION 12. Organization Name and Code: Show the code assigned to the manufacturing location on the purchase order. (Supplier Name and Volvo supplier No.) 13. Organization Manufacturing Address: Show the complete address of the location where the product was manufactured. SUBMISSION INFORMATION 14. Customer Name/ Division: Show the corporate name and division or operations group. (Volvo purchasing company, e.g. Volvo 3P, Volvo Powertrain, etc.) 15. Contact Name: Enter the name of your customer contact. (Volvo SQA and/or Volvo purchaser.) 16. Application: Enter the model year, vehicle name, or engine, transmission, etc. 17. Check the appropriate box to indicate Substances of Concern (Volvo black list STD 1009,1)/ISO marking reporting. REASON FOR SUBMISSION 18. Check the appropriate box. Add explanatory details in the "other" section.

REQUESTED SUBMISSION LEVEL 19. Identify the submission level requested by your customer. Check the submission items if a level 4 is requested. If not otherwise agreed Volvo request level 4. The minimum required mandatory documents are: 6. Process FMEA; 7. Control Plan; 9. Dimensional Results including Marked Drawing; 10. Material, Performance Test Results; 13. Appearance Approval Report (if applicable); 17. Records of Compliance with Volvo Specific Requirements (Review of Technical Specification ,RTS). Mandatory for Volv o Powertrain. 18. Part Submission Warrant (PSW). All other documents shall be submitted to Volvo upon request. DECLARATION 20. Explanation/Comments: Provide any explanatory details on the submission results; additional information may be attached as appropriate. 21. Enter the number or code that identifies the specific mold, cavity, and/or production process used to manufacture the sa mple parts. 22. The responsible supplier official, after verifying that the results show conformance to all customer requirements and th at all required documentation is available shall approve the declaration and provide Title, Phone Number, Email Address, and Fax Number. FOR CUSTOMER USE ONLY Leave blank

New 4th Edition PSW Completion Instruction Wording Appendix A Completion of the Part Submission Warrant PART INFORMATION 1. Part Name: Engineering released finished end item part name. (See Volvo Part Version Report.) 2. Customer Part Number(s): Engineering released finished end item part number. (Volvo PVR number.) 3. Part Revision Level: if applicable. (Volvo PVR Version.) 4. Tool Purchase Order Number: if applicable. 5. Engineering Drawing Change Level & Approval Date: Show change level and date for submission. (Volvo drawing issue, see PVR and drawing.) 6. Additional Engineering Changes: Include all authorized engineering change documents and approval dates not yet incorporated on the drawing but which are incorporated in the part. 7. Shown on Drawing Number: The design record that specifies the customer part number being submitted. (Volvo drawing No, see PVR and drawing.) 8. Purchase Order Number: Enter this number as found on the purchase order. 9. Part weight: Enter the actual weight in kilograms to four significant places. 10. Checking Aid No: Enter the checking aid number, if one is used for dimensional inspection. 11. Checking Aid's Engineering Change Level and Approval Date. ORGANIZATION MANUFACTURING INFORMATION 12. Organization Name and Code: Show the code assigned to the manufacturing location on the purchase order. (Supplier Name and Volvo supplier No.) 13. ORGANIZATION Manufacturing Address: Show the complete address of the location where the product was manufactured. SUBMISSION INFORMATION 14. Customer Name/ Division: Show the corporate name and division or operations group. (Volvo purchasing company, e.g. Volvo 3P, Volvo Powertrain, etc.) 15. Contact Name: Enter the name of your customer contact. (Volvo SQA and/or Volvo purchaser.) 16. Application: Enter the model year, vehicle name, or engine, transmission, etc. 17. Check the appropriate box to indicate Substances of Concern (Volvo black list STD 1009,1)/ISO marking reporting. REASON FOR SUBMISSION 18. Check the appropriate box. Add explanatory details in the "other" section. REQUESTED SUBMISSION LEVEL 19. Identify the submission level requested by your customer. Check the submission items if a level 4 is requested. If not otherwise agreed Volvo request level 4. The minimum required mandatory documents are: 6. Process FMEA; 7. Control Plan; 9. Dimensional Results including Marked Drawing; 10. Material, Performance Test Results; 13. Appearance Approval Report (if applicable); 17. Records of Compliance with Volvo Specific Requirements (RTS). Mandatory for Volvo Powertrain. 18. Part Submission Warrant (PSW). All other documents shall be submitted to Volvo upon request.

DECLARATION 20. Explanation/Comments: Provide any explanatory details on the submission results; additional information may be attached as appropriate. 21. Enter the number or code that identifies the specific mold, cavity, and/or production process used to manufacture the sample parts. 22. The responsible supplier official, after verifying that the results show conformance to all customer requirements and that all required documentation is available shall approve the declaration and provide Title, Phone Number, Email Address, and Fax Number. FOR CUSTOMER USE ONLY Leave blank

APPEARANCE APPROVAL REPORT


PART NUMBER PART NAME ORGANIZATION NAME REASON FOR SUBMISSION PART SUBMISSION WARRANT PRE TEXTURE DRAWING NUMBER BUYER CODE MANUFACTURING LOCATION SPECIAL SAMPLE FIRST PRODUCTION SHIPMENT RE-SUBMISSION ENGINEERING CHANGE E/C LEVEL APPLICATION (VEHICLES) DATE SUPPLIER/VENDOR CODE OTHER

APPEARANCE EVALUATION
ORGANIZATION SOURCING AND TEXTURE INFORMATION
PRE-TEXTURE EVALUATION CORRECT AND PROCEED CORRECT AND RESUBMIT APPROVED TO ETCH/TOOL/EDM AUTHORIZED CUSTOMER REPRESENTATIVE SIGNATURE AND DATE

COLOR EVALUATION
TRISTIMULUS DATA Da* Db* DE* CMC HUE
RED YEL GRN BLU

COLOR SUFFIX DL*

MASTER NUMBER

MASTER DATE

MATERIAL MATERIAL TYPE SOURCE

VALUE
LIGHT DARK

CHROMA
GRAY CLEAN

GLOSS
HIGH LOW

METALLIC BRILLIANCE
HIGH LOW

COLOR SHIPPING SUFFIX

PART DISPOSITION

COMMENTS

ORGANIZATION SIGNATURE

PHONE NO.

DATE

AUTHORIZED CUSTOMER REPRESENTATIVE SIGNATURE

DATE

March 2006

CFG-1002

APPEARANCE APPROVAL REPORT


PART NUMBER PART NAME ORGANIZATION NAME REASON FOR SUBMISSION

1 4
8
PART SUBMISSION WARRANT PRE TEXTURE

DRAWING NUMBER BUYER CODE MANUFACTURING LOCATION SPECIAL SAMPLE FIRST PRODUCTION SHIPMENT

2 5
9
RE-SUBMISSION ENGINEERING CHANGE E/C LEVEL

APPLICATION (VEHICLES)

6/7

DATE SUPPLIER/VENDOR CODE OTHER

10

11

APPEARANCE EVALUATION
ORGANIZATION SOURCING AND TEXTURE INFORMATION
12
PRE-TEXTURE EVALUATION CORRECT AND PROCEED CORRECT AND RESUBMIT APPROVED TO ETCH/TOOL/EDM

13

AUTHORIZED CUSTOMER REPRESENTATIVE SIGNATURE AND DATE

COLOR EVALUATION
14
COLOR SUFFIX DL*

21 20
METALLIC BRILLIANCE
HIGH LOW

22
PART DISPOSITION

15
TRISTIMULUS DATA Da* Db* DE* CMC

16
MASTER NUMBER

17
MASTER DATE

18

19
HUE
RED YEL GRN BLU

MATERIAL MATERIAL TYPE SOURCE

VALUE
LIGHT DARK

CHROMA
GRAY CLEAN

GLOSS
HIGH LOW

COLOR SHIPPING SUFFIX

COMMENTS

23

ORGANIZATION SIGNATURE

24

PHONE NO.

DATE

AUTHORIZED CUSTOMER REPRESENTATIVE SIGNATURE

25

DATE

March 2006

CFG-1002

Appendix B Report
1. 2. 3. 4. 5. 6./7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25.

Completion of the Appearance Approval

Customer part number: Engineering released customer part number. Drawing Number: Use the number of the drawing on which the part is shown if different from the part number. Application: Enter the model year(s) and vehicle or other program on which the part is used. Part Name: Use the finished part name on the part drawing. Buyer Code: Enter the code for specific buyer or part. E/C Level & Date: Engineering change level and E/C date for this submission. Organization Name: Organization responsible for submission (include supplier if available). Manufacturing Location: Location where part was manufactured or assembled. Supplier/Vendor Code: Customer-assigned code for organization location where the part was manufactured or assembled. Reason for submission: Check box(es) explaining the reason for this submission. Organization Sourcing & Texture Information: List all first surface tools, graining source(s), grain type(s), and grain and gloss masters used to check part. Pre-Texture Evaluation: To be completed by authorized customer representative (not used by GM). Color Suffix: Use alphanumeric or numeric color identification Tristimulus Data: List numerical (colorimeter) data of submission part as compared to the customer-authorized master. Master Number: Enter alphanumeric master identification (not used by Ford). Master Date: Enter the date on which the master was approved. Material Type: identify first surface finish and substrate (e.g;, paint/ABS). Material Source: Identify first surface and substrate suppliers. Example: Redspot/Dow. Color Evaluation, Hue, Value, Chroma, Gloss and Metallic Brilliance: Visual assessment by customer Color Shipping Suffix: Color part number suffix or color number. Part Disposition: To be determined by customer (approved or rejected). Comments: General comments by the organization or customer (optional). Organization Signature, Phone No. & Date: Organization certification that the document information is accurate and meets all requirements specified. Authorized Customer Representative Signature & Date: Authorized Customer Representative approval signature. THE AREAS INSIDE THE BOLD LINES ARE FOR CUSTOMER USE ONLY.

Appendix C Results

Production Part Approval,


Production Part Approval Dimensional Test Results

Dimensional

ORGANIZATION: SUPPLIER/VENDOR CODE: INSPECTION FACILITY:

PART NUMBER: PART NAME: DESIGN RECORD CHANGE LEVEL: ENGINEERING CHANGE DOCUMENTS:

ITEM

DIMENSION / SPECIFICATION

SPECIFICATION / LIMITS

TEST QTY. DATE TESTED

ORGANIZATION MEASUREMENT RESULTS (DATA)

OK

NOT OK

Blanket statements of conformance are unacceptable for any test results.


March 2006

CFG-1003

SIGNATURE

TITLE

DATE

Appendix D Results

Production Part Approval,


Production Part Approval Material Test Results

Material Test

ORGANIZATION: SUPPLIER/VENDOR CODE: MATERIAL SUPPLIER: *CUSTOMER SPECIFIED SUPPLIER/VENDOR CODE: *If source approval is req'd, include the supplier (Source) & Customer assigned code SPECIFICATION / LIMITS TEST QTY. DATE TESTED

PART NUMBER: PART NAME: DESIGN RECORD CHANGE LEVEL: ENGINEERING CHANGE DOCUMENTS: NAME OF LABORATORY: SUPPLIER TEST RESULTS (DATA) NOT OK

MATERIAL SPEC. NO. / REV / DATE

OK

Blanket statements of conformance are unacceptable for any test results.


March 2006

CFG-1004

SIGNATURE

TITLE

DATE

Appendix E Results

Production Part Approval,


Production Part Approval Performance Test Results

Performance Test

ORGANIZATION: SUPPLIER/VENDOR CODE: NAME OFLABORATORY: *CUSTOMER SPECIFIED SUPPLIER/VENDOR CODE: *If source approval is req'd, include the supplier (Source) & Customer assigned code SPECIFICATION / LIMITS TEST QTY. DATE TESTED

PART NUMBER: PART NAME: DESIGN RECORD CHANGE LEVEL: ENGINEERING CHANGE DOCUMENTS:

TEST SPECIFICATION / REV / DATE

SUPPLIER TEST RESULTS (DATA) / TEST CONDITIONS

OK

NOT OK

Blanket statements of conformance are unacceptable for any test results.


March 2006

CFG-1005

SIGNATURE

TITLE

DATE