Phased PPAP Part Submission Warrant

Phase 0 - Prototype Part Name: Shown on Drawing No. Engineering Change Level: Additional Engineering Changes: Safety and/or Government Regulation: Checking Aid No. ORGANIZATION MANUFACTURING INFORMATION Supplier Name & Supplier Code Street Address City Region Postal Code Country MATERIALS REPORTING Has customer reported required Substance of Concern information? Yes Are polymeric parts identified with appropriate ISO marking codes? REASON FOR SUBMISSION (Check One or More) Initial Submission Engineering Change(s) Correction or Discrepancy Other (Please Specify) REQUIRED SUBMISSION LEVEL (Check One) Sub-supplier or Material Source Change Change in Part Processing Parts Produced at Additional Location Yes Yes X No Purchase Order No. J 97" Roof X Phase 1 - Open Phase 1 Phase 2 Phase 3

ISQ-002-FO Rev: C Date: 03/08/2013 Copies must be verified for current revision X

Cust. Part Number: 3571149C93

Organization Part Number:

Dated: Dated: Weight(kg): Dated:

Checking Aid Engineering Change Level CUSTOMER SUBMITTAL INFORMATION Customer Name / Division Buyer / Buyer Code Application No No N/A N/A MDS ID:

Accept Date:

Change to Optional Construction or Material Tooling Inactive > 1 year Tooling Transfer, Replacement, Refurb, Additional

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 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22

Level 5 - Warrant and product samples and complete supporting data reviewed at supplier's manufacturing location. SUBMISSION RESULTS The results for Dimensional Measurements Material and Functional Tests Yes No Appearance Criteria (if "NO", explanation is required) Statistical Process Package

These results meet all drawing and specification requirements Mold / Cavity / Production Process:

DECLARATION I affirm that the samples represented by this warrant are representative of our parts, have been made by a process that meets all applicable Production Part Approval Process Manual 4th Ed. Requirements. I further affirm that these samples were produced at the production rate of / 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 hours.

Is each Customer Tool properly tagged and numbered? Org. Auth. Signature: Title: FOR NAVISTAR USE ONLY PPAP Warrant Disposition: EXPLANATION / COMMENTS Approved Phone: Rejected

Yes

No

N/A Print Name: Fax: Email: Expiration Date: Deviation #: Date:

Approved w/ Expiration

Customer Signature:

Print Name:

Date:

Phased PPAP Tracking Form

Phase 0 - Prototype Part Name: Shown on Drawing No. Engineering Change Level: Additional Engineering Changes: Safety and/or Government Regulation: Checking Aid No. ORGANIZATION MANUFACTURING INFORMATION Supplier Name & Supplier Code Street Address City Region Postal Code ORGANIZATION PPAP TRACKING INFORMATION PPAP Elements (AIAG) *Navistar Specific Requirements 1 1.1 1.2 2 3 4 5 6 7 8 9 10 10.1 10.2 10.3 10.4 11 12 13 14 15 16 17 18 *19 *20 *21 *22 Design Record Restricted Substances (IMDS) Polymeric Part Identification (as applicable) Engineering Change Documents, if required Customer Engineering approval, if required Design FEMA, if design responsible Process Flow Diagrams Process FMEA Control Plan Measurement System Analysis Studies Dimensional Results Material Confirmation (Mat Type / No Rest.) DVP&R - Material Test Results DVP&R - DV Performance Test Results DVP&R - PV Performance Test Results DVP&R - include R&Q Approved Supplier IQA Initial Process Studies Qualified Laboratory Documentation Appearance Approval Report (AAR) Sample Production Parts Master Sample Checking Aids Records of Compliance Part Submission Warrant (PSW) Pass Through Characteristics Analysis Run at Rate EDI Compliant Packaging and Labeling x x x x x x x x x x x x x x x x Country COMPLETION REQ.
0
Proto

ISQ-002-FO Rev: C Date: 03/08/2013 Copies must be verified for current revision Phase 3 X

Phase 1 - Open

Phase 1

Phase 2

97" Roof

Cust. Part Number: 3571149C93

Organization Part Number:

J Dated: Dated: Yes X No Purchase Order No. Checking Aid Engineering Change Level CUSTOMER SUBMITTAL INFORMATION Customer Name / Division Buyer / Buyer Code Application ELEMENT STATUS Completed Date Rev. Level Weight(kg): Dated:

CUSTOMER REVIEW INFORMATION Reviewed with PPAP Submission Yes / Yes / Yes / Yes / Yes / Yes / Yes / Yes / Yes / Yes / Yes / Yes / Yes / Yes / Yes / Yes / Yes / Yes / Yes / Yes / Yes / Yes / Yes / Yes / Yes / Yes / Yes / Yes / No No No No No No No No No No No No No No No No No No No No No No No No No No No No Accept / Reject / / / / / / / / / / / / / / / / / / / / / / / / / / / /

1
Open

x x x x x x x x x x x x x x x x x x x x x x x x x

x x x x x x x x x x x x x x x x x x x x x x x x x

x x x x x x x x x x x x x x x x x x x x x x x x x x x x

I attest that all items indicated above are complete as noted. I also understand it is the Supplier's obligation to complete all elements regardless of actual submission content. Org. Auth. Print Name: Navistar Notes: Title: Date:

Customer Print Name:

Review Date:

ISQ-002-FO Rev: C Date: 03/08/2013 Copies must be verified for current revision

Rev. No. A. B.

Effective Date 11/1/2012 11/15/2012

Revision History First release. Combining Truck and Engine PSW forms and adding PPAP tracking form Added 10.4 IQA to PPAP tracking form, moved form numbers to row 1 and removed from footer, so that form number and revision are shown always. Check boxes for Phase and Gov. Reg are not copied from PSW to Tracking form when selected. Replaced checkboxes with small square cells with value validation. Changed "Original Part Number" cover sheet and tracking form to "Supplier Part Number." Changed Phase 0 - Production to Phase 1 - Open on cover sheet and tracking form. Removed "Capacity Verification" from PPAP tracking form. Removed 23rd requirement from PSW cover sheet. Removed the shading from the PSW. Added Approved w/ Expiration to the cover sheet. Added Explanation and Comments section to cover sheet. Removed Phase 0 approval for quality and build event on coversheet. Added expiration date to cover sheet. Reorganized the layout of various cell for spacing and functionality.

C.

3/8/2013