CERTIFICATION COVER SHEET

Supplier Name:

Purchase Order No.: 

Packing List No.:

Item No.:

Part No.:

Rev:

Quantity Shipped:

Ship Date:

PaR Project No.:

Supplier Project No.:

The undersigned certifies that all materials furnished comply with the requirements of the applicable purchase order, specification, and drawing. 

Material Specs

Type

Heat

 

 

 

 

 

 

 

 

 

 

 

 

Filler Metal

Material Specs

Type

Heat

 

 

 

 

 

 

 

 

 

Other Processes:

 

SUPPLIER APPROVAL:  

                       

__________________________________

                 Printed Name:

 

__________________________________            Date:  ____________________

                  Signature