CERTIFICATE OF CONFORMANCE

Certificate Number Date Supplier Name & Address Customer Name & Address Purchase Order Number

Item number Quantity Description Revision Treceability Remarks

Confirmity Details

This is to certify that the parts/items/material identified above conform to all applicable drawings and/or specifications as evidenced by reports or other documentation on file and that all other purchase
order quantity and requirements have been met.

Name & Signature of person authorised to release products to customer