Volvo PSW 4th Edition PPAP

Part Submission WarrantPart Name Customer Part Number Rev.

If applicable

Tool PO Number Dated

Additional Engineering Changes Dated

Shown on Drawing Number Purchase Order No. Weight (kg)

Checking Aid Number Engineering Change Level Dated

ORGANIZATION MANUFACTURING INFORMATION SUBMISSION INFORMATION

Organization name and Code Customer Name/Division

Street Address Customer Contact

City State Zip Application

Note: Does this part contain any restricted or reportable substances?

Are plastic parts identified with appropriate ISO marking codes?

REASON FOR SUBMISSION (check at least one)Initial submission Change to Optional Construction or MaterialEngineering Change(s) Sub-Supplier or Material Source ChangeTooling: Transfer, Replacement, Refurbishment, or additional Change in Part ProcessingCorrection of Discrepancy Parts produced at Additional LocationTooling inactive > than 1 year Other - please specify below

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 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19(check)Level 5 - Warrant with product samples and complete supporting data reviewed at supplier's manufacturing location.

DECLARATIONI affirm that the samples represented by this warrant are representative of our parts and have been made to the applicable customerdrawings and specifications and are made from specified materials on regular production tooling with no operations other than the regularproduction process. I also certify that documented evidence of such compliance is on file and available for review.

EXPLANATION/COMMENTS

List Molds / Cavities / Production Processes

Organization Authorized Signature Date

Print Name Phone No. Fax

Title e-mail

FOR CUSTOMER USE ONLY PPAP Warrant Disposition:

Comment:

Customer Signature Date

Print Name

Engineering Drawing Change Level

Yes No

Yes No

Approved RejectedInterim Approval

Part Submission WarrantPart Name Customer Part Number Rev.

If applicable

Tool PO Number Dated

Additional Engineering Changes Dated

Shown on Drawing Number Purchase Order No. Weight (kg)

Checking Aid Number Engineering Change Level Dated

ORGANIZATION MANUFACTURING INFORMATION SUBMISSION INFORMATION

Organization name and Code Customer Name/Division

Street Address Customer Contact

City State Zip Application

Note: Does this part contain any restricted or reportable substances?

Are plastic parts identified with appropriate ISO marking codes?

REASON FOR SUBMISSION (check at least one)Initial submission Change to Optional Construction or MaterialEngineering Change(s) Sub-Supplier or Material Source ChangeTooling: Transfer, Replacement, Refurbishment, or additional Change in Part ProcessingCorrection of Discrepancy Parts produced at Additional LocationTooling inactive > than 1 year Other - please specify below

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 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19(check)Level 5 - Warrant with product samples and complete supporting data reviewed at supplier's manufacturing location.

DECLARATIONI affirm that the samples represented by this warrant are representative of our parts and have been made to the applicable customerdrawings and specifications and are made from specified materials on regular production tooling with no operations other than the regularproduction process. I also certify that documented evidence of such compliance is on file and available for review.

EXPLANATION/COMMENTS

List Molds / Cavities / Production Processes

Organization Authorized Signature Date

Print Name Phone No. Fax

Title e-mail

FOR CUSTOMER USE ONLY PPAP Warrant Disposition:

Comment:

Customer Signature Date

Print Name

Engineering Drawing Change Level

RejectedApproved

Yes No

Yes No

2

5

1 3

4

6

7 8 9

10 11

12

13

14

15

16

17

18

19

20

21

22

Yes No

Yes No

Interim Approval

Completion of the Part Submission Warrant

PART INFORMATION1. 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 INFORMATION12. 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 INFORMATION14. 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 SUBMISSION18. Check the appropriate box. Add explanatory details in the "other" section.

REQUESTED SUBMISSION LEVEL19. 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 Volvo Powertrain. 18. Part Submission Warrant (PSW). All other documents shall be submitted to Volvo upon request.

DECLARATION20. 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 ONLYLeave blank

New 4th Edition PSW Completion Instruction Wording

Appendix ACompletion of the Part Submission Warrant

PART INFORMATION

ORGANIZATION MANUFACTURING INFORMATION

SUBMISSION INFORMATION

REASON FOR SUBMISSION

REQUESTED SUBMISSION LEVEL

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.

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.

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.

18. Check the appropriate box. Add explanatory details in the "other" section.

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

FOR CUSTOMER USE ONLYLeave blank

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.

APPEARANCE APPROVAL REPORT

E/C LEVEL DATE

OTHER

APPEARANCE EVALUATION

ORGANIZATION SOURCING AND TEXTURE INFORMATION

COLOR EVALUATION

TRISTIMULUS DATA HUE VALUE CHROMA GLOSS

DL* Da* Db* DE* CMC RED YEL GRN BLU LIGHT DARK GRAY CLEAN HIGH LOW HIGH LOW

COMMENTS

DATE DATE

March CFG-10022006

PART NUMBER

DRAWINGNUMBER

APPLICATION(VEHICLES)

PARTNAME

BUYERCODE

ORGANIZATIONNAME

MANUFACTURINGLOCATION

SUPPLIER/VENDORCODE

REASON FOR PART SUBMISSION WARRANT SPECIAL SAMPLE RE-SUBMISSIONSUBMISSION PRE TEXTURE FIRST PRODUCTION SHIPMENT ENGINEERING CHANGE

PRE-TEXTUREEVALUATION

AUTHORIZED CUSTOMERREPRESENTATIVE

SIGNATURE AND DATE

CORRECT ANDPROCEED

CORRECT ANDRESUBMIT

APPROVED TOETCH/TOOL/EDM

COLORSUFFIX

MASTERNUMBER

MASTER DATE

MATERIALTYPE

MATERIALSOURCE

METALLICBRILLIANCE

COLORSHIPPING

SUFFIXPART

DISPOSITION

ORGANIZATIONSIGNATURE

PHONE NO. AUTHORIZED CUSTOMER

REPRESENTATIVE SIGNATURE

APPEARANCE APPROVAL REPORT

E/C LEVEL DATE

OTHER

APPEARANCE EVALUATION

ORGANIZATION SOURCING AND TEXTURE INFORMATION

COLOR EVALUATION

TRISTIMULUS DATA HUE VALUE CHROMA GLOSS

DL* Da* Db* DE* CMC RED YEL GRN BLU LIGHT DARK GRAY CLEAN HIGH LOW HIGH LOW

COMMENTS

PHONE NO. DATE DATE

March CFG-10022006

PARTNUMBER

DRAWINGNUMBER

APPLICATION(VEHICLES)

PARTNAME

BUYERCODE

ORGANIZATIONNAME

MANUFACTURINGLOCATION

SUPPLIER/VENDORCODE

REASON FOR PART SUBMISSION WARRANT SPECIAL SAMPLE RE-SUBMISSIONSUBMISSION PRE TEXTURE FIRST PRODUCTION SHIPMENT ENGINEERING CHANGE

PRE-TEXTUREEVALUATION

AUTHORIZED CUSTOMERREPRESENTATIVE

SIGNATURE AND DATE

CORRECT ANDPROCEED

CORRECT ANDRESUBMIT

APPROVED TOETCH/TOOL/EDM

COLORSUFFIX

MASTERNUMBER

MASTER DATE

MATERIALTYPE

MATERIALSOURCE

METALLICBRILLIANCE

COLORSHIPPING

SUFFIXPART

DISPOSITION

ORGANIZATIONSIGNATURE

AUTHORIZED CUSTOMERREPRESENTATIVE SIGNATURE

14 15 16 17 18 19 2021 22

23

24 25

12

13

11

8 9 10

4 5 6/7

2 31

1.2.

part number.3.4.5. 6./7.8.9.10.

manufactured or assembled.11.12.

grain type(s), and grain and gloss masters used to check part.13.

GM).14.15.

customer-authorized master.16.17.18.19.20.

assessment by customer21.22.23.24.

information is accurate and meets all requirements specified.25.

Representative approval signature.

Appendix B - Completion of the Appearance ApprovalReport

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

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

Reason for submission: Check box(es) explaining the reason for this submission.Organization Sourcing & Texture Information: List all first surface tools, graining source(s),

Pre-Texture Evaluation: To be completed by authorized customer representative (not used by

Color Suffix: Use alphanumeric or numeric color identificationTristimulus Data: List numerical (colorimeter) data of submission part as compared to the

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

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

Authorized Customer Representative Signature & Date: Authorized Customer

THE AREAS INSIDE THE BOLD LINES ARE FOR CUSTOMER USE ONLY.

Production Part Approval Dimensional Test Results

INSPECTION FACILITY:

ITEM DIMENSION / SPECIFICATION OK

Blanket statements of conformance are unacceptable for any test results.

March CFG-10032006

Appendix C - Production Part Approval, DimensionalResults

ORGANIZATION: SUPPLIER/VENDOR CODE:

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

SPECIFICATION / LIMITS

TEST DATE

QTY.TESTED

ORGANIZATION MEASUREMENTRESULTS (DATA)

NOTOK

SIGNATURE TITLE DATE

Production Part Approval Material Test Results

*CUSTOMER SPECIFIED SUPPLIER/VENDOR CODE:*If source approval is req'd, include the supplier (Source) & Customer assigned code NAME OF LABORATORY:

MATERIAL SPEC. NO. / REV / DATE SUPPLIER TEST RESULTS (DATA) OK

Blanket statements of conformance are unacceptable for any test results.

March CFG-10042006

Appendix D - Production Part Approval, Material TestResults

ORGANIZATION:SUPPLIER/VENDOR CODE:

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

SPECIFICATION / LIMITS

TEST DATE

QTY.TESTED

NOTOK

SIGNATURE TITLE DATE

Production Part ApprovalPerformance Test Results

NAME OFLABORATORY:*CUSTOMER SPECIFIED SUPPLIER/VENDOR CODE:*If source approval is req'd, include the supplier (Source) & Customer assigned code

TEST SPECIFICATION / REV / DATE OK

Blanket statements of conformance are unacceptable for any test results.

March CFG-10052006

Appendix E - Production Part Approval, Performance TestResults

ORGANIZATION:SUPPLIER/VENDOR CODE:

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

SPECIFICATION / LIMITS

TEST DATE

QTY.TESTED

SUPPLIER TEST RESULTS (DATA) /TEST CONDITIONS

NOTOK

SIGNATURE TITLE DATE