FLYSHEET AN-7

INSTRUCTIONS FOR EXECUTING "CERTIFICATE OF CONFORMANCE"

This purchase order requires Seller to procure certain articles or processing from specified sources and in compliance with governing specifications. The Quality System Requirement appended to this purchase order establish controls in connection with those procurements and requires Seller to execute and submit a "Certificate of Conformance" attesting compliance therewith. This flysheet provides instructions on how to complete each entry on this certificate, a copy of which is attached.

Date:Date certificate is signed.

Part No.:The Boeing Company part number that relates to the purchase order item number (Example: 70684-201-1).

Purchase Order No.:The Boeing Company purchase order number

(Example: A5ZV-876543-121).

Item No.:The item number of the The Boeing Company purchase order that relates to the above part number.

No. of Parts Delivered

with this Shipment:Self-explanatory

Review the four certification statements on the "Certificate of Conformance" form attached and ensure that they have been complied with.

Complete the three columns in the lower portion of the certificate as follows:

Column 1:Identify by title, number, change letter and date of each Material or Process Specification concerned. Examples:

LA0105-004 NC, Glass Fab/Polyester Laminates Structural 7-21-61

ST0135AB0006 NC, Glass Fab/Polyester Resin (Pre-Preg) 3-24-70

IID 564-0127-003, Rev. F (Contact Buyer for any questions/inquiries as to latest specification revisions.)

NOTE:In many cases a process specification or IID will invoke lower level specifications which have their own Certified Special Processors (CSP) or Approved Source List (ASL). These must also be included, the sources identified, and the date of the CSP List or ASL shown. For example,

Specification AA0111-008, "Processing of Aluminum Alloys for Dimensional Stability," incorporates Specification AA0111-025, "Heat Treatment of Aluminum Alloys." Both must be cited, and the suppliers used must be identified along with the date of the CSP List and document that attests thereto.

Certified Special Processor List is online at:

or available from CSP Administrator 714/762-2552

Column 2:The name and address of the material supplier or processor must be the one that furnished the material or performed the process and is included in Buyer's Approved Source List and/or Buyer's Certified Special Processor List.

Column 3:Identify the certification or other document and its date. A certification should note the "batch" or "lot" number. "Other" documentation includes CSP Survey Reports, QSLs, Purchase Orders, etc.

Examples:"ABC Co. P.O. #5131 dated 9-20-74"

"XYZ Co. Certification #4976 dated 8-31-74"

Seller - Identify seller's name, address and phone number.

Please complete the attached certificate form, following the above instructions, have it signed by the Seller's Authorized Representatives, and secure it to the shipping document accompanying this shipment. Seller may elect to use his own certificate provided that it includes the foregoing data elements.

CERTIFICATE OF CONFORMANCE

DATE:

Part No.:The Boeing Company Purchase Order No.:

Item No.:No. of parts delivered this shipment:

1.Seller certifies that these articles were produced either from materials furnished by the buyer or from materials for which seller has available for examination chemical and physical test reports or other evidence of conformance to material specifications.

2.Seller further certifies that all processes required by this order to be performed by a processor listed in buyer's "Certified Special Processors List," as amended, were performed by such processor and that the document(s) appended hereto in the form of processing certifications or referenced below is/are evidence of performance by such processor in accordance with applicable specifications.

3.Seller certifies that all material furnished by the seller required to be procured from a source listed in the The Company Company. Approved Source List was procured from a source so listed. This conformance is evidenced by copies of chemical and/or physical test reports or other evidence of conformance appended hereto or referenced below.

4.Seller certifies that articles were produced and inspected to the requirements of the referenced order.

Title, Number, Change Name & Address ofCertification or

Letter & Date of MaterialMaterial SupplierOther Document

or Process Spec.or ProcessorNumber & Date

Seller:Supplier:______By:Address:______Seller's Authorized Representative

Telephone:______

FORM 881-G-13 REV 1-2000Page 1 of 3