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Certificate of Conformance

Seller's Company Name and Address

Aerojet Purchase Order Number ______________________ Part Number ________________________ Quantity _____________

Line Item Number ___________

Drawing Number Specification(s), if applicable

_______________________ Revision __________ _______________________ Revision _____________

Aerojet Manufacturing Order Number, if applicable _____________________________ Serial Number(s), if applicable __________________________ Lot/Heat Number, if applicable __________________________ Date Code, if applicable ____________________ Exceptions/Special Provisions/Non-Conformances:

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 and quality requirements have been met.

________________________________________ Authorized Company Official Name and Title

_____________________ Date


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