Abstract

American National Standards Institute Inc.

This guide for certification of coating conformance form provides procurement information concerning products being furnished in accordance with a specific coating specification and additional requirements contained in the purchase order. The certification form is divided into four headings: General Type and Description(I), Buyer Information(II), Seller Information (III), and Certification (IV). The first heading consists of the following information: generic type, manufacturer’s designation, specification number, formula number, component number, component identification, and color. The second heading consists purchase order number, release number, part number, item number, and stock number. The third heading consists of seller’s representative, batch number, lot number, date of manufacture, and date of certification expiration. The last heading is a paragraph describing the certification.

Scope

1.1 This certification of coating conformance form provides procurement information concerning products being furnished in accordance with a specific coating specification and additional requirements contained in the purchase order (see Fig. 1).

CERTIFICATION OF COATING CONFORMANCE FORM

Number:
Date:

I. GENERAL TYPE AND DESCRIPTION:

Generic Type:

Manufacturer’s Designation:

Specification Number:

Formula Number:

Number of Components:

Component Identification (if applicable):

Color:

II. BUYER INFORMATION:

Name and Address:

Purchase Order Number:

Release Number (if applicable):

Part Number (if applicable):

Item Number (if applicable):

Stock Number (if applicable):

III. SELLER INFORMATION:

Name and Address:

Seller’s Representative:

(Include Telephone Number)

Batch Number:

Lot No.:

Date of Manufacture:

Date of Expiration of Certification:

IV. CERTIFICATION:

This is to certify that the above material being furnished has been manufactured in accordance with the specification and meets all specification requirements contained in the above purchase order.

 NAME AND TITLE SIGNATURE DATE

FIG. 1 Certification Form

1.2 The completed form can be utilized to help evaluate the acceptability of the paint being furnished.

Go to ASTM D5063 at ASTM.org

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