Dated: 14.05.

2016

DPTP AUTO PRODUCTS PVT.LTD.

PLOT NO. 143,
SEC.-06, IMT (MANESAR)

Sub Supplier Declaration for Raw Material Source

S.No Part Name Part No. Material Spec. Source Remarks

Primary Secondary
1 OUTER TUBE 2J0153-11 Grade EDD, TATA ESSAR Traders
IS:513

We hereby certify that the raw material used in the above listed parts shall not be from sources other than
the above.
We will procure material only from two sources as given above for any given part.
We will seek prior approval from BSIA for any changes due to availability/supply constraints before
making any change in the source of Raw materials.
Based on the approval from the BSIA on request for Source change ,We will submit the PPAP &
Component level DV/PV for the part which is processed using raw material from the new source.The raw
material from the new source will be introduced in mass production after BSIA approval of the PPAP &
Component level DV/PV.

Supplier Bridgestone STA

Dilip Mahindru
(Prop.)

……………. ……………… ……………………

 CHECKING AIDS
Document No. : CA 05
Customer Name : BRIDGESTONE INDIA AUTOMOTIVE PRODUCTS P.LTD. Supplier Name : DPTP AUTO PRODUCTS PVT.LTD.
Part Number / ECL : J0153-11 Supplier Code :
Part Description : OUTER TUBE Date : 14.05.2016
Rev No. and date 00
Dimension / Instrument ID
S.No. Measuring Instrument Least Count Range REMARKS
Specification No.
1 DIA Ø77.0 + 0/-0.6 V.C. 0.01MM 0-300
2 DIA Ø55.0 ± 0.3 V.C. 0.01MM 0-200
3 HEIGHT 61.4 ± 0.2 H.G. 0.01MM 0-300
5 Thickness 2.0±0.20 MM 0.01MM 0-25

Prepared By Approved By
 Part Submission Warrant
PART INFORMATION

Part Name PRESSURE PLATE Cust. Part Number 32AZ-022554M

Shown on Drawing Number 32AZ-022554M Organization Part Number -

Engineering Change Level Dated 21.09.2015

Additional Engineering Changes -- Dated --

Safety and/or Government Regulation ● Yes No Purchase Order No. Weight (kg)

Checking Aid Number CA05 Checking Aid Engineering Change Level 0 Dated 21.09.2015

ORGANIZATION MANUFACTURING INFORMATION CUSTOMER SUBMITTAL INFORMATION

DPTP AUTO PRODUTCS PVT.LTD. Rasandik Engineering Industries India ltd.

Organization Name and Supplier/vendor Code Customer Name/ Division
PLOT NO. 143,SECTOR-6,IMT-MANESAR , IMT Manesar, Gurgaon (HR)
Street Address Buyer/ Buyer Code
GURGAON HR Automobile
City: GURGAO Region HR Postal code:122050 Zip
Country: INDIA Application
MATERIALS REPORTING
Has customer-required Substances of Concern information been reported? Yes No
Submitted by IMDS or other customer format: IMDS

Are polymeric parts identified with appropriate ISO marking codes? Yes No ● n/a
REASON FOR SUBMISSION (Check at least one)

✘ Initial submission Change to Optional Construction or Material

Engineering Change(s) Supplier or Material Source Change
Tooling: Transfer, Replacement, Refurbishment, or additional Change in Part Processing
Correction of Discrepancy Parts produced at Additional Location
Tooling Inactive > than 1 year Other - please specify below

REQUESTED 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.
Level 5 - Warrant with product samples and complete supporting data reviewed at supplier's manufacturing location.

SUBMISSION RESULTS
The results for ✘ dimensional measurements, ✘ material and functional tests appearance criteria ✘ statistical process Control
These results meet all design requirements ✘ Yes No. (If "No" - Explanation Required).
Mold / Cavity / Production Process(es) N.A.
DECLARATION
I affirm that the samples represented by this warrant are representative of our parts which were made by a process which meets all
Production Part Approval Process Manual 4th Edition requirements including all Ford-specific requirements. I further affirm that these
samples were produced at the production rate of _ 800 / _8_ hours using One production streams. I also certify that
documented evidence of such compliance is on file and is available for review. I have noted any exceptions from this declaration below.

EXPLANATION/COMMENTS

Is each Customer Tool properly tagged and numbered? Yes No n/a

Organization Authorized Signature Date 14.05.2016
Print Name DILIP MAHINDRU Phone No. 9810077722 Fax No. 2585807

Title C.E.O. Email technofabsb14@gmail.com

FOR CUSTOMER USE ONLY (IF APPLICABLE)

PPAP Warrant Others______________________________________
Disposition Approved Rejected

Customer Signature . Date .

Print Name_______
Print Name_______ Customer Tracking number (Optional)_____________