Supplier Instructions:

1. Fill in the 8.5 x 11 Certified Material Tag. All other tags will be automatically populated.
a. All sections must be completed or marked with an N/A for Not Applicable.
b. Larger labels are for use on the outside of skids. Smaller labels are for
cartons and inner packing such as plastic bagged parts going into the clean
room. If packing requirements use all three types (bagged parts in cartons on
skids) please use all appropriate sized labels on bags, cartons and skids.
Bags within larger over pack boxes must contain a (white) certified material label
2. Revision letter must change if the sort critera changes.
3. Form must be printed on GREEN paper unless using Avery labels as noted.
a. The 8.5x11 and "Smaller Tags" tabs have had the label areas colored green
using the fill tool. If using green paper, change the fill color to "no fill" to avoid
using up green ink!
4. Attach to first 5 shipments on the outside of packaging on at least 2 sides of the skid.
All 4 sides is better. Subsequent shipments may be labeled with revision letter only.
5. Use ORANGE External Change Alert Tag (RO-814f6) supplied by GMCH production
readiness after PPAP approval for a corrective action breakpoint.

GMCH Rochester Supply Chain Instructions:

1. When Material arrives with Certified Material Tag, contact Supplier Quality for any
instructions regarding containment of uncertified material if not previously
communicated.
2. Notify manufacturing of breakpoint.

Form#: RO- Effective Date: 6/8/17 Supersedes: 2/12/15

terial label.

Form#: RO- Effective Date: 6/8/17 Supersedes: 2/12/15

 CERTIFIED MATERIAL
Supplier QES 3rd Party

DATE OF 1st SHIPMENT: Audit Level:

PART #:

Certified for: Sort Method:

Gage
Visual
Automated

Audit

Certification Mark on part (If Applicable):

Form#: RO- Effective Date:6/8/17 Supersedes: 2/12/15

 CERTIFIED MATERIAL
Supplier QES 3rd Party

DATE OF 1st SHIPMENT: 12/30/1899 Audit Level: 0

PART #: 0

Certified for: Sort Method:

0
Gage

Visual

Automated
Audit

Certification Mark on part (If Applicable):

0

CERTIFIED MATERIAL
Supplier QES 3rd Party

DATE OF 1st SHIPMENT: 12/30/1899 Audit Level: 0

PART #: 0

Certified for: Sort Method:

0
Gage

Visual
Automated

Audit

Certification Mark on part (If Applicable):

0

Form#: RO- Effective Date: 6/8/17 Supersedes: 2/12/15

 CERTIFIED MATERIAL CERTIFIED MATERIAL
DATE OF 1st SHIPMENT: 12/30/1899 Audit Level: 0 DATE OF 1st SHIPMENT: 12/30/1899 Audit Level: 0
PART #: 0 PART #: 0
Certified for: Sort Method: Certified for: Sort Method:
0 0

Certification Mark on part (If Applicable): Certification Mark on part (If Applicable):
0 0

CERTIFIED MATERIAL CERTIFIED MATERIAL

DATE OF 1st SHIPMENT: 12/30/1899 Audit Level: 0 DATE OF 1st SHIPMENT: 12/30/1899 Audit Level: 0
PART #: 0 PART #: 0
Certified for: Sort Method: Certified for: Sort Method:
0 0

Certification Mark on part (If Applicable): Certification Mark on part (If Applicable):
0 0

CERTIFIED MATERIAL CERTIFIED MATERIAL

DATE OF 1st SHIPMENT: 12/30/1899 Audit Level: 0 DATE OF 1st SHIPMENT: 12/30/1899 Audit Level: 0
PART #: 0 PART #: 0
Certified for: Sort Method: Certified for: Sort Method:
0 0

Certification Mark on part (If Applicable): Certification Mark on part (If Applicable):
0 0

CERTIFIED MATERIAL CERTIFIED MATERIAL

DATE OF 1st SHIPMENT: 12/30/1899 Audit Level: 0 DATE OF 1st SHIPMENT: 12/30/1899 Audit Level: 0
PART #: 0 PART #: 0
Certified for: Sort Method: Certified for: Sort Method:
0 0

Certification Mark on part (If Applicable): Certification Mark on part (If Applicable):
0 0

CERTIFIED MATERIAL CERTIFIED MATERIAL

DATE OF 1st SHIPMENT: 12/30/1899 Audit Level: 0 DATE OF 1st SHIPMENT: 12/30/1899 Audit Level: 0
PART #: 0 PART #: 0
Certified for: Sort Method: Certified for: Sort Method:
0 0

Certification Mark on part (If Applicable): Certification Mark on part (If Applicable):

Form#: RO- Effective Date:6/8/17 Supersedes: 2/12/15

0 0

Form#: RO- Effective Date:6/8/17 Supersedes: 2/12/15

 CERTIFIED MATERIAL CERTIFIED MATERIAL
DATE OF 1st SHIPMENT: 12/30/1899 Audit Level: 0 DATE OF 1st SHIPMENT: 12/30/1899 Audit Level: 0

PART #: 0 PART #: 0

Certified for: Sort Method: Certified for: Sort Method:

0 0

Certification Mark on part (If Applicable): Certification Mark on part (If Applicable):
0 0

CERTIFIED MATERIAL CERTIFIED MATERIAL

DATE OF 1st SHIPMENT: 12/30/1899 Audit Level: 0 DATE OF 1st SHIPMENT: 12/30/1899 Audit Level: 0

PART #: 0 PART #: 0

Certified for: Sort Method: Certified for: Sort Method:

0 0

Certification Mark on part (If Applicable): Certification Mark on part (If Applicable):
0 0

CERTIFIED MATERIAL CERTIFIED MATERIAL

DATE OF 1st SHIPMENT: 12/30/1899 Audit Level: 0 DATE OF 1st SHIPMENT: 12/30/1899 Audit Level: 0

PART #: 0 PART #: 0

Certified for: Sort Method: Certified for: Sort Method:

0 0

Certification Mark on part (If Applicable): Certification Mark on part (If Applicable):
0 0

Form#: RO- Effective Date:6/8/17 Supersedes: 2/12/15

0 0

Form#: RO- Effective Date:6/8/17 Supersedes: 2/12/15