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1、供应商名称：Supplier Name:日期：Date:供应商编号：Supplier Code：零件名称：Part Name:生产厂址：Plant Location:零件编号：Part Number:项目/型号:Program:图纸日期：Drawing Date:车型年代:Model Year:图纸版本：Drawing Version:零件编号Part Number客户日生产最低需求量Daily MMDB LCR日合同产能Daily Contracted按节拍生产结果Run at Rate ResultsPPAP状态PPAPStatus产能Capacity小时数Hours最终工序Final O
2、p.瓶颈工序Constraint生产时间Duration批准FullTotal合计需要时可另加页Use additional pages if required供应商监控 Supplier Monitored客户监控Customer Monitored控制计划评审（PD-SQD-009附件一GM 1927-16_PCPA)是否合格并作为GP-9报告的附件？Has the Process Control Plan Audit(Attachment GM1927-16)passed and is it attached?生产能力分析表（附件C）通过并作为GP-9报告的附件？Has the Capa
3、city Analysis(Attachments GM1960-C,C1,C2,and/or C3)passed and is it attached?在实施Run Rate前是否对分供方满足产能和质量要求的能力进行了书面确认？Has the subcontractors ability to meet the capacity and quality requirements been confirmed inwriting by the supplier prior to the Run at Rate?所生产的零件满足PPAP规定的顾客质量要求？Do the parts produce
4、d meet customers quality requirements as stated in PPAP?通过PASS有条件通过Conditional Pass 供应商能够在合同规定的工作时间内能够满足一汽通用项目组设定的产量需求，但是不能满足合同产能需求，同时供应商提供了满足合同产能的计划（包括重新进行产能分析的时间），并且SQE同意并获得SQE经理批准。失败供应商没有通过控制计划评审，未能表明满足合同生产能力，或没有提供分供方生产能力的书面证明FAIL Supplier failed the Process Control Plan Audit,failed to demonstra
5、te ability to produce contracted capacity,or failed to provide subcontractors written verification备注Comments:后续措施Follow up scheduled:是Yes否No我声明，本次提交所适用的样品是出自我们生产过程的，具有代表性的零件，且已符合生产件批准程序手册第四版的所有要求；我进一步保证这些样品是以 件/个小时的生产节拍制造的。同时，我保证所有符合性证明文件都已归档备妥，以获评审。我还说明了任何与此声明有偏差的内容，见下文。Iaffirmthatthesamplesreprese
6、ntedbythiswarrantarerepresentativeofourparts,whichweremadebyaprocessthatmeetsallProductionPartApprovalProcessManual4thEditionRequirements.Ifurtheraffirmthatthesesampleswereproducedattheproductionrateof_/_hours.Ialsocertifythatdocumentedevidenceofsuchcomplianceisonfileandavailableforyourreview.Ihaven
7、otedanydeviationfromthisdeclarationbelow.供应商签名Supplier Signature打印名称Print Name电话Phone Number供应商质量工程师签名SQE Signature打印名称Print Name电话Phone Number临时认可可售SaleableYesNoPPAP状态PPAPStatus日期Date日期Date有条件通过Conditional Pass 供应商能够在合同规定的工作时间内能够满足一汽通用项目组设定的产量需求，但是不能满足合同产能需求，同时供应商提供了满足合同产能的计划（包括重新进行产能分析的时间），并且SQE同意
8、并获得SQE经理批准。失败供应商没有通过控制计划评审，未能表明满足合同生产能力，或没有提供分供方生产能力的书面证明FAIL Supplier failed the Process Control Plan Audit,failed to demonstrate ability to produce contracted capacity,or failed to provide subcontractors written verificationIaffirmthatthesamplesrepresentedbythiswarrantarerepresentativeofourparts,whichweremadebyaprocessthatmeetsallProductionPartApprovalProcessManual4thEditionRequirements.Ifurtheraffirmthatthesesampleswereproducedattheproductionrateof_/_hours.Ialsocertifythatdocumentedevidenceofsuchcomplianceisonfileandavailableforyourreview.Ihavenotedanydeviationfromthisdeclarationbelow.