<p> Amerequip EU RoHS Compliance Declaration Part Number: Revision Level: Part Description: Supplier: Supplier Number: Supplier Contact: Phone: Email: Reason For Submission: *Attach documentation as needed</p><p>☐ Initial Submission ☐*Other – Please Specify: ☐ Correction of Discrepancy (Resubmission) Submission Information: Are all Raw Materials used in compliance with SPEC-C-Q005 Table 1? *Raw Material = bar stocks, sheet or plate, castings, molded components, etc. ☐ Yes ☐ No (If No, explanation required) Are all Ancillary Materials used in compliance with SPEC-C-Q005 Table 1? *Ancillary = wires, hardware, clips, grommets, ties, hoses, fittings, etc. ☐ Yes ☐ No (If No, explanation required) Are all Indirect Materials used in compliance with SPEC-C-Q005 Table 1? *Indirect = paints, thread locking compounds, weld wire, lubricants etc. ☐ Yes ☐ No (If No, explanation required) Chemical Substance Limits: This table is for reference only. See SPEC-C-Q005 Table 1.</p><p>Substance Concentration Limit by Mass in Any Homogeneous Material Cadmium 0.01% (100 ppm) Lead 0.1% (1000 ppm) Mercury 0.1% (1000 ppm) Hexavalent Chromium 0.1% (1000 ppm) Polybrominated biphenyls (PBB) 0.1% (1000 ppm) Polybrominated diphenyl ethers (PBDE) 0.1% (1000 ppm) Bis (2-ethylhexyl) phthalate (DEHP) 0.1% (1000 ppm) Bis (2-ethylhexyl) phthalate (DEHP) 0.1% (1000 ppm) Butyl benzyl phthalate (BBP) 0.1% (1000 ppm) Dibutyl phthalate (DBP) 0.1% (1000 ppm) Disobutyl phthalate (DIBP) 0.1% (1000 ppm)</p><p>Amerequip EU RoHS Compliance Declaration Agreement:</p><p>Name (printed): Title: Phone: Supplier Authorized Signature: Date: </p><p>Amerequip EU RoHS Compliance Declaration (F-C-QC057) • Rev B – 5/31/2017 • Approved by: Bob Heus Print Date: 04/04/18 This approval is advisory and does not change the Supplier's responsibility for ensuring that all characteristics meet their specifications. The Supplier is still responsible for the changes. If the changes result in deficiencies not found in these approved items, the Supplier will reimburse Amerequip for the expenses needed to correct the deficiencies. This reimbursement for deficiencies may be defined in Amerequip Supplier Requirements (F-C-QC027) or specific contracts.</p>