104.针对IOS-MAT-0010聚合物包括塑料硅胶和橡胶弹性体乳胶体材料的自我声明IOS-MAT-0010SDpolymerics.docxVIP

Self-declaration formPolymerics materials Spec. nr: Date: Version nr IOS-MAT-0010 2013-05-10 AA-10911-11 ? IKEA of Sweden AB ? 2013Page PAGE \* MERGEFORMAT 6 Self declaration for polymerics including plastics, silicone and rubber/ elastomers/ latex, according to IOS-MAT-0010针对IOS-MAT-0010聚合物包括塑料、硅胶、和橡胶/弹性体/乳胶体材料的自我声明 This form shall be used to certify compliance with requirements according to specification IOS-MAT-0010(AA-10911-11). This form-or an equivalent form with the same information- is to be signed by the final formulator(material producer) of the final polymeric material, i.e. the moulder or extruder(or the supplier of granules if they are pre-coloured and the moulder/ extruder does not add any additives when forming the plastic component ). This can be either the IKEA supplier or a sub-supplier(or a sub-sub-supplier, etc).此文件是针对IOS-MAT-0010(AA-10911-11)的符合性声明。此文件或具备同等信息的声明文件由聚合物完结材料的最终成型方（材料生产商）签署，即成型或挤出供应商（或进行预着色的粒子供应商，如果成型或挤出方在制作塑料部件时未添加任何化学助剂）。该签署人可以是宜家供应商或其下级供应商（或下-下级供应商，等）。 The self declaration shall be in English – addition of information in local language is voluntary.自我声明必须是英文的，以当地语言陈述的附加信息仅作参考。 Supporting documents, verifying fulfillment of the requirements, shall be listed inTable 4, such as: Test reports, Self declarations or certificates from sub-suppliers of raw material and chemicals used to make the polymeric material. 支持文件，即证实可以满足要求的文件，须列在表4中，比如： 测试报告 来自于生产该聚合材料所需的原材料和化学产品的下级供应商的自我声明或证书。 Table 1. List of polymeric material materials 表1. 聚合物材料清单 Material identification(trade name, article code, quality and/or other identification) 1 材料识别信息（商品名，产品编码，质量和/或其它识别信息）1 Material description (type of material such as material base content, physical characteristics, colour ect) 材料描述（材料类别例如材料基本内容，物理特性，颜色等） Contains only virgin polymeric material 仅含未经使用的聚合材料 Contains external recycled polymeric(state range of percentage of external recycled material) 含有来自于外部的回收聚合材料（具体说明所含外部回收材料的比例） FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX