Instructions For KC-327KCPBAGSDECLR BAG MANUFACTURER DECLARATION SHEET

Instructions For KC-327KCPBAGSDECLR BAG MANUFACTURER DECLARATION SHEET Approved bag manufacturers use this form to perform testing on the bags that are produced for export shipments. Submit the original of the completed form in hard copy or via facsimile (816-823-2586) to the Kansas City Commodity Office, International Procurement Division, Procurement Branch, Mail Stop 8738, P.O. Box 419205, Kansas City, MO 64141-6205. For questions or assistance, contact the Kansas City Commodity Office, International Procurement Division, Procurement Branch, at 816-926-6524. Bag manufacturers must complete Items 1 through 25a and b. Items 26a and 26b are for completion by Kansas City Commodity Office. Fld Name / Item No. 1 Company Name 2 Address 3 Phone Number 4a-c Production Capacity 5 Fabric Style No./Product Code 6 ID Marker Yarn(s) 7 ID Marker Location 8a-e Formula by Percentage Instruction Enter name of manufacturing company. Enter address of production facility. Enter telephone number (including area code) of production facility. Item 4a. Enter number of looms. Item 4b. Enter output per loom (meters per day) Item 4c. Enter average days of operation per week. Enter fabric style number and production code. Enter company ID marker yarn(s). Enter ID marker location. Item 8a. Item 8b. Item 8c. Item 8d. Item 8e. Enter Polypropylene Resin percentage. Enter Calcium Carbonate percentage. Enter UV Resin Compound percentage. Enter Color Concentrate percentage. Identify other and include percentage. Page 1 of 3 Fld Name / Item No. 9 100 Percent U.S. Origin 10 100 Percent Virgin Polymer 11 Meets FDA Requirements 12 Coating 13 Lot ID Method for Traceability 14 Warp and Fill Count 15 Twisted Yarns 16 Fabric Weight 17 Denier 18 Color 19 Sewing 20a-c Air Permeability 21a-c Impact Performance Test 22a-c Slide Angle Test 23a-c UV Resistance Percentage Check yes or no. Instruction Check yes or no. Check yes or no. Check yes or no. Enter lot ID method. Enter warp and fill counts. Check yes or no. If yes, enter frequency. Enter fabric weight (ounces per square yard) Enter grams. Check beige, white, or buff, as applicable. Enter threads per inch. Item 20a. Item 20b. Item 20c. Item 21a. Item 21b. Item 21c. Item 22a. Item 22b. Item 22c. Item 23a. Item 23b. Item 23c. Enter name of person performing test. Enter date test performed. Enter results (per cubic feet). Enter name of person performing test. Enter date test performed. Enter results (inches per second). Enter name of person performing test. Enter date test performed. Enter results (degrees). Enter name of person performing test. Enter date test performed. Enter results (percent). Page 2 of 3 Fld Name / Instruction Item No. 24a-d Item 24a. Enter pre-weathering pounds average warp. Tensile Strength Item 24b. Enter pre-weathering pounds average fill. Item 24c. Enter post-weathering pounds average warp. Item 24d. Enter post-weathering pounds average fill. 25a-b Item 25a. Enter date issued. Authorized Bag Item 25b. Signature of authorized bag manufacturer representative. Manufacturer Representative If you are mailing or faxing this form, print the form and manually enter your signature. 26a-b To be completed by U.S. Department of Agriculture-Farm Service USDA-FSA Agency official. Official Item 26a. Enter date received. Item 26b. Signature of USDA-FSA official receiving form. Page 3 of 3