Certification of Origin

1 Certi cation of Origin USMCA/T-MEC/CUSMA. 1 CERTIFIER Importer exporter Producer 2 CERTIFIER'S DETAILS 3 exporter 'S DETAILS (if di erent than the certi er). Name & Job Title Name Address (including country) Address (including country). Telephone Email Telephone Email Tax ID Number (business number) Tax ID Number (business number). 4 PRODUCER'S DETAILS (if di erent than the certi er or exporter ) 5 IMPORTER'S DETAILS (if di erent than the certi er). Please check one if applicable. Please check one if applicable. Available upon request by Various Producers the importing authorities Unknown Various importers Name Name Address (including country) Address (including country).

2 Telephone Email Telephone Email Tax ID Number (business number) Tax ID Number (business number). 6 DESCRIPTION OF THE GOOD 7 HARMONIZED SYSTEM (HS) 8 Origin 9 COUNTRY. Part or SKU Number TARIFF CLASSIFICATION CRITERION OF Origin . (if applicable) Description (minimum six-digit level). Additional goods can be listed on the continuation chart provided on page 4. 10 BLANKET PERIOD. Period covered by certi cation (if applicable) is up to 12 months from to Signed by the Certi er (see section 2). I certify that the goods described in this document qualify as originating and the information contained in this document is true and accurate. I assume responsibility for proving such representations and agree to maintain and present upon request, or to make available during a veri cation visit, documentation necessary to support this certi cation.

3 This certi cation consists of pages. 11 CERTIFIER'S SIGNATURE DATE. Page 1 of 4. COO - 11/2020 - E. Certi cation of Origin USMCA/T-MEC/CUSMA. Completion Instructions For purposes of obtaining preferential tari treatment, this document must be completed, legible and in the possession of the importer at the time of declaration. This document may be completed by the importer, exporter or producer. 1 CERTIFIER. Importer, exporter or Producer Certi cation of Origin : Indicate whether the certi er is the exporter , producer or importer in accordance with Chapter 5, Article (Claims for Preferential Tari Treatment) of the agreement. 2 CERTIFIER'S DETAILS. Provide the certi er's name, title, address (including country), telephone number and email address.

4 3 exporter 'S DETAILS. Provide the exporter 's name, address (including country), email address and telephone number, if di erent than the certi er. This information is not required if the producer is completing the Certi cation of Origin and does not know the identity of the exporter . The address of the exporter shall be the place of export of the good in a Party's territory. 4 PRODUCER'S DETAILS. Provide the producer's name, address (including country), email address and telephone number, if di erent than the certi er or exporter , or if there are multiple producers, state Various or provide a list of producers. A person that wants this information to remain con dential may state Available upon request by the importing authorities.

5 The address of a producer shall be the place of production of the good in a Party's territory. 5 IMPORTER'S DETAILS. Provide the importer's name, address, email address and telephone number (if known). The address of the importer shall be in a Party's territory. If the identity of the importer is unknown, or there are various importer's, please check the appropriate box. 6 DESCRIPTION OF THE GOOD. Provide a full description for each good ( , what is it?, what is it made from?, what is its intended use?). The description should be su cient to relate it to the invoice description and the Harmonized System (HS) description of the goods. If the Certi cation of Origin covers a single shipment of a good, indicate, if known, the invoice number related to the exportation.

6 7 HARMONIZED SYSTEM (HS) TARIFF CLASSIFICATION. Provide the HS tari classi cation of the good at the six-digit level. 8 Origin CRITERION. Specify the Origin Criterion under which the good quali es, as set out in Chapter 4, Article of the USMCA/T-MEC/CUSMA. agreement (Originating Goods). Criterion A: The good is wholly obtained or produced entirely in the territory of one or more of the USMCA/T-MEC/CUSMA. countries, as de ned in Article of the Agreement;. Criterion B: The good is produced entirely in the territory of one or more of the USMCA/T-MEC/CUSMA countries using non-originating materials, provided the good satis es all applicable requirements of product-speci c rules of Origin .

7 Criterion C: The good is produced entirely in the territory of one or more of the USMCA/T-MEC/CUSMA countries exclusively from originating materials; or Criterion D: The good is produced entirely in the territory of one or more of the USMCA/T-MEC/CUSMA countries. It is classi ed with its materials, or satis es the unassembled goods requirement, and meets a regional value content threshold of not less than 60% if the transaction value method is used, or not less than 50% if the net cost method is used (not including RVC for autos); except for goods in Chapter 61-63 of the H TS. Products provided for under the tari provisions set out in Chapter 2 Table , Table , and Table FOR IMPORTS ONLY Criterion E.

8 FOR CANADA IMPORTS ONLY Schedule 2 of the CUSMA Rules of Origin Regulations . FOR MEXICO IMPORTS ONLY Annex II of the Uniform Regulations regarding USMCA Rules of Origin Click the links below to view the full text of the Rules of Origin for the Importing Country: United States Mexico Canada Page 2 of 4. 9 COUNTRY OF Origin . Provide the country of Origin of the goods ( , United States, Mexico, Canada). 10 BLANKET PERIOD. Include the period if the certi cation covers multiple shipments of identical goods for a speci ed period of up to 12 months as set out in Chapter 5, Article (Basis of a Certi cation of Origin ) of the agreement. United States Mexico Canada 11 CERTIFICATION, CERTIFIER'S SIGNATURE AND DATE.

9 The certi cation must be signed and dated by the certi er and accompanied by the following statement: I certify that the goods described in this document qualify as originating and the information contained in this document is true and accurate. I assume responsibility for proving such representations and agree to maintain and present upon request, or to make available during a veri cation visit, documentation necessary to support this certi cation. Page 3 of 4. Certi cation of Origin USMCA/T-MEC/CUSMA. Continuation Chart Please list additional goods here. 6 DESCRIPTION OF THE GOOD 7 HARMONIZED SYSTEM (HS) 8 Origin 9 COUNTRY. Part or SKU Number TARIFF CLASSIFICATION CRITERION OF Origin .

10 (if applicable) Description (minimum six-digit level). Page 4 of 4.