有害物质不使用证明书(含卤素)

Form No.：TB-WI36-01 Rev.A P:1

Certificate of the Non-Use Hazardous Substances for Use-Halogen Product Date Company Representative Title 公司代表人职称：

Please Mark ■ Warranty Application 请于适用保证范围标示■：

□ All “Products” we sold to XX 所有我方售予XX “产品”

□XX Part number XX 料号：

Vender PN 供货商料号：

To XX Optoelectronics CO.,LTD ：

We hereby represent and warrant that the products and components (“Products”) we sold to XX Group do not contain the level 1 hazardous substances listed in the then current XX WI-07 document*, including but not limited to design, modification, purchasing, and manufacturing management, as well as the confirming and judging of the test, which the XX Group reserves the right to modify these documents at any time. The aforementioned Products include ：[1] Products and all materials of the Products; [2] packaging materials; and [3] all materials used in design, manufacturing and reworking processes. In addition, the information of hazardous substances classified at level 3 should be disclosed when these substances are intentionally used in the said Products.

此致XXXX 科技有限公司：

我们特此代表并保证所有售予XX 集团之产品及零组件(“产品”)，皆不含有当时XXWI-07文件中所列的一级有害物质*，包括但不限于设计、变更、采购、生产管理及确认测定及判定，上述文件XX 集团保留随时修改的权利。前述所提及的产品包含：[1]产品或产品所使用到的所有原物料；[2]包装材料；[3]设计、生产及重工过程中所使用到的所有原物料；此外，若前述提及之产品中刻意添加三级有害物质，则须揭露信息。

We further agree to indemnify and hold XX Group and their officers, directors, employees, successors and assigns, harmless from and against any losses, damages, claims, demands, suits, liabilities and expenses (including reasonable attorneys’ fees and court costs) arising out of or resulting from a ny lawsuit, judicial action, or similar proceeding for any breach of the foregoing warranty.

我们进一步同意赔偿和使XX 集团及其集团人员，包括高级主管、董事、员工、代理人、继承者和受让人，不受任何起因于我方违反前项保证所致之任何诉讼、司法上行为或类似行为而受有损失、损害、求偿、请求、诉讼、责任及费用(包括合理的律师费用和法院费用)。

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* If the Product contains the hazardous substances defined as the exemptions in WI-07, please check the appropriate box in the Appendix. (OEM/ODM/EMS vendor fill out ONLY).

*若您是外包商且产品所含有害物质属于WI-07 所定义之除外项目，请勾选附件之选项(零件供货商免填)。