Submit Your Sample Submit Your SampleSubmitter name/contactSubmitter name/contactCompany/OrganizationAddressStreet AddressCityStateZip CodeEmailPhone/MobileManufacturer name/contactEnter name hereCompany/OrganizationAddressStreet AddressCityStateZip CodePhone/MobileEmailManufacturers’ Certification Initial I hereby certify that all samples and/or technical information provided for CMA testing/review is supplied by the manufacturer. Initial I hereby certify that all information provided herein is complete, accurate and that the items submitted for testing are the materials disclosed in this document and sold in the marketplace under the listed item numbers. Initial I hereby certify that samples submitted meet ASTM D6400 or EN13432(biopolymer blends or monolayer), ASTM D6868 (coated fiber and multilayer structures), and/or meets criteria for compostability as an untreated wood, paper or wood fiber product and/or is designed specifically to be compostable. I certify that all results from ASTM tests completed are submitted with this profile as proofof meeting that standard or are represented by an equivalent certification (BPI or TUV) or other documentation as requested. Initial I acknowledge that CMA reserves the right to purchase items represented by this submission to independently test for accuracy andintegrity. Any “passing” result by CMA does not apply to any item other than the exact item/SKU listed herein that is tested or reviewed. Any results from this test do not apply to any item or items where there is variation in constituency or the manufacturing process. Initial To remain on any list of commercially accepted items for any facility or group of facilities, CMA reserves the right to require annualtesting or recertification at our request and discretion to ensure no changes in content or manufacturing process has occurred. Initial The testing for an item and an indication of acceptance by one or any CMA facilities does NOT authorize any use of facility or CMAlogos, trademarks, trade names, letterhead, or company name on such item, related marketing, educational or promotional materialof such item. Any such uses can be authorized, at our discretion, only pursuant to a formal written license agreement through the Compost Manufacturing Alliance, LLC. Initial It is acknowledged that CMA will not use or disclose any of the manufacturer’s information (except to the manufacturer or agent of the manufacturer that is designated, in writing, by the manufacturer) for the sole purpose of testing. To the extent that the manufacturer receives any information from CMA, other than Pass/Fail test results, the manufacturer shall make no use of such information except as permitted in writing by CMA. CMA shall retain records of its testing in accordance with its retention policies and protocols. Initial If submitting for recertification, I verify that the samples submitted and represented on this profile are identical to the original item submitted with no variation in constituency or manufacturing process. Printed name of manufacturerDateSignature of manufacturer: Sign Here Compost Manufacturing Alliance Sample Descriptions-PROFILE(For use with any facility within the CMA network- copy and add multiple pagSample ID # / SKUProduct DescriptionProduct Composition (100%)CommentsResults (CMA USE ONLY)CMA CommentsSample ID # / SKUProduct DescriptionProduct Composition (100%)CommentsResults (CMA USE ONLY)CMA CommentsSample ID # / SKUProduct DescriptionProduct Composition (100%)CommentsResults (CMA USE ONLY)CMA CommentsSample ID # / SKUProduct DescriptionProduct Composition (100%)CommentsResults (CMA USE ONLY)CMA CommentsSample ID # / SKUProduct DescriptionProduct Composition (100%)CommentsResults (CMA USE ONLY)CMA CommentsTests and reviews to which this document applies:Manufacturer NameManufacturer AddressAddressCityStateZip CodeLine Item/SKUS represented by this addendumCMA requires product submitters to identify products with the potential to contain per- and poly-fluoroalkyl substances (PFAS, sometimes referred to as PFCs). The following questions must be answered regarding products you are submitting for consideration at CMA facilities. Products containing >100ppm total fluorine are not eligible for CMA certification. Required information for CMA SUBMISSIONs related to fluorinated chemicals in products effective Jan. 1, 20191.Do/does your product(s) contain total fluorine > 100 ppm? Yes, > 100 ppm No, < 100 ppm2. What is/are the level(s) of total fluorine in your products? What laboratory method was used to determine fluorine levels? Please attach laboratory report, or provide results to CMA within 90 days of the signature date below Check if analytical is attached Check if analytical will be provided within 90 days of signature date below Item 35. PFAS are commonly used in/as lubricants and mold release agents. Have you checked to ensure PFAS are not being used in or on equipment to manufacture your products? Yes, I confirm PFAS are not used in the production process No, I cannot confirm PFAS are not being used in the production process. Additional comments to questions can be added hereAcknowledgement that all information as presented is correct and complete by manufacturer or authorized submitter.Manufacturer’s/Submitter’s Printed NameDate / TimeManufacturer’s /Submitter’s Signature Sign Here Submit