North American Free Trade Agreement Certificate of Origin
1. EXPORTER NAME AND ADDRESS
Pennsylvania Machine Works, Inc.
201 Bethel Avenue
Aston, Pa 19014-3443 U.S.A.
TAX IDENTIFICATION NUMBER: 231988630 		2. BLANKET PERIOD (DD/MM/YR)

FROM: 01/01/2012

TO: 31/12/2012

3. PRODUCER NAME AND ADDRESS:

SAME AS ABOVE

TAX IDENTIFICATION NUMBER: 		4. IMPORTER NAME AND ADDRESS:


TAX IDENTIFICATION NUMBER:
5.
DESCRIPTION OF GOOD(S):

 		6.
H.S. TARIFF
CLASSIFICATION
NUMBER
 		7.
PREFERENCE CRITERION
 8.
PRODUCER
 9.
NET COST
 10.
COUNTRY
OF ORIGIN
Stainless Steel Pipe Fittings 7307.23 C YES NO U.S.
Stainless Steel Pipe Nipples 7307.29 C YES NO U.S.
Carbon Steel Pipe Fittings 7307.93 C YES NO U.S.
Carbon Steel Pipe Nipples 7307.99 C YES NO U.S.
Chrome-Moly Pipe Fittings 7307.93 C YES NO U.S.
Aluminum Pipe Fittings 7609.00 C YES NO U.S.
Ni/Cu 400 Pipe Fittings 7507.20 C YES NO U.S.
Ni 200 Pipe Fittings 7507.20 C YES NO U.S.
Low Temperature Pipe Fittings 7307.99 C YES NO U.S.
Forged Steel Pipe Fittings 7307.92 C YES NO U.S.
Other Stainless Steel Fittings 7307.29 C YES NO U.S.
Other Fittings - Other Than Stainless Steel 7307.99 C YES NO U.S.
I CERTIFY THAT:
-The Information on this document is true and accurate and I assume the responsibility for proving such representations. I understand that I am liable for any false statements or material omissions made on or in connection with this document;
-I agree to maintain, and present upon request, documentation necessary to support this certificate, and to inform, in writing, all persons to whom the certificate was given of any changes that could affect the accuracy or validity of this certificate;
-The goods originated in the territory of one or more of the Parties, and comply with the origin requirements specified for those goods in the North American Free Trade Agreement, and unless specifically exempted in Article 411 or Annex 401, there has been no further production or any other operation outside the territories of the parties; and
-This certificate consists of 1 page(s), including all attachments.
11. AUTHORIZED SIGNATURE:
 COMPANY:
PENNSYLVANIA MACHINE WORKS
DATE: 12/31/2011
TELEPHONE: 610-497-3300 FAX: 610-497-3325
NAME: James B. Friant TITLE: Manager
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