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End-Use Certification

This _ MX-F401RFVX__ will be used for __Hypochlorite _ NaCIO

Select pump(s) or part(s) State end-useCIRCULATION_________________________________________________


by ___SOLUCIONES QUIMICAS VENEZOLANAS C.A_____ at the following location:
State end userStreet: __La Limpia Av. 28 c/84 a una cuadra de papelera Ramirez Maracaibo Edo. Zulia_______________

City: _______MARACAIBO_________________________________

Area Code:_________0261_________________________

Country: ___VENEZUELA_______________________________

Company Web Address: _NONE____________________

Specifically, the MX0438/MX0428 ____ will be used for _CIRCULATION OFNaCIO
Select pump(s) or part(s)

_______ _________________________.
Describe end-use

The ultimate consignee, SOLUCIONES QUIMICAS VENEZOLANAS C.AState name of ultimate consignee
____________, is located at the following address.

Street: La Limpia Av. 28 c/84 a una cuadra de papelera RamirezMaracaibo Edo. Zulia
City: ___________MARACAIBO______________________________

Area Code: ___________0261________________________

Country: ________VENEZUELA_________________________

Theultimate consignee is ___ PREPARATION OF CHEMICALS FOR HOUSEHOLD USE Describe business

Its primary customers are _SOLQUIVEN, VENCLORO_______________________.Identify classes of customers

__________ENRIQUE PARRA_________________________ certifies that it will not use this
Ultimate consignee’s name

MX0438/MX0428 ___ inresearch on, or the development, design, manufacture, construction,
Select pump(s) or part(s)
testing or maintenance of nuclear explosive devices, or components or subsystems of such a device;...
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