<MainDeclaration version="2.0">
<BusinessInfo mode="Distribute">
<Response date="2012-11-08" fieldLock="true">
<Authorizer name="Lloyd Luken" title="Lord of the Ring">
<Email address="Lluken@Lookout.com"/>
<SurfaceAddress/><Phone number="123 456 7890"/>
</Authorizer><SupplyCompany name="Lookout Labs, Inc.">
<CompanyID authority="not duns" identity="1234"/>
</SupplyCompany><Contact title="Lord of the Ring" name="Lloyd Luken"><Email address="Lluken@Lookout.com"/>
<SurfaceAddress/>
<Phone number="555-2045"/>
</Contact></Response>
<Declaration legalType="Custom" legalDef="To be accepted as submitted" supplierAcceptance="true"/>
<EBusinessInfo/></BusinessInfo>
<Include>
<Sectional name="LaboratoryReport"/>
</Include>
<Product numberOfInstances="1" unitType="Each">
<ProductID itemName="Fetzer valve" itemNumber="987654321" effectiveDate="2012-10-05">
<Amount UOM="g" value="8.8"/>
</ProductID><MaterialInfo/>

<Sample numberOfInstances="1" unitType="Each">
<ProductID itemName="Housing" itemNumber="H1">
<Amount UOM="g" value="3"/>
</ProductID>
<MaterialInfo>
<AnalyteList>
<AnalyteID authority="CAS" identity="7439- "/>
<Analyte name="lead">
<ReportedConcentration sampleID="S1" laboratoryReportingLimit="0.1" testMethod="EPA -method#" testSequence="">
<ReportedAmount value="100" UOM="ppm"/>
</ReportedConcentration>
</Analyte>
</AnalyteList>
<AnalyteList>
<AnalyteID authority="CAS" identity="- - "/>
<Analyte name="Cobalt">
<ReportedConcentration sampleID="S1" laboratoryReportingLimit="0.1" testMethod="EPA -method#" testSequence="">
<ReportedAmount value="30" UOM="ppm"/>
</ReportedConcentration>
</Analyte>
</AnalyteList>
</MaterialInfo>
</Sample>

<Sample numberOfInstances="1" unitType="Each">
<ProductID itemName="Base" itemNumber="B1">
<Amount UOM="massPercent" value="100"/>
</ProductID>
<MaterialInfo>
<AnalyteList>
<AnalyteID authority="CAS" identity="7439- "/>
<Analyte name="lead">
<ReportedConcentration sampleID="S1" laboratoryReportingLimit="0.1" testMethod="EPA -method#" testSequence="">
<ReportedAmount value="50" UOM="ppm"/>
</ReportedConcentration>
</Analyte>
</AnalyteList>
<AnalyteList>
<AnalyteID authority="CAS" identity="- - "/>
<Analyte name="Cobalt">
<ReportedConcentration sampleID="S1" laboratoryReportingLimit="0.1" testMethod="EPA -method#" testSequence="">
<ReportedAmount value="20" UOM="ppm"/>
</ReportedConcentration>
</Analyte>
</AnalyteList>
</MaterialInfo>
</Sample>

</Product>
</MainDeclaration>