SAMPLE …

                                        SAMPLE

                              [COMPANY LETTERHEAD]

                               Certificate of Compliance

                          Reduction of Toxics in Packaging


We certify that all packaging and packaging components sold to [Company Name] or its
subsidiaries in the State(s) of [State Name(s)] comply with the requirements of the toxics
in packaging law(s). Specifically:

1) We certify that the regulated metals ­ lead, mercury, cadmium, and hexavalent
chromium -- were not intentionally added to any package or packaging component
during the manufacturing process.

2) We further certify that the sum of the incidental concentration levels of lead,
mercury, cadmium and hexavalent chromium present in any package or package
component does not exceed 100 parts per million by weight.

3) We will maintain adequate documentation of this certification for inspection upon
request.


COMPANY NAME:________________________________________________
ADDRESS:______________________________________________________
_______________________________________________________________

CERTIFIED BY:
_______________________________             ______________________________
                        (Name)                                  (Signature)
_______________________________             ______________________________
                        (Title)                                 (Date)