USMCA / CUSMA CERTIFICATION OF ORIGIN
N.º COO-2026-0418
22 de out. de 2026
2. Certifier (name, title, address, phone, email)
Dana Kowalski, Export Compliance Manager Great Lakes Fixtures Inc 2200 Industrial Pkwy, Toledo, OH 43612, USA +1 419 000 0000, dana@example.com
3. Exporter (if different from the certifier)
Same as certifier
4. Producer
Same as exporter
5. Importer (if known)
Maple Home Supply Ltd 85 Commerce Valley Dr Markham, ON L3T 7V9, Canada +1 905 000 0000, imports@example.com BN 000000000RM0001
- Agreement
- USMCA (United States)
- 1. Certification by
- Exportador
- Certificate or reference no.
- COO-2026-0418
- Data
- 22 de out. de 2026
- Invoice no. (single shipment)
- INV-2026-0418
| 6. Description of the good | 6. HS code (6 digits) | 7. Origin criterion | País de origem | Quantity (optional) |
|---|---|---|---|---|
| Steel shelving units, 5 tier, 72 × 36 × 18 in, powder coated | 9403.20 | B | US | 240 units |
| Wood display tables, solid oak, 48 × 24 in | 9403.60 | A | US | 60 units |
9. Certification
I certify that the goods described in this document qualify as originating and the information contained in this document is true and accurate. I assume responsibility for proving such representations and agree to maintain and present upon request or to make available during a verification visit, documentation necessary to support this certification.
Origin criteria: A wholly obtained or produced; B meets the product specific rule of origin (Annex 4-B); C produced entirely from originating materials; D meets the rule under Article 4.2(4) or 4.2(5) (for example unassembled goods). The agreement has no official form: any document with these nine data elements is valid. Keep supporting records for at least 5 years.