Return of Goods Authorization: FORM-046 Rev1

IMPORTANT - PLEASE READ CAREFULY!

Many valves where in process handle hazardous chemicals that can be harmful to property or people. The person sending the materials assumes all responsibility for damage to persons or property due to acids or other chemicals contained in materials or equipment returned to Flowserve. No materials can be returned without authorization. Flowserve will not be responsible for material that is not authorized for return or is not accompanied by a return material authorization form. All returned material must be listed and properly described. This form must be sent completed in the annex to the invoice that accompanies the equipment. The absence of any information on this form may result in the product being returned without evaluation.

DATE: (mandatory)

RESPONSIBLE: (mandatory)

REASON OF RETURN: (mandatory) * Warraty analisysReturn of product out of warrantyREPAIR (Evaluate and submit offer)

PRODUCT INFORMATION: (mandatory)

CUSTOMER INFORMATION

Company: (mandatory)

Contact: (mandatory)

Telephone: (mandatory)

Mobile: (mandatory)

Address (mandatory)

STREET (mandatory)

NEIGHBORHOOD (mandatory)

CITY (mandatory)

STATE (mandatory)

ZIP CODE (mandatory)

COUNTRY (mandatory)

Email: (mandatory)

SAFETY DATA

SAFETY DATA (mandatory) * Item has never been in service, MSDS is not requiredItem has been in service with clean water, compressed air or steam. MSDS is not requiredItem has been in service and it is contaminated. MSDS must be send attached to this documentItem has benn in service and it is decontaminated. MSDS is attached.

Subject to decontamination fee..

Inform the midea (mandatory) Advise the procedure to cleaning the midea: (mandatory) File

Inform the midea (mandatory) File

DECONTAMINATION CERTIFICATE (mandatory completion if the equipment has been decontaminated)

"I certify that the returned products have been fully decontaminated, have no chemical residue and do not pose a risk to health or the environment in accordance with applicable laws and regulations."

Responsible for the security information (mandatory completion):

Name (mandatory) Position (mandatory) Date (mandatory)

Inadequate decontamination may result in the product being returned without evaluation, a decontamination fee being charged or the application of sanctions provided for by law.

Responsible for the security information (mandatory completion):

Name (obrigatório) Position (obrigatório) Date (obrigatório)

DETAILS OF THE OCCURRENCE (Provide as much detail as possible, including the tests carried out)

GUIDANCE FOR DECONTAMINATION

For adequate decontamination of the product, Flowserve recommends that the valve be completely disassembled. If you have any questions about how to proceed, please consult the Installation and Operation Manual for the respective valve. Make sure all fluid is removed by checking that there is no residue.

PACKING

Loose or unprotected packaging is not adequate protection. Returned equipment that is damaged in transit will not be accepted. Claims for such damages must be made with the carrier.

Placing the material directly on the body floor (packaging method) is prohibited. Use support pallets or other forms to prevent the material or bodywork from being damaged, avoiding inconvenience for both parties.

SHIPPING

Products must be sent to one of the addresses below: (mandatory)

• Receiving hours are from 8:00 am to 11:00 am and from 1:00 pm to 4:00 pm from Monday to Friday.
• Unless indicated, shipping and return shipping costs must be prepaid (customer payment).
• Please send "notas fiscais" files to nfe_sp@flowserve.com.

Return of Goods Authorization: FORM-046 Rev1

CUSTOMER INFORMATION

Address (mandatory)

SAFETY DATA

DECONTAMINATION CERTIFICATE (mandatory completion if the equipment has been decontaminated)

Responsible for the security information (mandatory completion):

Responsible for the security information (mandatory completion):

GUIDANCE FOR DECONTAMINATION

PACKING

SHIPPING

Simplifying IT
for a complex world.

Platform partnerships

Services

Business Challenges

Digital Transformation

Security

Automation

Gaining Efficiency

Industry Focus

Return of Goods Authorization: FORM-046 Rev1

CUSTOMER INFORMATION

Address (mandatory)

SAFETY DATA

DECONTAMINATION CERTIFICATE (mandatory completion if the equipment has been decontaminated)

Responsible for the security information (mandatory completion):

Responsible for the security information (mandatory completion):

GUIDANCE FOR DECONTAMINATION

PACKING

SHIPPING

Simplifying IT for a complex world.

Platform partnerships

Services

Business Challenges

Digital Transformation

Security

Automation

Gaining Efficiency

Industry Focus

Simplifying IT
for a complex world.