JEWELRY EVALUATION FORM COLORED STONE INFORMATION ACORD TM DATE CLIENT’S NAME AND ADDRESS GENERAL DESCRIPTION L G 10K TESTED 14K STAMPED DINNER RING FASHION RING NECKCHAIN 18K YL 22K WH BRACELET PENDANT PIN DIAMONDS RUBIES GARNET OTHER: 24K TT GD TR BROOCH SV BL P STICKPIN SAPPHIRES SS GR EARRINGS PEARL STRAND EMERALDS PL RD NP CL WRISTWATCH OPALS GF BM WEDDING SET ENGAGEMENT RING PB POCKET WATCH PEARLS WEDDING RING SB OTHER: AMETHYSTS AQUA CITRINE BLUE TOPAZ SET WITH: 2 MOUNTED IN: 4 NATURAL 6 8 WG YG PL SYNTHETIC PRONGS SIMULANT BEAD BEZEL CHANNEL PAVE SET INLAY DESCRIPTION: NEW ESTATE ANTIQUE PERIOD STYLE: COLORED STONE INFORMATION APPROX CIRCA: LAB REPORT#: GIA THE COLORED STONE IS A SPECIES: SIGNED: EGL IGI VARIETY: FACETED x WEIGHING: x CARAT TP TL OP mm DEPTH ESTIMATED BY FORMULA D SD WEIGHED LOOSE SI I VI GRAY TONE: VL P F CTR G OFF CTR BULGE: % % SL M SD D VD P F G ED SW: or MUNSELL COLOR GRADE: POLISH: VG or: L LW: or GEM DIALOGUE: CLARITY GRADE: BRILLIANCY: FLAT OTHER: U.V. FLUOR: CLARITY TYPE: LD PRIMARY COLOR: M GIA COLOR GRADE: HD DIAMETER ESTIMATED DUE TO MOUNTING. COLOR EVENNESS: KEEL: CABOCHON MODIFYING COLOR: COLOR INTENSITY OR SATURATION: N RI: SHAPE: MEASURING: Y OTHER: P F G WINDOWING: OUT OF SHAPE: Y VG % N CUT/SYMMETRY: EXTINCTION: DAMAGE: ABRAISON % NICK VG LIGHT RETURN: CHIP % FRACTURE DESCRIBE BELOW IDENTIFYING INCLUSIONS: COLORED STONE PHENOMENA INFORMATION OPAL: TYPE: NAT PLAY OF COLOR: DOUBLET P F PHENOMENA SATURATION: TRIPLET G P VG F VARIETY OR BASE COLOR: EX G AMOUNT: VG EX % BLACK TYPE OR PATTERN: WHITE PINFIRE FLASH MOSAIC PREDOMINANT COLOR: AMOUNT: % OTHER COLORS AND %: VOIDS: STARS: % MATRIX: % NUMBER OF LEGS: STRENGTH (WEAK TO BRIGHT): CENTERED: EYES: CRAZING: CENTERED: P Y F N STRENGTH (WEAK TO BRIGHT): CHANGE: AND LOCATION: N G VG SHARPNESS (WEAK TO DISTINCT): EX LENGTH OF LEGS: SHARPNESS (WEAK TO DISTINCT): P F G VG OPENING & CLOSING (NARROW TO WIDE): COLOR CHANGE: % Y P EX F P F G VG EX G VG G VG EX EX STRAIGHTNESS: VG FROM COLOR: WEAK F LENGTH: G P LEGS STRAIGHTNESS: EX MILK/HONEY: NONE P F TO COLOR: MODERATE STRONG LIGHTING: DAYLIGHT INCANDESCENT FLOURESCENT SMALL COLORED STONE INFO -- ALL SIZES AND GRADES ARE ESTIMATED AND BASED ON AVERAGES # CUT: NAT SYN SIM COLOR: GEM: CLARITY: ( x mm) CT # CUT: NAT SYN SIM COLOR: GEM: CLARITY: ( x mm) CT # CUT: NAT SYN SIM COLOR: GEM: CLARITY: ( x mm) CT # CUT: NAT SYN SIM COLOR: GEM: CLARITY: ( x mm) CT # CUT: NAT SYN SIM COLOR: GEM: CLARITY: ( x mm) CT # CUT: NAT SYN SIM COLOR: GEM: CLARITY: ( x mm) CT # (SPECIFY GEM: ) FOR A TOTAL WEIGHT OF: CARATS OF: MELEE # (SPECIFY GEM: ) FOR A TOTAL WEIGHT OF: CARATS OF: MELEE # (SPECIFY GEM: ) FOR A TOTAL WEIGHT OF: CARATS OF: MELEE MOUNTING INFORMATION DIE STRUCK THE PIECE IS: CAST HAND FABRICATED COMMERCIAL/FACTORY STAMPED DESIGNER CUSTOM MADE HALLMARKED MFG MARK: ACID TESTED ARTIST SIGNED: THE HEAD MEASURES: mm LONG X THE SHANK MEASURES: x COPYRIGHT: mm WIDE X mm WIDE BY Y N mm DEEP x mm THICK GROSS DWT: FINISH: DESIGN QUALITY: QUALITY OF MANUFACTURE: P QUALITY OF SETTING JOB: CONDITION IS: SCRATCHMARKS: P ACORD 102 (2000/08) F P F F G G G VG VG SETTING TECHNIQUE: VG OVERALL JEWELRY QUALITY GRADE: 1 2 3 4 P F G VG 5 6 7 8 NEEDED REPAIRS: Incl material copyrighted by JAG (Jeweler’s Advisory Group) c ACORD CORPORATION 1997 O CHAIN OR BRACELET INFORMATION -- USE MOUNTING SECTION FOR ANY ADDITIONAL INFORMATION CHAIN BRACELET STYLE: WEIGHT: DWT METAL/FINENESS: LENGTH: " - ( mm THICK X KT mm WIDE) COLOR: CLASP: PEARL INFORMATION -- USE MOUNTING SECTION FOR ANY ADDITIONAL INFORMATION TYPE NAT CULT SIM NUMBER OF STRANDS: KNOTTED # PARTIALLY KNOTTED OF PEARLS GRADE: SHAPE: UNIFORM NOT KNOTTED. PEARL SIZES: COLOR: BLEMISHES: OTHER: GRADUATED AAA VL mm AA ORIENT: L M A MH " " " H SPHERICITY: N CONTINUITY: P NACRE THICKNESS F G VTN VG THN B REMARKS SIGNATURE EVALUATOR’S SIGNATURE ACORD 102 (2000/08) " TYPE OF CLASP: x OVERTONE: N LENGTH: DATE PRINT/TYPE NAME LUSTER MED STK P F G VG EX P F G VG EX THK VTK