Request for Shipping Container Examination LCBO Use (only one product per form) Brand Name Size LCBO Number mL SCC-14 Number U.P.C./EAN Domestic Imported Kg If this SKU will be shipped in the same sized carton as any other product shipped to the LCBO, please provide the LCBO number: Approximate weight of Shipping Container (including product) AGENT SUPPLIER Name Name Agent Number Vendor Number Address Address Telephone Fax Telephone E-mail Address Fax E-mail Address Shipping Container Requested for: (1) New Product (4) SCC (Review) (2) Existing Brand (3) Re-Submission Sample Information (artwork will not be reviewed) Category Beer Wine Spirit Gift Item/Accessory Item Sample Type Selling Unit Carton Tray Prototype Glass Can PET Tetra Pack/Cheer Pack Closure Type Cork Screw-Cap Twist-Off/Crown T-Cork It is the responsibility of the applicant to ensure compliance with LCBO Product Packaging Standards and Canadian Association of Liquor Jurisdiction (CALJ) requirements for Product Identification In the event of any such non compliance, the applicant must, within 30 days of receipt of an invoice, reimburse the LCBO for its cost to remedy LCBO inventories as a result of such non compliance. Name (please print) LCB 2102 (04-13) Date Signature 1 LCBO No. Date Submitted Shipping Container Examination (Based on the carton submitted for review and subject to review upon receipt of each order) Section One - Marking Requirements Marking Height Location on Shipping Container SCC-14 2.54 cm Two adjacent panels * Select one Product Date Code format: P.O. Number Production Date Product Date Code * 1.27 cm Same end panel as SCC or Sales Units Unit Size Description Case Weight 1.27 cm 1.27 cm 1.06 cm 1.27 cm Same end panel as SCC Same end panel as SCC Same end panel as SCC One end panel Meets Specifications Yes Lot Number Best Before Date Same side panel as SCC-14 (must not exceed 18.9 kg) Yes Yes Yes Yes Yes No N/A No No No No No N/A N/A N/A N/A N/A Section Two - Shipping Container Codes (SCC) Format (One Only) Human Readable Characters Magnification Meets Spec. ITF UCC/EAN-128 Yes Yes No No UPC-A EAN-13 Other Yes Yes No No Yes No Acceptable format: HRC match bar code Yes No (record number if no match) Barcode(s) print quality is not graded but scannability is expected to be in full compliance with LCBO Product Packaging Specifications. Section Three – Construction Specifications Dimensions: Trays: Length: mm (min 200 mm – max. 540 mm) mm) Shrink Wrap Yes Width: (min 160 mm – max. 406 mm) No Height: mm Yes No Yes No (min 115 mm – max. 510 mm) Height of tray walls Compliant: Other: mm cm Compliant: Acceptable Weight Flaps Meet Yes Yes No No Bottle Partitions Burst Strength Yes Yes No No Securely Sealed Single Case Design Yes Yes No No ECT stamp Double Walled Flute Yes Yes No No N/A P.S.I. Not Correct Not Correct Perforations intended to create openings are not permitted. Consumer units must be packaged inside the shipping container in such a manner as to completely fill the container and must be securely packaged within the container to prevent displacement. Section Four – Piling Pattern (for Palletized Loads Shipped in Trailers) All palletized loads must be shipped on 48 x 40 CPC or equivalent pallets with an anti-skid cohesive applied between each tier and at minimum the top tier tied or polystrapped. (If currently shipping an approved SKU in the same sized carton dimensions and weight – please provide the approved product and TI HI information.) Number of cases per tier: Number of tiers per pallet: Validate TI HI from current SKU being shipped to the LCBO - see Page 1 for LCBO number: Packaging appears to comply with LCBO and CALJ requirements. Reviewed by: LCB 2102 (04-13) Yes Date: 2 No