WARNING: This product contains nicotine.
Nicotine is an addictive chemical.

General Certificate of Conformity

Domestic Manufacturer
Product Being Certified

Company Name: Purilum, LLC
Address Line 1: 967 Woodridge Park Road
Address Line 2:
City/State/Zip: Greenville, NC 27834

E-Liquid Name: Bantam - Flavor Free, Tobacco, Menthol, Banana Strawberry, Mango Passion, Sour Strawberry, Blue Berries, Butterscotch, Fruit Yogurt, Kiwi Berry, Citrus Strawberry, Toasted Tobacco, Raspberry Menthol, Cream & Honey, Purple Watermelon, Citrus Strawberry Menthol, Jasmine Milk Tea, Banana Muffin, Fruit and Cream, Nutty Caramel, Tart Lemon

Bottle Type/Size: 60ml bottles
Nicotine Level: 3mg, 6mg

Nicotine Salt Name: Bantam - Flavor Free, Tobacco, Menthol, Banana Strawberry, Mano Passion, Sour Strawberry, Blue Berries, Butterscotch, Fruit Yogurt, Kiwi Berry, Citrus Strawberry, Toasted Tobacco, Raspberry Menthol, Cream & Honey, Purple Watermelon, Citrus Strawberry Menthol, Jasmine Milk Tea, Banana Muffin, Fruit and Cream, Nutty Caramel, Tart Lemon

Bottle Type/Size: 30ml bottles
Nicotine Level: 18mg, 36mg
Individual Maintaining Records of Test Results
Date(s) and Place When the Product Was Tested for Compliance
Person’s Name: Michelle Gottlich
Address Line 1: 9001 Aerial Center Parkway
Address Line 2: Suite 125
City/State/Zip: Morrisville, NC 27560
E-mail address: Michelle@bantamvape.com
Telephone #: 1-919-274-4837		 16 C.F.R. § 1700.15(b) Testing:
Company Name: Bitner Associates, Inc.
Address Line 1: 1001 Forest Trail
Address Line 2:
City/State/Zip: Sugar Grove, IL 60554
Date of Test(s) or Test Reports: December 2, 2017

16 CFR § 1700.15(d) Testing:
Company Name: Life Pack Labs, LLC
Address Line 1: 2865 Scott Street
Address Line 2: Suite 103
City/State/Zip: Vista, CA 92081
Date of Test(s) or Test Reports: June 17, 2019
Date and Place Where Product Was Manufactured or Assembled
Identification of any Third-Party Laboratory on Whose Testing the Certificate Depends

Company Name: Purilum, LLC
Address Line 1: 967 Woodridge Park Road
Address Line 2:
City/State/Zip: Greenville, NC 27834
Country: United States of America
Date of Manufacture: January 1, 2020 – December 31, 2020

Company Name: Bitner Associates, Inc.
Address Line 1: 1001 Forest Trail
Address Line 2:
City/State/Zip: Sugar Grove, IL 60554
Country: USA
Telephone #: 630-880-0030

Company Name: Life Pack Labs, LLC
Address Line 1: 2865 Scott Street
Address Line 2: Suite 103
City/State/Zip: Vista, CA 92081
Country: USA
Telephone #: 760-295-3462
Citation to Safety Regulation to Which This Product Is Being Certified

 

16 C.F.R. §§ 1700.15 & 1700.20