Effective Date: April Rev. 7/31/2018- Void After: April Product: Fill Valves (Anti-Siphon) File No. 0210

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1 IAPMO Research and Testing, Inc. is a product certification body which tests and inspects samples taken from the supplier's stock or from the market or a combination of both to verify compliance to the requirements of applicable codes and standards. This activity is coupled with periodic surveillance of the supplier's factory and warehouses as well as the assessment of the supplier's Quality Assurance System. This listing is subject to the conditions set forth in the characteristics below and is not to be construed as any recommendation, assurance or guarantee by IAPMO Research and Testing, Inc. of the product acceptance by Authorities Having Jurisdiction. visit the IAPMO R&T Product Listing Directory at pld.iapmo.org Effective Date: April Rancho Viejo Road San Juan Capistrano, CA Identification: Manufacturer's name and trademark, model number, "1002" and critical level shall be permanently marked so as to be visible after installation. The product shall also bear the cupc certification mark. Characteristics: Anti-Siphon type flush tank fill valves (ballcocks) to be installed in accordance with the manufacturer's instructions and the requirements of the latest edition of the Uniform Plumbing Code. Products listed on this certificate have been tested by an IAPMO R&T recognized laboratory. This recognition has been granted based upon the laboratory's compliance to the applicable requirements of ISO/IEC Products are in compliance with the following code(s): Uniform Plumbing Code (UPC ) National Plumbing Code of Canada International Plumbing Code (IPC ) Products are in compliance with the following standard(s): This listing period is based upon the last date of the month indicated on the Effective Date and Void After Date shown above. Any change in material, manufacturing process, marking or design without having first obtained the approval of the Product Certification Committee, or any evidence of non-compliance with applicable codes and standards or of inferior workmanship, may be deemed sufficient cause for revocation of this listing. Production of or reference to this form for advertising purposes may be made only by specific written permission of IAPMO Research and Testing, Inc. Any alteration of this certificate could be grounds for revocation of the listing. This document shall be reproduced in its entirety.

2 ASSE and CSA B

3 Product: Fill Valves (Anti-Siphon) File No MODELS: 747UK127B 747UK118B 747E21B 747Zxxx 400UK122B *40(-) *45(-) *300(-) *350(-) *400(-) *703(-) *747(-) Note: (*) indicates a Prefix: PRO: Trade and Contractor Models 22: ONLY THE BEST INSIDE or Bundle Program Model Note: (-) indicates a Suffix. A: Standard 15/16 inch shank AP: Pallet Pack AR: Adjustable refill model B: 15/16 inch brass shank OR bulk packaging C: Geographic market packaging option OR additional parts and products included in Combo form CC: Geographic market packaging option AND additional parts and products included in Combo form CN: Manufactured in China CNx: Contractor specific packaging; x equals count D: Customer specific packaging EZi: Easy Fix, easy installation valve without end connection F: Customer specific packaging FS: Flush N Sparkle G: Customer specific packaging H: Horizontal packaging HP: High Performance HR: High refill model K: Specific packaging, additional parts or products included LS: Leak Sentry models M: Customer specific packaging Nx: Customer specific packaging; x equals count Px: Packaging option; x equals count R: Retail specific packaging S: Customer specific packaging U: Universal kit W: Customer specific packaging Page 3 of 5

4 Product: Fill Valves (Anti-Siphon) File No Z: In-wall cistern x: where x indicates numeric code for valve options xb: Bulk packaging: where x indicates numeric code for valve options xx: where xx indicates numeric code for valve options xxb: Bulk packaging: where x indicates numeric code for valve options xxx: where xxx indicates numeric code for valve options xxxb: Bulk packaging: where x indicates numeric code for valve options 133: Geographic market packaging option 1LG: Leak guard model 2LG: Leak guard model-specific packaging, additional parts or products included 3LG: Leak guard model-specific packaging, additional parts or products included 4LG: Leak guard model-specific packaging, additional parts or products included Page 4 of 5

5 ADDITIONAL COMPANY INFO: Kohler Company Model No Page 5 of 5