09 DI-MISC-81356A Compliance Certificate.pdf

DATA ITEM DESCRIPTION

Title: Certificate of Compliance Number DI-MISC-81356A Approval Date: 20071218 AMSC Number: N9036 Limitation: N/A DTIC Applicable: No GIDEP Applicable: No Office of Primary Responsibility: NAVICP Code 8741 Applicable Forms: N/A

Use/Relationship: The Certificate of Compliance provides certification from the contractor that the materiel supplied is in full compliance with all contract requirements. This DID contains the format, content, and intended use information for the data deliverable required by the contract.

This DID supersedes DI-MISC-81356.

Requirements:

1. Format. The Certificate of Compliance shall be presented in a format similar to that of Figure 1.

2. Content. The Certificate of Compliance shall contain:

a. Contractor’s name.

b. Contractor’s address.

c. Contractor’s phone number.

d. Date.

e. Contracting Agency’s name.

f. Contract Number.

g. National Stock Number (NSN).

h. Item nomenclature.

i. A statement certifying that all items furnished on the contract are in full compliance with all specification and contract requirements.

j. Authorized personnel’s signature.

k. Authorized personnel’s printed name and title.

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DI-MISC-81356A

From: ______________________ (Contractor’s name)

Address: ______________________ (Contractor’s address)

Phone Number: ________________ (Contractor’s phone number)

Date: ________________

To: _______________ (Contracting Agency)

Contract Number: _______________

National Stock Number: _______________

Item Nomenclature: ___________________

“All items furnished on this contract are in full compliance with all specification and contract requirements.”

(Signature of Authorized Personnel

(Printed Name and Title of Authorized Personnel)

Note: The recording of false, fictitious, or fraudulent statements or entries on this document may be punished as a felony under Federal Statutes.

3. End of DI-MISC-81356A

Figure 1 – Sample format for a Certificate of Compliance

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