Attachment 1 Certificate of Compliance.pdf
PDF 86 KB Posted
- Attached to
- Hose Assembly
- Solicitation number
- N4215825QE016
About this file
This is a Certificate of Compliance form associated with Solicitation N4215825QE016 for a Hose Assembly contract with the Norfolk Naval Shipyard. The form requires material identification details including contract number, order number, item number, NSN/LSN, manufacturer's part number, serial number, drawing/piece number, and lot/heat numbers.
The certificate requires two separate attestations from Quality Assurance Officials - one certifying that all items furnished comply with contract requirements, and another confirming that inspection and test reports represent the actual attributes of items and indicate full compliance. The form must be completed after items are shipped and returned to Norfolk Naval Shipyard's Code 2305.6 Expediting Section in Portsmouth, VA, with one copy to be delivered with the material. The document serves as a critical quality control mechanism to ensure delivered items meet all contractual specifications.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment A Technical Capability Statement.pdf | ||
| N4215825QE016.pdf |
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Text version
CERTIFICATE OF COMPLIANCE
Solicitation N4215825QE016 –HOSE ASSEMBLY
MATERIAL IDENTIFICATION (COMPLETE APPLICABLE ITEMS)
CONTRACT NO. ORDER NO ___________
ITEM NO. _______________________
NATIONAL/LOCAL STOCK NUMBER NSN/LSN ________________________
MANUFACTURER’S PART NO. ____________________________
MANUFACTURER’S SERIAL NO. __________________________
DRAWING AND PIECE NO. ______________________________
MANUFACTURER’S LOT/HEAT NOS. AS MARKED ON THE MATERIAL:
I ATTEST ALL ITEMS FURNISHED ON THIS CONTRACT ARE IN FULL COMPLIANCE WITH
ALL CONTRACT REQUIREMENTS.
SIGNATURE _________________________________ DATE _______
QUALITY ASSURANCE OFFICIAL
TITLE _________________________________
THE INSPECTION AND TEST REPORTS (AS APPLICABLE) PROVIDED REPRESENT THE
ACTUAL ATTRIBUTES OF THE ITEMS FURNISHED ON THIS CONTRACT AND INDICATE FULL
COMPLIANCE WITH ALL CONTRACT REQUIREMENTS.
REQ’D N/A
[ X ] [ ]
SIGNATURE _________________________________ DATE _________
QUALITY ASSURANCE OFFICIAL
TITLE ________________________________
“NOTE”: WHEN ITEM(S) HAVE BEEN SHIPPED, PLEASE COMPLETE CERTIFICATION(S) AND
RETURN. THIS WILL EXPEDITE RECEIPT AND PAYMENT.
MAIL TO:
NORFOLK NAVAL SHIPYARD
ATTN: CODE 2305.6, EXPEDITING SECTION
BLDG. 297
PORTSMOUTH, VA 23709-5000
DELIVER ONE (1) COPY WITH MATERIAL
ATTACHMENT (1)
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