Attachment 3-Certificate of Compliance.pdf
PDF 104 KB Posted
- Attached to
- CIRCUIT BREAKERS Federal contract opportunity
- Solicitation number
- N4215824QE012
About this file
This document is a certificate of compliance template for federal contract N4215824QE012 for circuit breakers and distribution panels. The template requires the contractor to certify that all materials furnished comply with contract requirements by providing the contract and order numbers, item numbers, national/local stock numbers, manufacturer part and serial numbers, drawing and piece numbers, and manufacturer's lot/heat numbers as marked on the materials. The quality assurance official must also sign and date, certifying that any inspection and test reports provided represent the actual attributes of the items furnished and indicate full compliance with all contract requirements. One copy of the completed certificate must be mailed to Norfolk Naval Shipyard, attention code 2305.6 expediting section, to expedite receipt and payment.
The related federal contract opportunity is solicitation N4215824QE012 for circuit breakers from the Department of the Navy Naval Sea Systems Command. The solicitation requires circuit breakers and distribution panels.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| N4215824QE012.pdf | ||
| Attachment 1-FAR Clause 52.212-1 Addendum.pdf | ||
| Attachment 2-Technical Capability Statement.pdf |
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Text version
Attachment 3 – N4215824QE012
CIRCUIT BREAKERS & DISTRIBUTION PANEL
CERTIFICATE OF COMPLIANCE
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
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