CERTIFICATE OF COMPLIANCE ATTACHMENT (4).pdf
PDF 161 KB Posted
- Attached to
- NNSY CUTTING SHIELD
- Solicitation number
- N4215826QC0015
About this file
This is a Certificate of Compliance template used for federal contracts, specifically for Norfolk Naval Shipyard.
The document serves as a quality assurance certification form that contractors must complete and submit when materials or items are shipped under a contract. The form requires contractors to identify the materials by completing applicable fields including contract number, order number, item number, National/Local Stock Number (NSN/LSN), manufacturer's part number, manufacturer's serial number, drawing and piece number, and manufacturer's lot/heat numbers. A Quality Assurance Official must attest that all items furnished are in full compliance with all contract requirements by signing and dating the first certification section. A second certification section requires another Quality Assurance Official signature to confirm that inspection and test reports provided represent the actual attributes of items furnished and indicate full compliance with contract requirements; this section is marked as required. The completed certificate, with one copy attached to the material shipment, should be mailed to Norfolk Naval Shipyard, Attention CODE 2305.6 Expediting Section, Building 297, Portsmouth, VA 23709-5000. The note emphasizes that returning completed certifications promptly upon shipment will expedite receipt and payment processing.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
ATTACHMENT (4)
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
File details come from the government source that posted it. Updated .