CERTIFICATE OF COMPLIANCE.pdf
PDF 360 KB Posted
- Attached to
- HEAT CABLE Federal contract opportunity
- Solicitation number
- N4215825QE023
About this file
This is a Certificate of Compliance form associated with Contract/Order No. N4215825QE023 and Requisition Number N42158-4317-6005 for the Norfolk Naval Shipyard.
The form requires material identification details including item number, national/local stock number (NSN/LSN), manufacturer's part number, serial number, drawing/piece number, and lot/heat numbers. It contains two signature sections for Quality Assurance Officials to attest that furnished items comply with all contract requirements. The form indicates inspection and test reports are not applicable (N/A) for this contract. Upon shipment completion, the signed certificate must be delivered with the material and mailed to the Norfolk Naval Shipyard, Code 2305.6 Expediting Section, Building 297 in Portsmouth, VA 23709-5000.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| TECHNICAL CAPABILITY STATEMENT.pdf | ||
| N4215825QE023.pdf | ||
| ORDERING DATA.pdf |
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Text version
CERTIFICATE OF COMPLIANCE
Requisition Number N42158-4317-6005
MATERIAL IDENTIFICATION (COMPLETE APPLICABLE ITEMS)
CONTRACT NO. ORDER NO. N4215825QE023
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
ENCLOSURE (1
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