CERTIFICATE OF COMPLIANCE.pdf
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- Attached to
- N4215825QE072 - ADAPTERS Federal contract opportunity
- Solicitation number
- N4215825QE072
About this file
The document is a Certificate of Compliance form for a naval shipyard contract, specifically related to Requisition Number N42158-5143-6004 and Contract/Order Number N4215825PE125. The form is designed for a quality assurance official to attest that all items furnished under the contract meet all contract requirements, with designated spaces to record material identification details such as stock numbers, manufacturer's part numbers, serial numbers, and lot/heat numbers. The completed certificate should be mailed to the Norfolk Naval Shipyard's Expediting Section in Portsmouth, VA, with one copy delivered along with the material to facilitate receipt and payment processing.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| TECHNICAL CAPABILITIES.pdf | ||
| CONTINUATION SHEET.pdf | ||
| N4215825QE072.pdf |
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Text version
CERTIFICATE OF COMPLIANCE
Requisition Number N42158-5143-6004
MATERIAL IDENTIFICATION (COMPLETE APPLICABLE ITEMS)
CONTRACT NO. ORDER NO. N4215825PE125
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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