CERTIFICATE OF COMPLIANCE.pdf

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Attached to
Pure Water Tank
Solicitation number
N4215826QE056
Issued by

About this file

This is a Certificate of Compliance form for federal contract solicitation N4215826QE056 issued by Norfolk Naval Shipyard. The form serves as a template for vendors to attest to the quality and compliance of materials being delivered under this contract.

The certificate requires vendors to complete material identification information including contract number, order number, item number, National/Local Stock Number (NSN/LSN), manufacturer's part number, serial number, drawing and piece number, and manufacturer's lot/heat numbers. A Quality Assurance Official must sign and date an attestation confirming that all items furnished are in full compliance with all contract requirements. A second signature section requires another Quality Assurance Official to certify that inspection and test reports represent the actual attributes of items furnished and indicate full compliance with contract requirements. The form indicates inspection and test reports are not required (N/A checkbox is marked). Vendors must deliver one copy of the completed certificate with the material shipment to Norfolk Naval Shipyard, ATTN: CODE 2305.6, Expediting Section, Building 297, Portsmouth, VA 23709-5000. The instructions note that prompt completion and return of this certification will expedite receipt and payment of the delivered materials.

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Text version

CERTIFICATE OF COMPLIANCE

SOLICITATION # N4215826QE056

VENDOR NAME

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

ENCLOSURE (1)

File details come from the government source that posted it. Updated .