CERTIFICATE OF COMPLIANCE.pdf
PDF 94 KB Posted
- Attached to
- Pure Water Tank
- Solicitation number
- N4215826QE056
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.
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
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 .