CERTIFICATE OF COMPLIANCE.pdf
PDF 94 KB Posted
- Attached to
- Composite
- Solicitation number
- N4215826QE057
About this file
This is a Certificate of Compliance form for Solicitation #N4215826QE057 issued by Norfolk Naval Shipyard. The form serves as a template for vendors to certify that materials furnished under this contract meet all contractual requirements. Vendors must complete applicable material identification fields 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 as marked on the material.
The certificate requires attestation from a Quality Assurance Official confirming that all items furnished are in full compliance with contract requirements, along with signature and date. A second certification section requires the Quality Assurance Official to confirm that inspection and test reports provided represent the actual attributes of furnished items and indicate full compliance with all contract requirements. The form indicates that inspection and test reports are not applicable (marked N/A). Upon shipment, vendors must complete the certification and return one copy with the material to Norfolk Naval Shipyard, Code 2305.6, Expediting Section, Building 297, Portsmouth, VA 23709-5000 to expedite receipt and payment.
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Other files
| File | Type | Posted |
|---|---|---|
| FAR 52.212-1 Addendum.docx | DOCX document | |
| FAR 52.212-2 Attachment (A).pdf | ||
| Solicitation N4215826QE057.pdf |
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Text version
CERTIFICATE OF COMPLIANCE
SOLICITATION # N4215826QE057
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)
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