CERTIFICATE OF COMPLIANCE.pdf

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N4215826QE062
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This is a Certificate of Compliance form for solicitation N4215826QE062 issued by Norfolk Naval Shipyard. The form serves as a quality assurance document that contractors must complete and submit upon delivery of materials or items ordered under the referenced contract. Contractors are required to attest that all items furnished are in full compliance with all contract requirements and to provide 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 as marked on the material.

The form requires signatures from Quality Assurance Officials at two separate points: first, to certify that all items meet contract requirements, and second, to confirm that inspection and test reports (where applicable) represent the actual attributes of the furnished items and indicate full compliance with contract specifications. The form indicates that inspection and test reports are not applicable (marked N/A with an X). Upon shipment, contractors 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. Timely return of the completed certification is noted as necessary to expedite receipt and payment processing.

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Other files

File Type Posted
Solicitation N4215826QE062.pdf PDF
FAR 52.212-1 Addendum.pdf PDF
DWG 509686.pdf PDF
FAR 52.212-2 Attachment - Technical Capabilities Form.pdf PDF

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CERTIFICATE OF COMPLIANCE

SOLICITATION # N4215826QE062

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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