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 | ||
| DWG 509686.pdf | ||
| FAR 52.212-2 Attachment - Technical Capabilities Form.pdf | ||
| FAR 52.212-1 Addendum.pdf |
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Text version
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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