Certificate of Compliance.pdf

This is a Certificate of Compliance form used for federal contracting purposes, specifically for Requisition Number N42158-6183-ZN01 submitted to Norfolk Naval Shipyard. The form serves as a quality assurance attestation document that contractors must complete and return upon shipment of materials to expedite receipt and payment. The certificate requires contractors to identify the specific material being furnished through multiple identifying 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.

The form contains two attestation sections, both requiring signatures and dates from Quality Assurance Officials. The first section certifies that all items furnished are in full compliance with all contract requirements. The second section addresses inspection and test reports, confirming that provided reports represent the actual attributes of furnished items and demonstrate full compliance with contract requirements; this section is marked as not applicable (N/A) on the template. Completed certifications must be mailed to Norfolk Naval Shipyard, CODE 2305.6, Expediting Section, Building 297, Portsmouth, VA 23709-5000, with one copy delivered alongside the material shipment.