COC 5178-6015.pdf
PDF 109 KB Posted
- Attached to
- HEPA FILTER Federal contract opportunity
- Solicitation number
- N4215825QE082
About this file
This is a Certificate of Compliance (COC) form for a federal contract related to a naval shipyard procurement. The document is specifically for Requisition Number N42158-5178-6015 and Contract/Order Number N42158-25-Q-E082, to be submitted to the Norfolk Naval Shipyard's Expediting Section in Portsmouth, VA. The form requires a quality assurance official to attest that all items furnished under the contract are in full compliance with contract requirements, and to complete material identification details such as manufacturer's part number, serial number, and lot/heat numbers. The form must be completed and returned when items are shipped to expedite receipt and payment, with one copy to be delivered with the material.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 52.212-2 - EVALUATION-COMMERCIAL ITEMS.pdf | ||
| 51786015 DWG 509686.pdf | ||
| Solicitation N4215825QE082.pdf |
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Text version
CERTIFICATE OF COMPLIANCE
Requisition Number N42158-5178-6015
MATERIAL IDENTIFICATION (COMPLETE APPLICABLE ITEMS)
CONTRACT NO. ORDER NO __N42158-25-Q-E082
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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