N3904024Q0043 CDRL Exhibit B for Item 0002.pdf
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- Attached to
- Manufacture Weld Qual Membranes for PNS
- Solicitation number
- N3904024Q0043
About this file
This document is an exhibit to a federal contract specifying data requirements for the manufacture of weld membranes. The contract is between a contractor and the Department of the Navy Naval Sea Systems Command for the production of weld qualification membranes as item 0002. The exhibit lists five required certifications to be provided with each shipment: a certificate of compliance, chemical certification of base materials, mechanical certification of base materials, liquid penetrant certification, and dimensional verification. It specifies the information to be included on the certifications and requires that all inspections, tests, and reports outlined in an attachment be provided to represent full compliance with contract requirements.
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Text version
CONTRACT: N3904024P0043
PRINTED: December 5, 2023 PAGE: 1 OF 5
EXHIBIT B
(ADP DD FORM 1423 (MECHANIZED EQUIVALENT) PER DAR CLAUSE 16-815)
CONTRACT DATA REQUIREMENTS LIST
SYSTEM/ITEM; WELD MEMBRANE PC 22 CATEGORY ____________
ITEM NO CONTRACTOR
01 SEQ NO A001
02 DATA DESC CERTIFICATE OF COMPLIANCE
03 SUBTITLE
04 DID NUMBER PER ATTACHMENT 1 TO EXHIBIT A
05 CONTRACT REF PARA. C.6.1
06 TECH OFFICE 138.2
07 DD 250 REQ DD
08 APP CODE
09 IAC INPUT
10 FREQUENCY O-TIME
11 AS OF DATE
12 DATE 1ST SUBM WITH MATERIAL
13 DATE SUB SUBM
14 DISTRIBUTION 410 __/ 0 VIA MAIL (N0 DD 250 REQD)
15 TOTAL __
16 REMARKS
SEQ. NO. A001
PREPARED BY ________________________________________________ DATE__________________ APPROVED BY ________________________________________________ DATE__________________
DD FORM 1423
PRINTED: December 5, 2023_ PAGE: 2 OF 5_
SYSTEM/ITEM; WELD MEMBRAN PC 22 CATEGORY ____________
01 SEQ NO A002
02 DATA DESC CHEMICAL CERTIFICATION
03 SUBTITLE BASE MATERIAL
04 DID NUMBER PER ATTACHMENT 1 TO EXHIBIT A
05 CONTRACT REF PARA. C.6.2
06 TECH OFFICE 138.2
07 DD 250 REQ DD
08 APP CODE
09 IAC INPUT
10 FREQUENCY O-TIME
11 AS OF DATE
12 DATE 1ST SUBM WITH MATERIAL
13 DATE SUB SUBM
14 DISTRIBUTION 410 __/ 0 VIA MAIL (N0 DD 250 REQD)
SEQ. NO. A002
PRINTED: December 5, 2023___ PAGE: 3 OF 5
01 SEQ NO A003
02 DATA DESC MECHANICAL CERTIFICATION
03 SUBTITLE BASE MATERIAL
04 DID NUMBER PER ATTACHMENT 1 TO EXHIBIT A
05 CONTRACT REF PARA. C.6.3
06 TECH OFFICE 138.2
07 DD 250 REQ DD
08 APP CODE
09 IAC INPUT
10 FREQUENCY O-TIME
11 AS OF DATE
12 DATE 1ST SUBM WITH MATERIAL
13 DATE SUB SUBM
14 DISTRIBUTION 410 __/ 0 VIA MAIL (N0 DD 250 REQD)
SEQ. NO. A003
PRINTED: December 5, 2023 PAGE: 4 OF 5_______
01 SEQ NO A004
02 DATA DESC LIQUID PENETRANT CERTIFICATION
03 SUBTITLE
04 DID NUMBER PER ATTACHMENT 1 TO EXHIBIT A
05 CONTRACT REF PARA. C.6.4
06 TECH OFFICE 138.2
07 DD 250 REQ DD
08 APP CODE
09 IAC INPUT
10 FREQUENCY O-TIME
11 AS OF DATE
12 DATE 1ST SUBM WITH MATERIAL
13 DATE SUB SUBM
14 DISTRIBUTION 410 __/ 0 VIA MAIL (N0 DD 250 REQD)
SEQ. NO. A004
CONTRACT N3904024P0043
PRINTED: December 5, 2023 PAGE: 5 OF 5_______
01 SEQ NO A005
02 DATA DESC DIMENTIONAL VERIFICATION
03 SUBTITLE
04 DID NUMBER PER ATTACHMENT 1 TO EXHIBIT A
05 CONTRACT REF PARA. C.6.5
06 TECH OFFICE 138.2
07 DD 250 REQ DD
08 APP CODE
09 IAC INPUT
10 FREQUENCY O-TIME
11 AS OF DATE
12 DATE 1ST SUBM WITH MATERIAL
13 DATE SUB SUBM
14 DISTRIBUTION 410 __/ 0 VIA MAIL (N0 DD 250 REQD)
SEQ. NO. A005
PREPARED BY________________________________________________ DATE__________________
PRINTED: December 5, 2023 PAGE: 1 OF 2_______
Attachment 1 to EXHIBIT B
CONTRACT/SOLICITATION N3904024Q0043
ITEM 0004 (Data for Item 0002) (DATE FOR ITEM) ___________________
REQUIRED CERTIFICATION
A. CERTIFICATION SHALL BE SUPPLIED WITH EACH SHIPMENT OF MATERIAL.
CERTIFICATION (CERTIFICATE OF COMPLIANCE) SHALL BE SUPPLIED AS OUTLINED IN
PARAGRAPH B. THE VENDOR IS LIABLE FOR CONDUCTING ALL TESTS, ANALYSES,
INSPECTIONS, AND EXAMINATIONS, ETC., AS SPECIFIED BY THE CONTRACT AND
SPECIFICATIONS WHETHER CERTIFICATIONS ARE REQUIRED OR NOT.
CERTIFICATE OF COMPLIANCE (PROVIDE THE FOLLOWING VERBATIM STATEMENT OR
COMPLETE THE OPTIONAL FORM AT THE END OF THIS PART)
"I ATTEST ALL ITEMS FURNISHED ON THIS CONTRACT ARE IN FULL COMPLIANCE WITH
ALL CONTRACT REQUIREMENTS".
B. CERTIFICATION SHALL BE SUPPLIED PER THE FOLLOWING INSTRUCTIONS:
1. THE CERTIFICATION OF COMPLIANCE SHALL CONTAIN THE SIGNATURE AND TITLE OF
THE VENDOR OFFICIAL DESIGNATED RESPONSIBLE FOR QUALITY ASSURANCE.
2. THE MATERIAL IDENTIFICATION (E.G. LOT, BATCH, PART #, ETC.) SHALL BE INCLUDED
ON THE CERTIFICATE OF COMPLIANCE.
PRINTED: December 5, 2023 PAGE: 2 OF 2_______
Attachment 1 to EXHIBIT B
CERTIFICATE OF COMPLIANCE
COMPANY NAME
MATERIAL IDENTIFICATION (COMPLETE APPLICABLE ITEMS)
CONTRACT NO. N3904024P0043 ORDER NO. ________________ ITEM NO. 0002
NATIONAL/LOCAL STOCK NO. NSN/LSN ____________________________________________________ MANUFACTURER’S PART NO. _____________________________________________________________ MANUFACTURER’S SERIAL NO. ___________________________________________________________ DRAWING AND PIECE NO. _________________________________________________________________
MANUFACTURER’S LOT/HEAT NOS. AS MARKED ON THE MATERIAL _________________________
ALL INSPECTIONS AND TEST REPORTS REQUIRED BY ATTACHMENT I TO EXHIBIT A (DD FORM
1423) FOR TRACEABILITY TO EACH CONTRACT ITEM MUST ACCOMPANY THIS SIGNED
STATEMENT:
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. I ATTEST ALL ITEMS FURNISHED ON
THIS CONTRACT ARE IN FULL COMPLIANCE WITH ALL CONTRACT REQUIREMENTS.
SIGNATURE________________________________________ DATE_____________________
QUALITY ASSURANCE OFFICIAL
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