N39040254276Q307 Attachment 1 to Exhibit A.pdf
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- Attached to
- Rubber Hose: 2 inch 75 feet long
- Solicitation number
- N39040254276Q307
About this file
This is an Attachment 1 to Exhibit A (DD Form 1423) that outlines certification requirements for material shipments under contract N39040254276Q307 for a 2-inch 75-foot rubber hose being procured by the Portsmouth Naval Shipyard.
The document specifies that vendors must provide a Certificate of Compliance with each shipment of material, containing a verbatim attestation statement confirming full compliance with contract requirements. The certification must be signed by the vendor's designated quality assurance official and include specific material identification details such as lot numbers, batch numbers, part numbers, manufacturer's serial numbers, and other traceability information. All inspection and test reports required by the contract must accompany the signed certification statement. The document includes both a standard certification statement format and an optional detailed form that captures comprehensive material identification information.
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Text version
CONTRACT __________________
PRINTED 17 OCTOBER 2024 PAGE _______
ATTACHMENT 1 TO EXHIBIT A (DD FORM 1423)
CONTRACT/SOLICITATION
ITEM ___________________________________________ (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.
CONTRACT __________________
PRINTED 17 OCTOBER 2024 PAGE _______
ATTACHMENT 1 TO EXHIBIT A (DD FORM 1423)
CERTIFICATE OF COMPLIANCE
COMPANY NAME
MATERIL IDENTIFICATION (COMPLETE APPLICABLE ITEMS)
CONTRACT NO. ______________ ORDER NO. ________________ ITEM NO.
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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