N3904026Q5446 Exhibit A.docx
DOCX document 31 KB Posted
- Attached to
- Nitrogen, Oxygen, Argon Service PLOMA Federal contract opportunity
- Solicitation number
- N3904026Q5446
About this file
This is a Contract Data Requirements List (DD Form 1423) that specifies documentation and certification requirements for the supply of industrial gases under solicitation N3904026Q5446 for Portsmouth Naval Shipyard's Nitrogen, Oxygen, and Argon Service contract.
The document establishes mandatory data submission requirements for three gas products: nitrogen bottles, oxygen bottles, and argon bottles. For each product, contractors must submit two categories of documentation with each delivery: (1) a Certificate of Compliance per contract reference paragraph C.5.1, and (2) Material Safety Data Sheets per contract reference paragraph C.5.2. All submissions are due as one submittal per delivery sequence, distributed via mail without requiring DD 250 forms. The Certificate of Compliance must include a verbatim attestation statement signed by a vendor quality assurance official confirming full compliance with all contract requirements, along with complete material identification information including lot/batch numbers, part numbers, serial numbers, and manufacturer details. The certificate must be accompanied by all inspection and test reports required for traceability to each contract item. The technical office responsible for oversight is 2320.SD. This requirements list applies to the base period of performance from April 17, 2026 through April 16, 2027, with four one-year option periods extending through April 16, 2031, with performance at Naval Base Point Loma, San Diego, California.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| N3904026Q5446 U00002 Combined Synopsis Solicitation.docx | DOCX document | |
| N3904026Q5446 Q and A.docx | DOCX document | |
| N3904026Q5446 U00001 Combined Synopsis Solicitation.docx | DOCX document | |
| N3904026Q5446 Attachment 1 - TC.docx | DOCX document | |
| N3904026Q5446 Combined Synopsis Solicitation.docx | DOCX document |
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Text version
CONTRACT __________________
PRINTED: 5 MARCH 2025 PAGE _______
ATTACHMENT 1 TO EXHIBIT A (DD FORM 1423)
(ADP DD FORM 1423 (MECHANIZED EQUIVALENT) PER DAR CLAUSE 16-815)
CONTRACT DATA REQUIREMENTS LIST
| SYSTEM/ITEM: NITROGEN BOTTLE | CATEGORY ____________ | ||
| ITEM NO | CONTRACTOR |
| 01 | SEQ NO | A002AA | |||
| 02 | DATA DESC | CERTIFICATE OF COMPLIANCE | |||
| 03 | SUBTITLE | NITROGEN GAS | |||
| 04 | DID NUMBER | PER ATTACHMENT 1 TO EXHIBIT A | |||
| 05 | CONTRACT REF | PARA. C.5.1 | |||
| 06 | TECH OFFICE | 2320.SD | |||
| 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 | ONE SUBMITTAL PER DELIVERY |
SEQ. NO. A002AA
| PREPARED BY ________________________________________________ | DATE__________________ |
| APPROVED BY ________________________________________________ | DATE__________________ |
DD FORM 1423
PRINTED: 5 MARCH 2025 PAGE _______
EXHIBIT A
| SYSTEM/ITEM: NITROGEN BOTTLE | CATEGORY ____________ | ||
| ITEM NO | CONTRACTOR |
| 01 | SEQ NO | A002AB | |||
| 02 | DATA DESC | MATERIAL SAFETY DATA SHEETS | |||
| 03 | SUBTITLE | NITROGEN GAS | |||
| 04 | DID NUMBER | PER ATTACHMENT 1 TO EXHIBIT A | |||
| 05 | CONTRACT REF | PARA. C.5.2 | |||
| 06 | TECH OFFICE | 2320.SD | |||
| 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 | ONE SUBMITTAL PER DELIVERY |
SEQ. NO. A002AB
| PREPARED BY ________________________________________________ | DATE__________________ |
| APPROVED BY ________________________________________________ | DATE__________________ |
| SYSTEM/ITEM: OXYGEN BOTTLE | CATEGORY ____________ | ||
| ITEM NO | CONTRACTOR |
| 01 | SEQ NO | A004AA | |||
| 02 | DATA DESC | CERTIFICATE OF COMPLIANCE | |||
| 03 | SUBTITLE | OXYGEN GAS | |||
| 04 | DID NUMBER | PER ATTACHMENT 1 TO EXHIBIT A | |||
| 05 | CONTRACT REF | PARA. C.5.1 | |||
| 06 | TECH OFFICE | 2320.SD | |||
| 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 | ONE SUBMITTAL PER DELIVERY |
SEQ. NO. A004AA
| PREPARED BY ________________________________________________ | DATE__________________ |
| APPROVED BY ________________________________________________ | DATE__________________ |
PRINTED: 5 MARCH 2025 PAGE _______
| SYSTEM/ITEM: OXYGEN BOTTLE | CATEGORY ____________ | ||
| ITEM NO | CONTRACTOR |
| 01 | SEQ NO | A004AB | |||
| 02 | DATA DESC | MATERIAL SAFETY DATA SHEETS | |||
| 03 | SUBTITLE | OXYGEN GAS | |||
| 04 | DID NUMBER | PER ATTACHMENT 1 TO EXHIBIT A | |||
| 05 | CONTRACT REF | PARA. C.5.2 | |||
| 06 | TECH OFFICE | 2320.SD | |||
| 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 | ONE SUBMITTAL PER DELIVERY |
SEQ. NO. A004AB
| PREPARED BY ________________________________________________ | DATE__________________ |
| APPROVED BY ________________________________________________ | DATE__________________ |
| SYSTEM/ITEM: ARGON BOTTLE | CATEGORY ____________ | ||
| ITEM NO | CONTRACTOR |
| 01 | SEQ NO | A006AA | |||
| 02 | DATA DESC | CERTIFICATE OF COMPLIANCE | |||
| 03 | SUBTITLE | ARGON GAS | |||
| 04 | DID NUMBER | PER ATTACHMENT 1 TO EXHIBIT A | |||
| 05 | CONTRACT REF | PARA. C.5.1 | |||
| 06 | TECH OFFICE | 2320.SD | |||
| 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 | ONE SUBMITTAL PER DELIVERY |
SEQ. NO. A006AA
| PREPARED BY ________________________________________________ | DATE__________________ |
| APPROVED BY ________________________________________________ | DATE__________________ |
PRINTED: 5 MARCH 2025 PAGE _______
| SYSTEM/ITEM: ARGON BOTTLE | CATEGORY ____________ | ||
| ITEM NO | CONTRACTOR |
| 01 | SEQ NO | A006AB | |||
| 02 | DATA DESC | MATERIAL SAFETY DATA SHEETS | |||
| 03 | SUBTITLE | ARGON GAS | |||
| 04 | DID NUMBER | PER ATTACHMENT 1 TO EXHIBIT A | |||
| 05 | CONTRACT REF | PARA. C.5.2 | |||
| 06 | TECH OFFICE | 2320.SD | |||
| 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 | ONE SUBMITTAL PER DELIVERY |
SEQ. NO. A006AB
| PREPARED BY ________________________________________________ | DATE__________________ |
| APPROVED BY ________________________________________________ | DATE__________________ |
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.
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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