N390406036V100 Attachment 1 to Exhibit A.pdf
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- Solicitation number
- N390406036V100
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This is a Certificate of Compliance form (DD Form 1423 Attachment) required for contract N39040Q5226V610. The vendor must supply a Certificate of Compliance with each shipment of material, attesting that all items furnished are in full compliance with all contract requirements. The certification must be signed and dated by the vendor's Quality Assurance official designated as responsible for quality assurance and must include material identification details such as lot number, batch number, part number, or other applicable identifiers.
The form requires vendors to complete material identification fields including contract number, order number, item number, National/Local Stock Number (NSN/LSN), manufacturer's part number, manufacturer's serial number, drawing and piece number, and manufacturer's lot/heat numbers as marked on the material. All inspection and test reports required for traceability to each contract item must accompany the signed statement. The vendor attests that inspection and test reports provided represent the actual attributes of items furnished and indicate full compliance with all contract requirements. This is a template document establishing the compliance certification procedures and format required under the contract.
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Text version
CONTRACT N39040Q5226V610
ATTACHMENT 1 TO EXHIBIT A (DD FORM 1423)
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 N39040Q5226V610
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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