N39040Q6036V238 Attachment 1 to Exhibit A_6036V238_239 - MEMBRANES.pdf
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- Solicitation number
- N39040Q6036V238
About this file
This is a Contract Data Requirements List (CDRL) in the form of DD Form 1423 (Mechanized Equivalent) for contract N39040Q6036V238 pertaining to thin membrane materials.
The document establishes data submission requirements for a Certificate of Compliance (COC) that must accompany each shipment of thin membrane materials. The contractor is required to submit one COC per item for a quantity of 90 units, with the first submission due with the material delivery. The submission must be made via WAWF (Wide Area Workflow) and distributed to Code 410. The vendor is responsible for conducting all required tests, analyses, inspections, and examinations as specified in the contract and specifications, regardless of whether certifications are formally required. The COC must contain a verbatim attestation statement: "I ATTEST ALL ITEMS FURNISHED ON THIS CONTRACT ARE IN FULL COMPLIANCE WITH ALL CONTRACT REQUIREMENTS." The certificate must be signed by the vendor's quality assurance official and include material identification details such as lot, batch, part number, serial number, drawing numbers, and manufacturer lot/heat numbers. All inspection and test reports required for traceability to each contract item must accompany the signed compliance statement. The technical office responsible for oversight is designated as office 138, with the contract reference being paragraph C.4.1.
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Text version
CONTRACT/SOLICITATION; N39040Q6036V238
EXHIBIT A
(ADP DD FORM 1423 (MECHANIZED EQUIVALENT) PER DAR CLAUSE 16-815)
CONTRACT DATA REQUIREMENTS LIST
SYSTEM/ITEM: THIN MEMBRANE
CATEGORY ____________
ITEM NO CONTRACTOR
01 SEQ NO A002AA
02 DATA DESC CERTIFICATE OF COMPLIANCE
03 SUBTITLE THIN MEMBRANE
04 DID NUMBER PER ATTACHMENT 1 TO EXHIBIT A
05 CONTRACT REF PARA. C.4.1
06 TECH OFFICE 138
07 DD 250 REQ SD
08 APP CODE
09 IAC INPUT
10 FREQUENCY O-TIME; SUBMIT ONE COC PER ITEM (90 UNITS)
11 AS OF DATE
12 DATE 1ST SUBM WITH MATERIAL
13 DATE SUB SUBM
14 DISTRIBUTION 0_-_N/A________/(1) - Code 410 VIA WAWF
15 TOTAL 1 __
16 REMARKS QTY (1) SUBMITTAL
SEQ. NO.:
PREPARED BY ______________________________________ DATE__________________
APPROVED BY ______________________________________ DATE__________________
DD FORM 1423
CONTRAC/ SOLICITATION: N39040Q6036V238
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.
CONTRAC/ SOLICITATION: N39040Q6036V238
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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