N39040Q6134V600 Attachment 1 to Exhibit A_Work Platform.pdf
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- Solicitation number
- N39040Q6134V600
About this file
This is a required certification template for federal contract N39040Q6134V600, establishing quality assurance and compliance documentation procedures for material shipments.
The certification requirements mandate that vendors supply a Certificate of Compliance with each shipment, signed by the vendor's designated quality assurance official. The certificate must include a verbatim attestation statement: "I ATTEST ALL ITEMS FURNISHED ON THIS CONTRACT ARE IN FULL COMPLIANCE WITH ALL CONTRACT REQUIREMENTS." Vendors remain liable for conducting all required tests, analyses, inspections, and examinations per contract specifications regardless of whether certifications are explicitly required. The certificate must contain complete material identification including contract number, order number, item number, National/Local Stock Number (NSN/LSN), manufacturer's part number, serial number, drawing and piece number, and lot/heat numbers as marked on the material. All inspection and test reports required by DD Form 1423 for traceability to each contract item must accompany the signed statement. The quality assurance official's signature and certification date are required fields on the optional form provided at the end of the attachment.
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Text version
CONTRACT N39040Q6134V600
ATTACHMENT 1 TO EXHIBIT A
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 N39040Q6134V600
ATTACHMENT 1 TO EXHIBIT A
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
File details come from the government source that posted it. Updated .