Attachment 3-Certificate of Compliance.pdf
PDF 104 KB Posted
- Attached to
- POWER PANELS
- Solicitation number
- N4215824QE009
About this file
This document is a certificate of compliance template for a federal contract to supply power panels and transformers. The contract number is N4215824QE009 being awarded by the Department of the Navy Naval Sea Systems Command. The template requires the contractor to certify that all materials furnished comply with all contract requirements by providing manufacturer and item identification information. Inspection and test reports must also be certified as representing the actual attributes of the items delivered and that they comply with the contract. One copy of the completed certificate is to be mailed along with the materials delivered to Norfolk Naval Shipyard.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment 2-Technical Capability Statement.pdf | ||
| Attachment 1-FAR Clause 52.212-1 Addendum.pdf | ||
| N4215824QE009.pdf |
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Text version
Attachment 3 – N4215824QE009
POWER PANEL & TRANSFORMER
CERTIFICATE OF COMPLIANCE
MATERIAL IDENTIFICATION (COMPLETE APPLICABLE ITEMS)
CONTRACT NO. ORDER NO ___________
ITEM NO. _______________________
NATIONAL/LOCAL STOCK NUMBER NSN/LSN ________________________
MANUFACTURER’S PART NO. ____________________________
MANUFACTURER’S SERIAL NO. __________________________
DRAWING AND PIECE NO. ______________________________
MANUFACTURER’S LOT/HEAT NOS. AS MARKED ON THE MATERIAL:
I ATTEST ALL ITEMS FURNISHED ON THIS CONTRACT ARE IN FULL COMPLIANCE WITH
ALL CONTRACT REQUIREMENTS.
SIGNATURE _________________________________ DATE _______
QUALITY ASSURANCE OFFICIAL
TITLE _________________________________
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.
REQ’D N/A
[ X ] [ ]
SIGNATURE _________________________________ DATE _________
QUALITY ASSURANCE OFFICIAL
TITLE ________________________________
“NOTE”: WHEN ITEM(S) HAVE BEEN SHIPPED, PLEASE COMPLETE CERTIFICATION(S) AND
RETURN. THIS WILL EXPEDITE RECEIPT AND PAYMENT.
MAIL TO:
NORFOLK NAVAL SHIPYARD
ATTN: CODE 2305.6, EXPEDITING SECTION
BLDG. 297
PORTSMOUTH, VA 23709-5000
DELIVER ONE (1) COPY WITH MATERIAL
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