CERTIFICATE OF COMPLIANCE. LSTR.pdf

106 KB Posted

Attached to
NNSY LS/TR Disposal Boxes
Solicitation number
N4215826QE067
Issued by

About this file

Written by GovTribe AI ·

This document is a Certificate of Compliance form used for federal contract deliveries. The certificate pertains to requisition number N42158-6169ZN01 and contract/order number N42158-26-Q-E067. The form requires completion of material identification information including item number, National/Local Stock Number (NSN/LSN), manufacturer's part number, serial number, drawing and piece number, and manufacturer's lot/heat numbers as marked on the material.

The form contains two attestations requiring Quality Assurance Official signatures and dates. The first attestation certifies that all items furnished on the contract are in full compliance with all contract requirements. The second attestation confirms that inspection and test reports provided represent the actual attributes of items furnished and indicate full compliance with all contract requirements, with a checkbox indicating this section is not applicable (N/A). The form instructions direct contractors to complete the certification upon shipment and return it to Norfolk Naval Shipyard, Attn: Code 2305.6, Expediting Section, Building 297, Portsmouth, VA 23709-5000, with one copy to be delivered with the material. The form serves as a required enclosure to expedite receipt and payment processing.

View the file

Other files

File Type Posted
QandA for LSTR Box.pdf PDF
Attachment (A). Technical Capability Statement.pdf PDF
6169ZN01 Continuation Sheet.pdf PDF
6169ZN01 Attachment (B)_LSTR Disposal Box Supplemental Requirements_Redacted.pdf PDF
Solicitation - N4215826QE067.pdf PDF
6169ZN01_2370.2-8143V-Z.pdf PDF

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

CERTIFICATE OF COMPLIANCE

Requisition Number N42158-6169ZN01

MATERIAL IDENTIFICATION (COMPLETE APPLICABLE ITEMS)

CONTRACT NO. ORDER NO N42158-26-Q-E067

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

ENCLOSURE (1

File details come from the government source that posted it. Updated .