CERTIFICATE OF COMPLIANCE.pdf

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COMPOSITE
Solicitation number
N4215827QE005
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This document is a Certificate of Compliance form for federal contract solicitation N4215827QE005 issued to ECOMASS TECHNOLOGIES, LP by Norfolk Naval Shipyard. The form serves as a quality assurance certification template that contractors must complete and return upon shipment of materials to attest that all items furnished comply with contract requirements. The certificate requires material identification information including contract number, order number, 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 attestation sections requiring signatures from Quality Assurance Officials. The first section certifies that all items furnished are in full compliance with all contract requirements. The second section confirms that inspection and test reports provided represent the actual attributes of items furnished and indicate full compliance, with an option to mark as "Not Applicable" (N/A is checked on this template). Contractors must deliver one copy of the completed certification with the material shipment to Norfolk Naval Shipyard, Attention CODE 2305.6, Expediting Section, Building 297, Portsmouth, VA 23709-5000. The instructions note that prompt return of completed certifications will expedite receipt and payment processing.

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Other files

File Type Posted
FAR 52.212-1 Addendum.pdf PDF
FAR 52.212-2 Attachment (A).pdf PDF
Solicitation N4215827QE005.pdf PDF

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Text version

CERTIFICATE OF COMPLIANCE

SOLICITATION # N4215827QE005

ECOMASS TECHNOLOGIES, LP

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

ENCLOSURE (1)

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