Certificate of Compliance.pdf
PDF 358 KB Posted
- Attached to
- NNSY HOSE ASSEMBLY
- Solicitation number
- N4215827QE006
About this file
This is a Certificate of Compliance form used for federal naval contracting with Norfolk Naval Shipyard. The form documents compliance with contract requirements for materials and items being furnished under Requisition Number N42158-6295ZN01-ZN03 and Contract/Order Number N4215827PEXXX.
The certificate 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. A Quality Assurance Official must attest that all items furnished are in full compliance with contract requirements and certify that inspection and test reports accurately represent the actual attributes of furnished items and demonstrate full compliance. One signed copy of this certification must be delivered with the shipment to Norfolk Naval Shipyard, Code 2305.6, Expediting Section, Building 297, Portsmouth, VA 23709-5000. The form notes that completing and returning the certification upon shipment will expedite receipt and payment processing.
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| File | Type | Posted |
|---|---|---|
| Solicitation - N4215827QE006.pdf |
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Text version
CERTIFICATE OF COMPLIANCE
Requisition Number N42158-6295ZN01-ZN03
MATERIAL IDENTIFICATION (COMPLETE APPLICABLE ITEMS)
CONTRACT NO. ORDER NO. N4215827PEXXX
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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