9274V000-00646-CDRL A007 - Certification of compliance.doc
DOC document 82 KB Posted
- Attached to
- CASK Containers
- Solicitation number
- N4523A20Q4008
About this file
This data item description and contract data requirements list specify certification requirements for a shielded shipping cask to be delivered under Navy contract N4523A9274V000. The contractor must provide a certification of compliance statement confirming the cask meets all specification requirements using their own format. This certification is due upon delivery of the cask to the Naval Shipyard Puget Sound in Bremerton, Washington. The contractor must submit one electronic copy of the certification to the Navy technical point of contact provided. The Navy will issue a single award firm fixed price commercial contract for the cask to the best value offeror under solicitation N4523A20Q4008 set aside for small businesses. The solicitation seeks proposals for the cask under NAICS code 332439 for a base period and three one-year options.
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SHIPYARD ENGINEERING AND PLANNING PROCEDURES MANUALADVANCE \D 3.60
ADVANCE \D 9.35
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item)
Form Approved
OMB No. 0704-0188
Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Please DO NOT RETURN your form to either of these address. Send completed form to the Government issuing Contracting Officer for the Contract/PR No. Listed in Block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY |
| TBD |
| A |
| TDF TM OTHER MISC |
D. SYSTEM/ITEM
SHIELDED SHIPPING CASK
E. CONTRACT/PR NO.
N4523A9274V000
F. CONTRACTOR
TBD
1. DATA ITEM NO.
A007
2. TITLE OF DATA ITEM
CERTIFICATION/DATA REPORT
3. SUBTITLE
CERTIFICATION of Compliance
4. AUTHORITY (Data Acquisition Document No.)
DI-MISC-80678
5. CONTRACT REFERENCE
NML
6. REQUIRING OFFICE
PSNS & IMF C/2310.3
7. DD 250 REQ
XX
9. DIST STATEMENT
REQUIRED
10. FREQUENCY
ASREQ
12. DATE OF FIRST
SUBMISSION
ASREQ
14. DISTRIBUTION
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
N/A
13. DATE OF SUBSEQUENT SUBMISSION
N/A
A. ADDRESSEE
Final
| Draft |
| Reg |
| Repro |
Required COC Documentation
Block 3: THE CERTIFICATION OF COMPLIANCE TO SPECIFICATION REQUIREMENTS STATEMENT paragraph 4.5.2 SHALL BE IN THE CONTRACTOR’S FORMAT.
BLOCK 12: THE CONTRACTOR SHALL PROVIDE THE CERTIFICATION OF COMPLIANCE TO CONTRACT SPECIFICATION REQUIREMENTS paragraph 4.5.2 WITH DELIVERY OF THE SHIELDED SHIPPING CASK TO PSNS.
BLOCK 14: THE CONTRACTOR SHALL PROVIDE ONE COPY OF THE CERTIFICATION OF COMPLIANCE TO CONTRACT SPECIFICATION REQUIREMENTS paragraph 4.5.2 STATEMENT IN ELECTRONIC UNPROTECTED SEACHABLE PDF FORMAT TO THE GOVERNMENT TECHNICAL POINT OF CONTACT (BELOW).
JERRY NAHRING
C/2310.3, PSNS & IMF
Jerry.nahring@navy.mil
| PSNS C/2310.3 |
| 0 |
| 1 |
| 0 |
| TOTAL |
| 0 |
| 1 |
| 0 |
| G. PREPARED BY |
| H. DATE |
| H. APPROVED BY |
| J. DATE |
| Mike Baker |
| 9 September, 2019 |
| Rich Balter |
| 10 September, 2019 |
DD Form 1423-1, FEB 2001 Previous edition may be used.
Page 1 of 2 Pages
DATA ITEM DESCRIPTION
Title: Certification/Data Report
Number: DI-MISC-80678 Approval Date: 880912 AMSC Number: N4533 Limitation: N/A DTIC Applicable: N/A GIDEP Applicable: N/A Office of Primary Responsibility: N/SEA 55Z3
Distribution Statement A: Approved for public release; distribution is unlimited Applicable Forms: N/A
Description/Purpose: Certification data is required to verify that specific qualifications have been obtained, tests have been performed, parts/assemblies/equipment/systems have been installed, tested, inspected and are ready for operation; that personnel have specific qualifications to perform assignments/operations/inspections; or to certify identicality, interchangeability, compatibility, reliability, or completeness of documentation being prepared or reviewed by a contractor. The technical effort involved shall be the result of equipment/procurement specification requirements.
Application/Interrelationship: Certification may be required for a single event/operation, or may be required for a specified time period, or certification may be required on a continuing basis with periodic re-certification or updating of the original certification.
The technical content requirements for this item shall be specified in the contract.
Requirements:
1 Format: The report shall be typewritten in narrative format on the contractor’s form.
2 Content: The report shall contain the contract number and data item sequence number, and shall contain a statement the specifically identifies the purpose and applicability of this certification.
2.1 Certification of completion: Certification that tests have been performed, inspections made, parts/assemblies/equipment/systems have been installed, tested, inspected, and area ready for operation, or that specific qualifications have been obtained shall provide objective evidence in support of the certification. Objective evidence may include such items as spectrographs, radiographs, material sampling, analysis, inspection and testing reports, or any other necessary documentation.
2.2 Certification of personnel. Certifications that personnel have specific qualifications shall be supported by licenses, permits, tests, statements of competency, or other documentation. The specific capabilities to perform an assignment, inspection, or other operations shall be stated in the certification.
2.3 Certification of data reviews. Certifications that documentation/data has been reviewed shall contain a statement of the “depth” of the examination and the results thereof. If the documentation being reviewed cannot be certified, the report shall so state and shall list the reasons, i.e., deficiencies, conflicting data, etc.
2.4 Certification of compliance. Certification of compliance to specific specification requirements shall be a statement to the effect that the contractor has complied.
3 Technical content:
3.1 The technical content shall be as specified on the DD Form 1423, Contract Data Requirements List.
3.2 Signature: The certification report shall be signed by the contractor’s authorized representative responsible for insuring that the equipment being delivered/service being performed is in accordance with contract requirements.
4 End of DI-MISC-80678
Page 2 of 2 Pages
17. PRICE GROUP
18. ESTIMATED� TOTAL PRICE
Original
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