CoC Template

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C

Certificate of Conformity
1. Supplier CoC Serial No.
Certificate of Conformity
2. Supplier Name and Address: 3. Contract Number:
4. Contract Modification Number:
5. Details of Concessions:

6. Acquirer Name and Address: 7. Deliver Address:

8. Contract 9. Product Description and/or part number 10. Quantity 11. Shipment Document 12. Undelivered
item number Numbers Quantity

13. Traceability Information reference (check the N/A box to indicate no traceability requirements)
a. Sub-contract/Order number:
b. Specification/Drawing number including issue:
c. Identification Marks and/or serial number(s):
N/A
d. Material Cast number:
e. Batch and/or Lot number:
f. Test and/or Inspection Report(s):
g. Incoming Release Note number/Reference:
14. Other Remarks or Comments: (e.g. Cure date. Shelf life.)

15. Supplier Statement of Quality:


It is certified that apart from the concessions noted in block #5 above, the products listed above conform in all respects to the
contract requirements.

Date: Name and Post Title: Signature:

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