Certificate Of Conformance Template PDF Details

A certificate of conformance template is a document that certifies the conformity to standards and specifications. This type of certification ensures that products or materials meet requirements, such as safety or quality standards. A certificate of conformance template can be used for many different industries and applications, including construction, manufacturing and more. As an example, a Certificate of Conformance Template may certify that a product meets all applicable federal regulations before it is marketed in the U.S., or that a building complies with specific regulatory guidelines before occupancy occurs.

This general guide will aid you to figure out the time it'll require you to complete certificate of conformance template, how many pages it has, and a handful of additional specific details about the PDF.

Form NameCertificate Of Conformance Template
Form Length2 pages
Fillable fields0
Avg. time to fill out30 sec
Other namescertificate conformance form, certificate of conformity form, certificate of conformance form, certificate of conformity templates sample

Form Preview Example


Index No. PX-4893

Page No. 1 of 2

Issue No. 005

(U) Certificate of Conformance

(Reference MNL-352209)

NOTE: Prior to completing this certification, the Supplier reviews and complies using the form instructions on page 2 of this document.

A. Purchase Order (PO)/Contract Data


PO/Contract No.:



2. Revision/Amendment No.:


PO Line Item Information:

Line Item Number _____________

Quantity _____________________


Heat/Cast Number _________________ Lot/Batch Number ___________________ Serial Number __________________________


Item Identification _______________________________________________________________________________________________







Supplier/Source Information





Supplier Name:



5. Supplier Address (Street/City/State):

NOTE: Nonconformance(s): Unless otherwise directed in writing by the Procurement Specialist, do not deliver/ship materials/items/equipment if there are any changes, deviations, substitutions and/or nonconforming conditions that have not been previously submitted and approved.


Applicable Requirements



Code/Standard No.:



Specification No.:



Technical Drawings/Diagrams:



Manufacturer Published Description/Product Description:

Manufacturer Specification:

10. Other:


D. Approved Changes/Deviations/Waivers/Substitutions/Nonconformances:

E. Certification Statement

_______________________________________ (Supplier), hereby certifies that the materials/items/equipment identified in Section A above,

and all required documentations, conforms in all respects to the stated Purchase Order/Contract requirements and that all exceptions, waivers, deviations, substitutions or nonconforming conditions are identified in Section D. Furthermore, information provided is accurate, complete, and true pursuant to 10 CFR 820.11 (see definition).

Authorized Certifying Official (See Definitions/Instructions):

Printed Name











Index No. PX-4893

Page No. 2 of 2

Issue No. 005

(U) Certificate of Conformance

(Reference MNL-352209)


Prepare a Certificate of Conformance (C of C) addressing each PO line item, Contract Deliverable, or each partial shipment. Unless otherwise specified, the C of C accompanies each shipment. All applicable form entries are completed.

A Supplier system-generated C of C may be attached and referenced and contains all applicable information required by the CNS Pantex PX-4893 form, specifically the information requested in Sections A, B, C, D and E.


Authorized Certifying Official - The certification is attested to by an authorized representative of the supplier; and the certification system, including the procedures for completing, reviewing, and approving the certificate are described in the Company’s administrative control system or Quality Assurance program.

Certification - The act of determining, verifying, and attesting in writing to the qualifications of personnel, processed, procedures, or items in accordance with specified requirements.

Certificate of Conformance - A document signed or otherwise authenticated by an authorized individual certifying the degree to which items or services meet specified requirements.

10 CFR 820.11 - Procedural Rules for DOE Nuclear Activities, Subpart “A”, Information requirements. The regulation states: Any information pertaining to a nuclear activity provided to DOE by any person or maintained by any person for inspection by DOE are complete and accurate in all material respects.

No person involved in a DOE nuclear activity conceals or destroys any information concerning a violation of a DOE Nuclear Safety Requirement, a Nuclear Statute, or the Act.

Section A, Purchase Order (PO)/Contract Data

Entry 1 Enter the complete CNS Pantex PO or Contract Number.

Entry 2 Enter PO/Contract Revision or Amendment Number, (if applicable).

Entry 3 Enter as applicable, the PO Line Item Number (i.e., 1, 2, 3), quantity, heat/cast number, lot/batch number, serial number, and item identification.

Section B, Supplier/Source Information

Entry 4 Enter the legal Supplier company name, as stated on the PO or Contract.

Entry 5 Enter the Supplier business address, as stated on the PO or Contract.

Section C, Applicable Requirements

Entry 6 Enter the applicable design code/standard number and applicable revision, issue, edition, or addendum.

Entry 7 Enter the applicable specification number and applicable revision, issue, edition, or addendum.

Entry 8 Enter the applicable technical drawing/diagram and applicable revision, issue, edition, or addendum.

Entry 9 Mark the applicable box manufacturer published description/product description or manufacturers specification.

Entry 10 Enter other applicable requirements documents and applicable revision, issue, edition, or addendum.

Section D, Approved Changes/Deviations/Waivers/Substitutions/Nonconformances

Enter any approved changes. Reference change documentation control numbers as applicable. (Attach additional pages if necessary).

Section E, Certification Statement (see definitions)

Enter the Company name (or commonly used acronym).

Print or type the authorized company certifying officials name, title, and date.

Sign or otherwise authenticate by company certifying official.


CNS Pantex, LLC

Fax: 806-477-3891


Or e-mail with a PDF file. supplierquality@pantex.com

Place a copy with the shipment.


How to Edit Certificate Of Conformance Template Online for Free

Couple of things can be simpler than filling out documentation applying the PDF editor. There isn't much you need to do to modify the certification of conformance form file - just abide by these steps in the following order:

Step 1: The initial step is to click the orange "Get Form Now" button.

Step 2: You're now capable of enhance certification of conformance form. You possess lots of options thanks to our multifunctional toolbar - you can include, erase, or change the text, highlight its particular components, as well as conduct many other commands.

To be able to complete the certification of conformance form PDF, enter the content for all of the sections:

step 1 to completing certificate of conformance format

Make sure you write down the demanded information in the Technical DrawingsDiagrams, D Approved, RevisionIssueEditionAddendum, E Certification Statement, Supplier hereby certifies that, Authorized Certifying Official See, Printed Name, Title, Signature, Date, and UNCLASSIFIED area.

certificate of conformance format Technical DrawingsDiagrams, D Approved, RevisionIssueEditionAddendum, E Certification Statement, Supplier hereby certifies that, Authorized Certifying Official See, Printed Name, Title, Signature, Date, and UNCLASSIFIED fields to insert

The system will require details to effortlessly submit the segment CNS Pantex LLC Fax Attn SUPPLIER, Or email with a PDF file, and UNCLASSIFIED.

Entering details in certificate of conformance format part 3

Step 3: Press the "Done" button. Now you can upload the PDF document to your gadget. Besides, you can send it via email.

Step 4: Produce a duplicate of every different form. It may save you time and allow you to keep clear of misunderstandings in the long run. Also, the information you have is not used or viewed by us.

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