Certificate of Conformance (Category A)
C of C & Certified Listing (Mechanical Assemblies, FAI Req’d.)
*The following is to be filled in by the part manufacturer’s or distributor’s authorized representative
Serialized assembly data. All items are required. A separate Certified Listing is Req’d. for each Serialized Assy.
LMC Purchase Order Number: _________________________________________
Assembly P.O. Part Number: __________________________________________
Assembly Nomenclature: _____________________________________________
Assembly Serial Number:_____________________________________________
Use the following table or attach a listing documenting this information for all piece parts.
Cage
Part Number Manufacturer Code Production Lot Qty
_______________ _______________ _______ ____________ ____
_______________ _______________ _______ ____________ ____
_______________ _______________ _______ ____________ ____
_______________ _______________ _______ ____________ ____
_______________ _______________ _______ ____________ ____
_______________ _______________ _______ ____________ ____
_______________ _______________ _______ ____________ ____
_______________ _______________ _______ ____________ ____
( Certificate of Compliance: Attach a certificate of compliance for all materials, finishes, coatings, surface treatments and special processes as defined by the engineering dwg’s & subtier dwg’s as applicable.
The undersigned states that “The articles furnished to Lockheed Martin are in conformance with the purchase order requirements, engineering drawings and specifications”.
The following is to be filled in by the part manufacturer’s or distributor’s authorized representative.
Supplier Name: _______________________________________________________________________
Cage Code: __________________________________________________________________________
Supplier Address: _____________________________________________________________________
Name (Print):_____________________________________________________
Title:____________________________________________________________
Signature:________________________________________ Date____________
Rev. 4 - Cat. D
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