Acceptance Certificate Template

Deliverable

[Deliverable name]

Statement of Work

[SoW reference]

Version

[Version]

Submission Date

[Date]

Acceptance Criteria

Criterion	Evidence	Result
[Criterion]	[Evidence]	Pass / Fail

Acceptance Decision

Accepted / Rejected / Accepted with observations

Comments

[Comments.]

Customer Approval

Name:

Role:

Signature:

Date:

Supplier Confirmation

Name:

Role:

Signature:

Date: