2.04.14 Attachment (13) - Contract Discrepancy Report DD2772.pdf

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Bridge DPM Contract Schedule I & II
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N0060426Q4024
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This is a blank DD Form 2772, Contract Discrepancy Report template prescribed by Federal Acquisition Regulation (FAR) 4.4 and the Department of Defense form 5220.22-V2. The form serves as the official mechanism for documenting, reporting, and resolving contract performance discrepancies between government quality assurance evaluators (QAE) and contractors.

The form is structured in three primary phases: initial discrepancy reporting, contractor response, and government evaluation and closeout. The QAE initiates the process by completing sections 1-7, which require the contract number, report number, contractor and manager information, preparation dates, a detailed description of the discrepancy or problem with reference to the Performance Work Statement (PWS), and the contracting officer's signature. The contractor then responds in sections 8-10 by identifying the cause, proposing corrective actions, and describing preventive measures, citing applicable quality control procedures. The government concludes the process in sections 11-13 by evaluating the contractor's response (acceptance, partial acceptance, or rejection), specifying government actions such as reduced payment or cure notices, and obtaining closeout signatures from the contractor, QAE, and Administrative Contracting Officer (ACO) with corresponding dates. This template is the September 1998 edition, with previous versions rendered obsolete.

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Prescribed by: 5220.22-V2; FAR 4.4;

PREVIOUS EDITION IS OBSOLETE.

DD FORM 2772, SEP 1998

CONTRACT DISCREPANCY REPORT

1. CONTRACT NUMBER 2. REPORT NUMBER FOR THIS DISCREPANCY

3. TO (Contractor and Manager's Name) 4. FROM (Name of QAE)

5. DATES (YYYYMMDD)

a. PREPARED b. RETURNED BY CONTRACTOR c. ACTION COMPLETE

6. DISCREPANCY OR PROBLEM (Describe in detail. Include reference to PWS Directive; attach continuation sheet if necessary.)

7. SIGNATURE OF CONTRACTING OFFICER

8a. TO (Contracting Officer) b. FROM (Contractor)

9. CONTRACTOR RESPONSE AS TO CAUSE, CORRECTIVE ACTION AND ACTIONS TO PREVENT RECURRENCE. (Cite applicable Q.C. program procedures or new Q.C. procedures. Attach continuation sheet(s) if necessary.)

10. SIGNATURE OF CONTRACTOR REPRESENTATIVE b. DATE (YYYYMMDD)

11. GOVERNMENT EVALUATION (Acceptance, partial acceptance, reflection. Attach continuation sheet(s) if necessary)

12. GOVERNMENT ACTIONS (Reduced payment, cure notice, show cause, other)

13. CLOSE OUT

NAME

(1)

TITLE

(2)

SIGNATURE

(3)

DATE (YYYYMMDD)

(4)

a. CONTRACTOR

NOTIFIED

b. QAE

c. ACO

DRAFT

SAMPLE

PREVIOUS EDITION IS OBSOLETE.

DD FORM 2772, SEP 1998

NEEDS DD67

Page of Prescribed by: 5220.22-V2; FAR 4.4;

DRAFT

INSTRUCTIONS

NEEDS DD67

PREVIOUS EDITION IS OBSOLETE.

DD FORM XXXX, 20YYMMDD DRAFT

Page of

CONTRACT DISCREPANCY REPORT

5. DATES (YYYYMMDD)

13. CLOSE OUT

NAME (1)

TITLE (2)

SIGNATURE (3)

DATE (YYYYMMDD)

(4)

a. CONTRACTOR NOTIFIED

b. QAE

c. ACO 9.0.0.2.20120627.2.874785 DD Form 2772, "CONTRACT DISCREPANCY REPORT"

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CurrentPage:
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one:
two:
three:
four:
5. DATES (YYYYMMDD) - a. PREPARED:
5. DATES (YYYYMMDD) - b. RETURNED BY CONTRACTOR:
5. DATES (YYYYMMDD) - c. ACTION COMPLETE:
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SignatureField1:
8a. TO (Contracting Officer) - enter recipient information:
8b. FROM (Contractor) - enter sender information:
9. CONTRACTOR RESPONSE AS TO CAUSE, CORRECTIVE ACTION AND ACTIONS TO PREVENT RECURRENCE. (Cite applicable Q.C. program procedures or new Q.C. procedures. Attach continuation sheet(s) if necessary.):
SignatureField2:
10b. DATE (YYYYMMDD):
eleven:
twelve:
13. CLOSE OUT - a. CONTRACTOR NOTIFIED - (1) NAME:
13. CLOSE OUT - a. CONTRACTOR NOTIFIED - (2) TITLE:
13. CLOSE OUT - a. CONTRACTOR NOTIFIED - (3) SIGNATURE:
13. CLOSE OUT - a. CONTRACTOR NOTIFIED - (4) DATE (YYYYMMDD):
13. CLOSE OUT - b. QAE - (1) NAME:
13. CLOSE OUT - b. QAE - (2) TITLE:
13. CLOSE OUT - b. QAE - (3) SIGNATURE:
13. CLOSE OUT - b. QAE - (4) DATE (YYYYMMDD):
13. CLOSE OUT - c. ACO - (1) NAME:
13. CLOSE OUT - c. ACO - (2) TITLE:
13. CLOSE OUT - c. ACO - (3) SIGNATURE:
13. CLOSE OUT - c. ACO - (4) DATE (YYYYMMDD):

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