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

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DPM Household Goods Packing, Moving, and Storage
Solicitation number
N0060426R0003
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This is a DD Form 2772, Contract Discrepancy Report, which is a standardized federal form prescribed by the Defense Federal Acquisition Regulation Supplement (DFARS) 5220.22-V2 and the Federal Acquisition Regulation (FAR) 4.4. The form serves as a quality assurance and contract management tool used to document, track, and resolve discrepancies or problems identified during contract performance.

The form is divided into three main sections: initial discrepancy reporting, contractor response, and government evaluation and closeout. The Quality Assurance Evaluator (QAE) completes the first section by documenting the contract number, report number, contractor information, dates (prepared, returned by contractor, and action complete), and a detailed description of the discrepancy with references to the Performance Work Statement (PWS) or other applicable directives. The contractor then responds in section nine by explaining the cause of the discrepancy, outlining corrective actions, and describing preventive measures, citing relevant quality control procedures. The Contracting Officer completes section eleven by evaluating the contractor's response for acceptance, partial acceptance, or rejection, and specifies any government actions such as reduced payment, cure notices, or show cause orders in section twelve. The form concludes with a closeout section requiring signatures and dates from the contractor, QAE, and Administrative Contracting Officer (ACO) to document that all parties have been notified and the discrepancy has been resolved.

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Text version

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PREVIOUS EDITION IS OBSOLETE.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:
PageCount:
one:
two:
three:
four:
5. DATES (YYYYMMDD) - a. PREPARED:
5. DATES (YYYYMMDD) - b. RETURNED BY CONTRACTOR:
5. DATES (YYYYMMDD) - c. ACTION COMPLETE:
TextField2:
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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