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Monterey Marina JANITIORIAL SERVICES
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36C26118Q0524
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36C26118Q0524 Attach 4 Discrepancy Report.docx

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Attachment #4

Service Provider Discrepancy Report

SERVICE PROVIDER DISCREPENCY REPORT
1. DISCREPENCY REPORT NUMBER

2. TO: (Service Provider and Manager Name)

3. FROM: (Name of Task Manager)

DATES

PREPARED

ORAL NOTIFICATION
RETURNED BY CONTRACTOR
ACTION COMPLETE

4. DISCREPENCY OR PROBLEM (Describe in Detail. Include PWS references. Attach Continuation Sheet if Necessary.)

5. SIGNATURE OF TASK MANAGER

6. TO: (Name of COR)

7. FROM: (Service Provider)

8. SERVICE PROVIDER RESPONSE AS TO CAUSE, EFFECT, CORRECTIVE ACTION AND ACTIONS TO PREVENT RECURRENCE. (Attach Continuation Sheet if necessary. Cite applicable SP QC program procedures or new QC procedures.)

9. SIGNATURE OF SP REPRESENTIVE

10. DATE

11. GOVERNMENT EVALUATION (Acceptance, partial acceptance, or rejection. Attach Coordination Sheet if necessary.)

1. GOVERNMENT ACTIONS (Cure notice, show cause, other.)

CLOSE OUT

SP NOTIFIED
NAME AND TITLE
SIGNATURE
DATE

TASK MANAGER

COR

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