D.3 ATTACHMENT 3 CONTRACT DISCREPANCY REPORT.docx

DOCX document 16 KB Posted

Attached to
J045--Extend RFQ Date and Time| CFA Exhaust Fan Repair and Testing Services - Hawaii
Solicitation number
36C26126Q0428
Issued by

About this file

This is a Contract Discrepancy Report template designed for documenting and resolving contract performance issues between contractors and the government. The form provides a structured format for initiating, tracking, and closing out discrepancies or problems that arise during contract execution. Key fields include spaces for the contract number, report number, contractor and project officer information, date prepared, and completion date. The template is divided into three main sections: an initial discrepancy or problem statement signed by the Contracting Officer, a contractor response section where the contractor explains the cause, corrective action taken, and preventive measures to avoid recurrence, and a government evaluation section documenting government actions and closeout procedures. Signature lines and dates are required from both the Contracting Officer and Contractor Representative to establish accountability and documentation of the issue resolution process.

This document serves as an administrative tool for the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 21 in managing contract compliance matters related to solicitation 36C26126Q0428 for J045 CFA Exhaust Fan Repair and Maintenance services. The form enables systematic tracking of contract performance discrepancies from identification through final resolution and closeout notification to both parties.

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Text version

ATTACHMENT 3 – CONTRACT DISCREPANCY REPORT

Contract No.

Report No. for this Discrepancy:

Contractor/Manager’s Name:

From: (Name of Project Officer)

Dates

Prepared:

Returned by Contractor:

Action Complete:

Discrepancy or Problem:

Signature of Contracting Officer:

To: (Contracting Officer)

From: (Contractor)

Contractor Response as to Cause, Corrective Action and Actions to Prevent Recurrence (Attach Continuation Sheet if Necessary)

Signature of Contractor Representative:

Date:

Government Evaluation:

Government Actions:

Close Out

Name
Title
Signature
Date

Contractor Notified

Project Officer

Contracting Officer

File details come from the government source that posted it. Updated .