Attachment 36-FTC-ADM-67 CDR.pdf
PDF 12 KB Posted
- Attached to
- Training Support Services Federal contract opportunity
- Solicitation number
- 70LART25RPFB00006
About this file
This is Form FTC-ADM-67, a Contract Discrepancy Report template used to document and track contract performance issues. The form is designed to facilitate communication between the government (specifically the Contracting Officer's Technical Representative - COTR) and contractors regarding contract discrepancies or problems.
The form includes sections for documenting key information such as contract number, report number, contractor details, and important dates (when prepared, contractor notification, contractor response, and action completion). It provides space for describing the discrepancy with reference to Statement of Work requirements, contractor response regarding cause and corrective actions, government evaluation of the response, and any resulting government actions such as payment deductions or cure notices. The form concludes with a close-out section requiring signatures from the contractor, COTR, and Contracting Officer, with copies distributed to the contractor, COTR, and procurement office.
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Text version
FTC-ADM-67 (5/90)
CONTRACT DISCREPANCY REPORT
1. CONTRACT NUMBER 2. REPORT NUMBER FOR THIS DISCREPANCY
3. To: (Contractor and Managers Name) 4. From: (Name of COTR)
5 DATES
PREPARED CONTRACTOR NOTIFIED RETURNED BY CONTRACTOR ACTION COMPLETED
6. DISCREPANCY OR PROBLEM: (Describe in Detail: include reference to SOW/Directive:attach continuation sheet if necessary.)
7. SIGNATURE OF CONTRACTING OFFICER DATE
TO: (Contracting Officer) FROM: (Contractor)
9. CONTRACTOR RESPONSE AS TO CAUSE, CORRECTIVE ACTION AND ACTIONS TO PREVENT RECURRENCE: ATTACH CONTINUATION SHEET IF NECESSARY. (Cite applicable Q.C.program procedures or new Q.C. program procedures.)
10. SIGNATURE DATE
11. GOVERNMENT EVALUATION (Acceptance, partial acceptance, rejection, attach continuation sheet if necessary.)
12. GOVERNMENT ACTIONS (Payment deduction, cure notice, show cause, other)
13 CLOSE OUT
NAME - TITLE SIGNATURE DATE
CONTRACTOR
NOTIFIED
COTR
CONTRACTING
OFFICER
ORIGINAL - CONTRACTOR COPY - COTR COPY - PROCUREMENT
Page 1 of 1)
Sheet1
File details come from the government source that posted it. Updated .