18QAA853000_ATT_9__CDR.pdf

RFQ 70Z08418QAA853000 ATTACHMENT 9 PAGE 1 OF 1

CONTRACT DISCREPANCY REPORT

1. Contract Number

2. Report Serial No.

3. Report # this Discrepancy

4. To: (Contractor and Managers Name)

5. From: (Name of COTR)

DATES

6. Prepared

Oral Notification

Returned by Contractor Action Complete

7. Discrepancy or Problem (Describe in detail: include reference to PMS/Directive: attach Continuation sheet if needed.

8. Signature of Contracting Officer

9. To: (Contracting Officer) From: (Contractor)

10. Contractor response as to cause, corrective action and actions to prevent recurrence. Attach continuation sheet if needed (Cite applicable QC program procedures(s) or new QC procedures(s).)

11. Signature of Contractor Representative

Date

12. Government Evaluation (Acceptance, rejection: Attach continuation sheet if needed)

13. Government Action (Payment deductions, cure notice, show cause, other)

14. Final Disposition

CLOSE OUT

Name – Title Signature Date

Contractor Notified

RFQ 70Z08418QAA853000 ATTACHMENT 9 PAGE 1 OF 1

QAE

Contracting Officer