Attachment 4 CDR.pdf

TISCOM Full Food Services Contract Discrepancy Report (CDR)

Attachment 4

Location of Service:

1. Contract No. DO # 2. FY: 3. Report #

4. TO: (Contractor/ QCI):

5. FROM: (COR/QAE):

6. DATES:

Prepared:

Oral Notification:

Returned by Contractor:

Action Complete:

7. Discrepancy or Problem (Describe in detail; include references to PWS section or other contract clause or provision; attach continuation sheet if necessary; COTR shall cite applicable QC program procedure(s))

Signature: __________________________________________ Signature of COR or Authorized Representative

8. TO: Contracting Officer:

9. FROM: Contractor:

10. Contractor’s response as to cause corrective action and actions to prevent reoccurrence;

attach continuation sheet if necessary;

11. Signature of Contractor’s Representative:

___________________________________________ Date:

12. Government Evaluation: acceptance, partial acceptance; rejection’ attached continuation sheet if necessary

13. Government Action: payment deductions; performance evaluation meetings; other actions)

14. Closeout Actions: (contractor notified; by whom/ date; follow-up action pending).