Appendix B Example Discrepancy Report.docx
DOCX document 18 KB Posted
- Solicitation number
- 12444524Q0015
- Issued by
-
Department of Agriculture Forest Service
About this file
This document provides an example discrepancy report template for use in a Quality Assurance Surveillance Plan (QASP) to document any issues with contractor performance on a federal contract. The template includes sections for the discrepancy report number, parties involved, contract details, a description of the problem with references to the Performance Work Statement, signatures from the Contracting Officer's Representative (COR) and contractor, the contractor's response and proposed corrective actions, a section for government evaluation and acceptance or rejection of the response, and areas for any subsequent government actions.
The related federal contract opportunity is a solicitation to provide operational service support to an air quality testing station located in the Mark Twain National Forest. The support includes site maintenance, on-ground operations, and troubleshooting or replacement of air quality testing instruments. The procurement will be a 100% small business set-aside conducted according to FAR Parts 12, 13, and 19. The contracting agency is the Department of Agriculture Forest Service.
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| File | Type | Posted |
|---|---|---|
| 7. Experience Questionnaire.docx | DOCX document | |
| Appendix C Example Guide - Inspection List.docx | DOCX document | |
| Appendix D Daily Diary.pdf | ||
| 3. Maps.pdf | ||
| 4. 2024 Calendar.pdf | ||
| 2. Quality Assurance Surveillance Plan (QASP).docx | DOCX document | |
| 6. Sampler Maintenance by Site Operators.pdf | ||
| 5. Taney County SCA WD 2015-5103.txt | TXT text file | |
| OM-RFQ 12444524Q0015.pdf | ||
| Appendix A Example Performance Requirement Summaries.docx | DOCX document | |
| 1. Performance Work Statement (PWS).docx | DOCX document |
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Text version
Appendix B: Example Discrepancy Report The following document is only an example, which is not all inclusive, that can be revised and used, if applicable, in the QASP as attachments or exhibits.
| DISCREPANCY REPORT |
| 1. DISCREPENCY REPORT NO. |
| 2. TO: (Contractor / Project Manager Name) |
| 3. FROM: (Name of COR) |
CONTRACT NUMBER: DATE:
| 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 COR
| 6. TO: (Name of COR) |
| 7. FROM: (Contractor / Project Manager) |
8. CONTRACTOR RESPONSE AS TO CAUSE, EFFECT, CORRECTIVE ACTION AND ACTIONS TO PREVENT RECURRENCE (Attach Continuation Sheet if necessary. Cite applicable Contractor QC program procedures or new QC procedures)
| 9. SIGNATURE OF CONTRACTOR REPRESENTIVE |
| 10. DATE |
11. GOVERNMENT EVALUATION (Acceptance, partial acceptance, or rejection. Attach Coordination Sheet if necessary)
12. GOVERNMENT ACTIONS (Cure notice, show cause, other)
CLOSE OUT
KTR NOTIFIED
| NAME AND TITLE |
| SIGNATURE |
| DATE |
COR
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