Appendix I - Performance Assessment Report (PAR).pdf

PERFORMANCE ASSESSMENT REPORT (PAR)

(If more space is needed, use reverse and identify by number)

1. CONTRACT/TASK ORDER NUMBER 2. CONTRACTOR 3. TYPE OF SERVICES

4. QUALITY ASSURANCE PERSONNEL (QAP) SIGNATURE AND DATE 5. QAP PHONE 6. SUSPENSE DATE

I. PERFORMANCE

7. DEFICIENCY (CHECK ALL BOXES THAT APPLY)

NEW

REPEAT

NO DEFICIENCY NOTED

8. SERVICES SUMMARY or PWS PARAGRAPH ITEM REVIEWED

9. BRIEF DESCRIPTION OF DEFICIENCY (IF DEFICIENCY BOX WAS

CHECKED)

10. DETAILED PERFORMANCE ASSESSMENT

II. CONTRACTOR VALIDATION

11. CONTRACTOR REPRESENTATIVE CONCUR NON-

CONCUR

12. CORRECTIVE ACTION ESTIMATED COMPLETION DATE

13. CONTRACTOR REPRESENTATIVE CORRECTIVE ACTION AND PREVENTION OF RECURRENCE OR REASON FOR NON-

CONCURRENCE OF QAP CITED DEFICIENCY

III. ACTION KORRECTED

14. CONCUR NON-CONCUR QAP SIGNATURE AND DATE

15. QAP REMARKS (REQUIRED)

16. CONTRACTOR REPRESENTATIVE REMARKS

Performance Assessment Report (PAR) Instructions

Block 1. Quality Assurance Personnel (QAP) enters contract or task order number.

Block 2. QAP enters contractor name.

Block 3. QAP enters type of services.

Block 4. QAP signs and dates.

Block 5. QAP enters telephone number.

Block 6. QAP assigns suspense date for Contractor Representative validation if a deficiency box was checked in Block 7.

Part I. Contractor Performance

Block 7. QAP checks all boxes that apply.

Block 8. QAP enters Services Summary or Statement of Work (PWS) paragraph item reviewed.

Block 9. QAP enters brief description of deficiency and tracking number if the deficiency box was checked in Block 7. Detailed description will be on Corrective Action Report (CAR).

Block 10. QAP enters a detailed performance assessment if the deficiency box in Block 7 was not checked.

Parts II and III will be used only if a deficiency was documented in Part I.

Part II. Contractor Validation

Block 11. Contractor Representative checks one box in response to QAP cited deficiency. If Concurrence is indicated, Contractor Representative continues to Block 12. If Non-Concurrence is indicated, continue to Block 13 and state reason(s) for Non-Concurrence with QAP cited deficiency and return PAR to QAP.

Block 12. Contractor Representative enters Estimated Completion Date of Corrective Action and continues to Block 13.

Block 13. Contractor Representative details Corrective Action and the Action Taken to Prevent Recurrence or Reason for Non-Concurrence of QAP cited deficiency.

Part III. Deficiency Corrected

Block 14. QAP checks appropriate block, signs, and dates.

Block 15. (Required Entry) QAP remarks regarding the Corrective Action and the Action Taken to

Prevent Recurrence. If Non-Concur was checked, this block should be very detailed to explain why.

Block 16. Contractor Representative enters remarks if further discussion is needed about QAP concurrence with Contractor’s Corrective Action and Action Taken to Prevent Recurrence.

Continuation Sheet. A Continuation Sheet is to be used to expand on any information that will not fit in the applicable numbered block.