Attachment 11 - Technical Exhibit E1-E2 Customer Complaint Record and Special Cleaning Form.pdf

CUSTOMER COMPLAINT RECORD

Complainant’s Information

Date of Complaint Time of Complaint

Organization Name Building #

Name Phone

Email Alt Phone

Description/Nature of Complaint

This section for Quality Assurance (QA) Officer

Contract Document Reference

Validation QA Signature

Date

This section for Contract Officer’s Representative (COR) Action taken by Contractor and/or COR & Follow-Up Notes to Complainant

Attachment(s)

Date Contractor Notified Time Phone

Email Issued resolved:

YES NO Explain:

Received & Validated by (COR Signature)

Date

Fort Wainwright Alaska Supplement to DA Form 5477

MAR 2018

Technical Exhibit E1- Customer Complaint Record Technical Exhibits E1-E2

Technical Exhibit E2 - SPECIAL/EMERGENCY PROJECT FORM (Custodial Service Request)

Request Made By: Date:

Location Of Services Required: Date/Time Service Required:

Brief Description Of Services Required:

Signature of Requestor: Phone Number:

Received at Contract Management Division by: (with date) approved disapproved

Received at Contractor Office by (with date): will perform cannot perform

Contractor Concerns/Issues: (state reason service cannot be performed if applicable)

Information below this line to be filled out by Contract Management Personnel only!

Estimated Cost of Service:

Actual cost of service (as invoiced by provider):

Contract Management Division Form Custodial 1 March 2010

Technical Exhibits E1-E2