Attachment 2 - Contractor Discrepancy Report - EIS.pdf
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- Solicitation number
- 36C10G20Q0050
About this file
This combined synopsis and solicitation from the Department of Veterans Affairs seeks quotes for a requirements contract to purchase brand name or equal endoscopy information systems. The VA requires endoscopy information systems from vendors including Provation, Pentx EndoPro, and Utech EndoSoft. The contract would have a one-year base period and four one-year options and utilize ordering officers and contracting officer representatives. Quotes are due by February 15, 2021 and shall include pricing for all contract line items in Attachment 3. Award will be made to the responsible vendor providing the best value based on technical capability, past performance, and price.
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Text version
CONTRACT DISCREPANCY REPORT
1. CONTRACT NUMBER 2. REPORT NUMBER FOR THIS DISCREPANCY
3. TO (Contractor and Manager's Name) 4. FROM (Name of QAE)
5. DATES (YYYYMMDD)
a. PREPARED b. RETURNED BY CONTRACTOR c. ACTION COMPLETE
6. DISCREPANCY OR PROBLEM (Describe in detail. Include reference to PWS Directive; attach continuation sheet if necessary.)
7. SIGNATURE OF CONTRACTING OFFICER
8a. TO (Contracting Officer) b. FROM (Contractor)
9. CONTRACTOR RESPONSE AS TO CAUSE, CORRECTIVE ACTION AND ACTIONS TO PREVENT RECURRENCE. (Cite applicable Q.C.
program procedures or new Q.C. procedures. Attach continuation sheet(s) if necessary.)
10. SIGNATURE OF CONTRACTOR REPRESENTATIVE b. DATE (YYYYMMDD)
11. GOVERNMENT EVALUATION (Acceptance, partial acceptance, reflection. Attach continuation sheet(s) if necessary)
12. GOVERNMENT ACTIONS (Reduced payment, cure notice, show cause, other)
13. CLOSE OUT
NAME
(1)
TITLE
(2)
SIGNATURE
(3)
DATE (YYYYMMDD)
(4)
a. CONTRACTOR
NOTIFIED
b. QAE
c. ACO
DD FORM 2772, SEP 1998 REPLACES MT FORM 352-R, WHICH IS OBSOLETE. Adobe Professional 8.0
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| qae_name: |
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| aco_name: |
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