Attachment 2 - EST II QASP_20 Jan 22.docx

Quality Assurance Surveillance Plan

For

Engagement Skills Trainer II (EST II) Support

20 January 2022

Cheryl M. Todd

Contracting Officer

Email: Cheryl.m.todd.civ@army.mil Fort Jackson MICC

1LT Ykevaa T. Hunt

Contracting Officer Representative

B CO. HHBn Executive Officer Email:Ykevaa.t.hunt.mil@army.mil Fort Jackson, SC

TABLE OF CONTENTS

Subject Page Number

1. Overview 3

2. Description of Services 3

3. Roles and Responsibilities 3

4. Contract Quality Requirements 4

5. Government Surveillance 4

6. Non-Conforming Performance 5

7. Deduct Plan 6

8. Data Analysis 6

9. Acceptance of Services 7

10. COR Status 7

11. Contractor Performance Assessment Reporting System (CPARS) 7

12. Combatting Trafficking In Persons 7

13. COR/Quality Assurance Surveillance Files 7

14. QASP Changes 8

1. Overview. This quality assurance surveillance plan (QASP) is pursuant to the requirements listed in the performance work statement (PWS) titled Engagement Skills Trainer II (EST II) Instructor/Operator Support. This plan sets forth the procedures and guidelines Fort Jackson Training Center will use in ensuring the required performance standards or services levels are achieved by the Contractor.

1.1 Purpose. This QASP is a Government developed document used to ensure that the Government receives quality services, and pays only for conforming services actually provided. The objective of this firm fixed price is to provide EST II Instructor/Systems Operator support to Fort Jackson, South Carolina.

1.2 Intent. The intent of this QASP is to: 1) ensure Contractor performance meets or exceeds contract/TO terms, conditions and specifications; 2) hold the Contractor accountable for quality control (QC); and 3) encourage the Contractor to take appropriate steps to control and improve quality. Accordingly, the Government will perform surveillance on the TO in accordance with (IAW) this QASP, but reserves the right to monitor the TO in any manner necessary, at any times necessary, and at all places necessary to ensure that the rendered services conform to contract/TO requirements. The Government also reserves the right to perform quality assurance (QA) at the Subcontractor level and perform QA at the Contractor's place of business, if applicable. Sub-contract service providers shall be accountable to the Contractor who, in turn is responsible to the Government. Resolution of non-conforming services discovered at the Subcontractor level will be addressed with the prime Contractor. The Government will not exercise any supervisory controls over the contract service providers performing the services herein.

2. Description of Services.

2.1 Scope of Work. The Contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items and non-personal services necessary to perform Engagement Skills Trainer (EST) II Support as defined in this Performance Work Statement (PWS), excepting those items specified as Government furnished property and services. Fort Jackson requires contracted EST II system operators to man five (5) 15-lane and one (1) 10-lane systems. An instructor/system operator is required for each of these six (6) EST II systems. The system also requires a Senior or Lead Training and Development Specialist II to monitor Contractor personnel. The instructor/system operators are responsible for the operation and preventive maintenance of computer hardware, software, weapons system, target systems, video, and audio control panel operation, after action review processing and playback. The Instructor/System operator operates the system in support of various drills and or exercises for Active Army, Army Reserves, or Army National Guard units as they conduct EST and related weapon instruction.

2.2 Type of Contract. This will be a non-personnel services contract to provide EST II instructor and operator support. The Government will not exercise any supervision or control over the contract service providers performing the services herein. Such contract service providers shall be accountable solely to the Contractor who, in turn shall be responsible to the Government. The Government will award a Firm-Fixed Price (FFP) Contract.

3. Roles and Responsibilities.

3.1 Government.

3.1.1 Contracting Officer (KO). The KO is the only person authorized to direct changes in any of the requirements under this contract. In the event the Contractor effects any such change at the direction of any person other than the KO, the change will be considered to have been made without authority, and solely at the risk of the Contractor. No changes in, or deviation from the terms and conditions shall be affected, without a written modification to the contract, executed by the KO authorizing such changes.

3.1.2 Contracting Officer Representative (COR). The COR will monitor all technical and performance aspects of the task order, and assist the (KO) in contract administration. The COR is authorized to perform the following functions:

3.1.2.1 Assure that the Contractor performs the technical requirements of the task order.

3.1.2.2 Perform inspections necessary in connection with task order performance.

3.1.2.3 Maintain written and oral communications with the Contractor concerning technical and performance aspects of the task order.

3.1.2.4 Issue written interpretations of technical requirements, including Government drawings, designs, and specifications.

3.1.2.5 Monitor Contractor's performance and documents and notifies both the KO and Contractor of all deficiencies.

3.1.2.6 Coordinate availability of Government furnished property.

3.1.2.7 Provide site entry of Contractor personnel.

A letter of designation, which states the responsibilities and limitations, will be issued to the COR and On-Site COR (OSCOR). A copy is sent to the Contractor, stating the responsibilities and limitations of the COR and OSCOR, especially with regard to changes in cost, price, or delivery dates. The COR and OSCOR are not authorized to change any of the terms and conditions of the resulting order.

The KO shall use the Department of Defense (DoD) Contracting Officer Representative Tracking (CORT) Tool to electronically track COR nominations, appointments, terminations, and training certifications for each COR appointed to conduct oversight on this task order. The OSCOR will upload their current training certificates in CORT under their online CORT Profile for this task order. The OSCOR will send the surveillance documents, correspondence with the Contractor, Contractor trip reports and other related documents to the COR. The COR will upload surveillance documents, correspondence with the Contractor, Contractor trip reports and other related documents to CORT. The COR will upload the COR Monthly Report, after coordinating/obtaining information from the OSCOR each month. The COR will also upload their current training certificates, Contractor’s Monthly Status Reports (MSR), and other miscellaneous documents into the CORT Tool within their online CORT Profile for this task order. The CORT Tool is available within the Wide Area Work Flow (WAWF) suite of tools at: https://wawf.eb.mil/ .

3.1.3. On Site Contracting Officer’s Representative (OSCOR). The KO will designate the OSCOR via written documentation. The OSCOR’s authority is limited to administering the technical aspects of this TO, as specified in the KO’s appointment letter. The OSCOR is responsible for monitoring, assessing, and communicating the technical performance of the Contractor and assisting the Contractor. The OSCOR will complete QA evaluations and forms associated with the conducted evaluations.

3.1.4. Contract Administrator. The official Government representative delegated authority by the Contracting Officer to administer a contract. This individual is normally a member of the appropriate Contracting/Procurement career field and advises on all technical contractual matters.

3.1.5. Property Administrator. An authorized representative of the Contracting Officer appointed in accordance with agency procedures responsible for administering the contract requirements and obligations relating to Government property in possession of a Contractor.

3.2. Contractor

3.2.1. Contract Manager. The Contractor is responsible for running the program. The Contractor may supervise the program team and manage conflicts within different departments. The Contractor plans and sets program goals and milestones and develops risk management strategies. The Contractor defines resources and schedules for the implementation of the program. The Contractor, clearly, defines requirements and sets targets accordingly. The Contractor recognizes areas for internal improvement and develops plans for implementing the improvements.

For quick access, the contact information for the performance of this QASP is provided: Government Personnel:

Table 1; Key Positions for Contract Administration

4. Contract Quality Requirements.

4.1 Contractor’s Quality Control Program. The Government will evaluate the adequacy of the Contractor’s Quality Control Plan (QCP) performance under this task order in accordance with this QASP.

The Contractor’s QCP is the means by which they assure that all work is completednd complies with the requirement of the contract PWS. It is essential that Government Surveillance Personnel understand that QC is the responsibility of the Contractor, and not the Government.

As such, the Government will focus their efforts on validating if the Contractor is maintaining an adequate quality control inspection systems that ensures the Contractor maintains evidence that services provided conform to contract quality requirements. The Contractor shall provide inspection data to the Government on request for validation.

The Contractor’s QCP shall include a process that can identify, prevent, and ensure non-recurrence of defective services. QCP is to be delivered within 30 Days of award to the OSCOR.

4.2 Government Quality Assurance. The Government will evaluate the Contractor’s performance under this contract in accordance with this QASP. This plan is primarily focused on what the Government must do to ensure that the Contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and minimum acceptable defect rate(s).

4.2.1 This QASP describes:

4.2.2. How the performance standards will be applied:

4.2.2.1. The Performance Standard for each requirement in the PWS will be applied as prescribed in the PWS. Ensure that each Performance requirement within the PWS includes a Measurable performance standard in terms of quality, timeliness, or quantity.

4.2.2.2 Ensure the method of assessing Contractor performance against performance standards is included in this QASP.

4.2.2.3 Ensure each Performance Requirement includes an acceptable quality limit (AQL). AQL is the worst tolerable performance that is still considered acceptable rate

5. Government Surveillance.

5.1 Methods of Surveillance. The following Methods of Surveillance will be utilized in monitoring the Contractors’ performance:

5.1.1 100% Inspection. Reserved for the highest risk areas where consequence of failure is high (i.e. life or limb are threatened) or there is likelihood of mission failure.

5.1.2 Random Sampling. When a service is performed relatively frequently and a statistically valid sample can be selected for audit. The most appropriate method for frequently recurring tasks.

5.1.3 Periodic Sampling. Planned sampling of a service at specific predetermined dates and times. May be appropriate for tasks that occur infrequently.

5.1.4 Customer Feedback. The DA Form 5477, Customer Complaint Record, Attachment 2, will be used to document/record all complaints. Not a valid method of surveillance, but a good indicator of areas where surveillance should be conducted or intensified.

The DA Form 5477, Customer Complaint Record, Attachment 2, will be placed at convenient locations for the end user of these services, and made available to document/record all complaints. The COR will collect the customer complaints each surveillance cycle and investigate for validity as soon as possible (ASAP).

5.1.4.1 The following procedures will be followed when a complaint is received:

5.1.4.1.1 The COR/OSCOR will investigate to determine the validity of the complaint.

5.1.4.1.2 If the complaint is determined to be invalid, the COR will inform the person who submitted the complaint of the reason(s) as soon as possible.

5.1.4.1.3 For validated complaints that are true contractual non-conformances, the procedures in paragraph 6 below will be applied.

5.1.4.1.4 A Customer Complaint Log will be used to document each validated customer complaint and attached to the COR Monthly Surveillance Report in CORT.

5.2 Surveillance Schedule. The OSCOR will develop a monthly schedule of surveillance activities based on the Performance Standards as outlined in the Performance Requirements Summary (PRS), as well as any other critical contractual requirements determined to be higher risk requiring oversight. A Surveillance Schedule (Attachment 3) will be created each month utilizing the DA 5475 (http://armypubs.army.mil/eforms/pdf/A5475.PDF), COR Surveillance Schedule, or locally generated equivalent. The surveillance outlined in the monthly schedule will be as detailed and in-depth as necessary to provide the Government with the objective quality evidence required to support acceptance of the services provided by the Contractor. The schedule will provide planned periodic surveillance during all required hours of the Contractor’s operation. The schedule is “FOR OFFICIAL USE ONLY” and is not releasable to anyone other than authorized Government personnel. The schedule will identify the method of surveillance, the date of inspection, place of inspection, activity to be monitored, and who will conduct the surveillance (dates and times can be altered without a formal change to the schedule as long as all inspections are performed). Surveillance Schedules will be completed at the beginning of each month during the PoP to schedule the upcoming month surveillance activity. Completed Surveillance Schedules will be sent to the COR and the COR will file these documents in the online CORT (https://wawf.eb.mil) file for this task order, either as an attachment to Monthly COR Status Report or uploaded separately in the Miscellaneous Documents Section of the CORs’ CORT file.

5.3 Surveillance Instructions/Checklists. A Surveillance Checklist (Attachment 4) will be created each month utilizing the DA 5476, COR Surveillance Checklist, or locally generated equivalent. The Checklist is “FOR OFFICIAL USE ONLY” and is not releasable to anyone other than authorized Government personnel. Each Month’s Surveillance Checklist will be completed with the Surveillance Schedule. Completed Surveillance Checklist will be filed in the online CORT (https://wawf.eb.mil) file for this task order, either as an attachment to Monthly COR Status Report or uploaded separately in the Miscellaneous Documents Section of the CORs’ CORT file.

5.4 Surveillance Documentation. Each months’ Completed Surveillance Documentation, to include the Monthly Surveillance Report must be filed in the online CORT file; https://wawf.eb.mil, for this task order, either as an attachment to MSR, or uploaded separately in the Miscellaneous Documents Section of the CORs’ online CORT file. All inspections/observations will be documented and will include as a minimum date and time, who performed the inspection, what was inspected, to what standard and the results. Successful or exceptional performance will be documented as well as deficiencies in Contractor performance. Documentation will be maintained for future reference, audit, proof of inspection, and past performance documentation. DA Form 5481, Tally Checklist (http://armypubs.army.mil/eforms/pdf/A5481.PDF) may be used for this purpose.

6. Non-Conforming Performance. A Non-conformance occurs when the Contractor fails to meet the terms, conditions, and/or specifications of the task order. All instances of non-conformance must be documented by the COR. The COR will provide the details of the non-conformance using the Contract Discrepancy Report (CDR), DA Form 5479, Attachment 5, to the KO, who will notify the Contractor of each nonconformance occurrence, unless the KO has authorized the COR to submit directly to the Contractor, and copy the KO. Resolution of any non-conformance discovered at the Subcontractor level will be addressed with the prime Contractor. Non-conformances are classified as either: Level I (Minor); Level II (Major); or Level III (Critical).

6.1 Level I (Minor). Level I non-conformance is not likely to materially reduce the usability of services for their intended purpose or is a departure from established standards having little bearing on completing the contract requirement. Minor non-conformances can usually be corrected on the spot and can be issued to the Contractor through either a verbal or written Contract Discrepancy Report (CDR). However, the Government is still required to document verbal Level I CDRs. The COR may issue verbal Level I CDRs directly to the appropriate level of Contractor management. The COR will notify the KO as soon as practical when a verbal Level I CDR is issued and document them in their Monthly Reports. If the non-conformance cannot be corrected on the spot, the Contractor shall be given a suspense date to correct the deficiency. The KO will issue and sign written Level I CDRs, Attachment 5.

6.2 Level II (Major). Level II non-conformance is likely to result in failure of the services to meet contract requirements. Also, repeated discrepancies, a large number of documented Level I CDRs and trends indicating failure of the Contractor’s quality control program can be classified as Level II CDRs. The KO issues all Level II CDRs in writing, Attachment 5. The COR will notify the KO as soon as practical when a major non-conformance is identified.

6.3 Level III (Critical). Level III non-conformances result in hazardous or unsafe conditions due to the manner in which the services are performed; prevent or impact a vital agency mission as a result of performance; or are for repeated or uncorrected Level II CDRs. The Contracting Office Director or Deputy Director issues written Level III CDRs. The COR is responsible for notifying the KO immediately upon discovery of a critical non-conformance.

6.4 Documenting CDRs. The COR will provide the details of the non-conformance using the CDR, DA Form 5479, Attachment 5. If the Requiring activity prefers to issue a locally developed CDR, documentation must include as a minimum: the Contract or Task Order number; reference to the specific task order requirement; the specific discrepancy to the requirement; where it was discovered; the date and time it was discovered; the Contractor representative who was notified; and the suspense date for Contractor response/corrective action.

6.5 Tracking and Resolving CDRs. All CDRs, verbal and written, regardless of issuer will be included in the COR’s Monthly Report. The COR and KO shall track CDRs to ensure the Contractor identifies and takes appropriate corrective action to the root cause and the specific non-conformance is corrected within the required timeline. The KO will make a final written determination of the Government’s remedies if the non-conformance is not corrected by the Contractor after receiving notice and a reasonable opportunity to correct the work.

7. DEDUCT PLAN. This acquisition does not include a Deduct Plan.

8. Data Analysis. Data Analysis will be performed to identify trends in cost, schedule and/or performance risks. The results of Data Analysis will be documented in COR Status Reports and may be used to make adjustments to surveillance schedules, increase or decrease surveillance, if deemed appropriate. Negative trends noted using Government data/observations could result in issuing the Contractor a Contract Discrepancy Report. Trends noted using Contractor data will not result in a CDR unless the Contractor is not addressing the negative trend. QASP changes based on Data Analysis will be coordinated with the KO for approval.

9. Acceptance of Services. When all services have been deemed acceptable and there is documented objective quality evidence to support acceptable performance, the COR will accept the services provided and authorize payment of the Contractor. This is accomplished by approving the Contractor’s Receiving Reports in Procurement Integrated Enterprise Environment formally known as Wide Area Workflow at https://wawf.eb.mil/.

10. COR Status Report. COR Status Reports will be submitted on a monthly basis to the KO via the CORT Tool. COR Status Reports must be uploaded into the CORT Tool, using the “Smart Form” Monthly Surveillance Report. Reports will be due NLT the 10th day of the month following the month of surveillance. Reports will provide a synopsis of the Contractors performance for the inclusive dates of the report. The synopsis must contain a summary of surveillances performed, Customer Feedback if any, CDRs if any, an analysis of the Contractor’s performance, recommended adjustments to surveillance schedules, and any other pertinent contract information IAW FAR 46.104, and the COR Appointment Letter. Completed Surveillance Checklists and CDRs, if any, will be included as attachments to COR Status Reports, or referenced in the monthly report and uploaded separately in the Miscellaneous Documents Section of the CORs’ Online CORT file for this task order. See para 4.2.

11. Contractor Performance Assessment Reporting System (CPARS). Documented surveillance data (COR Status Reports, Completed Surveillance Checklists, Customer Feedback and CDRs, if any) will be used to support CPARS ratings. CPARS will be completed IAW Army Federal Acquisition Regulation Supplement (AFARS), Subpart 5142.15 – Contractor Performance Information.

12. Combating Trafficking In Persons (CTIP). In accordance with PGI 222.17 and FAR 52.222-50, the KO will be notified immediately of any information from any source that alleges a Contractor employee, subcontractor, and/or subcontractor employee has engaged in conduct that violates the United States Government “zero” tolerance policy regarding trafficking in persons.

13. COR/Quality Assurance Surveillance Files. The official COR/Quality Assurance Surveillance File will be maintained in the on-line CORT Tool, IAW DoDI 5000.72, and DFARS PFI 201.602-2.1.

14. QASP Changes. This QASP is a living document and, as such, may be changed as needed based on Data Analysis (trends), task order modifications by the KO, etc. The COR will send any recommended changes to the KO for approval and the KO must approve all changes.

1LT Ykevaa T. Hunt Contracting Officer Representative B CO. HHBn Executive Officer Fort Jackson, SC Ofc. 803.751.6778 Email:Ykevaa.t.hunt.mil@army.mil

Attachments:

1. Performance Requirements Summary (PRS)

2. Customer Complaint Record, DA Form 5477

3. Surveillance Schedule, DA Form 5475

4. Surveillance Checklist(s)

5. Contract Discrepancy Report, DA Form 5479

Attachment 1

Performance Requirements Summary / Deliverable Schedule

The Contractor service requirements are summarized into performance objectives that relate directly to mission essential items. The performance threshold briefly describes the minimum acceptable levels of service required for each requirement. These thresholds are critical to mission success.

Responsible For Surveillance

1.6.2.1 Provide Quality Control Plan (QCP).

OSCOR

1.6.10.1 Provide AT Level 1 Training Certificates

1.6.10.3.2 Provide

iWATCH Training Certificates Provide each Contractor completed certificate within thirty (30) calendar days of task order award, Or, Completed within thirty (30) calendar days of new employees’ start date, Or , Results reported to the OSCOR no later than thirty (30) calendar days after contract award or new employees’ commencing performance.

1.6.10.3.4 Provide

OPSEC SOP

1.6.10.3.5 Provide

OPSEC

Training Certificates

1.6.10.3.6 Provide IA/IT Training Certificates

Inspection

OSCOR

Provide Monthly Status Report submitted NLT 18th of every month until all PWS task are completed.

5.2-5.2.2 Provide Management Meeting Support

5.2.3 Provide Meeting Notes and

Correspondence e

5.1.11 Input TS-MATS Usage Reports

5.3.9 Operate

Computer Control Station

5.3.9-5.3.10;

5.3.12-5.3.13 Conduct Preventive Maintenance

5.3.10 Upload Scheduled Maintenance Load all scheduled preventive maintenance into the TS-MATS web based program IAW Level 10 operation and maintenance procedures required for the EST II found in TS-MATS, User’s Guide 11 February 2015

5.3.11 Performance daily maintenance

5.3.144.7 Conduct User Certifications

End of Attachment 1

Attachment 2

Customer Complaint Record, DA Form 5477

End of Attachment 2

Attachment 3

Surveillance Schedule, DA Form 5475

End of Attachment 3

Attachment 4

Surveillance Checklist(s)

Contractor:

Contract Number:

Service Provided: EST II Instructors/Operators

COR Name:

1 Did the Contractor teach training and operation tasks for Engagement Skills Trainer (EST II)? 5.2.2

Comments:

2 Did the Contractor prepare assigned instruction by ensuring instructional materials, training aids and systems are present and are operational? 5.2.3

Comments:

3 Did the Contractor present instructions according to lesson plans, based on student’ need? 5.2.4

Comments:

4 Did the Contractor evaluate performance and provide special assistance to students requiring special or additional training? 5.2.9

Comments:

5 Did the Contractor provide guidance and problem solving techniques to resolve operational problems? 5.2.11

Comments:

6 Did the Contractor ensure that usage data and scheduled maintenance for simulators is entered into the TS-MATS web based program? 5.2.12

Comments:

7 Did the Contractor operate the computer control station in order to (IOT) control training sequencing and video/audio playback functions to facilitate realistic training and capture after action review (AAR) teaching points? 5.3.3

Comments:

8 Did the Contractor conduct preventative maintenance of the computer control stations, consoles, and weapons daily? 5.3.4

Comments:

9 Did the Contractor load all scheduled preventive maintenance into the TS-MATS web based program IAW -10 operation and maintenance procedures required for the EST II? 5.3.5

Comments:

10 Did the Contractor perform daily maintenance and up keep of the EST II training facility? 5.4.6

Comments:

11 Did the Contractor conduct user certification training on the EST II as well as other associated/non-associated weapons training simulators, i.e. Laser Marksmanship Training Systems and Low Cost Advanced Target Senior? 5.4.7

Comments:

Comments:

Comments summary, to include, positive trends, negative trends, concerns, customer comments, and any additional COR comments:

End of Attachment 4

Attachment 5

Contract Discrepancy Report, DA Form 5479

End of Attachment 5 image1.emf

DATE OF COMPLAINT TIME OF COMPLAINT

NATURE OF COMPLAINT

CONTRACT REFERENCE

VALIDATION

DATE CONTRACTOR INFORMED COMPLAINT TIME CONTRACTOR INFORMED OF COMPLAINT

ACTION TAKEN BY CONTRACTOR (Responsible officer)

RECEIVED AND VALIDATED BY

ORGANIZATION

INDIVIDUAL

NOTE: ( ) Used for in-house operation.

CUSTOMER COMPLAINT RECORD

For use of this form, see DA PAM 5-20; the proponent agency is ACSIM.

SOURCE OF COMPLAINT

(Responsible officer) (Responsible officer)

DA FORM 5477, MAR 2008 PREVIOUS EDITIONS ARE OBSOLETE. APD PE v1.01ES initiator:ralph.gaines@us.army.mil;wfState:distributed;wfType:email;workflowId:b71742b09d8a4c49a6eb59ab36d6e236

DATE OF COMPLAINT:

TIME OF COMPLAINT:

ORGANIZATION INDIVIDUAL SOURCE OF COMPLAINT:

NATURE OF COMPLAINT:

CONTRACT REFERENCE:

VALIDATION:

DATE CONTRACTOR INFORMED COMPLAINT Responsible officer:

TIME CONTRACTOR INFORMED OF COMPLAINT Responsible officer:

ACTION TAKEN BY CONTRACTOR Responsible officer:

RECEIVED AND VALIDATED BY:

NOTE Used for inhouse operation:

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Text2:

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6.

2. 3.

PREPARED ORAL NOTIFICATION RETURNED BY CONTRACTOR ACTION COMPLETE

4. DISCREPANCY OR PROBLEM (Describe in Detail: Include reference in PWS / Directive: Attach continuation sheet if necessary.)

5. SIGNATURE OF CONTRACTING OFFICER

7.

8. CONTRACTOR RESPONSE AS TO CAUSE, CORRECTIVE ACTION AND ACTIONS TO PREVENT RECURRENCE. ATTACH

1. CONTRACT NUMBER

9. SIGNATURE OF CONTRACTOR REPRESENTATIVE 10. DATE

11. GOVERNMENT EVALUATION (Acceptance, partial acceptance, rejection: attach continuation sheet if necessary)

12. GOVERNMENT ACTIONS (Payment deduction, cure notice, show cause, other.)

CONTRACT DISCREPANCY REPORT

For use of this form, see DA PAM 5-20; the proponent agency is ACSIM.

TO: (Contractor and Manager Name)

DATES

CLOSE OUT

CONTRACTOR

NOTIFIED

NAME AND TITLE SIGNATURE DATE

QAE

CONTRACTING

OFFICER

CONTINUATION SHEET IF NECESSARY. (Cite applicable Q.A. program procedures or new A.W. procedures.)

DA FORM 5479, MAR 2008 APD PE v1.01ES

FROM: (Name of QAE)

TO: (Contracting Officer) FROM: (Contractor)

PREVIOUS EDITIONS ARE OBSOLETE.