Attachment 4 - Contract Discrepancy Report.pdf
PDF 61 KB Posted
- Attached to
- 7G20--Medical Emergency Alert Devices RFP
- Solicitation number
- 36C10G24R0014
About this file
This document is a Contract Discrepancy Report template to be used by the Department of Veterans Affairs. It outlines a process for documenting and resolving issues with contractor performance on a medical emergency alert devices contract. The solicitation seeks proposals for a base period of twelve months plus four additional twelve-month option periods to provide medical emergency alert devices. The contracting agency is the Department of Veterans Affairs Headquarters. The template includes sections for describing discrepancies in detail with reference to performance work statements, documenting contractor responses and corrective actions, and sections for signatures and dates from the contractor, contracting officer, and quality assurance evaluator upon resolution.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C10G24R0014 0005.docx | DOCX document | |
| Attachment 1 - Schedule of Supplies 36C10G24R0014 0005.xlsx | XLSX spreadsheet | |
| Attachment 1 - Schedule of Supplies 36C10G24R0014 0004.xlsx | XLSX spreadsheet | |
| 36C10G24R0014 0004.docx | DOCX document | |
| Attachment 6 - Past Performance Questionnaire 36C10G24R0014 0004.docx | DOCX document | |
| Attachment 5 - MEAD Questions and Answers 36C10G24R0014 0004.xlsx | XLSX spreadsheet | |
| NAICS - Notice and Order.pdf | ||
| 36C10G24R0014 0003.docx | DOCX document | |
| 36C10G24R0014 0002.docx | DOCX document | |
| 36C10G24R0014 02.docx | DOCX document | |
| 36C10G24R0014 0001.docx | DOCX document | |
| 36C10G24R0014.docx | DOCX document | |
| Attachment 6 - Past Performance Questionnaire.docx | DOCX document | |
| Attachment 1 - Schedule of Supplies 36C10G24R0014.xlsx | XLSX spreadsheet | |
| Attachment 2 - Pay.gov Vendor Submittal Instructions.docx | DOCX document | |
| Attachment 5 - MEAD Questions.xlsx | XLSX spreadsheet | |
| Attachment 3 - Quarterly Reporting Tool.xlsx | XLSX spreadsheet |
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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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