Attachment 4 - Contract Discrepancy Report.pdf

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6515--VACUUM ERECTILE DEVICE FOLLOW-ON (VA-24-00017777)
Solicitation number
36C10G26Q0001
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The document is a Contract Discrepancy Report (DD Form 2772) from September 1998, used to document and track contract performance issues. The form provides a structured template for reporting contractual problems, including sections for describing the specific discrepancy, contractor response, government evaluation, and potential actions. Key sections include space for contract number, dates, detailed problem description, contractor's explanation of cause and corrective actions, government's evaluation of the issue, and close-out documentation. The form is designed to facilitate communication between the government and contractor regarding contract performance deviations, with areas for both parties to document their perspectives and proposed resolutions.

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Other files

File Type Posted
Attachment 5 - VED Q and A.xlsx XLSX spreadsheet
36C10G26Q0001 0001.docx DOCX document
Attachment 7 - Sample Letter of Supply.docx DOCX document
Attachment 6 - Past Performance Questionnaire.docx DOCX document
Attachment 3 - Quarterly Reporting Tool.xlsx XLSX spreadsheet
Attachment 5 - VED Questions.xlsx XLSX spreadsheet
Attachment 1 - Schedule of Supplies.xlsx XLSX spreadsheet
Attachment 8 - Authorized Gov Distributor Letter.docx DOCX document
Attachment 2 - Pay.gov Vendor Submittal Instructions.docx DOCX document
36C10G26Q0001.docx DOCX document

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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

ctr_no:
rpt_no:
to:
from:
prep_date:
ret_date:
comp_date:
discrep:
to_ctr:
from_ctr:
ctr_resp:
rep_date:
govt_eval:
govt_act:
notif_name:
notif_title:
notif_date:
qae_name:
qae_title:
qae_date:
aco_name:
aco_title:
aco_date:
Reset:

File details come from the government source that posted it. Updated .