Attachment 6 - DD Form 2772 Contract Discrepancy Report.pdf

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Security System Upgrades
Solicitation number
W911S825BA016
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The document is a DD Form 2772 Contract Discrepancy Report, a standard federal form used to document and track contract performance issues. The form provides a structured template for reporting specific contract problems, including sections for describing the discrepancy, contractor response, government evaluation, and potential actions. The form is prescribed by FAR 4.4 and 5220.22-V2, with the version dated September 1998, and is designed to facilitate communication between government contracting officers and contractors when performance deviations occur.

The form includes key sections such as contract number, report number, dates, detailed discrepancy description, contractor's response to the issue, proposed corrective actions, government evaluation, potential government actions (such as reduced payment or cure notice), and close-out documentation. While this specific form is blank, it serves as a critical tool for maintaining contract quality control and documenting performance-related communications in federal contracting processes.

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Prescribed by: 5220.22-V2; FAR 4.4;

PREVIOUS EDITION IS OBSOLETE.

DD FORM 2772, SEP 1998

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

DRAFT

SAMPLE

PREVIOUS EDITION IS OBSOLETE.

DD FORM 2772, SEP 1998

NEEDS DD67

Page of Prescribed by: 5220.22-V2; FAR 4.4;

DRAFT

INSTRUCTIONS

NEEDS DD67

PREVIOUS EDITION IS OBSOLETE.

DD FORM XXXX, 20YYMMDD DRAFT

Page of

CONTRACT DISCREPANCY REPORT

5. DATES (YYYYMMDD)

13. CLOSE OUT

NAME (1)

TITLE (2)

SIGNATURE (3)

DATE (YYYYMMDD)

(4)

a. CONTRACTOR NOTIFIED

b. QAE

c. ACO 9.0.0.2.20120627.2.874785 DD Form 2772, "CONTRACT DISCREPANCY REPORT"

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CurrentPage:
PageCount:
one:
two:
three:
four:
5. DATES (YYYYMMDD) - a. PREPARED:
5. DATES (YYYYMMDD) - b. RETURNED BY CONTRACTOR:
5. DATES (YYYYMMDD) - c. ACTION COMPLETE:
TextField2:
SignatureField1:
8a. TO (Contracting Officer) - enter recipient information:
8b. FROM (Contractor) - enter sender information:
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.):
SignatureField2:
10b. DATE (YYYYMMDD):
eleven:
twelve:
13. CLOSE OUT - a. CONTRACTOR NOTIFIED - (1) NAME:
13. CLOSE OUT - a. CONTRACTOR NOTIFIED - (2) TITLE:
13. CLOSE OUT - a. CONTRACTOR NOTIFIED - (3) SIGNATURE:
13. CLOSE OUT - a. CONTRACTOR NOTIFIED - (4) DATE (YYYYMMDD):
13. CLOSE OUT - b. QAE - (1) NAME:
13. CLOSE OUT - b. QAE - (2) TITLE:
13. CLOSE OUT - b. QAE - (3) SIGNATURE:
13. CLOSE OUT - b. QAE - (4) DATE (YYYYMMDD):
13. CLOSE OUT - c. ACO - (1) NAME:
13. CLOSE OUT - c. ACO - (2) TITLE:
13. CLOSE OUT - c. ACO - (3) SIGNATURE:
13. CLOSE OUT - c. ACO - (4) DATE (YYYYMMDD):

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