ATTACHMENT 9 - VISN4 DME CONTRACT DEFICIENCY REPORT.docx
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About this file
This is a Contract Deficiency Report (CDR) template used by the Department of Veterans Affairs, Veterans Integrated Service Network 4 (VISN 4) for documenting and resolving contract discrepancies related to Durable Medical Equipment (DME) services. The form serves as a standardized tool for identifying, communicating, and tracking quality issues or non-conformances with the DME services contractor supporting VISN 4 East medical centers.
The CDR template establishes a structured communication process between the Contracting Officer and the Contractor's Representative. The form requires documentation of: the specific discrepancy or problem with detailed references to relevant Performance Work Statement (PWS) directives; the contractor's response addressing the root cause and corrective action plan; government evaluation and acceptance determination; and final closeout procedures. The template includes signature blocks for the Contracting Officer's Representative (COR), Contracting Officer, and Contractor Representative, along with specific date fields to track the timeline from CDR preparation through contractor response and final resolution. This appendix is designed to ensure quality control and accountability in the delivery of DME storage, delivery, installation, and repair services across VISN 4 East medical centers.
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Text version
ATTACHMENT 9
VISN4 DME CONTRACT DEFICIENCY REPORT (CDR)
CONTRACT DISCREPANCY REPORT
| 1. CONTRACT NUMBER |
| 2. REPORT NUMBER FOR THIS DISCREPANCY |
| 3. TO: (Contracting Officer) |
| 4. FROM: (Name of COR) |
5. DATES
a. CDR 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 COR |
| Date: |
| 8. SIGNATURE OF CONTRACTING OFFICER |
| Date: |
| 9a. TO (Contracting Officer) |
| 9a. FROM (Contractor) |
10. CONTRACTOR RESPONSE AS TO CAUSE, CORRECTIVE ACTION AND ACTIONS TO PREVENT RECURRENCE. (Cite applicable quality control program procedures or new procedures. Attach continuation sheet(s) if necessary.)
| 11. SIGNATURE OF CONTRACTOR REPRESENTATIVE |
| Date: |
12. GOVERNMENT EVALUATION. (Acceptance, partial acceptance, reflection. Attach continuation sheet(s) if necessary.)
13. GOVERNMENT ACTIONS (Acceptance, partial acceptance, reflection. Attach continuation sheet(s) if necessary.)
14. CLOSE OUT
| NAME |
| TITLE |
| SIGNATURE |
| DATE |
a. CONTRACTOR NOTIFIED
b. COR
c. CONTRACTING OFFICER
CRG Chapter 7 Appendix F COR Roles and Responsibilities Page 1 of 4 Revision 03 Effective Date: 09/01/2024
File details come from the government source that posted it. Updated .