Attachment E Contract Discrepancy Report.pdf

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Attached to
Air Emissions
Solicitation number
2031ZA24Q00034
Issued by

About this file

This document is a Contract Discrepancy Report which provides a standardized format for documenting and addressing performance issues related to a federal contract. The report identifies the contract number, a description of the discrepancy or problem, the contractor's response for addressing the root cause and corrective actions taken, and the government's evaluation and actions. The related federal contract opportunity is for air emissions compliance testing on the nickel electroforming and chrome electroplating lines at the Bureau of Engraving and Printing's District of Columbia Facility. The contractor must provide all necessary personnel, equipment, and services to perform the testing in accordance with permit requirements and EPA regulations. The document does not contain any specifics on the solicitation, response dates, award, or pricing terms.

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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 COR)

5. DATES (YYYYMMDD)

a. DATE PREPARED b. CDR DATE RETURNED BY CONTRACTOR c. ACTION COMPLETE DATE

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 FOR ADDRESSING ROOT CAUSE OF DEFICIENCY, ACTION TAKEN TO CORRECT THE SPECIFIC DEFICIENCY, ACTION TAKEN TO CORRECT AND PREVENT THE RECURRENCE OF THE ROOT CAUSE OF DEFICIENCY AND TARGET DATES FOR IMPLEMENATION OF IDENTIFIED CORRECTIVE ACTION. (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, rejected. 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

b. COR

c. CO

BEP_OA_CDR_Rev#1_1-24-18

Attachment E

1 CONTRACT NUMBER:
2 REPORT NUMBER FOR THIS DISCREPANCY:
3 TO Contractor and Manager s Name:
4 FROM Name of COR:
a DATE PREPARED:
b C D R D AT E RETURNED BY CONTRACTOR:
c ACTION COMPLETE DATE:
6 DISCREPANCY OR PROBLEM Describe in detail Include reference to PWS Directive attach continuation s heet if necessary:
8a TO Contracting Officer:
b FROM Contractor:
9 CONTRACTOR RESPONSE FOR ADDRESSING ROOT CAUSE OF DEFICIENCY ACTION TAKEN TO CORRECT THE SPECIFIC DEFICIENCY ACTION TAKEN TO CORRECT AND PREVENT THE RECURRENCE OF THE ROOT CAUSE OF DEFICIENCY AND TARGET DATES FOR IMPLEMENATION OF IDENTIFIED CORRECTIVE ACTION Cite applicable QC program procedures or new QC procedures Attach continuation s heet s if necessary:
b DATE YYYYMMDD:
11 GOVERNMENT EVALUATION Acceptance partial acceptance rejected Attach continuation sheets if necessary:
12 GOVERNMENT ACTIONS Reduced payment cure notice show cause other:
13 CLOSE OUTRow1:
NAME 1a CONTRACTOR:
TITLE 2a CONTRACTOR:
DATE YYYYMMDD 4a CONTRACTOR:
NAME 1b COR:
TITLE 2b COR:
DATE YYYYMMDD 4b COR:
NAME 1c CO:
TITLE 2c CO:
DATE YYYYMMDD 4c CO:

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