Attachment IV Contract Data Sheet 25RA019.pdf

CONTRACT DATA SHEET

____-R-_______ _______-

CONTRACTOR NAME _____________________________________________________________

Contract Number: ______________________ Date Completed: _____________________________

Contract Type: Firm Fixed Price _____ Other (Specify) ___________________________________

Item/Service Description: _____________________________________________________________

Contract Quantity/Period of Performance: _______________________________________________

Customer Name: ____________________________________________________________________

Customer POC (Person who can verify data): _____________________________________________

Address: ______________________________________ Telephone: __________________________

FAX: __________________________

PERFORMANCE INFORMATION

YES NO

1. Were all supplies/services delivered within the ORIGINAL contract schedule? ____ ____*

2. Did all delivered supplies/services comply with the contract specifications? ____ ____ *

3. Did any of the delivered supplies/services require replacement, modification or ____* ____ rework in order to be acceptable?

4. Were any modifications issued relaxing the contract specifications/delivery ____* ____ requirements?

5. Was/is any part of this contract terminated for default, in litigation, or the ____* ____ subject of any protest or claims?

6. Did you receive any quality awards in the past three years? ____* ____

7. If applicable, describe any corrective action(s) initiated to solve any problems ____* ____ deficiencies on this contract. Discuss the success of the corrective action(s) taken.

NOTE: Answers in columns containing an asterisk (*) require an explanatory narrative either in the space provided above or on a separate sheet of paper.

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