B08-NGLD-M QASP.DOCX

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Next Generation Load Device Medium (NGLD-M)
Solicitation number
W15P7T-21-R-0001
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About this file

This document is a Quality Assurance Surveillance Plan (QASP) for the Next Generation Load Device-Medium (NGLD-M) Engineering Development, Production, and Sustainment contract. The QASP outlines performance standards and monitoring methods for program management, engineering and development support, production, and sustainment services. Key performance objectives include personnel management, cost and schedule control, testing and evaluation, certification, training, and supply chain management. The QASP details acceptance criteria, inspection procedures, and reporting requirements to measure performance against objectives. It also provides templates for performance reports, corrective action plans, and customer complaint records to document monitoring results. The primary surveillance methods are 100% inspection, random sampling, and periodic inspection of deliverables, reports, and production lots to validate performance.

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Acquisition Sensitive Next Generation Load Device-Medium (NGLD-M) 03 April 2020

QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)

1. Contract Title:

Next Generation Load Device-Medium (NGLD-M) Engineering Development, Production, and Sustainment

2. Purpose:

This QASP provides a systematic method to evaluate performance for the stated contract. This QASP explains the following:

· What will be monitored

· How monitoring will take place

· Who will conduct the monitoring

· How monitoring efforts and results will be documented

This QASP does not detail how the contractor accomplishes the work, rather the QASP is created with the premise that the contractor is responsible for management and quality control actions to meet the terms of the contract. It is the Government’s responsibility to be objective, fair, and consistent in evaluating performance. In addition, the QASP should recognize that unforeseen and uncontrollable situations may occur.

This QASP is a “living document” and the Government may review and revise as needed. Updates shall ensure that the QASP remains a valid, useful, and enforceable document. Copies of the original QASP and revisions shall be provided to the contractor and Government officials implementing surveillance activities.

The following FAR clauses may apply to this contract as applicable to specific task orders/delivery orders:

· 52.246-1 Contractor Inspection Requirements

· 52.246-2 Inspection of Supplies

· 52.246-3 Inspection of Supplies – Cost-Reimbursement

· 52.246-4 Inspection of Services – Fixed-Price

· 52.246-5 Inspection of Services – Cost-Reimbursement

· 52.246-7 Inspection of Research and Development – Fixed-Price

· 52.246-8 Inspection of Research and Development – Cost-Reimbursement

· 52.246-11 Higher Level Quality Requirements (AS9100, Rev D)

· 52.246-16 Responsibility for Supplies

3. Roles and Responsibilities:

The following personnel shall oversee and coordinate surveillance activities.

Contracting Officer (KO) – The KO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the United States in the contractual relationship. The KO shall also ensure that the contractor receives impartial, fair, and equitable treatment under this contract. Upon completion of this effort, the KO will determine the final assessment of the contractor’s performance. The KO is responsible for cost control and for resolving differences between the observations documented by the COR, PM and project representatives and the contractor.

Contracting Officer’s Representative (COR) – The COR is designated in writing by the KO to act as his or her representative to assist in administrating the contract. The COR is responsible for providing continuous technical oversight of the contractor’s performance. The COR uses the QASP to conduct the oversight/surveillance process. The COR shall keep a Quality Assurance (QA) file that accurately documents the contractor’s actual performance. The purpose of the QASP is to ensure that the contractor meets the performance standards contained in the contract. The COR is responsible for reporting early identification of performance problems to the KO. The COR is required to provide an annual performance assessment to the KO which will be used in documenting past performance. The QASP is the primary tool for documenting contractor performance. The COR is not empowered to make any contractual commitments or to authorize any contractual change on the Government’s behalf.

Program/Project Manager (PM) – The Government PM provides program oversight and supports the COR’s performance assessment activities. The role of the Government’s quality assurance plan is to ensure that the contractor is performing in accordance with the contract requirements and contract standards are achieved.

Other Key Government Personnel- This may include performance monitors, inspectors, technical experts, workforce service division and center directorate level security personnel, requirements office, or others (i.e. users) who provide information that helps the KO, COR, and PM monitor contractor performance. Such agencies as Defense Contract Management Agency (DCMA) will support this contract.

4. Primary Method of Surveillance:

In an effort to minimize the performance management burden, simplified surveillance methods will be used by the Government to evaluate contractor performance when appropriate. The following are primary methods of surveillance:

· One Hundred Percent Inspection. This is usually only the most appropriate method for infrequent tasks or tasks with stringent performance requirements, e.g., where safety or health is a concern. With this method, performance is inspected/evaluated at each occurrence. The COR will review generated documentation and enter summary results into the Surveillance Activity Checklist (SAC).

· Random Sampling. This is usually the most appropriate method for recurring tasks. With random sampling, services and products are sampled to determine if the level of performance is acceptable. Random sampling works best when the number of instances of the services and products being monitored are very large and a statistically valid sample can be obtained. Computer programs may be available to assist in establishing sampling procedures. Random sampling will be performed by the COR and/or designated inspector

· Periodic Inspection. Products and/or services may be monitored daily, weekly, monthly, quarterly, semiannually, and/or annually. The Government will schedule inspections with the contractor; however, some inspections are for a time or frequency that are not announced, such as random inspections, accident investigations, etc.. The COR or other Government appointed representative typically performs the periodic inspection.

· Customer Input. Although usually not a primary method, this is a valuable supplement to more systematic methods. For example, in a case where random sampling indicates unsatisfactory service, customer complaints can be used as substantiating evidence. In certain situations where customers can be relied upon to complain consistently when the quality of performance is poor, customer surveys and customer complaints may be a primary surveillance method, and customer satisfaction an appropriate performance standard. In all cases, complaints should be documented, preferably on a standard form.

The contractor is expected to establish and maintain professional communication between its employees and customers. The primary objective of this communication is customer satisfaction. Customer satisfaction is the most significant external indicator of the success and effectiveness of all services provided and can be measured through survey results and customer complaints.

Performance management drives the contractor to be customer focused through initially and internally addressing customer complaints and investigating the issues and/or problems but the customer always has the option to communicate complaints to the KO or COR, as opposed to the contractor.

Customer complaints, to be considered valid, must set forth clearly and in writing the detailed nature of the complaint, must be signed, and must be forwarded to the COR. The COR will accept those customer complaints and investigate using the Quality Assurance Monitoring Form – Customer Complaint Investigation, identified in Appendix 3.

Surveillance Matrix

The Surveillance Matrix (Appendix 1) is the list of performance objectives and standards that must be performed by the contractor. This matrix details the method of surveillance the COR will use to validate and inspect these performance elements. Inspection of each element will be documented in the COR file.

Performance objectives define the desired outcomes. Performance Standards define the level of service required under the contract to successfully meet the performance objective. The inspection methodology defines how, when, and what will be assessed in measuring performance. The Government performance surveillance, using this QASP, to determine the quality of the contractor’s performance as it relates to the performance element standards. The AQL performance Standard Table should be used to form the foundation of the COR’s inspection checklist.

5. Performance Standards:

The COR will determine whether the contractor has managed to contract effectively and efficiently, with successful and timely response to user and client needs. The COR will confirm whether the contractor has satisfactorily met all reporting requirements, including subcontracting reports when applicable.

Task 1

Program Management – Personnel Management Management of Contractor Personnel

Program Management – Cost, Schedule, Performance Establish and Manage a Project Cost

Establish and Manage a Project Schedule

Establish and Manage a Task or Sub-Task Schedule

Submit Required Contract Deliverables

Property Management

Configuration Management

Task 2 Engineering and Developmental Support Management of Engineering and Developmental Requirements for both Software and Hardware

Conduct Required Testing and Evaluation

NSA Certification

Logistics Services – training, manuals and sustainment planning

Prototypes

Task 3 NGLD-M Production Low-Rate Production Quantities

Full-Rate Production Quantities

Quality Control Production Process

Production Costs and Schedule

Shipping and Delivery

Supply Chain and Source Management

Task 4 Sustainment Services Hardware and Software Sustainment

Training and Training Materials

Supply Support

6. Documenting Performance:

Acceptable Performance.

The Government shall document positive performance. A Performance Assessment Report (PAR) template is attached (Appendix 2). Any report may become part of the supporting documentation for fixed price payments, award/incentive fee payments, Contractor Performance Assessment Reporting System (CPARS) entries, or other actions. Government acceptance of services permits the contractor to invoice for the service fee.

Unacceptable Performance.

Unacceptable contractor performance can be identified by customer complaints (Appendix 3) or through other surveillance evaluations. When unacceptable performance occurs, the COR will inform the contractor. The COR will document unacceptable performance, place it in the COR file, and provide a copy to the KO.

When the COR determines formal written communication is required, the COR will prepare a Corrective Action Report (CAR). The CAR is forwarded to the KO for release to the contractor. A CAR template is attached to this QASP (Appendix 4). The contractor shall acknowledge receipt of the CAR in writing. The CAR will specify if the contractor is required to prepare a corrective action plan to document how the contractor shall correct the unacceptable performance and avoid a recurrence. The CAR will also state how long after receipt the contractor has to present this corrective action plan to the KO and COR. The Government may withhold payment for services until corrective action is taken. The Government will review the contractor's corrective action plan to determine acceptability. Upon Government acceptance of the corrected actions, the Government will determine if payment is permitted for corrective services and materials required. Any CAR may become a part of the supporting documentation for contract payment deductions, fixed fee deductions, award fee nonpayment, CPARS or other actions deemed necessary by the KO.

7. Mandatory or Regulatory Compliance Items:

The contractor shall provide initial proof of compliance with regulatory and compliance items contained in the contract. The COR and the KO will evaluate the initial submission and will conduct ad hoc reviews of the contractor's compliance throughout the remainder of the contract. The contractor will monitor compliance in the following areas:

· Applicable federal, state, and local laws and regulations

· Security regulations such as Operation Security (OPSEC), Information Security (INFOSEC), and Cyber Threat as indicated in the PWS

· NSA requirements as outlined in the NGLD-M Information Assurance Security Requirements Document (IASRD)

· Rules, regulations, and certifications as described in the PWS

8. Acceptable Quality Level (AQL):

By monitoring the contractor, the COR will determine whether the performance levels set forth in the contract have been attained. The Government shall use standards to determine contractor performance and shall compare the contractor performance to the Acceptable Quality Level (AQL) as specified in the summary Matrix.

Additionally, any unacceptable performance shall be determined by the COR. If the number of complaints/defects exceeds the performance threshold for any objective, the COR will determine the possible cause of the unacceptable performance. Government-caused complaints/defects will not be counted against the contractor. If the contractor’s performance is judged unacceptable for any requirement by the COR, the COR will document the discrepancy as a non-conformance and inform the KO (if needed) for resolution. Significant (major non-conformance) performance deficiencies must be submitted to the KO using a Contractor Discrepancy Report (CDR) and include supporting documentation.

9. Evaluation Method:

This contract will be evaluated using the above surveillance methods in section 4 above against each of the performance standards outlined in section 5 above. Further detail of these methods is located in Appendix 1 – Surveillance Matrix.

10. Performance Rating

In evaluating the quality of contractor’s performance, the following performance ratings may be used (same as CPAR ratings).

Performance Rating Criteria

Exceptional
Performance meets contractual requirements and exceeds many to the government’s benefits. The contractual performance of the element or sub-element being assessed was accomplished with no problems and contractor actions were highly effective.
Very Good
Performance meets contractual requirements and exceeds some to the government benefits. The contractual performance was accomplished with few minor problems for which corrective actions taken by the contractor were effective.
Satisfactory
Performance meets contractual requirements. The contractual performance contains some minor problems for which corrective actions taken by the contractor were satisfactory.
Marginal
Performance does not meet some contractual requirements. The contractual performance reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear marginally effective or were not fully implemented.
Unsatisfactory
Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Appendix 1 - Surveillance Matrix Performance Standards Acceptable Quality Levels Methods of Calculation

Surveillance
Results/Ratings

Program Management – Personnel Management

Manage of Contractor Personnel
Target Criteria:

Staff the contract in accordance with approved staffing plan.

Minimum Acceptable:

1. All personnel are qualified to perform assigned tasks

2. No more than 10% Personnel turnover per contract

Monthly Status Report and Spend Pan will be reviewed by COR. For percentage of total contractors, hours
Measurement Interval:

Monthly or as required

Measurement Period:

. Monthly for the prior month Source of Measurement Data:

Monthly Status Report, Spend plan, Method of Surveillance:

Government review. 100 % Inspection Timing of Measurement:

.Monthly Reporting Frequency:

Reporting to commence upon Contract Award and continue throughout the Period of Performance.

1. Exceptional

2. Very Good

3. Satisfactory

4. Marginal

5. Unsatisfactory

Program Management – Cost, Schedule, Performance

Establish and Manage a Project Cost;

Target Criteria:

Project immediately starts after Kickoff Meeting for Government

Minimum Acceptable:

Outcome of meeting allows immediate kick-off of project with Minimal clarification

Monthly Status Report and Spend plan will be reviewed by COR Determination of contractor maintaining costs, burn rate, materials and travel costs
Measurement Interval:

Monthly or as required Measurement Period:

Monthly Source of Measurement Data: Monthly Status Report Method of Surveillance:– Government review 100% Inspection Timing of Measurement:

Monthly Reporting Frequency:

Reporting to commence upon Contract Award and continue throughout the Period of Performance.

1.Exceptional 2.Very Good 3.Satisfactory 4.Marginal 5.Unsatisfactory

Program Management Cost Control

Establish and Manage a Project Schedule
Target Criteria:

1. Submit Option Year Schedule for Government Approval by Task/Sub-Task and Organization at least 60 days Prior to Expiration of Current contract Year

2. Ensure all Schedule Baseline Changes are Approved by the Government Through a Formal Change Process

3. Provide an Updated Schedule Status in the Monthly Status Report (MSR) Minimum Acceptable:

1. Schedule Changes are Requested Prior to Missing Expectations

2. All Services are Performed Within Government Approved Schedule Monthly Schedule Status Updates Are Accurate

Monthly Status Report will be reviewed by COR and Technical APM
Measurement Interval:

Monthly or as required Measurement Period:

Monthly Source of Measurement Data: Monthly Status Report Method of Surveillance:– Government review Periodic Inspection Timing of Measurement:

Monthly Reporting Frequency:

Reporting to commence upon Contract Award and continue throughout the Period of Performance.

1.Exceptional 2.Very Good 3.Satisfactory 4.Marginal 5.Unsatisfactory

Establish and Manage a Task or Sub-task Schedule;
Target Criteria:

Submit Base Period Schedule by Task/Sub-Task and Supported Organization within 10 days after TO

Minimum Acceptable:

Schedule Submissions are Accepted by the Government

Monthly Status Report and required CDRLS will be reviewed by COR and Technical APM
Measurement Interval:

Monthly or as required Measurement Period:

Monthly Source of Measurement Data: Monthly Status Report and various CDRLS Method of Surveillance:– Government review Periodic Inspection Timing of Measurement:

Monthly Reporting Frequency:

Reporting to commence upon Contract Award and continue throughout the Period of Performance.

1. Exceptional

2. Very Good

3. Satisfactory

4. Marginal

5. Unsatisfactory 6.

7.

Submit Required Contract Deliverables
Target Criteria:

Submit 100% of contract deliverables listed in section 11 of the PWS on time and accurate. COR and PM must approve all changes prior to the due date Minimum Acceptable:

95% of all deliverables accepted without change

Monthly reports or as indicated on each deliverable per DD1423
Measurement Interval:

Dependent on Deliverable.

Measurement Period:

Dependent on Deliverable.

Source of Measurement Data: Government review. CO/COR will have final decision on measurement.

Method of Surveillance – Government review. 100% Inspection Timing of Measurement:

Dependent on deliverable.

Reporting Frequency:

Dependent on Deliverable

1. Exceptional

2. Very Good

3. Satisfactory

Property Management
Target Criteria:

Submit 100% accountability on a yearly basis with 10% accountability on a monthly basis Minimum Acceptable:

90% accuracy on all property

Monthly reports will be reviewed by COR and Government RMD division
Measurement Interval:

Monthly/Annually Measurement Period:

Monthly Source of Measurement Data: Government review of Monthly Report; Annual onsite 100% property assessment by COR/Gov’t Rep. CO/COR will have final decision on measurement.

Method of Surveillance – Government review.

Timing of Measurement:

Monthly/Annually Reporting Frequency:

Reporting to commence upon Contract Award and continue Monthly throughout the Period of Performance

1. Exceptional

2. Very Good

3. Satisfactory

4. Marginal

5. Unsatisfactory

Configuration Management
Target Criteria:

100% baseline configuration maintained error free and on schedule per task order event

Minimum Acceptable:

95% of configuration baseline maintained without error and on schedule per task order event

Review by Government personnel per event
Measurement Interval:

As required by event Measurement Period:

Interval between events Source of Measurement Data:

Configuration Management Documentation Method of Surveillance:– Government review Periodic Inspection Timing of Measurement:

As required by event Reporting Frequency:

Reporting to commence upon contract award thru the Period of Performance as required by event

1. Exceptional

2. Very Good

3. Satisfactory

Engineering and Development Support

Management of Engineering Services and Developmental Requirements both software and hardware
Target Criteria:

100% baseline configuration maintained error free and on schedule per task order event

Minimum Acceptable:

95% of configuration baseline maintained without error and on schedule per task order event

Review by Government personnel per event, COR, Technical APM, and Engineers
Measurement Interval:

As required by event Measurement Period:

Interval between events Source of Measurement Data:

Configuration Management Documentation Method of Surveillance:– Government review Random and Periodic Inspection Timing of Measurement:

As required by event Reporting Frequency:

Reporting to commence upon contract award thru the Period of Performance as required by event 1.Exceptional 2.Very Good 3.Satisfactory

Conduct required Testing and Evaluation
Target Criteria:

100% that testing and evaluation will be conducted

Minimum Acceptable:

Provide support for government personnel in testing and evaluation Government personnel must complete a review of the technical documentation

Measurement Interval:

As required by event Measurement Period:

As per test and evaluation schedule Source of Measurement Data:

Test and Evaluation Report Method of Surveillance:– Government review 100% inspection Timing of Measurement:

As required by event Reporting Frequency:

Reporting to commence upon Certification phase and continue throughout the Period of Performance as required by event 1.Exceptional 2.Very Good 3.Satisfactory

NSA Certification
Target Criteria:

Pass certification on first attempt

Minimum Acceptable:

Pass certification on second attempt

NSA personnel approval of tested product
Measurement Interval:

As required by event Measurement Period:

As per NSA schedule Source of Measurement Data:

NSA test report Method of Surveillance:– Government review 100% Inspection Timing of Measurement:

As required by event Reporting Frequency:

Reporting to commence upon Certification phase and continue throughout the Period of Performance as required by event 1.Exceptional 2.Very Good 3.Satisfactory

Logistics Services – including training, manuals
Target Criteria:

Electronic training with error free manual

95% accuracy on all training materials Government personnel must complete a review of the technical documentation

Measurement Interval:

As required by event Measurement Period:

As required per event Source of Measurement Data:

Training material Method of Surveillance:– Government review 100% Inspection Timing of Measurement:

As required by event Reporting Frequency:

Reporting to commence upon government approval and acceptance and continue throughout the Period of Performance as required by event 1.Exceptional 2.Very Good 3.Satisfactory

Prototypes
Target Criteria:

100% of production lot acceptance

97% of production lot Government personnel must complete a review of the technical documentation

Measurement Interval:

By Production Lot Measurement Period:

Completed production event Source of Measurement Data:

Production lot Method of Surveillance:– Visual Inspection/testing Timing of Measurement:

Random if >3% fail, then 100% inspection Reporting Frequency:

Upon testing of each production lot 1.Exceptional 2.Very Good 3.Satisfactory

NGLD-M Production

Low-Rate Production quantities
Target Criteria:
Percentage of the production lot size
Measurement Interval:

By Production Lot Measurement Period:

Completed production event Source of Measurement Data:

Production lot Method of Surveillance:– Visual Inspection/testing Timing of Measurement:

Random if >3% fail, then 100% inspection Reporting Frequency:

Upon testing of each production lot 1.Exceptional 2.Very Good 3.Satisfactory

Full-Rate Production quantities
Target Criteria:
Percentage of the production lot size
Measurement Interval:

By Production Lot Measurement Period:

Completed production event Source of Measurement Data:

Production lot Method of Surveillance:– Visual Inspection/testing Timing of Measurement:

Random if >3% fail, then 100% inspection Reporting Frequency:

Upon testing of each production lot 1.Exceptional 2.Very Good 3.Satisfactory

Quality Control Production Process
Target Criteria:

100% assuring/monitoring that all manufacturing operations/processes are accomplished under controlled conditions as per contractor’s quality management plan Minimum Acceptable:

As cited under LRIP and FRP under MIN

Periodic Site Visits as determined by the Government
Measurement Interval:

As determined by Government Measurement Period:

As determined by Government Source of Measurement Data:

Contractor’s Quality Control Management Plan Method of Surveillance:– Visual Inspection Random and Periodic Inspections Timing of Measurement:

As determined by Government Reporting Frequency:

Monthly 1.Exceptional 2.Very Good 3.Satisfactory

Production Costs and Schedule
Target Criteria:

100% accuracy on cost and schedule

97% accuracy on cost and slip of schedule Government personnel must complete a review of the technical documentation associated with cost and schedule along with the COR and Technical APM

Measurement Interval:

Monthly or as required Measurement Period:

Monthly Source of Measurement Data: Monthly Status Report Method of Surveillance:– Government review 100% Inspection Timing of Measurement:

Monthly Reporting Frequency:

Reporting to commence upon Contract Award and continue throughout the Period of Performance.

1.Exceptional 2.Very Good 3.Satisfactory

Shipping and Delivery
Target Criteria:

Delivered and shipped 100% on time

Delivered and shipped 97% on time Government personnel must complete a review of the technical documentation associated with Task Order/ Delivery Order Management Plan

Measurement Interval:

Monthly or as required Measurement Period:

At shipping period Source of Measurement Data:

Task Order/ Delivery Order Management Plan Method of Surveillance:– Government review 100% Inspection Timing of Measurement:

Monthly Reporting Frequency:

Reporting to commence upon Contract Award and continue throughout the Period of Performance.

1.Exceptional 2.Very Good 3.Satisfactory

Supply Chain and Source Management
Target Criteria:

Adhere 100% to vendors Supply Chain Risk Management (SCRM)

95% of SCRM maintained without error Government personnel must complete a review of the technical documentation associated with SCRM

Measurement Interval:

As required by event Measurement Period:

As required per event Source of Measurement Data:

Training material Method of Surveillance:– Government review 100% Inspection Timing of Measurement:

As required by event Reporting Frequency:

Reporting to commence upon government approval and acceptance and continue throughout the Period of Performance as required by event 1.Exceptional 2.Very Good 3.Satisfactory

Sustainment Services

Hardware and Software Sustainment
Target Criteria:

Government personnel must complete a review of the technical documentation associated with SCRM

Measurement Interval:

As required by event Measurement Period:

As required per event Source of Measurement Data:

Training material Method of Surveillance:– Government review 100% Inspection Timing of Measurement:

As required by event Reporting Frequency:

Reporting to commence upon government approval and acceptance and continue throughout the Period of Performance as required by event 1.Exceptional 2.Very Good 3.Satisfactory

Training and Training Materials
Target Criteria:

Electronic training with error free manual

95% accuracy on all training materials Government personnel must complete a review of the technical documentation

Measurement Interval:

As required by event Measurement Period:

As required per event Source of Measurement Data:

Training material Method of Surveillance:– Government review 100% inspection Timing of Measurement:

As required by event Reporting Frequency:

Reporting to commence upon government approval and acceptance and continue throughout the Period of Performance as required by event 1.Exceptional 2.Very Good 3.Satisfactory

Supply Support
Target Criteria:

Government personnel must complete a review of the technical documentation associated with SCRM

Measurement Interval:

As required by event Measurement Period:

As required per event Source of Measurement Data:

Training material Method of Surveillance:– Government review Periodic Inspection Timing of Measurement:

As required by event Reporting Frequency:

Reporting to commence upon government approval and acceptance and continue throughout the Period of Performance as required by event 1.Exceptional 2.Very Good 3.Satisfactory

PERFORMANCE ASSESSMENT REPORT (PAR)

(If more space is needed, use reverse and identify by number)

1. CONTRACT/TASK ORDER NUMBER
2. CONTRACTOR
3. TYPE OF SERVICES

4. QUALITY ASSURANCE PERSONNEL (COR) SIGNATURE AND DATE

5. COR PHONE
6. SUSPENSE DATE

I. PERFORMANCE

7. |_| DEFICIENCY (CHECK ALL BOXES THAT APPLY)

|_| NEW

|_| REPEAT

|_| NO DEFICIENCY NOTED

8. SERVICES SUMMARY or PWS PARAGRAPH ITEM REVIEWED

9. BRIEF DESCRIPTION OF DEFICIENCY (IF DEFICIENCY BOX WAS CHECKED)
10. DETAILED PERFORMANCE ASSESSMENT

II. CONTRACTOR VALIDATION

11. CONTRACTOR REPRESENTATIVE |_| CONCUR |_| NON-CONCUR

12. CORRECTIVE ACTION ESTIMATED COMPLETION DATE

13. CONTRACTOR REPRESENTATIVE CORRECTIVE ACTION AND PREVENTION OF RECURRENCE OR REASON FOR NON-CONCURRENCE OF COR CITED DEFICIENCY

III. ACTION CORRECTED

14. |_| CONCUR |_| NON-CONCUR COR SIGNATURE AND DATE

15. COR REMARKS (REQUIRED)

6. CONTRACTOR REPRESENTATIVE REMARKS

Appendix 2 – Performance Assessment Report

Appendix 3 – Customer Complaint Record

CUSTOMER COMPLAINT RECORD

DATE/TIME OF COMPLAINT

SOURCE OF COMPLAINT

ORGANIZATION

BUILDING NUMBER

INDIVIDUAL

PHONE NUMBER

NATURE OF COMPLAINT

CONTRACT REFERENCE

VALIDATION

DATE/TIME CONTRACTOR INFORMED OF COMPLAINT

ACTION TAKEN BY CONTRACTOR

RECEIVED/VALIDATED BY

Appendix 4 – Corrective Action Report

CORRECTIVE ACTION REPORT (CAR)

(If more space is needed, use reverse and identify by number)

1. CONTRACTOR

2. CONTRACT NUMBER

3. TYPE OF SERVICES

4. FUNCTIONAL AREA

5. SUSPENSE DATE

6. CONTROL NUMBER

7. DEFICIENCY |_| MAJOR |_| MINOR

FINDING:

FINDING IMPACT:

Please respond with a written corrective action plan that details the corrective action of the cited deficiency, the cause of the deficiency, and actions taken to prevent recurrence by Suspense Date in Block 5. If date was not entered in Block 5, the contractor is not required to provide a response.

8. QUALITY ASSURANCE PERSONNEL (COR)

TYPED NAME AND GRADE

SIGNATURE AND DATE

9. ISSUING AUTHORITY

TYPED NAME AND GRADE

SIGNATURE AND DATE

10. COR RESPONSE TO CONTRACTOR CORRECTIVE ACTION AND ACTION TAKEN TO PREVENT RECURRENCE

11. COR DETERMINATION

|_| ACCEPTED |_| REJECTED

12. CLOSE DATE

Enclosure 6, Page 1 of 11 Pages 17Jul2013/Version 2

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