C04d_Attachment 4 Discrepancy Report 1232SA26Q0815.pdf

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Roll Up Door Biocontainment Enclosures
Solicitation number
1232SA26Q0815
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About this file

This is a Discrepancy Report form used in federal contract administration to document and track performance or compliance issues. The form functions as a formal communication tool between the Contracting Officer's Representative (COR) and the contractor to identify, investigate, and resolve contract discrepancies.

The report process follows a structured workflow beginning with the COR's identification of a discrepancy or problem in Section 4, which must include detailed descriptions and references to the Performance Work Statement (PWS) or applicable contract requirements. The COR documents whether notification was provided orally or in writing and signs the initial report. The contractor then provides a formal response in Section 8, addressing the root cause, effects, corrective actions, and preventive measures, citing relevant Quality Control (QC) program procedures. The government evaluates the contractor's response in Section 11, determining acceptance, partial acceptance, or rejection, and may issue government actions such as cure notices or show cause orders in Section 12. The form concludes with a closeout section requiring signatures from the KTR (Key Technical Representative) and COR with dates to formally document resolution of the discrepancy. The form includes checkboxes to track the preparation status and allows for continuation sheets when detailed explanations exceed available space.

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Text version

DISCREPANCY REPORT 1. DISCREPENCY REPORT NO.

2. TO: (Contractor / Project Manager Name) 3. FROM: (Name of COR)

CONTRACT NUMBER: DATE:

PREPARED ORAL NOTIFICATION RETURNED BY CONTRACTOR ACTION COMPLETE

4. DISCREPENCY OR PROBLEM (Describe in Detail. Include PWS references. Attach Continuation Sheet if Necessary)

5. SIGNATURE OF COR

6. TO: (Name of COR) 7. FROM: (Contractor / Project Manager)

8. CONTRACTOR RESPONSE AS TO CAUSE, EFFECT, CORRECTIVE ACTION AND ACTIONS TO PREVENT RECURRENCE (Attach Continuation Sheet if necessary. Cite applicable Contractor QC program procedures or new QC procedures)

9. SIGNATURE OF CONTRACTOR REPRESENTIVE 10. DATE

11. GOVERNMENT EVALUATION (Acceptance, partial acceptance, or rejection. Attach Coordination Sheet if necessary)

12. GOVERNMENT ACTIONS (Cure notice, show cause, other)

CLOSE OUT

KTR NOTIFIED

NAME AND TITLE SIGNATURE DATE

COR

1 DISCREPENCY REPORT NO:
2 TO Contractor Project Manager Name:
3 FROM Name of COR:
CONTRACT NUMBER DATE:
PREPARED:
ORAL NOTIFICATION:
RETURNED BY CONTRACTOR:
ACTION COMPLETE:
4 DISCREPENCY OR PROBLEM Describe in Detail Include PWS references Attach Continuation Sheet if Necessary:
6 TO Name of COR:
7 FROM Contractor Project Manager:
8 CONTRACTOR RESPONSE AS TO CAUSE EFFECT CORRECTIVE ACTION AND ACTIONS TO PREVENT RECURRENCE Attach Continuation Sheet if necessary Citeapplicable Contractor QC program procedures or newQC procedures:
11 GOVERNMENT EVALUATION Acceptance partial acceptance or rejection Attach Coordination Sheet if necessary:
12 GOVERNMENT ACTIONS Cure notice show cause other:
NAME AND TITLEKTR NOTIFIED:
DATEKTR NOTIFIED:
NAME AND TITLECOR:
DATECOR:
Text1:
Date4_af_date:

File details come from the government source that posted it. Updated .