C1a -70FB7020R00000002 Attachment 5 SF-364 Report of Discrepancy.pdf

REPORT OF DISCREPANCY (ROD)

SHIPPING PACKAGING

1. DATE OF PREPARATION 2. REPORT NUMBER

3. TO (Name and address, include ZIP Code) 4. FROM (Name and address, include ZIP Code)

5a. SHIPPER'S NAME 5b. NUMBER AND DATE OF

INVOICE

6. TRANSPORTATION DOCUMENT

NUMBER (GBL, Waybill; TCN, etc.)

7a. SHIPPER'S NUMBER (Purchase order/Shipment, Contract, etc.)

7b. OFFICE ADMINISTRATION CONTRACT 8. REQUISTIONER'S NUMBER (Requi-sition, Purchase Request, etc)

9. SHIPMENT, BILLING, AND RECEIPT DATA 10. DISCREPANCY DATA 11.

AC-2

TION

CODENSN/PART NUMBER AND

NOMENCLATURE

(a)

UNIT

OF ISSUE

(b)

QUANTITY

SHIPPED/

BILLED

(c)

QUANTITY

RECEIVED

(d)

QUAN-

TITY

(a)

UNIT

PRICE

(b)

TOTAL

COST

(c)

CODE1

(d)

12. REMARKS (Continue on separate sheet of paper if necessary)

1DISCREPANCY CODES 2 ACTION CODES

CONDITION OF MATERIAL

C1 — In condition other than that indicated on release/ receipt document C2 — Expired shelf life C3 — Damaged parcel post shipment

SUPPLY DOCUMENTATION

D1 — Not received D2 — Illegible or mutilated D3 — Incomplete improper or without authority (Only when receipt cannot be properly process)

MISDIRECTED MATERIAL

M1 — Addressed to wrong activity

OVERAGE/ DUPLICATE SHIPMENTS

O1 — Quantity in excess of that on receipt docu-ment O2 — Quantity in excess of that requested (Other than unit of issue pack) O3— Quantity duplicates shipment

PACKING DISCREPANCY

P1 — Improper preservation P2 — Improper packing P3 — Improper marking P4 — Improper unitization

PRODUCT QUALITY DEFICIENCIES

Q1 — Deficient material (Applicable to Grant Aid and FMS shipments only)

SHORTAGE OF MATERIAL

S1 — Quantity less than that on receipt document S2 — Quantity less than that requested (Other than unit of issue pack) S3 — Non-receipt of parcel post shipments ITEMS TECHNICAL DATA MARKINGS (i.e, Name Plates, Log Books, Opening Handbooks, Special Instructions, etc.)

T1 — Missing T2 — Illegible or mutilated T3 — Precautionary operational markings missing T4 — Inspection data missing or incomplete T5 — Serviceability operating data missing or incomplete T6 — Warranty data missing WRONG ITEM (Identify requested item as a separate copy in item 9 above) W1 — Incorrect item received W2 — Unacceptable substitute

OTHER DISCREPANCIES

Z1 — See remarks

1A— Disposition instructions re-quested (Reply on reverse) 1B— Material being retained (See remarks) 1C— Supporting supply documenta-tion requested 1D— Material still required expedite shipment (Not applicable to

FMS)

1E— Local purchase material to be returned at supplier's expense unless disposition instructions to the contrary are received within 15 days (Reply on re-verse) (Not applicable to FMS) 1F— Replacement shipment requested (Not applicable to FMS) 1G— Reshipment not required. Item to be re-requisitioned.

1H— No action required. Information only 1Z— Other action requested (See remarks)

13. FUNDING AND ACCOUNTING DATA

14a. TYPED OR PRINTED NAME, TITLE, AND PHONE NUMBER OF PRE-

PARING OFFICAL

14b. SIGNATURE

15. DISTRIBUTION ADDRESSEES FOR COPIES

STANDARD FORM 364 (REV. 2-80)

16. FROM: 17. DISTRIBUTION ADDRESSEES FOR COPIES

18. TO:

Use window envelope to mail this document. Insert name, and address, including ZIP Code, starting one typing space below the left dot.

Each address line must NOT extent beyond right dot.

Address must not exceed four singles space typing lines.

19. IN ACCORDANCE WITH NOTICE OF DISCREPANCY ON FACE OF THIS FORM:

a. MATERIAL

HAS

BEEN

WILL

BE

SHIPPED

DOCUMENT NUMBER

NO RECORD OF SHIPMENT. RESUBMIT REPORT TO

b. PROPER OFFICE UNDER APPROPRIATE REGULATION.

AN ADJUSTMENT IN BILL-

ING HAS BEEN / WILL BE

c. PROCESSED AS A: CREDIT DEBIT

INVOICE/BILL

d. ATTACHED

PROOF OF DELIVERY (Parcel Post Shipments) OR EVIDENCE OF

e. SHIPMENTS ENCLOSED.

AN ADJUSTMENT IN BILLING FOR THE REPORTED DISCREPANCY WILL NOT BE PROCESSED FOR THE FOLLOWING REASON

f. WHICH IS CITED IN THE INDICATED REGULATION.

(1) REASON FOR NOT PROCESSING (2) PRESCRIBING REGULATION

(a) DISCREPANCY WAS NOT REPORTED WITHIN THE TIME

FRAMES ALLOWED AND/OR

(b) DOLLAR VALUE DOES NOT MEET THE CRITERIA PRE-

SCRIBED IN THE REGULATION OR AGREEMENT INDI-

CATED IN 19f(2)

(a) CHAPTER 5 OF THE GSA HANDBOOK. DISCREPANCIES OR

DEFICIENCIES IN GSA OR DOD SHIPMENTS, MATERIAL,

OR BILLINGS (FPMR 101-26.8)

(b) CHAP.2 AND/OR 7 OF DOD 4000.25-7-M, MILITARY STAND-

ARD BILLING SYSTEM (MILSBILLS) AND/OR DD 1513, U.S.

DOD OFFER AND ACCEPTANCE, AS APPLICABLE.

20. THE FOLLOWING DISPOSITION IS TO BE MADE OF THE REFERENCED MATERIAL:

PROCESS FOR DISPOSAL IN ACCORDANCE

a. WITH SERVICE/AGENCY DIRECTIVES.

c. RETAIN MATERIAL AT NO CHARGE.

REPRESENTATIVE WILL CALL FOR DISCUS-

b. SION CONCERNING DISPOSITION IN:

d. MATERIAL WILL BE PICKED UP IN:

DAYS

DAYS

e. SHIP MATERIAL (Specify location):

(1) GBL APPROPRIATIONS CHARGEABLE:

(2) CHARGES COLLECT-VIA: FREIGHT EXPRESS PARCEL POST ($ postage advanced herewith.

NOTE: Please enclose postage. Material cannot to returned Parcel Post collect.)(3) PARCEL POST LABEL ATTACHED (4) FREIGHT PREPAID

f. OTHER (Specify)

IF MATERIAL IS STILL REQUIRED,

21. SUBMIT NEW REQUISITION

REPLACEMENT WITH SATISFACTORY

22. MATERIAL WILL BE MADE ON OR BEFORE:

DATE

23. REMARKS (Continue on separate sheet of paper if necessary)

24a. TYPED OR PRINTED NAME AND PHONE NUM-

BER OF PREPARING OFFICAL

24b. SIGNATURE 24c. DATE

STANDARD FORM 364 BACK (REV. 2-80)

REPORT OF DISCREPANCY (ROD)

SHIPPING

PACKAGING

1. DATE OF PREPARATION

2. REPORT NUMBER

3. TO (Name and address, include ZIP Code)

4. FROM (Name and address, include ZIP Code) 5a. SHIPPER'S NAME 5b. NUMBER AND DATE OF

INVOICE

6. TRANSPORTATION DOCUMENT

NUMBER (GBL, Waybill; TCN, etc.)

7a. SHIPPER'S NUMBER (Purchase order/Shipment, Contract, etc.)

7b. OFFICE ADMINISTRATION CONTRACT

8. REQUISTIONER'S NUMBER (Requi-sition, Purchase Request, etc)

11.

AC-2

TION

CODE

NSN/PART NUMBER AND

NOMENCLATURE

(a)

UNIT

OF ISSUE

(b)

QUANTITY

SHIPPED/

BILLED

(c)

QUANTITY

RECEIVED

(d)

QUAN-

TITY

(a)

UNIT

PRICE

(b)

TOTAL

COST

(c)

CODE1

(d)

12. REMARKS (Continue on separate sheet of paper if necessary)

1DISCREPANCY CODES

2 ACTION CODES

CONDITION OF MATERIAL

C1 — In condition other than that indicated on release/ receipt document C2 — Expired shelf life C3 — Damaged parcel post shipment

SUPPLY DOCUMENTATION

D1 — Not received D2 — Illegible or mutilated D3 — Incomplete improper or without authority (Only when receipt cannot be properly process)

MISDIRECTED MATERIAL

M1 — Addressed to wrong activity

OVERAGE/ DUPLICATE SHIPMENTS

O1 — Quantity in excess of that on receipt docu-ment O2 — Quantity in excess of that requested (Other than unit of issue pack) O3— Quantity duplicates shipment

PACKING DISCREPANCY

P1 — Improper preservation P2 — Improper packing P3 — Improper marking P4 — Improper unitization

PRODUCT QUALITY DEFICIENCIES

Q1 — Deficient material (Applicable to Grant Aid and FMS shipments only)

SHORTAGE OF MATERIAL

S1 — Quantity less than that on receipt document S2 — Quantity less than that requested (Other than unit of issue pack) S3 — Non-receipt of parcel post shipments ITEMS TECHNICAL DATA MARKINGS (i.e, Name Plates, Log Books, Opening Handbooks, Special Instructions, etc.)

T1 — Missing T2 — Illegible or mutilated T3 — Precautionary operational markings missing T4 — Inspection data missing or incomplete T5 — Serviceability operating data missing or incomplete T6 — Warranty data missing WRONG ITEM (Identify requested item as a separate copy in item 9 above) W1 — Incorrect item received W2 — Unacceptable substitute

OTHER DISCREPANCIES

Z1 — See remarks 1A— Disposition instructions re-quested (Reply on reverse) 1B— Material being retained (See remarks) 1C— Supporting supply documenta-tion requested 1D— Material still required expedite shipment (Not applicable to

FMS)

1E— Local purchase material to be returned at supplier's expense unless disposition instructions to the contrary are received within 15 days (Reply on re-verse) (Not applicable to FMS) 1F— Replacement shipment requested (Not applicable to FMS) 1G— Reshipment not required. Item to be re-requisitioned.

1H— No action required. Information only 1Z— Other action requested (See remarks)

13. FUNDING AND ACCOUNTING DATA

14a. TYPED OR PRINTED NAME, TITLE, AND PHONE NUMBER OF PRE-

PARING OFFICAL

14b. SIGNATURE

15. DISTRIBUTION ADDRESSEES FOR COPIES

STANDARD FORM 364 (REV. 2-80)

16. FROM:

17. DISTRIBUTION ADDRESSEES FOR COPIES

18. TO:

Use window envelope to mail this document. Insert name, and address, including ZIP Code, starting one typing space below the left dot. Each address line must NOT extent beyond right dot. Address must not exceed four singles space typing lines.

19. IN ACCORDANCE WITH NOTICE OF DISCREPANCY ON FACE OF THIS FORM:

a. MATERIAL

HAS

BEEN

WILL

BE

SHIPPED

DOCUMENT NUMBER

NO RECORD OF SHIPMENT. RESUBMIT REPORT TO

b. PROPER OFFICE UNDER APPROPRIATE REGULATION.

AN ADJUSTMENT IN BILL-

ING HAS BEEN / WILL BE

c. PROCESSED AS A:

CREDIT

DEBIT

INVOICE/BILL

d. ATTACHED PROOF OF DELIVERY (Parcel Post Shipments) OR EVIDENCE OF

e. SHIPMENTS ENCLOSED.

AN ADJUSTMENT IN BILLING FOR THE REPORTED DISCREPANCY WILL NOT BE PROCESSED FOR THE FOLLOWING REASON

f. WHICH IS CITED IN THE INDICATED REGULATION.

(a) DISCREPANCY WAS NOT REPORTED WITHIN THE TIME

FRAMES ALLOWED AND/OR

(b) DOLLAR VALUE DOES NOT MEET THE CRITERIA PRE-

SCRIBED IN THE REGULATION OR AGREEMENT INDI-

CATED IN 19f(2)

(a) CHAPTER 5 OF THE GSA HANDBOOK. DISCREPANCIES OR

DEFICIENCIES IN GSA OR DOD SHIPMENTS, MATERIAL,

OR BILLINGS (FPMR 101-26.8)

(b) CHAP.2 AND/OR 7 OF DOD 4000.25-7-M, MILITARY STAND-

ARD BILLING SYSTEM (MILSBILLS) AND/OR DD 1513, U.S.

DOD OFFER AND ACCEPTANCE, AS APPLICABLE.

20. THE FOLLOWING DISPOSITION IS TO BE MADE OF THE REFERENCED MATERIAL:

PROCESS FOR DISPOSAL IN ACCORDANCE

a. WITH SERVICE/AGENCY DIRECTIVES.

c. RETAIN MATERIAL AT NO CHARGE.

REPRESENTATIVE WILL CALL FOR DISCUS-

b. SION CONCERNING DISPOSITION IN:

d. MATERIAL WILL BE PICKED UP IN:

DAYS

DAYS

e. SHIP MATERIAL (Specify location):

(1) GBL APPROPRIATIONS CHARGEABLE:

(2) CHARGES COLLECT-VIA:

FREIGHT

EXPRESS

PARCEL POST

($ postage advanced herewith.

NOTE: Please enclose postage. Material cannot to returned Parcel Post collect.)

(3) PARCEL POST LABEL ATTACHED

(4) FREIGHT PREPAID

f. OTHER (Specify)

IF MATERIAL IS STILL REQUIRED,

21. SUBMIT NEW REQUISITION

REPLACEMENT WITH SATISFACTORY

22. MATERIAL WILL BE MADE ON OR BEFORE:

DATE

23. REMARKS (Continue on separate sheet of paper if necessary) 24a. TYPED OR PRINTED NAME AND PHONE NUM-

BER OF PREPARING OFFICAL

24b. SIGNATURE 24c. DATE

STANDARD FORM 364 BACK (REV. 2-80)

8.2.1.4029.1.523496.503679