Attachment_17.pdf

502 CONS/JBKAE FA3016-16-R-0009

JBSA Lackland, TX

Attachment 17 30 Oct 2015 Page 1 of 1

ATTACHMENT 17

PERFORMANCE ASSESSMENT REPORT FORM

TRAINER AND STATIC DISPLAY MAINTENANCE SERVICES

PERFORMANCE ASSESSMENT REPORT (PAR)

INSTRUCTIONS:

- COR will submit SECTION I to SP following a performance assessment

- SP shall submit SECTION II to COR within one business day of receipt of SECTION I

-- SP shall complete blocks 12 through 15 only if COR listed discrepancy(ies) in block 7 -- SP shall internally submit a Form 1 Trainer Maintenance Services work order if COR listed discrepancy(ies) in block 7

- COR will complete SECTION III after SP submits SECTION II

- CO will mediate disagreements between COR and SP

- COR will provide SP with a copy of the completed Form 2 SECTION I. PERFORMANCE ASSESSMENT (Completed by COR)

1. AIRPARK/TRAINING AREA NAME/NUMBER

(Use name/number listed on PWS)

2. ITEM NAME/NUMBER (Use name/number listed on PWS)

3. PERFORMANCE RATING

□ SATISFACTORY

□ UNSATISFACTORY

4. PWS PARAGRAPH(S) 5. SERVICE SUMMARY NUMBER(S)

6. DETAILED PERFORMANCE ASSESSMENT

(Use bullet statements)

7. DESCRIPTION OF DISCREPANCY(IES)

(If applicable, use bullet statements)

8. COR NAME (Type Last, First, MI) 9. COR SIGNATURE 10. DATE

SECTION II. SP COMMENTS (Completed by SP contract manager (CM))

11. DESCRIPTION OF CORRECTIVE ACTION(S)

(If applicable, use bullet statements)

12. REASON FOR DISCREPANCY

(If applicable, use bullet statements)

13.ESTIMATED COMPLETION DATE

(If applicable)

14. WORK ORDER NUMBER

(If applicable)

15. SP CM NAME 16. DOES SP CONCUR WITH

SECTION II?

□ YES

□ NO

17. SP CM SIGNATURE 18. DATE

SECTION III. COR COMMENTS (Completed by COR)

19. DOES COR CONCUR WITH

SECTION III?

□ YES

□ NO

20. REASON FOR NON-CONCURRENCE

(If applicable, use bullet statements)

21. COR NAME 22. COR

SIGNATURE

23. DATE

FA-XXXX-XXX Form 2

□ SATISFACTORY