Attach_2_Ambulance_Quality_Assurance_Surveillance_Plan_(QASP).pdf

QUALITY ASSURANCE SURVEILLANCE PLAN FOR

AMBULANCE SERVICES

AT THE

UNITED STATES AIR FORCE ACADEMY

Quality Assurance Surveillance Plan for Ambulance Services 26 Sept 2013

TABLE OF CONTENTS

1.0 PURPOSE

2.0 OBJECTIVES

3.0 RESULTS THE MULTI-FUNCTIONAL TEAM IS STRIVING TO ACHIEVE

4.0 MULTI-FUNCTIONAL TEAM MEMBERS’ ROLES & RESPONSIBILITIES

5.0 CONTRACTING OFFICER REPRESENTATIV (COR) APPOINTMENT AND TRAINING

6.0 GENERAL

7.0 APPROACH, METHOD, AND TOOLS USED TO ASSESS CONTRACTOR

PERFORMANCE

8.0 CONTRACT MANAGER NOTIFICATION

9.0 DISCREPENCY REPORTING

10.0 NON SERVICE SUMMARY (SS) ITEMS

11.0 CERTIFICATION OF SERVICES

12.0 PERFORMANCT METRICS

13.0 CONTRACTOR RATING (CPARS)

14.0 MULTI-FUNCTIONAL TEAM SIGNATURE PAGE

15.0 APPENDCIES

Appendix A –Customer Complaint Record

Appendix B – Corrective Action Report (CAR)

Appendix C – Performance Assessment Report (PAR)

Appendix D – COR Report

Quality Assurance Surveillance Plan for Ambulance Services 26 Sept 2013

1. PURPOSE.

This Quality Assurance Surveillance Plan (QASP) has been developed and adheres to Performance-Based

Services Acquisition (PBSA) guidelines. This QASP will also be used to implement the Performance

Management Assessment Program by interfacing with the Management and Oversight of Acquisition of

Services Process (MOASP). This QASP will be used by the Multi-functional team and the Contracting

Officer Representatives (COR) to ensure contractor compliance and progress at meeting mission objectives on the ambulance service contract.

2. OBJECTIVE.

This QASP is designed to provide the Multi-functional team a vehicle to ensure delivery of the desired mission support services within cost and on schedule. The QASP will also provide the COR an effective systematic surveillance method for each item listed in the Performance Work Statement (PWS), specifically on the Service Summary (SS). The premise of commercial contracting is for the Contractor to assume responsibility for the work they produce. The government will also rely on the Contractor's submitted

Quality Control Plan (if applicable) for ensuring contractual requirements are met.

3. RESULTS.

The results in managing this acquisition through this QASP, is to provide the United States Air Force

Academy with ambulance services that are acceptable and timely while protecting Government resources.

4. MULTI-FUNCTIONAL TEAM ROLES & RESPONSIBILITIES.

The following government officials will participate in performance management of this contract through use of the Management and Oversight of Acquisition of Services Process (MOASP) and the contractor. Their roles and responsibilities are described as follows:

4.1. Contracting Officer Representative (COR): is responsible for monitoring, assessing, recording and reporting on contractor compliance with the terms and conditions of the contract. These individuals will have primary responsibility for completing quality assurance monitoring forms that will be used to document the inspection and evaluation of the contractor’s performance. The COR will maintain surveillance documentation, notify the Contracting Officer (CO) of any significant performance deficiencies and recommend improvements to the QASP and Performance Work Statement (PWS) throughout the life of the acquisition.

4.2. The Contracting Officer (CO): has overall responsibility for overseeing the contractor’s performance.

The CO will also be responsible for the day-to-day monitoring of the contractor’s performance in the areas of contract compliance, contract administration, cost control, and property control; reviewing the COR assessment of the contractor’s performance; and resolving all differences between the COR version and the contractor’s version of events. The CO is the only person with the authority to direct the contractor in the performance of their duties under the contract and to make interpretations of and changes to the contract.

The CO will facilitate Multi-functional Team meetings.

4.3. The COR Management/Supervisor: has overall responsibility for developing the PWS and the Quality

Assurance Surveillance Plan and ensuring they satisfy mission requirements, are performance-based, foster innovation, and define metrics. The COR MANAGEMENT/SUPERVISOR will also be responsible to assign competent and capable functional experts to the Multi-functional Team who will be available full time or as warranted by the procurement cycle. The COR MANAGEMENT/SUPERVISOR will also assign, as a minimum, a primary and an alternate COR and notify the CO of any changes to this designation. Review contractor performance documentation, prepared by the COR on a regular basis to ensure performance is

Quality Assurance Surveillance Plan for Ambulance Services 26 Sept 2013 compatible with contract and mission objectives. The COR MANAGEMENT/SUPERVISOR is also responsible for identifying mission essential services and developing the necessary documents for

Continuation of Essential DoD Contractor Services During Crisis.

4.4. The Contracting Division Director and/or The Director of Business Operations(DBO):

serves as the Business Advisor to senior leadership; developing and implementing acquisition strategies for services acquisitions; providing oversight of the Multi-functional Team in planning, assessing contractor performance, and managing the acquisition throughout the life of the requirement IAW the FAR, DFARS and AFFARS. Also provide Management and Oversight of the Acquisition of Services Process (MOASP) reports on service acquisitions to the MAJCOM for consolidation.

4.5. The Quality Assurance Program Coordinator (QAPC): develops, manages and implements the United

States Air Force Academy’s Quality Assurance Program; supports the Multi-Functional Team in the development of contract requirements, ensuring requirements are clearly stated and enforceable; aids in development of the Service Summary (SS) and Quality Assurance Surveillance Plan and provides training to all COR Management/Supervisors, CORs and others that interact with this contract as needed.

4.6. The Contract Administrator (CA): is the focal point for issues regarding the contract; prepares and processes modifications to the contract; assists the CO in ensuring contractor performance meets contract standards; records and transcribes minutes for meetings.

4.6.1. CAs will perform COR personnel assessment on a periodic basis as determined by the CO. The contract administrator (CA) will verify that the COR is accomplishing their surveillance according to this

Quality Assurance Surveillance Plan. Observation of one or two checks will be sufficient to verify the QA’s procedures. If deficiencies are discovered in COR surveillance procedures, the contracting officer will notify

COR Management/Supervisor and provide any assistance the COR Management/Supervisor may request, such as additional training for CORs. The CA will ensure that the COR is documenting their surveillances on a timely basis. A check of the QA files will also be performed on a periodic basis as determined by the

CO/CA.

4.7. The Contractor: is the service provider and will ensure that a government acceptable quality control system is provided and maintained. The contractor is required to provide all services identified in the PWS not just those identified in the SS. The contractor will also provide support to Senior Leadership as required

(e.g., performance metrics, briefings).

5. COR APPOINTMENT AND TRAINING.

5.1. A primary and alternate COR will be appointed for this contract. The COR Management/Supervisor is the designating authority.

5.2. Each COR will be available to receive QAPC provided training (previously referred to as Phase 1), CO

Led Training (previously referred to as Phase 2), Defense Acquisition University (DAU) Continuous

Learning Module (CLM) 003 (Ethics), DAU Continuous Learning Course (CLC) 107 (OPSEC Contract

Requirements) and DAU CLC 106 (COR Basic) or DAU CLC 222 (COR Course). DAU 106 or 222 will be determined by the category of contract (A, B, or C).

5.3. Each COR will be available to receive Refresher training provided by the QAPC as required and maintain the appropriate number of COR specific training hours every three years as determined by the

Quality Assurance Surveillance Plan for Ambulance Services 26 Sept 2013 category of contract. A- type contracts must maintain 8 hours every three years and ethics (every year. B and C type contracts must maintain 16 hours every three years and ethics (CLM 003) every year.

6. GENERAL.

Government surveillance will be conducted by inspections that mirror the market research findings. COR documentation of contractor performance should be accomplished as the observation is completed, thus preventing loss of information. All documentation generated in the performance of this plan will be marked, "For Official Use Only".

7. APPROACH, METHODS, AND TOOLS OF INSPECTION APPLICABLE TO THIS

CONTRACT.

7.1. ONE-HUNDRED PERCENT INSPECTION

The COR will inspect and evaluate the contractor’s performance each time it is performed. The results of the contractor’s overall performance is then evaluated to determine acceptability of the service provided. The

COR will use this process to verify that completed reports are received on time. The COR will also use this process for observing response times documented in the report. The data will be compiled at the end of each month of service to verify performance meets the acceptable threshold.

7.2. CUSTOMER COMPLAINT

The COR is the point of contact and must collect all customer complaints. The AF Form 714, Customer

Complaint Record, or a similar locally devised form may be used for this purpose (see Appendix A). All complaints and any resulting resolution of such complaints must be documented with the information required on the customer complaint form. Customer complaint forms become a permanent part of the COR surveillance records. The COR will contact each customer involved with this contract, periodically to assure there is an understanding of the contract requirement by all appropriate personnel and that they have a sufficient number of complaint forms. All customer complaints must be validated and approved at a level above the COR in the following manner:

1. Anyone who observes unacceptable services, either incomplete or not performed, should immediately contact the COR.

2. The COR will verbally notify the contractor of the written complaint. The contractor will be given four hours after verbal notification to correct or otherwise resolve the unacceptable performance unless there is a bona fide time constraint requiring performance by a certain time period. If the contractor disagrees with the complaint after investigation and challenges the validity of the complaint, the contractor will notify the COR.

3. The COR will conduct an investigation to determine the validity of the complaint. If the COR determines the complaint to be valid and is approved at a level above the COR, the COR will document the findings and notify the customer. The contractor will be given an additional two hours to correct the defect.

4. The contractor shall return the written customer complain document to the COR, completed with the actions taken to correct the defect. The government will retain this document to ensure the contractor has taken appropriate action(s) to prevent the recurrence of defects. At the end of each month, all validated complaints will be counted to determine if performance is satisfactory or unsatisfactory based on the criteria in the

Services Summary.

Quality Assurance Surveillance Plan for Ambulance Services 26 Sept 2013

SS SURVEILLANCE ITEMS

The SS elements are often considered the most mission critical service characteristics of the contract. Adjust the

Performance Objective or Performance Threshold by modification to the contract when necessary. Update QASP if the assessment method chosen below proves unsatisfactory to adequately portray the service performance.

The assessment methods shown in the table for each SS element are the primary means to evaluate the performance objective, and assess whether the performance threshold was met.

No. Performance Objective

PWS

Paragraph Performance Threshold

Assessment

Method

Response time for all emergent requests for service on USAFA, to include Basic Life Support

(BLS) and Advanced Life

Support (ALS), shall be within nine (9) minutes.

This requirement does not apply to non-emergent or transfer calls

1.1.3.

90% of emergent responses within nine minutes and all responses within twelve minutes in a month

100% inspection

The contractor shall provide the full range of

EMT, paramedic, and ambulance transport services, and provide medical care and treatment appropriate to patient’s condition.

1.1.4.

No more than 1validated customer complaint per quarter.

customer complaints

The contractor shall prepare and submit documentation of each ambulance response within 24 hours following the response to the COR.

1.3.1.

No more than 1 late report per month. Late reports will be submitted no later than 48 hours following the response.

100% inspection

The contractor shall not balance bill TRICARE eligible members for any balance due, no exceptions.

Unnecessary or excessive expenses denied by insurance; contractor shall not seek further direct reimbursement from the patient or the government.

1.8, 1.1.1

100% Compliance, No validated patient/customer complaints related to improper billing.

customer complaints

Quality Assurance Surveillance Plan for Ambulance Services 26 Sept 2013

CALCULATING CONTRACTOR COMPLIANCE

RANDOM SAMPLING, PERIODIC INSPECTION, OR 100% INSPECTION

The following formula will be used to calculate contractor compliance when the aforementioned inspection methods are used.

1. COR performed 100 observations in a given timeframe (normally measured monthly)

2. COR noted 10 contractor non-compliances

3. # of defects (10) is divided by the # of observations performed (100)

4. Contractor is found to be 10% defective

5. This number is then subtracted from 100% to give you the percentage compliant

6. This number is then compared to the performance threshold to see if the performance objective is met.

number of defects found = % defective number of observations performed

Lot Size = Total number of service outputs in a surveillance period (normally a month).

(NOTE: The SDS is the biggest influence on what is to be surveyed by the QA. If, for example, the SDS states that the contractor will be performing custodial services by square feet, then the COR’s surveillance should parallel that objective.)

Defect = A service output that does not meet the terms and conditions of the contract.

8. CONTRACT MANAGER NOTIFICATION.

The COR will ensure that the contract manager/project manager is informed of contract performance status.

The contract manager/project manager should also be informed of any contract discrepancies noted during

COR surveillance.

9. DISCREPANCY REPORTING.

The COR will notify the contract manager/project manager of any discrepancies noted during the COR’s inspections. This notification is for discrepancy correction only and does not indicate concurrence to the discrepancy by the contractor. The COR will also notify the CA of all discrepancies noted during the surveillance. The frequency and method of notification to the CA will be provided to the COR during phase two training.

10. NON-SS ITEMS.

Everything that is written into the PWS is required to be provided by the contractor, thus everything in the

PWS is subject to government surveillance.

11. CERTIFICATION OF SERVICES.

The COR will complete a monthly COR Report and coordinate through the COR

MANAGEMENT/SUPERVISOR before providing a copy to the CA for posting in the contract file. In addition, certification of services is performed by COR via Wide Area Work Flow (WAWF) system. At the end of each billing period, service provider inputs invoice information in the WAWF system. WAWF automatically notifies appropriate COR via email of pending invoice. COR accesses WAWF and verifies accuracy of service provider’s data. If data is correct, COR certifies invoice and payment is conducted by

Quality Assurance Surveillance Plan for Ambulance Services 26 Sept 2013

Defense Finance Accounting System (DFAS). If COR encounters errors in service provider’s invoice, COR consults with on site manager to mutually rectify data. If service provider disagrees with COR, issue is forwarded to the CO for resolution.

12. PERFORMANCE METRICS (MOASP).

Performance metrics are to be used to track contractor progress quarterly towards meeting stated performance objectives. The effort in assessing contractor performance validates that the performance metrics align with the performance-based work statement and overall mission support objectives and states any negative variances as applicable. These metrics are consolidated and submitted by the CO annually to the Service Designated Official for review and are drawn upon for annual MOASP reporting. In addition, any SS item failure will be reported by the COR to the CO who will in-turn notify the QAPC for metrics reporting to the Wing Commander.

13. CONTRACTOR RATING (CPARS).

Contractor’s Performance Assessment Rating (CPAR) is applicable to all service contracts valued over

$1,000,000. Guidance on CPARS is available from the Department of the Air Force CPARS Guide and the

10th Contracting Division CPARS representative.

Quality Assurance Surveillance Plan for Ambulance Services 26 Sept 2013

14. MULTI-FUNCTIONAL TEAM SIGNATURES. The following Multi-Functional Team member signatures indicate their review and acceptance of the Quality Assurance Surveillance Plan for Ambulance services. These signatures indicate coordination on this Quality Assurance Surveillance Plan at the time of development. These team members are not the only individuals on the MFT but are the individuals that will have continual interface with this contract. No further Multi-Functional Team coordination is needed unless the intent of the Quality Assurance Surveillance Plan is changed.

SIGNATURES

This Performance assessment plan represents the 10th MDG Squadron’s requirement to provide sufficient and qualified functional resources to oversee the Ambulance Service contract. Properly trained, properly appointed COR will help effectively assess contractually performed mission requirements and report sufficiently on contractor performance.

COR Management/Supervisor Date

This QASP establishes the Contracting Officer’s requirement to provide sufficient contract administration resources in support of the functional area’s contracted mission requirements. The QASP also provides instructions for effectively responding when negative performance indicators are present.

Contracting Officer Date

This QASP meets the responsibilities to establish a performance assessment team for a major service contract and describes how performance is measured, assessed, and managed upon contract award.

Quality Assurance Program Coordinator Date

Additional Team Members Signature:

Contract Specialist: _____________________________________

Contracting Officer Representatives (Primary): _____________________________________

Other: _____________________________________

Other: _____________________________________

Quality Assurance Surveillance Plan for Ambulance Services 26 Sept 2013

Appendix A – SAMPLE CUSTOMER COMPLAINT

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

Quality Assurance Surveillance Plan for Ambulance Services 26 Sept 2013

Customer Complaint Record Template, Feb 05 (SAF/AQCP) Appendix B – SAMPLE 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. CONTRACTING OFFICER REPRESENTATIVE (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

Quality Assurance Surveillance Plan for Ambulance Services 26 Sept 2013

Corrective Action Report (CAR) Template, Feb 05 (SAF/AQCP)

CORRECTIVE ACTION REPORT (CAR)

Continuation Sheet

(Number to correspond with applicable Item Number on reverse)

Corrective Action Report (CAR) Template, Feb 05 (SAF/AQCP)

Quality Assurance Surveillance Plan for Ambulance Services 26 Sept 2013

Corrective Action Report (CAR) Instructions

Block 1. Enter Contractor Name.

Block 2. Enter Contract Number.

Block 3. Enter Contract Name or Type of Services.

Block 4. Enter Functional Area of the Contract.

Block 5. Enter the assigned suspense date given the contractor to provide a response to the CAR. A date must be entered for a

Major CAR. A date is optional at the discretion of the Contracting Officer Representative (COR) initiating the CAR if the finding is

Minor.

Block 6. All CARs will be tracked with a Control Number. The COR Management/Supervisor/functional director is the Issuing Authority for his/her contract Contracting Officer Representatives (CORs) generating CARs. By providing the control number to the COR originating the CAR, the Issuing Authority demonstrates concurrence with the finding. The control number will be made up of the first two letters of the name of the site or contract, the last two digits of the calendar year, and a three digit number starting with 001 and progressing upward throughout the calendar year (e.g., WP04-001).

Block 7.

1. Check the block that indicates whether the identified deficiency is assigned as a Major or Minor finding. See Quality Assurance Surveillance Plan (QASP), paragraph 6.1.4, for the definitions of Major and Minor findings and associated explanations.

2. Finding: Clearly state the details of the finding followed by a reference to the stated contractual requirement. The reference must state the portion of the contract, part, section, paragraph and subparagraph and must make a complete brief quotation of the contract reference.

3. State the impact that the finding has or could have on the accomplishment of the mission that the contract provides.

4. When determining how long to give the contractor to respond to the identified finding, the normal is 10 working days.

The suspense date should reflect this unless the finding requires a greater amount of time to come to solution. Major findings require a contractor response. Minor findings may require a contractor response at the discretion of the COR initiating the CAR and/or the Issuing Authority.

Blocks 8 and 9. Contract CORs initiating a CAR must sign in Block 8 and the Issuing Authority signs in Block 9. Each annotates the date at the time of signature.

Block 10. Upon review of the contractor’s reply, the originator of the CAR will enter comments regarding acceptance or rejection of the contractor’s response. This block may also contain any comments regarding follow-on inspections conducted or needed at a later date to validate that the finding has not reoccurred.

Block 11. The COR selects Accept or Reject after reviewing the contractor’s response.

Block 12. The COR enters a close date after advising the Issuing Authority that the contractor’s response is acceptable and the Issuing Authority concurs. The Issuing Authority will then forward the closed CAR to the contractor and report accordingly in the monthly COR Report or other applicable contracting officer services report. This routing remains the same if the contractor response is unacceptable and the CAR remains open until an acceptable response is received except that the Issuing Authority forwards the open CAR back to the contractor for additional information.

Continuation Sheet. The Continuation Sheet is to be used to expand on any information that will not fit in the applicable numbered block.

Quality Assurance Surveillance Plan for Ambulance Services 26 Sept 2013

Appendix C – SAMPLE PERFORMANCE ASSESSMENT REPORT

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. CONTRACTING OFFICER REPRESENTATIVE (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 SOW 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)

16. CONTRACTOR REPRESENTATIVE REMARKS

Performance Assessment Report (PAR) Template, Feb 05 (SAF/AQCP)

Quality Assurance Surveillance Plan for Ambulance Services 26 Sept 2013

PERFORMANCE ASSESSMENT REPORT

Continuation Sheet

(Number to correspond with applicable Item Number on reverse)

Performance Assessment Report (PAR) Template, Feb 05 (SAF/AQC)

Quality Assurance Surveillance Plan for Ambulance Services 26 Sept 2013

Performance Assessment Report (PAR) Instructions

Block 1. Contracting Officer Representative (COR) enters contract or task order number.

Block 2. COR enters contractor name.

Block 3. COR enters type of services.

Block 4. COR signs and dates.

Block 5. COR enters telephone number.

Block 6. COR assigns suspense date for Contractor Representative validation if a deficiency box was checked in Block 7.

Part I. Contractor Performance

Block 7. COR checks all boxes that apply.

Block 8. COR enters Services Summary or Statement of Work (SOW) paragraph item reviewed.

Block 9. COR enters brief description of deficiency and tracking number if the deficiency box was checked in Block 7.

Detailed description will be on Corrective Action Report (CAR).

Block 10. COR enters a detailed performance assessment if the deficiency box in Block 7 was not checked.

Parts II and III will be used only if a deficiency was documented in Part I.

Part II. Contractor Validation

Block 11. Contractor Representative checks one box in response to COR cited deficiency. If Concurrence is indicated, Contractor Representative continues to Block 12. If Non-Concurrence is indicated, continue to Block 13 and state reason(s) for Non-Concurrence with COR cited deficiency and return PAR to COR.

Block 12. Contractor Representative enters Estimated Completion Date of Corrective Action and continues to Block 13.

Block 13. Contractor Representative details Corrective Action and the Action Taken to Prevent Recurrence or Reason for Non-Concurrence of COR cited deficiency.

Part III. Deficiency Corrected

Block 14. COR checks appropriate block, signs, and dates.

Block 15. (Required Entry) COR remarks regarding the Corrective Action and the Action Taken to

Prevent Recurrence. If Non-Concur was checked, this block should be very detailed to explain why.

Block 16. Contractor Representative enters remarks if further discussion is needed about COR concurrence with Contractor’s

Corrective Action and Action Taken to Prevent Recurrence.

Continuation Sheet. The Continuation Sheet is to be used to expand on any information that will not fit in the applicable numbered block.

Quality Assurance Surveillance Plan for xxxxxxxxx Services

06 Sept 2006

Contract No. FA7000-xx-x-xxxx

Appendix D – SAMPLE COR Report

MEMORANDUM FOR Contracting

FROM: Quality Assurance Evaluator

SUBJECT: Monthly COR Report, FA7000-XX-X-XXXX, Name of Contract

Period Covered: enter the period of time that you performed your Evaluations (1-31

August 99)

Overview of performance: describe your overall perspective of the contractor’s performance.

Tell what the contractor did or failed to do. Let the Contract Specialist (CS) or Contracting

Officer (CO) know if they are acceptable or not acceptable. Describe what you’re doing to resolve unsatisfactory conditions if you stated unacceptable performance.

Discrepancy reports: describe any contract nonconformities (verbal/written), proposed corrective action, any help needed from the CS, Contracting Officer, etc.

Change of Personnel: notify proposed changes of personnel (i.e. COR

MANAGEMENT/SUPERVISOR or CORs on this contract). New CORs will require nomination/appointment letters, Phase I and II training.

Areas of Concern: List any items that you’re having difficulties with, any potential problems, concerns about the evaluation process, etc. Let the QAM know you need assistance. Don’t wait until it’s too late and the auditors/IG visit you.

John Jones

Contracting Officer Representative (COR) cc

COR Management/Supervisor

Contracting Officer