AFOTEC_Form_6 _Corrective_Action_Report.pdf

CORRECTIVE ACTION REPORT (CAR)

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

4. PERFORMANCE WORK STATEMENT (PWS) 5. SUSPENSE DATE 6. CONTROL NUMBER

7. MAJOR MINOR

(Please repond within 30 days, unless otherwise stated in Block 5 above, 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.)

9. QUALITY ASSURANCE PERSONNEL (QAP)

TYPED NAME AND GRADE SIGNATURE AND DATE

TYPED NAME AND GRADE

TYPED NAME AND GRADE

10. ISSUING AUTHORITY

11. CONTRACTING OFFICER

12. QAP RESPONSE TO CONTRACTOR CORRECTIVE ACTION AND ACTION TAKEN TO PREVENT RECURRENCE

SIGNATURE AND DATE

13. CONTRACTOR RESPONSE 14. CLOSE DATE

RELEASABILITY: Access to this form is restricted: this form is FOUO when filled in; requests for accessibility must be approved by the OPR.

SIGNATURE AND DATE

ACCEPTED REJECTED

AFOTEC Form 6, 20080301

FINDING:

FINDING IMPACT:

8. CONTRACTOR'S RESPONSE: