Form_6.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.)

8. CONTRACTING OFFICER'S REPRESENTATIVE

TYPED NAME AND GRADE SIGNATURE AND DATE

TYPED NAME AND GRADE

9. CONTRACTING OFFICER

11. COR RESPONSE TO CONTRACTOR CORRECTIVE ACTION AND ACTION TAKEN TO PREVENT RECURRENCE

SIGNATURE AND DATE

12. CONTRACTOR RESPONSE 13. COR SIGNATURE AND DATE

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

ACCEPTED REJECTED

AFOTEC Form 6

FINDING:

FINDING IMPACT:

10. CONTRACTOR'S RESPONSE:

TYPED NAME AND GRADE

14. CONTRACTING OFFICER

SIGNATURE AND DATE