Government_Furnished_Property_Discrepancy_Report.doc

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Village Marine Tec Reverse Osmosis Desalination System Support
Solicitation number
HSCG40-13-R-AG169
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Government Furnished Property Discrepancy Report

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GOVERNMENT FURNISHED PROPERTY

DISCREPANCY REPORT

If any items provided as government furnished property under this contract/order fail to conform to the requirements of the contract/order, the contractor shall complete this form and return it to the Contract Administrator within 10 calendar days of receipt of the government furnished property.

The Contractor shall complete and submit this form if the government-furnished material is not received at the contractor’s facility within 14 calendar days after receipt of order.

This form shall be returned via email to the Contract Administrator, Martine.M.Duvall@uscg.mil or via facsimile at (410) 762-6306, Attn: Martine Duvall.

The Contract Administrator shall provide disposition instructions to the Contractor no later than 10 calendar days after receipt of this report.

1. DATE OF PREPARATION:

2. CONTRACT/PURCHASE ORDER NUMBER:

3. TO (Name and address of Contracting Agency)

4. FROM (Name, address, and telephone number)

5. GOVERNMENT-FURNISHED MATERIAL TO BE RECEIVED (Provide the item name, stock number, part number, serial number, quantity, etc., that should have been received under the contract/purchase order) (Continue on separate piece of paper if necessary)

ITEM NAME

STOCK NUMBER
PART NUMBER
SERIAL NUMBER
QUANTITY

6. ACTUAL MATERIAL RECEIVED (Provide the item name, stock number, part number, serial number, quantity, etc., that was actually received) (Continue on separate piece of paper if necessary)

ITEM NAME

STOCK NUMBER
PART NUMBER
SERIAL NUMBER
QUANTITY

Describe deficiencies of material identified above.

7. TYPED OR PRINTED NAME OF SUBMITTER

8. SIGNATURE
9. DATE

NOTE: Contractor shall provide copies of all documentation that accompanied the shipment or that is packaged inside the container.

File details come from the government source that posted it. Updated .