SOL_17QAA8516_ATT_3__CONTRACT_DISCREPANCY_REPORT.pdf

RFQ HSCG84-17-Q-AA8516 PAGE 1 OF 3

GROUNDS MAINTENANCE SERVICES ATTACHMENT 3

USCG SFO GALVESTON, TX

CONTRACT DISCREPANCY REPORT

1. Contract Number 2. Report Serial No. 3. Report # this Discrepancy

4. To: (Contractor and Managers Name) 5. From: (Name of QAE)

DATES

6. Prepared Oral Notification

Returned by Contractor Action Complete

7. Discrepancy or Problem (Describe in detail: include reference to PMS/Directive: attach continuation sheet if needed.

8. Signature of Contracting Officer

9. To: (Contracting Officer) From: (Contractor)

10. Contractor response as to cause, corrective action and actions to prevent recurrence. Attach continuation sheet if needed (Cite applicable QC program procedures(s) or new QC procedures(s).)

11. Signature of Contractor Representative

Date

12. Government Evaluation (Acceptance, rejection: Attach continuation sheet if needed)

13. Government Action (Payment deductions, cure notice, show cause, other)

14. Final Disposition

CLOSE OUT

Name – Title

Signature

Date

Contractor Notified

QAE

Contracting Officer

RFQ HSCG84-17-Q-AA8516 PAGE 2 OF 3

USCG SFO GALVESTON, TX

PERFORMANCE EVALUATION MEETING RECORD

1. Date of Meeting:_______________________________

2. Persons in Attendance (Representing)

1)_______________________________________ 2)________________________________________

3)_______________________________________ 4)________________________________________

5)_______________________________________ 6)________________________________________

3. Contract Discrepancy Reports Discussed (List):

4. Other Discrepancies, Problems or Topics Discussed (Describe in detail. Attach continuation sheet if needed)

5. Contractor Actions Required. (Attach continuation sheet if needed)

6. Government Actions Required. (Attach continuation sheet if needed)

7. Signature of Contractor’s Project Manager Date

8. Signature of Government Representative Date (Contracting Officer, COTR, or QAE)

RFQ HSCG84-17-Q-AA8516 PAGE 3 OF 3

USCG SFO GALVESTON, TX

Procedures for Completing the Contract Discrepancy Report (CDR)

1. Contract Number. (Your contract Number)

2. Report Serial Number. Each Contract Discrepancy Report for a particular contract shall be numbered sequentially beginning with the last three digits of your contract number followed by a "-" then 001. Example 029-001

3. Report # this Discrepancy. If this is a reoccurring discrepancy, this is completed by COTR as 1st, 2nd, 3rd, etc.

4. To: (Contractor or Managers Name). Self explanatory.

5. From: (Name of QAE) Contracting Officer's Technical Representative's COTR name or person completing the form.

6. Prepared: The date completed by the COTR.

Oral Notification: The date an oral notification was given.

Returned by Contractor: Date contractor returned form Action Complete: Date Action Complete

7. Discrepancy of Problem: A brief but detailed explanation of the discrepancy bring reported, including references to the section of the Solicitation that is affected. Completed by the COTR.

8. Signature of the Contracting Officer: After COTR completes all required fields, the form is forwarded the MLC-fcp-1 for approval.

9. To: (Contracting Officer) Completed by the Contractor after review of the discrepancy when forwarding back.

From: (Contractor) Name of authorized Contractor Representative

10. Contractor response as to cause, corrective action and actions to prevent recurrence.

A brief but detailed explanation of the Contractor's position including suggested remedies.

Attach a continuation sheet if necessary.

11. Signature of Contractor Representative & Date: Signature of an authorized Contractor representative certifying the Contractor's position with regard to the CDR.

12. Government Evaluation: Comments on the Government's evaluation of the Contractor's recommended course of action. Attach a continuation sheet if necessary.

13. Government Action: Corrective action(s) directed by the government.

14. Final Disposition: To be completed by the Government.

15. Close out: To be completed by the Government.