Attachment_5A_Quality_Assurance_Monitoring_Caribbean_v2.0_Aug_2016.pdf

QUALITY ASSURANCE MONITORING FORM

MAINTENANCE LOCATION:

SERVICE or STANDARD:

SURVEY PERIOD:

SURVEILLANCE METHOD (Check One):

Random Sampling Periodic Inspection 100% Inspection Customer Complaint

LEVEL OF SURVEILLANCE (Check One):

Monthly Quarterly Annually As needed

BARCODES SAMPLED:

ANALYSIS OF RESULTS:

Service Provider’s Name:

Meets Standards

(>90%FMC)

Does Not Meet Standards (<90%FMC)

Service Provider’s Performance (Check One):

PREPARED BY (Print): DATE:

PREPARED BY (Sign):

Return to Storage

Service Comments:

Observed Service Provider Performance Measurement Rate (Units FMC/Total Sampled):

Unit Pass and Fail below is based on the 10% inspection, NOT overall for service provided

Units Pass Units Fail Totaled Sampled

RFP:

ATTACHMENT 5A: QUALITY ASSURANCE MONITORING FORM

OCONUS_AUG. 2016

08.22.2016

RFP:

ATTACHMENT 5A: QUALITY ASSURANCE MONITORING FORM

OCONUS_AUG. 2016

08.22.2016