SOW - Doc A9 - Contractor QC Report.pdf
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- N4425526P7000
About this file
This document is a Contractor Quality Control Report template designed for tracking and documenting work performance, quality assurance, and compliance during a contract's execution. The form includes sections for preparatory, initial, and follow-up phases of work, with checkboxes and fields to record details such as whether specific work phases were performed, compliance with contract specifications, safety requirements (EM385-1-1), and any rework items identified.
The template provides space for the contractor's authorized Quality Control (QC) Manager to certify the report's accuracy, documenting equipment, materials, and work performed during the reporting period. It also includes a section for Government Quality Assurance Representatives to add remarks or exceptions, allowing for comprehensive documentation and oversight of contract work. The form is structured to capture detailed information about work activities, testing, personnel, and any issues that may arise during the contract's execution.
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CONTRACTOR QUALITY CONTROL REPORT
(ATTACH ADDITIONAL SHEETS IF NECESSARY)
DATE
REPORT NO
PHASE CONTRACT NO CONTRACT TITLE
4296/2C (9/98)
WAS PREPARATORY PHASE WORK PREFORMED TODAY?
IF YES, FILL OUT AND ATTACH SUPPLEMENTAL PREPARATORY PHASE CHECKLIST.
PREPARATORY NOYES
Schedule Activity No Definable Feature of Work (DFOW) Index #
WAS INITIAL PHASE WORK PREFORMED TODAY?
IF YES, FILL OUT AND ATTACH SUPPLEMENTAL INITIAL PHASE CHECKLIST.
INITIAL YES NO
Schedule Activity No Definable Feature of Work (DFOW) Index #
WORK COMPLIES WITH CONTRACT AS APPROVED DURING INITIAL PHASE?
WORK COMPLIES WITH SAFETY REQUIREMENTS AND INSPECTION COMPLIES WITH EM385-1-1?
FOLLOW-UP NOYES
YES NO
Schedule Activity No
Description of Work, Testing Performed & By Whom, Definable Feature of Work, Specification Section, Location and List of Personnel Present
REWORK ITEMS IDENTIFIED TODAY (NOT CORRECTED BY CLOSE OF BUSINESS) REWORK ITEMS CORRECTED TODAY (FROM REWORK ITEMS LIST)
Schedule Activity No Description Schedule
Activity No Description
REMARKS (Also Explain Any Follow-Up Phase checklist Item From Above That Was Answered "NO"; Work Deficiency, Safety Deficiency.) Manuf. Rep On-Site, etc.
Schedule Activity No Description
On behalf of the contractor, I certify that this report is complete and correct and equipment and material used and work performed during this reporting period is in compliance with the contract drawings and specifications to the best of my knowledge except as noted in this report. AUTHORIZED QC MANAGER AT SITE DATE
GOVERNMENT QUALITY ASSURANCE REPORT DATE
QUALITY ASSURANCE REPRESENTATIVE'S REMARKS AND/OR EXCEPTIONS TO THE REPORT: FOR GOVERNMENT USE ONLY.
Schedule Activity No Description
DATEGOVERNMENT QUALITY ASSURANCE MANAGER
CONTRACTOR QUALITY CONTROL REPORT
(ATTACH ADDITIONAL SHEETS IF NECESSARY)
DATE
REPORT NO
PHASE
CONTRACT NO
CONTRACT TITLE
4296/2C (9/98)
WAS PREPARATORY PHASE WORK PREFORMED TODAY?
IF YES, FILL OUT AND ATTACH SUPPLEMENTAL PREPARATORY PHASE CHECKLIST.
PREPARATORY
Schedule Activity No Critical Path Schedule Activity Number that pertains to the Definable Feature of Work that Preparatory Phase work was performed today; use one number per line.
Definable Feature of Work (DFOW) The Definable Feature of Work for which Preparatory Phase work was performed today.
Index #
WAS INITIAL PHASE WORK PREFORMED TODAY?
IF YES, FILL OUT AND ATTACH SUPPLEMENTAL INITIAL PHASE CHECKLIST.
INITIAL
Schedule Activity No Critical Path Schedule Activity Number that pertains to the Definable Feature of Work that Initial Phase work was performed today; use one number per line.
Definable Feature of Work (DFOW) The Definable Feature of Work for which Initial Phase work was performed today.
Index #
WORK COMPLIES WITH CONTRACT AS APPROVED DURING INITIAL PHASE?
WORK COMPLIES WITH SAFETY REQUIREMENTS AND INSPECTION COMPLIES WITH EM385-1-1?
FOLLOW-UP
Schedule Activity No Critical Path Schedule Activity Number that pertains the the Definable Feature of Work that Follow-up was performed today; use one number per line.
Description of Work, Testing Performed & By Whom, Definable Feature of Work, Specification Section, Location and List of Personnel Present The Definable Feature of Work and all other general facts that are associated with Follow Up oversight which was provided.
REWORK ITEMS IDENTIFIED TODAY (NOT CORRECTED BY CLOSE OF BUSINESS)
REWORK ITEMS CORRECTED TODAY (FROM REWORK ITEMS LIST)
Schedule Activity No Critical Path Schedule Activity Number that pertains to the Rework Item identified today; use one number per line.
Description Description of the Rework Item identified today.
Schedule Activity No Critical Path Schedule Activity Number that pertains to the Rework Item corrected today; use one number per line.
Description Description of the Rework Item corrected today.
REMARKS (Also Explain Any Follow-Up Phase checklist Item From Above That Was Answered "NO"; Work Deficiency, Safety Deficiency.) Manuf. Rep On-Site, etc.
Schedule Activity No Critical Path Schedule Activity Number that pertains to the Remarks; use one number per line.
Description Provide any pertinent information regarding discussions, direction provided, QC problem areas, deviations from QC Plan, construction deficiencies encountered, QC meetings held, as-built drawing updated, and any Follow-up Phase item from above that was answered NO.
On behalf of the contractor, I certify that this report is complete and correct and equipment and material used and work performed during this reporting period is in compliance with the contract drawings and specifications to the best of my knowledge except as noted in this report.
AUTHORIZED QC MANAGER AT SITE
DATE
GOVERNMENT QUALITY ASSURANCE REPORT
DATE
QUALITY ASSURANCE REPRESENTATIVE'S REMARKS AND/OR EXCEPTIONS TO THE REPORT: FOR GOVERNMENT USE ONLY.
Schedule Activity No Critical Path Method (CPM) Schedule Activity Number that pertains to the QA Remarks and/or exceptions; use one number per line.
Description FEAD/ROICC remarks and/or exceptions to the contents of this report.
DATE
GOVERNMENT QUALITY ASSURANCE MANAGER
8.0.1291.1.339988.308172
| This is the date work was accomplished for this report; typically today's date.: |
| Shall be sequential to previous report.: |
| Construction Contract Number and Task Order (TO) Number, if any.: |
| Use Contract Title and Location.: |
| Button3: |
| Button4: |
| : |
| FEAD/ROICC remarks and/or exceptions to the contents of this report.: |
| DateTimeField1: |
| SignatureField1: |
| DateTimeField3: |
| SignatureField2: |
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