Contract_Discrepancy_Report.pdf

EVALUATION OF CONTRACTOR PERFORMANCE

To: Contracting Officers Representative

Date:

Contact: Contractor: XYZ

Task: Survey Period: 1st Quarter FY XX

Method of Surveillance: Task Originator review.

Evaluation of Contractor Performance: Performance Assessment Rating

Timeliness and Quality of Work

Control Of Government Furnished Property

Deliverables

Funds Status Report

Narrative Discussion Of Contractor Performance During Survey Period:

Recommendations:

Prepared By:

Note(s):

1. Evaluation follows PAP Table 1. Performance Rating Criteria.

2. See PAP Section 4.0

CONTRACT DISCREPANCY REPORT

DATE AND TIME:

CONTRACT NUMBER:

CONTRACTOR:

SITE:

DESCRIPTION OF DISCREPANCY: (reference SOW/Directive)

DATE(S) OF VERBAL NOTIFICATION:

ORIGINATOR’S SIGNATURE:

ABOVE PORTION OF FORM IS TO BE FILLED OUT BY COR OR ACOR

CONTRACTOR’S RESPONSE AS TO CAUSE, CORRECTIVE ACTION, AND ACTION(S) TO

PREVENT RECURRENCE. CITE APPLICABLE QA PROGRAM PROCEDURES OR NEW QA

PROCEDURES:

SIGNATURE OF CONTRACTOR REPRESENTATIVE:

DATE:

ABOVE PORTION TO BE FILLED OUT BY CONTRACTOR

GOVERNMENT EVALUATION (ACCEPTANCE, PARTIAL ACCEPTANCE, REJECTION):

CLOSE OUT (TO BE FILLED OUT WHEN DISCREPANCY HAS BEEN SATISFACTORILY SOLVED):

FUNCTION NAME/TITLE SIGNATURE DATE

ORIGINATOR

CONTRACTOR

APPENDIX A