CONTRACT_DISCREPANCY_REPORT.docx
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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
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