Attachment_21_Corrective_Action_Report_(1)_june_9_2015.docx

CORRECTIVE ACTION REPORT (CAR)

(If more space is needed, use reverse and identify by number)

1. CONTRACTOR

2. CONTRACT NUMBER

3. TYPE OF SERVICES

4. FUNCTIONAL AREA

5. SUSPENSE DATE

6. CONTROL NUMBER

7. DEFICIENCY |_| MAJOR |_| MINOR

FINDING:

FINDING IMPACT:

Please respond with a written corrective action plan that details the corrective action of the cited deficiency, the cause of the deficiency, and actions taken to prevent recurrence by Suspense Date in Block 5. If date was not entered in Block 5, the contractor is not required to provide a response.

8. QUALITY ASSURANCE PERSONNEL (QAP)

TYPED NAME AND GRADE

SIGNATURE AND DATE

9. ISSUING AUTHORITY

TYPED NAME AND GRADE

SIGNATURE AND DATE

10. QAP RESPONSE TO CONTRACTOR CORRECTIVE ACTION AND ACTION TAKEN TO PREVENT RECURRENCE

11. QAP DETERMINATION

|_| ACCEPTED |_| REJECTED

12. CLOSE DATE

Corrective Action Report (CAR) Template, Feb 05 (SAF/AQCP)

CORRECTIVE ACTION REPORT (CAR)

Continuation Sheet (Number to correspond with applicable Item Number on reverse)

Corrective Action Report (CAR) Template, Feb 05 (SAF/AQCP)

Corrective Action Report (CAR) Instructions

Block 1. Enter Contractor Name.

Block 2. Enter Contract Number.

Block 3. Enter Contract Name or Type of Services.

Block 4. Enter Functional Area of the Contract.

Block 5. Enter the assigned suspense date given the contractor to provide a response to the CAR. A date must be entered for a Major CAR. A date is optional at the discretion of the Quality Assurance Personnel (QAP) initiating the CAR if the finding is Minor.

Block 6. All CARs will be tracked with a Control Number. The Contracting Officer Representative (COR) is the Issuing Authority for his/her contract Quality Assurance Evaluators (QAPs) generating CARs. By providing the control number to the QAP originating the CAR, the Issuing Authority demonstrates concurrence with the finding. The control number will be made up of the first two letters of the name of the site or contract, the last two digits of the calendar year, and a three digit number starting with 001 and progressing upward throughout the calendar year (e.g., WP04-001).

Block 7.

1. Check the block that indicates whether the identified deficiency is assigned as a Major or Minor finding. See Performance Plan (PP), paragraph 6.1.4, for the definitions of Major and Minor findings and associated explanations.

2. Finding: Clearly state the details of the finding followed by a reference to the stated contractual requirement. The reference must state the portion of the contract, part, section, paragraph and subparagraph and must make a complete brief quotation of the contract reference.

3. State the impact that the finding has or could have on the accomplishment of the mission that the contract provides.

4. When determining how long to give the contractor to respond to the identified finding, the normal is 10 working days. The suspense date should reflect this unless the finding requires a greater amount of time to come to solution. Major findings require a contractor response. Minor findings may require a contractor response at the discretion of the QAP initiating the CAR and/or the Issuing Authority.

Blocks 8 and 9. Contract QAPs initiating a CAR must sign in Block 8 and the Issuing Authority signs in Block 9. Each annotates the date at the time of signature.

Block 10. Upon review of the contractor’s reply, the originator of the CAR will enter comments regarding acceptance or rejection of the contractor’s response. This block may also contain any comments regarding follow-on inspections conducted or needed at a later date to validate that the finding has not reoccurred.

Block 11. The QAP selects Accept or Reject after reviewing the contractor’s response.

Block 12. The QAP enters a close date after advising the Issuing Authority that the contractor’s response is acceptable and the Issuing Authority concurs. The Issuing Authority will then forward the closed CAR to the contractor and report accordingly in the monthly report. This routing remains the same if the contractor response is unacceptable and the CAR remains open until an acceptable response is received except that the Issuing Authority forwards the open CAR back to the contractor for additional information.

Continuation Sheet. The Continuation Sheet is to be used to expand on any information that will not fit in the applicable numbered block.