Exhibit C - CDRL A003 Quality Deficiency Report.pdf

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Attached to
Overhaul of the Joystick, Data Entry
Solicitation number
W58RGZ-20-R-0079
Issued by

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CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

06/26/2019Page 1 of 2

5895-01-6168227

JOYSTICK, DATA ENTRY

D. SYSTEM / ITEM

A003

1. DATA ITEM NO.

GOINS, VIOLA

G. PREPARED BY

06/10/2019

H. DATE

MCREE, DAVID L.

I. APPROVED BY

06/12/2019

J. DATE

WOOD, MARY SHANNA

LOG #

CONCUR:

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY

DATE: 06/12/2019

4. AUTHORITY (DATA ACQUISITION DOC NO) 5. CONTRACT REFERENCE

2. TITLE OF DATA ITEM

6. REQUIRING OFFICE

3. SUBTITLE

F. CONTRACTORE. CONTRACTOR / PR NO.

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

14. DISTRIBUTION

8. APP CODE

b. COPIES

DRAFT FINAL

REG REPRO

a. ADDRESSEE 11. AS OF DATE 13. DATE OF SUBEQUENT

SUBMISSION

15. TOTAL

17. PRICE GROUP 18. ESTIMATED TOTAL PRICE

AMSAM-MSC-CLP

NSN:

PRID: PART NUMBER:FB751-1 26277-201 STATUS: R

AMSRD-AMR-SE-TD

Quality Deficiency Report

DI-QCIC-80736 SOW, PARA S RDMR-SEQ

LT

N/A

D SEE BLK 16

JUNE 3, 2019

SEE BLK 16

SEE BLK 16

0 1 0

0 1 0

16. REMARKS:

BLOCKS 10, 12, AND 13: No report is necessary unless there is a discrepancy.

Contractor shall submit NLT 10 days after discovery of deficiency.

The Contractor shall coordinate quality deficiency with the Cognizant Government Representative.

Block 9: DISTRIBUTION STATEMENT D. Distribution is authorized to Department of Defense and U.S. DoD contractors only for Administrative or Operational use as of June 3, 2019. Other requests for this document shall be referred to RDMR-SEQ.

Export Control Act Warning-Not Required.

POC: PHONE:

06/26/2019Page 2 of 2

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