Attachment_D-Problem_Notification_Form.docx
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Attachment D-Problem Notification Form (Draft)
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ATTACHMENT D
PROBLEM NOTIFICATION REPORT FORM
CONTRACT NUMBER:
DATE:
| 1. | Nature and sources of problem: | |
| 2. | COR was verbally notified on: (date) ___________________ | |
| 3. | Is action required by the Government? Yes_____ | No_____ |
| 4. | If YES, describe Government action required and date required: | |
| 5. | Will problem impact delivery schedule? Yes_____ | No_____ |
| 6. | If YES, identify what deliverables will be affected and extent of delay: | |
| 7. | Can required delivery be brought back on schedule? Yes_____ No_____ | |
| 8. | Describe corrective action needed to resolve problems: | |
| 9. | When will corrective action be completed? |
10. Is increase cost to the Government anticipated? Yes_____ No_____ Explain impact:
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