A2_QASP.pdf

SOF TEAMS III QASP

W900KK-18-R-0033

9 February 2018, Ver. 1.0

QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)

FOR

160th Special Operations Aviation Regiment (Airborne) [SOAR(A)]

Special Operations Forces Training, Engineering and Maintenance

Support (SOF TEAMS) III

9 February 2018

Version 1.0

Prepared by

U.S. Army PEO Simulation, Training and Instrumentation

(PEO STRI)

12211 Science Drive

Orlando, FL 32826-3276

REVISION HISTORY

DATE VER PARAGRAPHS DESCRIPTION

02/09/2018 1.0 STIII RFP Release i

Table of Contents

1. PURPOSE

2. AUTHORITY

3. SCOPE

4. GOVERNMENT RESOURCES

5. RESPONSIBILITIES

6. METHODS OF QA SURVEILLANCE

7. PERFORMANCE REPORTING

8. DOCUMENTATION

9. ACRONYM LIST

10. ATTACHMENT A – SURVEILLANCE RECORD

11. ATTACHMENT B – SURVEILLANCE ACTIVITY CHECKLIST

12. ATTACHMENT C – ACCEPTABLE QUALITY LEVEL (AQL) RATINGS

13. ATTACHMENT D – OVERALL RATINGS GUIDELINES

14. ATTACHMENT E – FORMS

1. PURPOSE

This Quality Assurance Surveillance Plan (QASP) is a Government developed and applied document used to make sure that systematic quality assurance methods are used in the administration of the Performance

Based Service Contract (PBSC) standards included in this contract and in subsequent task orders issued thereunder. The intent is to ensure that the Contractor performs in accordance with performance metrics set forth in the contract documents, that the Government receives the quality of services called for in the contract and that the Government only pays for the acceptable level of services received. This QASP is intended to be a “living document” that will be revised or modified as circumstances warrant throughout the life of the contract.

2. AUTHORITY

Authority for issuance of this QASP is provided under Contract Section E – Inspection and Acceptance, which provides for inspections and acceptance of the articles, services, and documentation called for in task orders to be accomplished by the Contracting Officer or duly authorized representative.

3. SCOPE

To fully understand the roles and the responsibilities of the parties, it is important to first define the distinction in terminology between the Quality Control Plan and the Quality Assurance Surveillance Plan.

The Contractor, and not the Government, is responsible for management and quality control actions necessary to meet the quality standards set forth by the contract and follow-on task orders. The Contractor manages his Quality Assurance Plan (QAP) for compliance with contract deliverables and then uses the

QAP to guide and to rigorously document the implementation of the required management and quality control actions to achieve the specified results. The QASP on the other hand, is put in place to provide

Government surveillance oversight of the Contractor’s quality control efforts to assure that they are timely, effective and are delivering the results specified in the contract or task order. The QASP is not intended to duplicate the Contractor’s QAP.

4. GOVERNMENT RESOURCES

The following definitions for Government resources are applicable to this plan:

Contracting Officer - A person duly appointed with the authority to enter into, administer, or terminate contracts and make related determinations and findings on behalf of the Government.

Contracting Officer’s Representative (COR) - An individual appointed by the Contracting Officer to act as his authorized representative for the technical administration of specific task order(s) issued under the contract. The duties and limitations of the COR are contained in a written letter of designation and/or in the body of the issued task order.

5. RESPONSIBILITIES

The Government resources shall have responsibilities for the implementation of this QASP as follows:

Contracting Officer – The Contracting Officer ensures performance of all necessary actions for effective contracting, ensures compliance with the terms of the contract and safeguards the interests of the United

States in the contractual relationship. It is the Contracting Officer that assures the Contractor receives impartial, fair, and equitable treatment under the contract. The Contracting Officer is ultimately responsible for the final determination of the adequacy of the Contractor’s performance.

Contracting Officer’s Representative (COR) – The COR provides detailed technical oversight of the

Contractor’s performance and reports findings to the Contracting Officer in a timely, complete and impartial fashion to support the Contracting Officer’s technical administration activities. While the COR may serve as a direct conduit to provide Government guidance and feedback to the Contractor on technical matters, he or she is not empowered to make any contractual commitments or to authorize any contractual changes

9 February 2018, Ver. 1.0 on the Government’s behalf. Any changes that the Contractor deems may affect contract, price, terms, or conditions shall be referred to the Contracting Officer for action.

6. METHODS OF QA SURVEILLANCE

The below listed methods of surveillance shall be used in the administration of this QASP. In addition to specific instructions that may be mentioned, the appropriate and standardized form that is to be used for documentation of QA surveillance is the Surveillance Activity Checklist (see ATTACHMENT B –

SURVEILLANCE ACTIVITY CHECKLIST).

Customer Feedback – Customer feedback may be obtained either from the results of formal customer satisfaction surveys or from random customer complaints. Customer complaints, to be considered valid, must set forth clearly and in writing the detailed nature of the complaint, must be signed and must be forwarded to the COR. The COR shall maintain a summary log of all formally received customer complaints as well as a copy of each complaint in a documentation file. The COR shall also keep the tabulated results of all customer satisfaction surveys on file and shall enter the summary results into the

Surveillance Activity Checklist and provide this to the Contracting Officer.

100% Inspection - This level of inspection shall be accomplished by monitoring and documentation.

Each month, the Contracting Officer, or if so designated, the appropriate COR, shall review the generated documentation and enter summary results into the Surveillance Activity Checklist.

Periodic Inspection - Periodic inspections shall be conducted if and when specified in individual task orders. For the potential tasks that have been identified so far and included in this QASP, the appropriate

COR typically performs the periodic inspection on a monthly basis.

Random Monitoring - Random monitoring shall be conducted if and when deemed necessary by the

Contracting Officer or COR. The random monitoring shall be performed by the Contracting Officer or by the appropriate designated COR.

7. PERFORMANCE REPORTING

Remedies for Non-Conformance

If inspections indicate unacceptable performance, the COR will notify the CO of the deficiencies for correction. If deficiencies are not corrected within the required time frame, the COR should notify the CO for action. If the contractor disagrees with the noted discrepancy and an agreement cannot be reached, the

CO shall be notified for a final decision

Customer Complaint Form

The COR must furnish instructions to the customer receiving the contractor’s service. The customer must retain supporting evidence of complaint or feedback. After the COR validates feedback or complaint demonstrating contractor noncompliance, the COR processes a Performance Assessment Report (PAR) or

Corrective Action Report (CAR) to the CO. ALL Customer Complaint forms WILL be validated by the

COR prior to notifying the contractor.

Corrective Action Request (CAR)

The COR will forward the CAR to the CO for action. A copy will be provided to the contractor’s representative by the CO. Contractors will be given two business days to respond and ten business days to complete or propose corrective action(s) with an actual or estimated completion date. Most CARs will be corrected within 30 calendar days depending on the complexity of the finding, the contractor may be allowed up to six months (maximum) correcting a CAR. The contractor will be asked the status of the CAR on a monthly basis. The COR will keep an electronic log of all CARs and will keep a hard copy of CARs in the COR file.

Contract Performance Assessment Reporting System (CPARS)

9 February 2018, Ver. 1.0

CPARS will be initiated annually, documenting contractor performance for this specific contract. More frequent updates may be made as required to document a significant improvement or degradation of the level of contract performance.

Disputes

Every attempt will be made to resolve all disputes arising under this contact/plan using the Alternate Dispute

Resolution (ADR) as outlined in FAR 33.214. If no resolution can be made under ADR, the CO will render a Contracting Officer’s final decision.

8. DOCUMENTATION

The COR will, in addition to providing documentation to the Contracting Officer, maintain a complete

Quality Assurance file. The file will contain copies of all reports, evaluations, recommendations, and any actions related to the Government’s performance of the quality assurance function, including the originals of the Surveillance Record (see ATTACHMENT A – SURVEILLANCE RECORD) and all Surveillance

Activity Checklists (see ATTACHMENT B – SURVEILLANCE ACTIVITY CHECKLIST). All such records will be retained for the life of this contract. The COR will forward these records to the Contracting

Officer at termination or completion of the contract.

9. ACRONYM LIST

ADR Alternate Disputes Resolution

AQL Acceptable Quality Level

CAR Corrective Action Request

CDRL Contract Data Requirements List

CET Contractual Engineering Task

CO Contracting Officer

COR Contracting Officer’s Representative

CPARS Contractor Performance Assessment Reporting System

FAR Federal Acquisition Regulation

IAW In Accordance With

PAR Performance Assessment Report

PC Production Control

PEO STRI Program Executive Office for Simulation, Training and Instrumentation

PM STS Product Manager SOF Training Systems

PM Program Manager

POC Point of Contact

QA Quality Assurance

QAP Quality Assurance Plan

QAR Quality Assurance Representative

QASP Quality Assurance Surveillance Plan

QASP Quality Assurance Surveillance Plan

QC/QA Quality Control/Quality Assurance

TADSS Training Aids, Devices, Simulators, and Simulations

TEAM TADSS Engineering And Maintenance

STIII SOF TEAMS III

SS Services Summary

9 February 2018, Ver. 1.0

10. ATTACHMENT A – SURVEILLANCE RECORD

Time/Date of

Inspection

Inspected

Item Inspector Findings

9 February 2018, Ver. 1.0

11. ATTACHMENT B – SURVEILLANCE ACTIVITY CHECKLIST

1. CONTRACTOR: TBD

2. COR/Site Manager: TBD/TBD

3. PERIOD OF PERFORMANCE: April 2019

4. CONTRACT NO / SERVICE: W900KK-18-R-0033

5. CONTRACT DESCRIPTION: TRAINING, ENGINEERING, AND MAINTENANCE SUPPORT

If an Element does not apply, an N/A rating will be given and the standard is not factored into the evaluation.

Element #

PWS Para.

Title

Acceptable Quality Level (AQL)

Assigned

Rating Surveillance Method

Unsatisfactory Marginal Satisfactory Very Good Exceptional

1) Overall

Rating

Products or services are unacceptable. They do not meet PWS requirements.

Product or service requires correction with significant

Government involvement.

Meets PWS requirements after Government intervention and guidance.

Product or service meets all

PWS requirements. There are only minor corrective actions required and minimal Government intervention.

Product or service exceeds all PWS requirements.

There are only minor corrective actions required and are resolved with no

Government intervention.

Product or service exceeds all PWS requirements.

Highly effective corrective actions. Improved performance and quality.

Monitor issues thru TEAM meetings, Management

Information Systems, Customer feedback and via the monthly CDRLs.

Narrative:

2) 3.1.2

Financial

Management

Invoices/vouchers are submitted with more than two errors on invoice/vouchers submitted

Invoices/vouchers are submitted with no more than one error on invoice/vouchers submitted

Invoices/vouchers are submitted with no errors on all invoice/vouchers submitted

N/A N/A COR monthly review of invoices/vouchers posted on

WAWF and STIII portal.

MONTHLY

Narrative:

3) 3.1.3.4

Program

Communications

Not responsive (within one business day, more than 3 times in one month) to

Government requests

(written or verbal communications, and data calls).

Not responsive (within one business day, no more than

3 times per month) to

Government requests

(written or verbal communications, and data calls).

Responds to Government requests within one business day.

Responds to Government requests within one business day with no oversight.

Anticipates, identifies and recommends changes in technical and contractual matters.

Responds to and exceeds

Government requests within one business day with no oversight. Anticipates, identifies and recommends changes in technical and contractual matters.

Surveillance during meetings;

routine correspondence with the PM office.

Narrative:

9 February 2018, Ver. 1.0

Element #

PWS Para.

Title

Acceptable Quality Level (AQL) Assigned

Rating Surveillance Method

Unsatisfactory Marginal Satisfactory Very Good Exceptional

4) 3.2.1.2

Reporting

CDRLs do not meet requirements. Requires correction with significant

Government involvement.

CDRLs do not meet all requirements. There are corrective actions required and moderate Government intervention/guidance and required

All CDRLs meet all requirements. There are only minor corrective actions required and minimal Government intervention.

CDRLs meet delivery schedule. Some early deliveries to the

Government's benefit.

All CDRLs meet all requirements with one or more CDRLs exceeding requirements to the

Government’s benefit.

Surveillance of Contractor’s

CDRLs. MONTHLY/AS

REQUIRED

Narrative:

5) 3.3.1.2

Software

Maintenance

Loss of TADSS availability due to lack of current

TADSS software backup.

Loss of TADSS subsystem availability/currency due to lack of current software backup.

If applicable, executes software backup/restore processes NLT 15 days after start of government usage of newly fielded TADSS

AND/OR

Backup of fielded TADSS performed weekly if software changed

If applicable, executes software backup/restore processes NLT 7 days after start of government usage of newly fielded TADSS

AND

performed weekly if software changed

If applicable, executes software backup/restore processes prior to government usage of newly fielded

TADSS

performed weekly if software changed

Monthly Backup report reviews.

Narrative:

6) 3.5.1

Contractor

Performance

Factor

(CPF)

Two or more

CMS CPF < 95%

One CMS CPF < 95%

CPF Average (CPFA) of all

CMS devices in training

95% ≤ AOA ≤ 97%

no CMS CPF < 95%

97% < CPFA < 99%

no CMS CPF < 97%

99% ≤ CPFA

no CMS CPF < 98%

Surveillance via the CDRLs, Utilization Report and ULLS-

A.

Narrative:

7) 3.5.2

Engineering

Support

CPF

(ESCPF)

Two or more

CMS ESCPF < 90%

One CMS ESCPF < 90%

ESCPF Average (ESCPFA) of all CMS devices

90% ≤ ESCPFA ≤ 92%

no CMS CPF < 90%

ESCPFA of all CMS devices

92% < ESCPFA < 94%

ESCPFA of CMS devices

94% ≤ ESCPFA

Surveillance via the CDRLs, Utilization Report and ULLS-

A.

Narrative:

8) 3.3

Scheduled

Maintenance

One or more PMIs not completed or completed more than 4 days later than

“Upgrade to Red X” date

No more than one PMI completed less than 4 days beyond “Upgrade to Red X” date

All PMIs completed NLT

“Upgrade to Red X” date

At least 80% of PMIs finished by due date

All PMIs finished by due date

Surveillance via CDRLs, ULLS-A and other MIS tools.

MONTHLY

9) 3.1.3.4.1 TRR < 50% 50% < TRR < 70% 70% < TRR < 80% 80% < TRR < 95% TRR > 95% CMS TRR%

9 February 2018, Ver. 1.0

Element #

PWS Para.

Title

Acceptable Quality Level (AQL) Assigned

Rating Surveillance Method

Unsatisfactory Marginal Satisfactory Very Good Exceptional

TADSS

Reliability Rate by

MRR1 No interruptions and no discrepancies during training period. RF = 1.0

LASAR =

Surveillance via CDRLs, ULLS-A and other MIS tools.

MONTHLY

By

CMS and UMS MRR2 No interruptions and only minor discrepancies during training period. RF = .95

MH47-1 =

MRR3 No interruptions, some discrepancies during training period. RF = .80

MH47-2 =

MRR4

One major system inoperative with other systems partially degraded or a general degradation exists throughout device or trainer.

Period interrupted once due to system problems during the same training period.

RF = .50

MH60-1 =

MRR5 More than one major system inoperative or trainer period interrupted twice or more during the same training period. RF = .25

MH60-2 =

MRR6 Device not available for Scheduled Training Time due to CDT. RF = 0 UMS =

Notes: Chargeable Down Time (CDT), Non Chargeable Down Time (NCDT) and device modifications will be factored in when analyzing reliability rating.

TRR% = (C / STT ) X 100

Key:

C = ∑ ((𝐻𝑜𝑢𝑟𝑠𝑀𝑅𝑅)(𝑅𝑒𝑙𝑖𝑎𝑏𝑖𝑙𝑖𝑡𝑦𝐹𝑎𝑐𝑡𝑜𝑟𝑀𝑅𝑅))

𝑀𝑅𝑅=1

Sum of number of hours completed at each MRR level multiplied by RF for that MRR level. (2.25 hours per training period)

MRR = Mission Reliability Rating (1-6) are the hours of STT completed at the MRR 1-6 respectively.

RF = Reliability Factor adjustment for the hours of STT completed.

STT = Scheduled Training Time in hours

TRR = TADSS Reliability Rate

MAJOR SYSTEM = Audio, CAAS, Cockpit air conditioning, Cockpit displays, COMM/NAV/RADAR, Flight controls, IOS, I/O, Motion, Visual, Use this area to address any additional narrative, concerns, or items of note:

9 February 2018, Ver. 1.0

12. ATTACHMENT C – ACCEPTABLE QUALITY LEVEL (AQL) RATINGS

FAR Subpart 42.1503, Table 42-1, Evaluation Rating Definitions

Exceptional Performance meets contractual requirements and exceeds many to the Government’s benefit.

The contractual performance of the element or sub-element being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

To justify an Exceptional rating, identify multiple significant events and state how they were of benefit to the Government. A singular benefit, however, could be of such magnitude that it alone constitutes an

Exceptional rating. Also, there should have been NO significant weaknesses identified.

Very Good Performance meets contractual requirements and exceeds some to the Government’s benefit.

The contractual performance of the element or sub-element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

To justify a Very Good rating, identify a significant event and state how it was a benefit to the Government. There should have been no significant weaknesses identified.

Satisfactory Performance meets contractual requirements.

The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

To justify a Satisfactory rating, there should have been only minor problems, or major problems the contractor recovered from without impact to the contract/order. There should have been NO significant weaknesses identified. A fundamental principle of assigning ratings is that contractors will not be evaluated with a rating lower than Satisfactory solely for not performing beyond the requirements of the contract/order.

Marginal Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

To justify Marginal performance, identify a significant event in each category that the contractor had trouble overcoming and state how it impacted the Government. A

Marginal rating should be supported by referencing the management tool that notified the contractor of the contractual deficiency (e.g., management, quality, safety, or environmental deficiency report or letter).

Unsatisfactory Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

To justify an Unsatisfactory rating, identify multiple significant events in each category that the contractor had trouble overcoming and state how it impacted the Government.

A singular problem, however, could be of such serious magnitude that it alone constitutes an unsatisfactory rating. An

Unsatisfactory rating should be supported by referencing the management tools used to notify the contractor of the contractual deficiencies (e.g., management, quality, safety, or environmental deficiency reports, or letters).

9 February 2018, Ver. 1.0

13. ATTACHMENT D – OVERALL RATINGS GUIDELINES

Provided for information only; Overall Rating will be calculated based on QASP input and determined based on guidance below.

Exceptional - to receive an "overall" rating of Exceptional, must receive Exceptional in both CPF and

Scheduled Maintenance and Very Good ratings in at least two of the remaining elements without receiving lower than a satisfactory rating in any element.

Very Good - to receive an "overall" rating of Very Good, must receive Very Good in both CPF and

Scheduled Maintenance and no lower than a Satisfactory rating in any other element.

Satisfactory - to receive an "overall" rating of Satisfactory must receive Satisfactory or higher in CPF and Scheduled Maintenance and no more than two marginal ratings and no unsatisfactory ratings.

Marginal - to receive an "overall" rating of Marginal, must receive Marginal or higher in CPF and

Scheduled Maintenance and no more than two Unsatisfactory ratings.

Unsatisfactory - to receive an "overall" rating of Unsatisfactory, does not meet any rating above.

14. ATTACHMENT E – FORMS

PERFORMANCE ASSESSMENT REPORT (PAR)

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

1. CONTRACT/TASK ORDER NUMBER 2. CONTRACTOR 3. TYPE OF SERVICES

4. QUALITY ASSURANCE PERSONNEL (QAP) SIGNATURE AND DATE

5. QAP PHONE 6. SUSPENSE DATE

I. PERFORMANCE

7. DEFICIENCY (CHECK ALL BOXES THAT APPLY)

NEW

REPEAT

NO DEFICIENCY NOTED

8. SERVICES SUMMARY or PWS PARAGRAPH ITEM REVIEWED

9. BRIEF DESCRIPTION OF DEFICIENCY (IF DEFICIENCY BOX WAS

CHECKED)

10. DETAILED PERFORMANCE ASSESSMENT

II. CONTRACTOR VALIDATION

11. CONTRACTOR REPRESENTATIVE CONCUR NON-CONCUR

12. CORRECTIVE ACTION ESTIMATED COMPLETION DATE

13. CONTRACTOR REPRESENTATIVE CORRECTIVE ACTION AND PREVENTION OF RECURRENCE OR REASON FOR NON-

CONCURRENCE OF QAP CITED DEFICIENCY

III. ACTION CORRECTED

14. CONCUR NON-CONCUR QAP SIGNATURE AND DATE

15. QAP REMARKS (REQUIRED)

16. CONTRACTOR REPRESENTATIVE REMARKS

PERFORMANCE ASSESSMENT REPORT

Continuation Sheet

(Number to correspond with applicable Item Number on reverse)

Performance Assessment Report (PAR) Instructions

Block 1. Quality Assurance Personnel (QAP) enters contract or task order number.

Block 2. QAP enters contractor name.

Block 3. QAP enters type of services.

Block 4. QAP signs and dates.

Block 5. QAP enters telephone number.

Block 6. QAP assigns suspense date for Contractor Representative validation if a deficiency box was checked in Block 7.

Part I. Contractor Performance

Block 7. QAP checks all boxes that apply.

Block 8. QAP enters Services Summary or Performance Work Statement (PWS) paragraph item reviewed.

Block 9. QAP enters brief description of deficiency and tracking number if the deficiency box was checked in Block 7.

Detailed description will be on Corrective Action Report (CAR).

Block 10. QAP enters a detailed performance assessment if the deficiency box in Block 7 was not checked.

Parts II and III will be used only if a deficiency was documented in Part I.

Part II. Contractor Validation

Block 11. Contractor Representative checks one box in response to QAP cited deficiency. If Concurrence is indicated, Contractor Representative continues to Block 12. If Non-Concurrence is indicated, continue to Block 13 and state reason(s) for Non-Concurrence with QAP cited deficiency and return PAR to QAP.

Block 12. Contractor Representative enters Estimated Completion Date of Corrective Action and continues to Block 13.

Block 13. Contractor Representative details Corrective Action and the Action Taken to Prevent Recurrence or Reason for Non-Concurrence of QAP cited deficiency.

Part III. Deficiency Corrected

Block 14. QAP checks appropriate block, signs, and dates.

Block 15. (Required Entry) QAP remarks regarding the Corrective Action and the Action Taken to Prevent Recurrence. If Non-Concur was checked, this block should be very detailed to explain why.

Block 16. Contractor Representative enters remarks if further discussion is needed about QAP concurrence with Contractor’s Corrective Action and Action Taken to Prevent Recurrence.

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

CUSTOMER COMPLAINT RECORD

DATE/TIME OF COMPLAINT

SOURCE OF COMPLAINT

ORGANIZATION

BUILDING NUMBER

INDIVIDUAL

PHONE NUMBER

NATURE OF COMPLAINT

CONTRACT REFERENCE

VALIDATION

DATE/TIME CONTRACTOR INFORMED OF COMPLAINT

ACTION TAKEN BY CONTRACTOR

RECEIVED/VALIDATED BY

Customer Complaint Record Template

Corrective Action Request

CORRECTIVE ACTION REQUEST

Level I_____ Level II ______

1. DATE (DD/MM/YYYY):

2. REFERENCE NUMBER:

3. TO (Contractor):

XXX, SOF TEAMS III CONTRACT

4. FROM (Quality Assurance Personnel):

5. THE FOLLOWING DISCREPANCIES REQUIRE CORRECTIVE ACTION AS TO THE CORRECTION OF DEFECTS AND CAUSE, INCLUDING A

DESCRIPTION OF THE:

A. ROOT CAUSE OF THE DEFICIENCY.

B. ACTION TAKEN TO CORRECT THE SPECIFIC DEFICIENCY.

C. ACTION TAKEN TO CORRECT AND PREVENT RECURRENCE OF ROOT CAUSE OF DEFICIENCY.

D. ACTION TAKEN TO DETERMINE IF OTHER PRODUCT IS AFFECTED BY THE SAME OR SIMILAR

DEFICIENCY AND ACTION TAKEN REGUARDING SUSCEPTIBLE PRODUCT.

E. ACTION TAKEN TO CORRECT THE WEAKNESS WHICH ALLOWED DEFICIENT PRODUCT TO BE PRESENTED TO THE GOVERNMENT FOR

ACCEPTANCE.

F.TARGET DATES FOR IMPLEMENTATION OF IDENTIFIED CORRECTIVE ACTION.

CONTRACT NUMBER:

Requirement:

Deficiency:

Request that your corrective action response address the elements of block 5, A - F above, as applicable.

THIS DISCREPANCY WILL AFFECT PRODUCTION SCHEDULES (If "YES" is checked, send copy to production element)

YES NO

FOR LEVEL II CAR IT IS REQUESTED THAT A REPLY AS TO CORRECTIVE ACTION TAKEN BE SUBMITTED WITHIN TWO (2)

BUSINESS DAYS OF THE ABOVE DATE. IN THE EVENT CORRECTIVE ACTION CANNOT BE FINALIZED BY THAT DATE, A WRITTEN

REQUEST FOR AN EXTENSION MUST BE SUBMITTED PRIOR TO THE SUSPENSE DATE. PLEASE REFER TO THE ABOVE REFERENCE

NUMBER IF SEPARATE COMMUNICATION IS USED.

SIGNATURE OF ISSUER:

//signed//

TYPED OR PRINTED NAME OF QAP

(Last, First, MI)

5. CONTRACTOR'S REPLY (QAP will attach separate reply to file copy of this form)

5A. TYPED OR PRINTED NAME OF CONTRACTOR

REPRESENTATIVE (Last, First, MI)

5B. SIGNATURE DATE:

6. STATEMENT OF VERIFICATION AND EVALUATION OF CONTRACTOR'S ACTION (To be completed by QAP):

6A. TYPED OR PRINTED NAME OF QAP

(Last, First, MI)

5B. SIGNATURE 5C. DATE:

7. STATEMENT OF FOLLOW-UP ACTION, WHEN NECESSARY:

CORRECTIVE ACTION REQUEST LOG

CONTRACTOR: xxx

CONTRACT NUMBER: xxx

CAR

Number

CAR

Level

Date

Issued

Due

Date

Date

Response

Received

Date of

Follow-Up

Date

Closed

Description of Deficiency