Attachment_I_B_-_PWS_-_Problem_Notification_Report_Form.pdf

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Attached to
TCM N&S Federal contract opportunity
Solicitation number
W91249-17-R-0001
Issued by
Department of the Army Materiel Command Mission and Installation Contracting Command Fort Eustis

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PWS - Attachment IB - Problem Notification Report Form

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15 Dec 15

ATTACHMENT B

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:

PROBLEM NOTIFICATION REPORT FORM
Thank you for taking time to assist us in improving the level of service.
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