Attachment 6_Quality Assurance Surveillance Plan.pdf
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- Attached to
- Fords Farm Maintenance and Repair
- Solicitation number
- W91ZLK-25-R-6844
About this file
This document is a Quality Assurance Surveillance Checklist for a federal contract related to maintenance and repair services. The checklist outlines specific performance requirements with 100% compliance expectations across multiple areas, including quarterly/regular inspections, defect notification, preventive maintenance, repairs, estimates, replacement parts/materials, and documentation. Surveillance methods involve periodic assessments by the Contracting Officer's Representative (COR), Technical Point of Contact (TPOC), or Facility Manager, with evaluation criteria spanning adherence to safety protocols, industry standards, timely reporting, and documentation maintenance. The document provides a structured framework for monitoring and evaluating contractor performance, with compliance levels designated as Exceeds (E), Met (M), Partially Met (PM), Not Met (NM), or Not Applicable (NA).
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Text version
A. Contract Number: Compliance:
B. Contractor: E: Exceeds NM: Not Met C. Task Order: M: Met NA: Not Applicable
PM: Partially Met
Performance Requirement Performance Standard Method of
Surveillance
Acceptable Performance Level (APL)
Compliance:
E, M, PM, NM,
NA
Quarterly /Regular Inspections (4)
Adherence to ATC Safety Protocols and industry standards (e.g., NEC).
COR, TPOC, or Facility Manager periodic assessment.
100% Compliance
Defect Notification
Documentation of defects on the inspection record with notation of violations. Tag out of unsafe equipment.
COR, TPOC, or Facility Manager periodic assessment.
100% Compliance
Preventive Maintenance Service Adherence to industry standards.
COR, TPOC, or Facility
Manager periodic assessment.
100% Compliance
Repairs
As required at any time by the COR, and Facility Manager. If defect requiring urgent repair is noted during inspection/maintenance service, the contractor will notifiy the COR immediately after completing maint/inspection procedures. Work shall adhere to industry standards.
COR, TPOC, or Facility Manager periodic assessment.
100% Compliance
Estimates Written estimates will be provided to
COR within 5 working days after repair request.
COR periodic assessment. 100% Compliance
Replacement Parts/Material
Contractor will obtain all repair parts and materials for inspection, preventive maintenance, repair, and modification services.
Contractor shall strive to obtain parts and materials as quickly as reasonable.
COR periodic assessment. 100% Compliance
Documentation/Records
Produce and maintain records in accordance with industry standards
(e.g., NEC). Documentation of scheduled inspections and PMs will be provided to the COR within 5 working days after the end of the period. Documentation of repair and modification services will be provided to the COR within five (5) working days after the completion of the action.
COR and/or TPOC periodic assessment. 100% Compliance
Summary and / or General Observations:
Recommendations:
COTR / COR: Name: Signature:
Date:
Chief, ATC Contracts Team: Name: Signature:
Date:
QUALITY ASSURANCE SURVEILLANCE CHECKLIST
COMMENTS
Sheet1
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