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Attachment 3: Contractor Discrepancy Report

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A PDF document (103 KB) attached to Detached Duty Recruiter Coworking Stations, from the US Coast Guard. Due Oct 29, 2026, 12:00 PM (UTC-4).

File name: Attachment 3 - Contractor Discrepancy Report.pdf

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Attachment 3 – Contractor Discrepancy Report

1. Contract Number

2. Report Serial No.

3. Report # this Discrepancy

4. To: (Contractor and Managers Name)

5. From: (Name of QAE)

DATES

6. Prepared

Returned by Contractor

Oral Notification

Action Complete

7. Discrepancy or Problem (Describe in detail: include reference to PMS/Directive: attach needed.

continuation sheet if

8. Signature of Contracting Officer

9. To: (Contracting Officer)

From: (Contractor)

10. Contractor response as to cause, corrective action and actions to prevent recurrence. Attach continuation sheet if needed (Cite applicable QC program procedures(s) or new QC procedures(s).)

11. Signature of Contractor Representative

Date

12. Government Evaluation (Acceptance, rejection: Attach continuation sheet if needed)

13. Government Action (Payment deductions, cure notice, show cause, other)

14. Final Disposition

CLOSE OUT

Contractor Notified
QAE
Contracting Officer

Name – Title

Signature

Date

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