Fillable Printable Quality Deficiency Notice Evaluation Of Correction Action

Quality Deficiency Notice Evaluation Of Correction Action

QUALITY DEFICIENCY NOTICE

EVALUATION OF CORRECTION ACTION

NAME OF SUPPLIER AND ADDRESS

NSN

OAS NAME AND SIGNATURE ADDRESS DATE

DATE

RECEIPT ACKNOWLEDGED

Corrective action verified and found acceptable.

Corrective action not acceptable and/or not implemented (Explain below)

This matter is being referred to the Administrative Contracting Officer for action. Direct further correspondence on this

matter to the ACO.

CERTIFIED RECEIPT NO.

OAS SIGNATURE

RECEIPT ACKNOWLEDGED CERTIFIED RECEIPT NO.

GSA FORM 3539 (11-84)

LOT NO.

PRIME CONTRACTOR AND ADDRESS

CONTRACT NO.

ORDER NO.

A deficiency exists in your quality control system. The nature of the deficiency is

Immediate action is required to correct the deficiency and the condition that caused it. Shipping nonconforming material and/or failure

to take acceptable corrective action on time may result in termination of your right to proceed with this contract. Nonconforming

material will be returned to you at your expense.

Please provide a written response of correction action taken or to be taken to your OAS within 5 workdays after receiving this notice.

GENERAL SERVICES ADMINISTRATION