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Case Record Storage and Retrieval Services RFP (Part I)

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APPENDIX C: SOW TECHNICAL EXHIBITS<br />

TECHNICAL EXHIBITS C-2<br />

CONTRACT DISCREPANCY REPORT<br />

TO:<br />

FROM:<br />

DATES: Prepared: __________________<br />

Returned by Contractor: __________________<br />

Action Completed: __________________<br />

DISCREPANCY PROBLEMS: ___________________________________________________________________<br />

___________________________________________________________________________________________<br />

___________________________________________________________________________________________<br />

_____________________________<br />

Signature of County Representative<br />

_________________________<br />

Date<br />

CONTRACTOR RESPONSE (Cause <strong>and</strong> Corrective Action): ________________________________________<br />

___________________________________________________________________________________________<br />

___________________________________________________________________________________________<br />

____________________________<br />

Signature of Contractor Representative<br />

_________________________<br />

Date<br />

COUNTY EVALUATION OF CONTRACTOR RESPONSE: ____________________________________________<br />

___________________________________________________________________________________________<br />

___________________________________________________________________________________________<br />

____________________________<br />

_________________________<br />

Signature of County Representative<br />

Date<br />

COUNTY ACTIONS:__________________________________________________________________________<br />

___________________________________________________________________________________________<br />

___________________________________________________________________________________________<br />

CONTRACTOR NOTIFIED OF ACTION:<br />

County Representative’s Signature <strong>and</strong> Date ________________________________________________________<br />

Contractor Representative’s Signature <strong>and</strong> Date _____________________________________________________<br />

CASE RECORD STORAGE AND RETRIEVAL SERVICES (<strong>RFP</strong>) 2012 174

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