DEFICIENCY/COMPLAINT REPORT
Complete this form to report complaints against vendors, commodities, or to report any unsatisfactory service by the Purchasing Office. Be sure to
furnish all necessary detail so that a satisfactory settlement of the complaint can be made. Please verify all information to insure accuracy. Complaint
reports become a permanent record of the commodity or vendor concerned and must be accurate to guarantee an equitable settlement to serve as a
guide for future action.
Dept/Campus
Date of Complaint
Contract Number Purchase Order Number
Name and Address of Vendor
Commodity or Service Covered by Complaint
NATURE OF COMPLAINT (check all that apply)
DELIVERY QUALITY OTHER
Delivery not made on date ordered or
promised
Quality of Commodity is inferior Invoice price higher than authorized
Delivery made at an unsatisfactory hour Unsatisfactory and unauthorized substitute Weight received at variance with invoice or
shipping ticket
Delivery made to wrong destination Unsatisfactory workmanship in installation
of commodity
Quantity delivered in excess of order
Improper method of delivery Commodity lacks required inspection
stamps
Quantity delivered less than ordered
Unauthorized delivery made before
issuance of order
Delivery in damaged condition
*REMARKS
NOTE: Give detailed explanation of complaint in this space. Indicate manner in which you suggest complaint be settled. Be specific. If necessary to
submit additional documentation, please include a copy of this form with your faxed or mailed documents.
Instructions to Dept/Campus
Complaint Initiated By (Name) Title Phone No.
Print copy for your records prior
to submittal.
Complaint Form Executed By (Name)
Title Phone No.
Your Email Address:
Action Taken [To be completed by Purchasing Office]
__________________________________________________________________________________________________________________________
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Louisiana State University
and A&M College
Office of Purchasing
213 Thomas Boyd Hall
Baton Rouge, Louisiana 70803-3001
