VENDOR PERFORMANCE
REPORT
Date:
Department:
Contact Name:
Title:
Phone Number:
Email Address:
Contract Number:
Date Goods/Services Received:
Vendor Name:
Vendor VID:
Vendor Contact Name:
Vendor Email Address:
Vendor Address:
Vendor Phone:
Vendor Fax Number:
Vendor Performance (check all that apply):
Quality:
Delivery Issues:
Service Issues:
1.
Exceptional Performance
8.
15.
Failed to replace
damaged goods or
correct service issues
2.
Inferior or defective
merchandise
9.
Unauthorized delivery of
goods or services
16.
Services not performed
to specifications
3.
Merchandise/service poor
quality
10.
Goods delivered
damaged
17.
Installation
unsatisfactory
4.
Warranty problem
11.
Incorrect quantity
delivered
18.
Invoice incorrect
5.
Unauthorized substitute
delivered by vendor
12.
Delivery made to wrong
destination
19.
Service unreliable
6.
Received wrong item
13.
Quantity delivered and
billed in excess of order
20.
Will not return calls or
emails
7.
Other Explain below
14.
Other Explain below
21.
Other-Explain below
Provide a brief explanation of exceptional or unacceptable vendor performance:
Department Signature:
- - - - - - - - - - - - - - - This Section Below Used By Procurement Only - - - - - - - - - - - - - - -
Purchasing Agent:
Date Vendor Notified:
Vendor Response: (Explain in detail and attached additional sheets if necessary):
Date vendor response sent to Department:
Other action taken by Procurement:
Reviewed By:
Managing Director, Procurement Date
09-16-2014 Page 2 of 2
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