Deficiency/Complaint Report Complete all applicable information and submit to the Office of Purchasing. Department * Campus Date of Complaint * Contract Number Purchase Order Number Name of Vendor * Vendor Address Commodity or Service Covered by Complaint * Type of Complaint * Delivery not made on date ordered or promised Delivery made at an unsatisfactory hour Delivery made to wrong destination Improper method of delivery Unauthorized delivery made before issuance of order Delivery in Damaged Condition Quality of Commodity is inferior Unsatisfactory and unauthorized substitute Unsatisfactory workmanship in installation of commodity Commodity lacks required inspection stamps Invoice price higher than authorized Weight received at variance with invoice or shipping ticket Quantity delivered in excess of order Quantity delivered less than ordered Other Other REMARKS NOTE: Give detailed explanation of complaint in this space. Indicate manner in which you suggest complaint be settled. Be specific. If necessary submit additional documentation to the Office of Purchasing with reference to deficiency form. Detail * Complaint Initiated By (Name) * Title * Phone Number * Complaint Form Executed By (If Other Than Above) E-Mail Address (Of Initiator) Please print filled form prior to submitting. Leave this field blank
