PWS Appendix J.pdf

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99 CES Custodial Services
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F3GECE5230A001
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This document is Appendix J outlining the required reports and forms for a federal contract, likely related to facility cleaning and maintenance services at Air Force installations. The appendix specifies submission timelines and responsible parties for various deliverables essential to contract performance and compliance.

Contractors must submit the Written Proof of Records Check prior to the Pre-Performance Conference and include the Contractor's Quality Control Plan (QCP) with their initial proposal. Upon contract award, contractors are required to provide Cleaning Frequency Schedules, a list of Cleaning and Restroom Supplies, and identification of Primary and Alternate Points of Contact (POCs). Additional forms—AF Form 332 (Civil Engineer Work Order) and AF Form 3952 (Chemical/Hazardous Material Authorization)—must be completed as needed during performance. The Employee Statement Form is mandatory for any employee assigned to independent work at youth facilities, teen centers, child development centers, or other child-related facilities in accordance with AFI 34-144. This form requires employees to disclose any arrests or convictions related to crimes involving children, substance abuse, sex crimes, or violent crimes, with space for detailed descriptions of dispositions if applicable. Customer Complaint Forms and Employee Statement Forms are submitted as needed throughout contract performance. All completed forms must be provided to the Contracting Officer for verification and record-keeping purposes.

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APPENDIX J - Required Reports/Forms

Required Due Date Written Proof of Records Check Pre-Performance Conference Contractor’s QCP With Proposal Cleaning Frequency Schedules Upon Contract Award Cleaning and Restroom Supplies Upon Contract Award Primary/Alternate POCs Upon Contract Award AF Form 332 – Civil Engineer Work Order

As Needed

AF Form 3952 - Chemical/Hazardous Material Authorization

As Needed

Customer Complaint Form As Needed Employee Statement Form As Needed

Employee Statement Form In accordance with AFI 34-144, this form is to be completed by any employee who will be assigned independent work at the Youth Center, Teen Center, Child Development Center or any facility concerning children. Completed copies will be provided to the Contracting Officer. 1. Have you ever been arrested or convicted of a crime involving a child?

_______ Yes _______ No If yes, describe the disposition of the arrest or charge.

________________________________________________________________________ 2. Have you ever been arrested or convicted of a crime involving substance abuse. _______ Yes _______ No If yes, describe the disposition of the arrest or charge.

________________________________________________________________________ 3. Have you ever been arrested or convicted of a crime involving a sex crime or violent crime. _______ Yes _______ No If yes, describe the disposition of the arrest or charge.

Your signature certifies that the above statements are true, correct, complete, and made in good faith.

NAME

SIGNATURE DATE

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