W911SA-21-Q-3032 MI043 MS GR - Attachment 4 - Grounds Service Ticket V 1.5 (18 JAN 2019).docx

On Site Service Ticket – Grounds Maintenance Version 1.5; 18 JAN 2019 Contract number: _____________________ Location: _____________________

DATE: __________

LAWN MAINTENANCE TYPE (include all) ☐Type 1 ☐Type 2 ☐Type 3 ☐Type 4 ☐Mowing ☐Edging ☐Trimming ☐Policing ☐Spring/Fall Cleanup ☐Weed & Feed (Provide Chemical report) ☐Weeding ☐Aeration ☐Herbicide Application (Provide Chemical report) Comments:

Check In/Out:

Vendor Employee(s) Name (print):_____________________________________________________

Designated Rep. Person Check-In Print Name: _____________________________________________ Designated Rep. Person Check-Out Print Name: ___________________________________________

This Service Ticket shall be filled out by the contracted vendor each time the service provider performs services on location. This service ticket does not provide proof of inspection or acceptance of services. The Government reserves the right to fully inspect work performance of all requirements under contract any time or place it deems necessary.