W911SA-21-Q-3067 Attachment 4 Custodial Service Ticket Template.docx

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Attached to
Custodial Services IL079, Elwood, Illinois
Solicitation number
W911SA-21-Q-3067
Issued by

About this file

This solicitation is for custodial services at Facility IL079 located in Elwood, Illinois. The contractor shall provide all labor, transportation, equipment, materials, supervision, and other items or services necessary to perform custodial services in accordance with the performance work statement, task and frequency charts, and the terms and conditions of the solicitation and resultant contract. The contractor will furnish all supplies necessary to fulfill the performance work statement. The period of performance is from 28 September 2021 through 27 September 2022 with four, one-year options and a six month option to extend services. This procurement is set aside as 100% for service-disabled veteran-owned small businesses under NAICS code 561720 with a size standard of $19.5 million. A site visit is scheduled for 16 June 2021 and questions must be submitted by 18 June 2021.

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Text version

On Site Service Ticket – Custodial Version 1.6; 18 JAN 2019 Contract number: _____________________ Location: _____________________

DATE: __________

Custodial Service TYPE (include all): ☐Dust Mop ☐Damp Mop ☐Spray Buff, Burnish ☐Strip, wax, Buff ☐Seal, Polish ☐Remove Trash ☐Vacuum ☐Carpet Shampoo ☐Service Restrooms (Clean/Sanitize toilets, urinals, sinks, showers, walls, partitions) ☐ Contractor Restroom Cleaning Sheet completed ☐Restroom floor cleaning ☐Low Dusting ☐High Dusting ☐Window Cleaning 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.

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