W911SA-22-Q-3059 Attachment 4 Custodial Service Ticket.docx

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Attached to
Custodial Services in Des Moines, Iowa at USARC IA033
Solicitation number
W911SA-22-Q-3059
Issued by

About this file

This solicitation is for custodial services at an Army Reserve facility in Des Moines, Iowa. The performance period is from September 2022 to August 2028 with option years, providing cleaning services such as dusting, mopping, vacuuming, restroom cleaning and window cleaning. Quotes are due by the date and time listed on the solicitation, and must include a signed SF1449, completed supplemental information, and price schedule attachment. A site visit will be held on July 11th. Questions are due by July 15th. The solicitation will be issued on July 1st and can be accessed at sam.gov under number W911SA-22-Q-3059. The Department of the Army Materiel Command Mission and Installation Contracting Command at Fort McCoy is the contracting agency.

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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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