A01.12_Attachment_1_-_Janitorial_Cleaning_Log.pdf

JANITORIAL CLEANING LOG

___________ TO ____________

DD/MM/YY DD/MM/YY

Facility Name: ___________________________________________________________________________

GOVERNMENT REPRESENTATIVE PRINTED NAME

GOVERNMENT REPRESENTATIVE SIGNATURE

DATE FORM COMPLETED: _______________________________

DAILY (TWO DAYS PER WEEK (TYP. TUE & FRI): MON TUES WED THUR FRI

EMPTY AND RE-LINE TRASH RECEPTACLES

CLEAN BATHROOM AND KITCHEN FIXTIRES

CLEAN AND SANITIZE TOILETS, URINALS, SINKS

REPLENISH BATHROOM AND KITCHEN SUPPLIES

SWEEP AND DAMP MOP VINYL AND TILE FLOORS

HEPA VACCUM OPEN AREA CARPETS

CLEAN SWITCHES, DOOR KNOBS AND HANDLES

SPOT CLEAN WASHABLE SURFACES

SWEEP OR VACUUM MATS AND EXTERIOR ENTRYWAYS

MONTHLY:

REMOVE MARKS AND WAX/POLISH VINYL AND TILE

HEPA VACCUM HARD TO REACH CARPET AREAS

DAMP CLEAN VENTS AND WINDOW BLINDS AND SILLS

EVERY SIX MONTHS:

WASH INTERIOR AND EXTERIOR OF WINDOWS

DEEP CLEAN CARPETS

STRIP, SCRUB, WAX, BUFF VINYL AND TILE FLOORS

PLEASE MARK "Y", "N" or “N/A”TO INDICATE SATIFACTORY PERFORMANCE

To ensure open communication and accountability, at the sole discretion of the Government, this form shall be completed upon completion of each service day and signed and submitted by janitorial employees. The completed sheets would be used to validate/verify services are received in accordance with the contract requirements and to ensure fair and accurate payment for services rendered.

Note: Anything outside of the ordinary must be documented in full detail on the back of this form.

PRINTED JANITOR NAME: SIGNATURE OF JANITOR: DATE SIGNED: