Items 1 to 4: building and time
Building name and number, time A. began and B. completed, total personnel and total man-hours.
GSA64
Periodic Building Cleaning Work Assignment and Report
- Agency
- GSA
- Revision
- Rev. 12/1980
- Fillable fields
- 94
- Pages
- 1
- Official source
- GSA form page
- Checked
- October 20, 2026
GSA Form 64: Periodic Building Cleaning Work Assignment and Report
GSA Form 64, Periodic Building Cleaning Work Assignment and Report, is a General Services Administration (GSA) form, printed as GSA Form 64 Rev. 12-80. GSA hosts it in its forms library. GSA's page lists a current revision date of 12/1990 and no authority or regulation.
The instructions say custodial supervisors use it to make daily assignments for periodic cleaning work, and custodial employees use it to report completed work. Cleaning contractors use it to propose periodic work for the following work day and to report the jobs performed that day, and the contracting officer's designated representative uses it to approve proposed work and inspect work reported complete.
The form has the building name and number, the time began and completed, total personnel and total man-hours, then rows for work description, location, quantity, work completed and remarks, with the employee's and supervisor's names and dates. You can fill it out free in your browser on this page and download the result without an account.
What's on GSA Form 64
Instructions
Two paragraphs on who uses the form, how the work is recorded, and when it is turned in or submitted.
Items 5 to 7: the work
Work description, location (room no., corridor, lobby, or either) and quantity (by measure or count).
Items 8 and 9: completion and remarks
A work completed check column, and remarks for work not completed and unusual conditions.
Names and dates
Employee's name and date, and supervisor's name and date, at the foot of the form.
The form is a single page.
How to complete GSA Form 64
- 1
Enter the building and time
Fill in the building name and number, the time work began and was completed, total personnel and total man-hours.
- 2
List each job
For each row, describe the work, its location by room number, corridor or lobby, and the quantity by measure or count.
- 3
Check the completed work
Mark item 8 for each job completed.
- 4
Explain what was not done
The form says to show under Remarks the location and amount of work not completed, if any, and state reasons, noting unusual conditions such as equipment or power failure or reassignment to another job.
- 5
Add names and dates
Enter the employee's name and the supervisor's name, each with a date.
- 6
Turn it in at the close of work
Employees turn it in to the supervisor each day. Cleaning contractors submit it to the designated GSA representative each day.
Why fill Form GSA64 on indox
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Where it goes and what the form says
Where it goes
The form says it shall be turned in to the supervisor each day at the close of work. Contractors submit it to the designated GSA representative each day at the close of work.
How the work is recorded
The form says work accomplished and reported on it is to be entered on a daily basis on the Rotational Card System and building floor plans, to keep periodic cleaning work on a current basis.
Contracted jobs
The note says forms showing work scheduled and completed for contracted jobs such as window washing, blind washing, insect and rodent control and carpet cleaning shall be submitted to the designated GSA representative daily.
Revision and authority
The form prints Rev. 12-80. GSA's page lists a current revision date of 12/1990 and no authority or regulation. The form prints no OMB number.
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GSA3618
Daily Abstract of Deductions for Contractual Cleaning
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GSA353
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Who uses GSA Form 64?
The instructions printed on the form describe who assigns, reports and approves the work.
Official sources and the blank
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Questions about Form GSA64
Who issues GSA Form 64?
The footer reads GENERAL SERVICES ADMINISTRATION and GSA Form 64 Rev. 12-80. GSA hosts it in its forms library, and GSA's page lists no authority or regulation.
Who fills out GSA Form 64?
The form says custodial supervisors use it for daily assignments, custodial employees use it to report completed work, and cleaning contractors use it to propose and report periodic work.
When is it turned in?
The form says it shall be turned in to the supervisor each day at the close of work. Contractors submit it to the designated GSA representative each day at the close of work.
What goes in the Remarks column?
The location and amount of work not completed, if any, and the reasons, plus unusual conditions such as equipment or power failure or reassignment to another job.
How do cleaning contractors use it?
To propose periodic work for the following work day and report the jobs performed that day. The contracting officer's designated representative uses it to approve proposed work and inspect work reported complete.
Which revision date is current?
The PDF prints Rev. 12-80. GSA's page lists a current revision date of 12/1990.