Att_3_Seed_Analysis_Request_Form.docx

SEED ANALYSIS REQUEST FORM

This Attachment must be completed by the Contractor and Certified Sampler to provide Seed Testing Information to a seed laboratory as described in the Inspection and Acceptance Section of the Solicitation. Contractor shall send this Seed Analysis request form with seed delivery to the BLM Regional Seed Warehouse after sample is taken. (With split samples, both seed and Attachment 3 Form are sent to Boise Regional Seed Warehouse.)

Spread Sheet ID# (SSID#) _______________________________ Species: ______________________________________________ Germplasm ID: ________________________________________ Vendor Name: ________________________________________ Vendor Lot Number: ___________________________________ Seed Lab Sent to: ______________________________________ Sampler Name: ________________________________________

Contractor: Please call each BLM office to coordinate which Tests need to be requested (rush, email, etc) from the seed labs. Please list pounds delivered to each location, check to indicate that a seed test will be sent to that location.

Seed Lab: Send seed test results to each of the offices receiving seed and checked.

CHARGE ALL SEED LAB TEST FEES TO THE CONTRACTOR.

SEED LOT SAMPLE INFORMATION

Seed Lot Information

Total Pounds

Seed Certified

Number of Bags

Seed Non-Certified

Bag Size

Seed Source Identified

Number of Bags Sampled

Seed Source Origin

Date Sampled

Seed Treated?

Date Sample Sent to Lab

If treated please list type

Delivery Contact

Boise Regional Seed Warehouse 1962 Commerce Avenue Boise, ID 83705

(208) 384-3277 Office

(208) 384-3324 Fax dcthomas@blm.gov

CONTRACTOR

Delivery/Purchaser Location

Boise Regional Seed Warehouse Send Seed Test Results to Rico Galvan and Derek Conn

Ely Regional Seed Warehouse Send Seed Test Results to Rico Galvan and James Andrews

Twin Falls Seed Warehouse Send Seed Test Results to Scott Uhrig and Tony Owens and Rico Galvan

Send Seed Tests To All Managers:

ATTACHMENT 3

BOISE

Rico Galvan rgalvan@blm.gov (Admin Manager) Phone: 208-384-3277 Fax: 208-384-3324 1962 Commerce Ave Boise, ID 83705

AND

Derek Conn dconn@blm.gov (Ops Manager) Phone: 208-384-3277 Fax: 208-384-3324 1962 Commerce Ave Boise, ID 83705

ELY

James Andrews jandrews@blm.gov (Ops Manager) Phone: 775-289-3461 Fax: 775-289-3483 1111 Medlyn Way Ely, NV 89301

TWIN FALLS

Scott Uhrig cuhrig@blm.gov Phone: 208-732-7232 Fax: 208-308-7335 400 West F Street Shoshone, ID 83352

AND

Tony Owens aowens@blm.gov Phone: 208-732-7208 Fax: 208-308-7335 400 West F Street Shoshone, ID 83352