Att 3 Seed Analysis Request Form Revised 2020.docx
DOCX document 46 KB Posted
- Attached to
- BLM FY21-1 Spring Consolidated Seed Buy.
- Solicitation number
- 140L3721R0002
About this file
This document contains a seed analysis request form template and information about a Bureau of Land Management seed procurement solicitation. The seed analysis request form template requires contractors to provide seed testing information to laboratories, including the seed lot number, species, variety or germplasm identification, seed zone, seed source, treatment details if applicable, and signatures authorizing test result release to the government. The related solicitation is for the BLM's FY21-1 Spring Consolidated Seed Buy and is seeking seed deliveries with samples sent to BLM receiving warehouses in Boise, Ely, and Shoshone, Idaho for testing and acceptance. Test results will be sent to the provided email address.
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Other files
| File | Type | Posted |
|---|---|---|
| B09 Sol_140L3721R0002 spec and clauses_revised Prebid call_0001.docx | DOCX document | |
| B11 Seed Meeting sign in sheet_0001.xlsx | XLSX spreadsheet | |
| Sol_140L3721R0002_Amd_0001.pdf | ||
| B11 PreBid conference Call Questions and Answers_0001.docx | DOCX document | |
| Sol_140L3721R0002.pdf | ||
| Attachment-1-Bid_Sheet_Spring_2021.xlsx | XLSX spreadsheet | |
| Att 2 AOC collection.docx | DOCX document | |
| Att 4 Seed Inspection.docx | DOCX document |
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Text version
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 must send this Seed Analysis request form with every seed delivery to the BLM receiving warehouse after samples are taken. (With split lots, seed samples will be sent to each receiving warehouse.)
| Spread Sheet ID# (SSID#) |
| Click or tap here to enter text. |
| Species |
Common Name
Variety or Germplasm ID. / Gen.
| Eco-Region & Seed Zone |
| Click or tap here to enter text. |
| G0 County, State, Elevation, Precip |
Vendor Name
Vendor Lot Number
Seed Lab Sent to
Sampler Name & Date
Contractor: The Seed Sampling and Testing Costs Shall Be Borne By The Contractor.
I herby authorize the Seed lab to release the test result to the government upon completion of the test.
Signature__________________________________ Date_________
Seed Lab: All test results will be sent to: blm_id_seed_all@blm.gov
SEED LOT SAMPLE INFORMATION
Seed Lot Information
| Seed Quality |
| Yes |
| No |
| Tests Requested |
Total Pounds
| Seed Certified | ||
| ☒ | ☐ | Purity |
| ☒ |
Number of Bags
| Seed Non-Certified | ||
| ☐ | ☐ | TZ |
| ☒ |
Bag Size
| Seed Source Identified | ||
| ☒ | ☐ | Noxious (all Western States) |
| ☒ |
Number of Bags Sampled
| Seed Source Origin | ||
| ☒ | ☐ | Rush |
| ☐ |
Date Sampled
| Seed Treated? | |
| ☐ | ☒ |
Date Sample Sent to Lab
| If treated please list type | |
| Click or tap here to enter text. | |
| ☒ |
| Remarks: |
| Other: |
Office/Organization Purchasing Seed
| Pounds Delivered |
| Send Test To: |
| Bill To: |
Boise Regional Seed Warehouse 1962 Commerce Ave Boise, ID 83705 Phone: 208-384-3277 (Derek Conn)
| blm_id_seed_all@blm.gov |
| CONTRACTOR |
Ely Regional Seed Warehouse 1111 Medlyn Way Ely, NV 89301 Phone: 208-384-3277 (Derek Conn)
| blm_id_seed_all@blm.gov |
| CONTRACTOR |
Shoshone Seed Warehouse 329 N Highway 75 Shoshone, ID 83352 Phone: 208-732-7208 (Tony Owens)
| blm_id_seed_all@blm.gov |
| CONTRACTOR |
National Seed Warehouse System Contracting Officer’s Represenatives
Phone: 208-373-3838 (Eduardo Almeida) Spring Phone: 208-373-3836 (Ricardo Galvan) Fall
NA
| blm_id_seed_all@blm.gov |
| CONTRACTOR |
ATTACHMENT 3
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