Att_3_Seed_Analysis_Request_Form_Revised_2021.docx
DOCX document 37 KB Posted
- Attached to
- BLM FY22-1 Spring Consolidated Seed Buy.
- Solicitation number
- 140L3722R0006
About this file
This document is a seed analysis request form and instructions for contractors to complete and submit with seed deliveries under the Bureau of Land Management's FY22-1 Spring Consolidated Seed Buy solicitation. Contractors must send the completed form and a split sample of each seed lot to the designated BLM receiving warehouse after a certified sampler takes the samples. The form requests identifying information on the seed lot including kind, species, variety, seed zone, vendor, and sampler details. Contractors must select test types and authorize release of results to the BLM. Seed samples will be sent to one of three BLM regional seed warehouses in Boise, Ely, or Shoshone, Idaho depending on delivery location. Test results will be distributed to the BLM and vendor email addresses provided.
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Other files
| File | Type | Posted |
|---|---|---|
| A06_Spring_Buy_Sol_spec_and_clauses_Amd_0001_0001.docx | DOCX document | |
| Sol_140L3722R0006_Amd_0001.pdf | ||
| B11_Pre-bid_Questions_and_answers_0001.docx | DOCX document | |
| Attachment-1-Bid_Sheet_Spring_2022_revised_Amd_001_0001.xlsx | XLSX spreadsheet | |
| Attachment-1-Bid_Sheet_Spring_2022.xlsx | XLSX spreadsheet | |
| Att_2_AOC_collection.docx | DOCX document | |
| Sol_140L3722R0006.pdf | ||
| 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#)
Kind of Species
Common Name
Variety or Germplasm ID. / Gen.
Eco-Region & Seed Zone
G0 County, State, Elev, Precip
Vendor Name
Vendor Lot Number
Samplers Affiliated Agency
Name of Sampler, Print
Signature of Sampler & Date
Lab sample will be sent to
Lot Information
| Certification Class |
| Yes |
| No |
| Tests Requested |
Total Pounds
| Certified | ||
| ☐ | ☐ | Purity |
| ☒ |
Number of Bags
| Selected | ||
| ☐ | ☐ | TZ |
| ☒ |
Bag Size
| Source Identified | ||
| ☐ | ☐ | Noxious |
(All Western States)
Number of Bags Sampled
| Non-Certified | ||
| ☐ | ☐ | Species Check (Downy Brome) |
| ☒ |
Date Sampled
| Seed Treated? | ||
| ☐ | ☐ | Rush |
| ☐ |
Date Sample Sent to Lab
| If treated please list type |
| ☒ |
| Remarks: |
| Other: |
Contractor: The seed sampling and testing costs shall be borne by the contractor.
I hereby 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 and Vendor’s email address _______________
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 (Matt Thornton)
| 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 |
ATTACHMENT 3
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