Attachment 2 - Pilot Qualification Form.doc
DOC document 49 KB Posted
- Solicitation number
- RFP-751-250000001768-1
- Issued by
- Michigan
About this file
This document is a Pilot Qualification Form issued by the Michigan Department of Natural Resources (DNR) for contract pilots seeking to perform aviation services. The form outlines comprehensive qualification requirements for both fixed-wing and rotary-wing pilots, detailing specific flight experience hours needed across various categories such as pilot-in-command time, cross-country flying, night flying, and operations in typical terrain. Pilots must meet stringent experience thresholds, including 750 hours of fixed-wing pilot-in-command time and 1,000 total aircraft hours for rotary-wing pilots.
The qualification form includes a detailed background screening section requiring pilots to disclose any previous aviation incidents, regulatory violations, criminal history, driving records, and medical conditions. Vendors are responsible for maintaining current documentation and must provide updated certificates to the DNR lead pilot at least ten days before any document's expiration. Failure to maintain current documentation could result in contract cancellation. The form mandates pilots submit copies of their medical and pilot certificates, and they may be required to complete an additional flight proficiency test at the vendor's expense if deemed necessary by DNR leadership.
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Text version
MICHIGAN
DEPARTMENT OF NATURAL RESOURCES
PILOT QUALIFICATION FORM
Pilot Name: ___________________________________
DOB: ________________________
Address: _____________________________________ Certificate No.: ________________
Employer: ____________________ FAA Medical Class: _____ Date Last Issued: _____________
Date of Last BFR: ______________
Type of License:
Commercial
ATP
Mechanic
Ratings:
Single Engine Land Single Engine Sea
Multi-Engine Land
Multi-Engine Sea
Instrument Instructor
ATTACH COPY OF MEDICAL CERTIFICATE AND PILOT CERTIFICATE
PILOT IN COMMAND FLIGHT TIME
Contract pilots must be current and capable of piloting aircraft for the types of missions to be flown. In addition to the general qualifications and the following minimum flight experience requirements, contract pilots may be required to demonstrate their flight proficiency on an actual “flight test”, at the vendor’s expense, if deemed necessary by the DNR lead pilot. Aircraft used for such tests will be equipped with dual controls.
| PILOT-IN-COMMAND – FIXED WING |
| REQUIRED PIC HOURS OF FLYING TIME |
| HOURS |
| A) Pilot-In-Command (PIC) in fixed wing |
| 750 |
| _________ |
| B) PIC in each class of single-engine airplane to be flown |
| 100 |
| _________ |
| C) PIC during preceding 12 months |
| 100 |
| _________ |
| D) PIC extended cross-country |
| 200 |
| _________ |
| E) PIC night flying |
| 50 |
| _________ |
| F) PIC Operations in typical terrain and landing facilities, as applicable |
| 200 |
| _________ |
| G) PIC in class to be flown, proceeding 30 days |
| 5 |
| _________ |
| H) PIC related type of flying |
| 50 |
| _________ |
PILOT-IN-COMMAND – ROTARY WING
| A) Pilot-In-Command (PIC) of all aircraft, including fixed wing |
| 1000 |
| _________ |
B) Helicopter:
| 1) Pilot-In-Command (PIC) in rotor wing |
| 500 |
| _________ |
| 2) PIC night flying |
| 10 |
| _________ |
| 3) PIC typical terrain |
| 50 |
| _________ |
| 4) PIC in weight class to be flown (light, medium, or heavy) |
| 100 |
| _________ |
| 5) PIC make and model, preceding 60 days |
| 10 |
| _________ |
GO TO PAGE 2→→→→→→→→→→→→→→→→
ANSWER ALL QUESTIONS
1) Are you flying under any waiver or limitations?
Yes No 2) Have you ever had a claim, incident or accident?
No
3) Have you ever been penalized, fined or cited for violation of Yes No an aviation regulation?
4) Have you ever been convicted of a felony or are you under Yes
No indictment for a felony?
5) Has your driver’s license ever been suspended?
No
6) Have you ever been convicted of driving a motor vehicle under Yes the influence of alcohol/narcotics or reckless driving?
7) Have you ever been treated for chemical dependency or Yes alcohol abuse?
8) Are you regularly using medication?
No Throughout the life of this contract, it is the vendor’s sole responsibility to keep these documents current. Vendor must provide the DNR lead pilot with current replacements for expired documents not later than ten (10) days prior to expiration of those documents. Failure to provide this information prior to expiration date may result in the balance of the contract being canceled.
Pilot Signature
Date
File details come from the government source that posted it. Updated .