Attachment 4 - 88th RD Universal Pest Management Application Reporting Form.docx
DOCX document 24 KB Posted
- Solicitation number
- W911SA-23-Q-3001
About this file
This document contains a federal contract solicitation for grounds maintenance services and a universal pest management application reporting form template.
Solicitation W911SA-23-Q-3001 will be issued on February 8, 2023 to procure grounds maintenance services at one location in Milwaukee, Wisconsin. The performance period is March 1, 2023 through February 29, 2024 with four option years and a six-month option to extend. Quotes are due by the date and time listed in the solicitation and shall include all required documents. The solicitation can be accessed on SAM.gov. The place of performance is 4850 W Silver Spring Drive in Milwaukee. Written questions must be submitted by February 13, 2023.
The universal pest management application reporting form is a template to document pest control operations. It requires information on application date, location, type of operation, site description, pest, area treated, applicator name, pesticide/herbicide used, quantity applied, and comments. The applicator must sign and include their certification number.
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Other files
| File | Type | Posted |
|---|---|---|
| Solicitation.pdf | ||
| Attachment 2 - Drawings.pdf | ||
| Attachment 1 - Price Schedule - Vendor.xlsx | XLSX spreadsheet | |
| Attachment 3 - AT OPSEC.pdf |
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Text version
88th Readiness Division
UNIVERSAL PEST MANAGEMENT APPLICATION REPORTING FORM
A separate form shall be filled out for each pest management operation.
Please print for number 1-9.
1. Date of Application: _________________________
2. Location: 2a. Inside or Outside (circle one) 2b. Facility name and/or building #: _______________________________________
3. Type of Pest Control Operation: ______________________________________________ (e.g., baiting, power spray, ULV, manual application of pesticide etc.)
4. Site Description: ______________________________________ (e.g., office, lawn, unimproved ground, fence line, parking lot cracks, etc.)
5. Pest: _________________________________________(rodents, spiders, nates, weeds, etc.)
6. Area Treated: _________________________________ [Include unit, SF (square feet), LF (linear feet), AC (acre), CF (cubic feet), EA (each - for baiting only)]
7. Applicator’s Name: ___________________________________
8. Pesticide/Herbicide Used:
8a. Pesticide/Herbicide Trade Name: _______________________________________ 8b. Pesticide/Herbicide Active Ingredient: ___________________________________ 8c. EPA or Country Reg #: ________________________________________________ 8d. Formulation: _________________________________________________________ 8d. Quantity of pesticide applied: ___________________________________________ [include unit, FL (fluid ounce), GA (gallon), ML (milliliter), LT (liter), LB (pound), DR (dry ounce), GR (gram), KG (kilogram)] 8e. Final Concentration Applied: _______________________________________ (amount of active ingredient per acre/area)
9. Comments: (survey results, wind conditions, sanitation deficiencies, etc.)
10. Signature of Applicator: ____________________________________________
11. Certification # of Applicator: _________________________________________
12. Copy sent to 88th PMC on (date)____________
File details come from the government source that posted it. Updated .