Attachment 4. Pest Management-chemical reporting Form.pdf
PDF 145 KB Posted
- Attached to
- Herbicide Application Services 934th AW
- Solicitation number
- FA6633-24-Q-A005
About this file
This document is a Request for Quotation (RFQ) for Herbicide Application Services at the 934th Airlift Wing in Minneapolis, MN. The government is seeking a contractor to provide pre-emergent/post-emergent herbicide applications and non-selective herbicide treatments for a total of approximately 26 acres, including lawn care, fence lines, sidewalks, curbs, and pavement joints. The contract includes a base year from June 2024 to May 2025 with four one-year option periods. Quotes are due by 12:00 PM Central Standard Time on Monday, May 6, 2024. This requirement is a 100% total set-aside for small businesses under NAICS code 561730. The Performance Work Statement (PWS) dated April 2024 provides the full scope of work. An optional site visit is scheduled for April 24, 2024.
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Text version
DEPARTMENT OF THE AIR FORCE
AIR FORCE RESERVE COMMAND
18 Mar 2024
FROM: 934 CES/CEO
SUBJECT: UNIVERSAL PEST MANAGEMENT APPLICATION REPORTING FORM
1. This form shall be filled out for each pest management function, which includes any service for lawn care that requires chemical applications.
Please print for number 1-9.
1. Date of Application: _____________________________
2. Location: 2a. Inside or Outside (circle one)
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 SF (sq ft), LF (linear ft), AC (acre), CF (cubic ft), 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: _________________________________(percentage of AI from label) 8e. Amount of Product Used: ___________________________________________ [include unit, e.g., FL (fluid ounce), GA (gallon), ML (milliliter), LT (liter), LB (pound), DR (dry ounce), GR (gram), KG (kilogram) AND how much water was added] 8f. Final Concentration Applied: _______________________________________ [amount of ACTIVE INGREDIENT (AI) per area (examples: 1.5 oz/gal, 4lbs/1000 SF] 8g. Total Amount of Active Ingredient applied in this pest management operation:
___________________________________ [in fl oz (if liquid) or weight (if solid)]
9. Comments: (survey results, wind conditions, sanitation deficiencies, etc.)
10. Signature of Applicator: ____________________________________________
11. Certification # and Expiration Date of Applicator:
12. Copy sent to 934TH PMC on (date)___________________
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