Contractor Applicator Licensing Form.pdf

PDF 30 KB Posted

Attached to
District 3 Herbicide Spraying Service
Solicitation number
6100065252
Issued by
Lycoming County, Pennsylvania

About this file

This Contractor Applicator Licensing Form is an attachment to a herbicide spraying service procurement for the Pennsylvania Department of Transportation (PennDOT), District 3, covering nine counties in central Pennsylvania including Bradford, Columbia, Lycoming, Montour, Northumberland, Snyder, Sullivan, Tioga, and Union. Contractors must submit bids electronically through the PA Supplier Portal at www.pasupplierportal.state.pa.us, with all line items required to be bid or the submission will be considered void. Bids will be publicly opened and read virtually via Microsoft Teams, with questions due to Sandra Duke at sanduke@pa.gov by Friday, March 6, 2026, at 10:00 am Eastern Standard Time. The initial contract term is one year, with the option for mutual renewal for up to four additional one-year terms.

The Contractor Applicator Licensing Form requires bidders to provide their company name, designate a project manager with a 24-hour cell phone number, and submit documentation including a Pennsylvania Department of Agriculture Pesticide Application Business License (with the BU number), a copy of the Pesticide Application Business License, and copies of all Pesticide Applicators Certifications ID cards. This form must be completed and returned with the bid submission. No mailed bids will be accepted. For bidding assistance, contractors can contact the Supplier Service Center at (877) 435-7363, option #1.

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Text version

Attachment K. Contractor Information Form

This page is to be completed and returned with bid.

1. Contractor Name: ____________________________________________________

2. Contractor is to list Project Manager: _____________________________________

3. Contractor is to list Project Manager 24 hour-a day Cell Phone number:

4. Contractor is to list Pennsylvania Department of Agriculture, Pesticide Application Business License BU number:

5. Provide a copy of Pesticide Application Business License.

6. Provide a copy of all Pesticide Applicators Certifications ID cards.

File details come from the government source that posted it. Updated .