RFP Att E - Proposal Cover Sheet Pilot and Applicator License Form.doc
DOC document 75 KB Posted
- Solicitation number
- S-62900-00004954
- Issued by
- Tillamook County, Oregon
About this file
This document is the Attachment E - Affidavit of Compliance with Tax Laws for a Request for Proposals (RFP) for Aerial Herbicide Services in the Tillamook, Forest Grove, and Astoria Districts in Oregon. The RFP is seeking qualified helicopter pilots and commercial applicators to provide aerial herbicide application services in Clatsop, Tillamook, and Washington counties. The RFP requires the submission of pilot qualifications, including the pilot's name, license information, flight hours, and experience. It also requires the listing of commercial applicators and their license information. The proposal cover sheet must be signed, certifying the qualifications of the pilots and applicators.
The RFP is for a 2023 Aerial Herbicide project, with a closing date and time for submitting proposals. The contract will be awarded to the successful bidder, but the document does not specify the term of the contract or any renewal options.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| RFP Att H - Certified Disadvantage Business Outreach Plan.doc | DOC document | |
| RFP Att F - Reference Check Form.doc | DOC document | |
| Forest_Grove_Aerial_Site_Prep_Vincinty_Map.pdf | ||
| Forest_Grove_Aerial_Site_Prep_Maps.pdf | ||
| RFP Att B - Affidavit of Trade Secret.doc | DOC document | |
| RFP Att D - Proposer Information Sheet.doc | DOC document | |
| Final Aerial Herbicide RFP.doc | DOC document | |
| RFP Att G- Cost Proposal form.docx | DOCX document | |
| 2023_AstoriaSitePrep_Unit_Maps.pdf | ||
| Final Sample Contract.docx | DOCX document | |
| RFP Att I - PROPOSAL CHECKLIST.doc | DOC document | |
| Turkey Products~3.docx | DOCX document | |
| Final 2023 Aerial Herbicide RFP 4954 Tab Sheet.xlsx | XLSX spreadsheet | |
| RFP Att C - Proposer Certification Sheet.doc | DOC document | |
| 2023_Overview_Map_Astoria.pdf | ||
| Tillamook Aerial Site Prep~3.zip | ZIP file |
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Text version
RFP [###-####-##] – [RFP title] ATTACHMENT E – AFFIDAVIT of COMPLIANCE with TAX LAWS
RFP-62900-00004954
2023 Aerial Herbicide- Tillamook, Forest Grove, and Astoria Districts Att E
ATTACHMENT E – Proposal Cover Sheet Pilot and Applicator License Information Organization Name: _____________________________________________________
Primary Contact Person: ___________________ Title: __________________________ Address: ______________________________________________________________
City, State, Zip: _________________________________________________________
Telephone: _______________ Fax: _______________
E-mail Address: ________________________________________________________
Name and title of the person(s) authorized to represent the Proposer in any negotiations and sign any Purchase Orders that may result:
Name: __________________________Title:__________________________________
| PILOT 1 |
| PILOT 2 |
| PILOT 3 |
| PILOT 4 |
PILOT NAME:
PILOT QUALIFICATIONS:
OREGON PILOT REGISTRATION NOS:
MEDICAL DATE:
TOTAL HELICOPTER FLIGHT HOURS:
HOURS IN MAKE & MODEL FOR
THIS CONTRACT:
HOURS DURING PRECEDING 60 DAYS:
HOURS OVER TYPICAL TERRAIN:
HOURS OF FOREST SPRAYING
WITH HELICOPTERS:
NO. OF TAKE OFFS AND LANDINGS
(at typical altitudes and helispots)
I certify that the pilots, as listed above, are qualified helicopter pilots and have the type and amount of experience as given.
Signature:
Title:
Company Name:
Date:
Commercial
Commercial
Applicator
Trainee
Exp.
Employee Name
License No.
License No.
Date
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
I certify that the employees, as listed above, possess a valid license of the type stated above.
Signature:
Title:
Company Name:
Date:
(No Aceptable)
Version 1.0 - November 19, 2014
File details come from the government source that posted it. Updated .