Solicitation Mosquito treatment at GO Residences 2026 Final.pdf

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

1. REQUISITION NUMBER

PR15790532

2. CONTRACT NO.

3. AWARD/EFFECTIVE

DATE

4. ORDER NUMBER

5. SOLICITATION NUMBER

191D3226R0013

6. SOLICITATION ISSUE DATE

January 26, 2026

7. FOR SOLICITATION

INFORMATION CALL

a. NAME

Widodo Winaskita

b. TELEPHONE NUMBER(No collect calls)

5083-1000

8. OFFER DUE DATE/

LOCAL TIME

February 13, 2026 on or before 04.00 pm WIB

9. ISSUED BY CODE

10. THIS ACQUISITION IS 11. DELIVERY FOR FOB 12. DISCOUNT TERMS

Contracting Office

American Embassy Jakarta.

Jl. Medan Merdeka Selatan No. 5

Jakarta Pusat

Tel. 021-5083-1000

UNRESTRICTED

SET ASIDE: % FOR

SMALL BUSINESS

DESTINATION UNLESS

BLOCK IS MARKED

SEE SCHEDULE

HUBZONE SMALL

BUSINESS

13a. THIS CONTRACT IS A RATED ORDER

UNDER DPAS (15 CFR 700)

8(A) 13b. RATING

NAICS:

SIZE STD:

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE

16. ADMINISTERED BY CODE

GSO/PCU

Jl. Medan Merdeka Selatan 5 Jakarta

17a. CONTRACTOR/ CODE

OFFEROR

FACILITY

CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO.

Financial Management Center American Embassy Jakarata Jl. Medan Merdeka Selatan No. 5 Jakarta Pusat

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS

BLOCK BELOW IS CHECKED SEE ADDENDUM

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

Mosquito Treatment Services at the US

Embassy Residences in various addresses in Jakarta Area

Lot

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN 1

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

HEREIN.

29.AWARD OF CONTRACT: REF. _________________ OFFER

DATED _______________. YOUR OFFER ON SOLICITATION

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH

ARE SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT)

30c. DATE SIGNED

31b. NAME OF CONTRACTING OFFICER (Type or Print)

Bryant H. Whitfield

31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 1449 (REV 4/2002)

PREVIOUS EDITION IS NOT USABLE

Computer Generated Prescribed by GSA - FAR (48 CFR) 53.212

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ____________________________

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED

CORRECT FOR

36. PAYMENT 37. CHECK NUMBER

PARTIAL FINAL

COMPLETE PARTIAL FINAL

38. S/R ACCOUNT NO.

39. S/R VOUCHER NO. 40. PAID BY

41.a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 42a. RECEIVED BY (PRINT)

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

41C. DATE

42b. RECEIVED AT (Location)

42c. DATE REC’D (YY/MM/DD) 42d. TOTAL CONTAINERS

TABLE OF CONTENTS

SECTION 1 – THE SCHEDULE

• SF 1449 cover sheet

• Continuation To SF-1449, RFQ Number 191D3226R0013, Prices, Block 23

• Continuation To SF-1449, RFQ Number 191D3226R0013, Schedule of Supplies/Services, Block 20

Description/Specifications/Work Statement

• Attachment 1 to Description/Specifications/Performance Work Statement, Contractor Furnished

Material

SECTION 2 – CONTRACT CLAUSES

• Contract Clauses

• Addendum to Contract Clauses - FAR and DOSAR Clauses not Prescribed in Part 12

SECTION 3 – SOLICITATION PROVISIONS

• Solicitation Provisions

• Addendum to Solicitation Provisions - FAR and DOSAR Provisions not Prescribed in Part 12

SECTION 4 – EVALUATION FACTORS

• Evaluation Factors

• Addendum to Evaluation Factors - FAR and DOSAR Provisions not Prescribed in Part 12

SECTION 5 – REPRESENTATIONS AND CERTIFICATIONS

• Offeror Representations and Certifications

• Addendum to Offeror Representations and Certifications - FAR and DOSAR Provisions not

Prescribed in Part 12

SECTION 1 - THE SCHEDULE

CONTINUATION TO SF-1449

RFQ NUMBER 191D3226R0013

PRICES, BLOCK 23

1. SCOPE OF CONTRACT

The Contractor shall perform Mosquito Treatment Services, including furnishing all labor, material, equipment and services, for US Embassy Residences in various addresses in Jakarta Area. The price listed below shall include all labor, materials, insurance (see FAR 52.228-3 and 52.228-5), overhead, and profit. The Government will pay the Contractor the fixed price per month for standard services that have been satisfactorily performed.

After contract award and submission of acceptable insurance certificates, the Contracting Officer shall issue a Notice to Award. The Notice to Award will establish a date (a minimum of ten (10) days from date of contract award unless the Contractor agrees to an earlier date) on which performance shall start.

The performance period of this contract is from the start date in the Notice to Award and continuing for 12 months, with 4 (four), one-year options to renew. The initial period of performance includes any transition period authorized under the contract.

2.0 PRICING

B.3.1 VALUE ADDED TAX

VALUE ADDED TAX (VAT). The Contractor shall include VAT as a separate charge on the Invoice and as a separate line item in Section B.

B.4 BASE PERIOD PRICES

No. Address SQM

Qty of

Services

Unit

Price

Total

1 DIPONEGORO 04 2,558 26

2 DIPONEGORO 18 1,240 26

3 HANG TUAH 18 503 26

4 LATUHARHARY 11 552 26

5 LEMBANG 43A 347 26

6 POLOMBANGKENG 2 904 26

7 POLOMBANGKENG 19 899 26

8 POLOMBANGKENG 21 1,100 26

JAMES ZADROGA 9/11 VICTIMS HEALTH AND COMPENSATION ACT OF

2010 NOTICE: UNLESS A WAIVER OR EXCEPTION APPLIES, PAYMENTS

SUBSEQUENT TO THIS PROCUREMENT ARE SUBJECT TO AN EXCISE

TAX OF 2% PERSUANT TO 26 U.S.C. 5000C.

9 PURWOREJO 16 441 26

10 SENJAYA BUNTU I/52 663 26

11 SRIWIJAYA II/21 723 26

12 SUTAN SYAHRIR 11 451 26

13 TEUKU UMAR 59 1,468 26

WIJAYA I/36 or CIBITUNG

II/36 535

15 WIJAYA III/14 286 26

16 WIJAYA IV/12 392 26

17 FOA 01 556 26

18 FOA 02 713 26

19 FOA 03 602 26

20 FOA 04 533 26

21 FOA 05 545 26

22 FOA 06 390 26

23 FOA 07 574 26

24 FOA 08 509 26

25 FOA 09 610 26

26 FOA 10 525 26

27 FOA 11 1,285 26

28 FOA 12 663 26

29 FOA 13 357 26

30 FOA 14 428 26

31 FOA 15 514 26

32 FOA 16 553 26

33 FOA 17 605 26

34 FOA 18 544 26

35 FOA 19 478 26

36 FOA 20 696 26

37 TS-3 8,106 26

38 TS-4 3,071 26

39 Prapatan Compound 4,403 26

40 Galuh Compound 3,942 26

Total

VAT

Grand Total

B.5 FIRST OPTION YEAR PRICES

Services

Unit

Price

Total

1 DIPONEGORO 04 2,558 26

2 DIPONEGORO 18 1,240 26

3 HANG TUAH 18 503 26

4 LATUHARHARY 11 552 26

5 LEMBANG 43A 347 26

6 POLOMBANGKENG 2 904 26

7 POLOMBANGKENG 19 899 26

8 POLOMBANGKENG 21 1,100 26

9 PURWOREJO 16 441 26

10 SENJAYA BUNTU I/52 663 26

11 SRIWIJAYA II/21 723 26

12 SUTAN SYAHRIR 11 451 26

13 TEUKU UMAR 59 1,468 26

WIJAYA I/36 or CIBITUNG

II/36 535

15 WIJAYA III/14 286 26

16 WIJAYA IV/12 392 26

17 FOA 01 556 26

18 FOA 02 713 26

19 FOA 03 602 26

20 FOA 04 533 26

21 FOA 05 545 26

22 FOA 06 390 26

23 FOA 07 574 26

24 FOA 08 509 26

25 FOA 09 610 26

26 FOA 10 525 26

27 FOA 11 1,285 26

28 FOA 12 663 26

29 FOA 13 357 26

30 FOA 14 428 26

31 FOA 15 514 26

32 FOA 16 553 26

33 FOA 17 605 26

34 FOA 18 544 26

35 FOA 19 478 26

36 FOA 20 696 26

37 TS-3 8,106 26

38 TS-4 3,071 26

39 Prapatan Compound 4,403 26

40 Galuh Compound 3,942 26

Total

B.6 SECOND OPTION YEAR PRICES

Services

Unit

Price

Total

1 DIPONEGORO 04 2,558 26

2 DIPONEGORO 18 1,240 26

3 HANG TUAH 18 503 26

4 LATUHARHARY 11 552 26

5 LEMBANG 43A 347 26

6 POLOMBANGKENG 2 904 26

7 POLOMBANGKENG 19 899 26

8 POLOMBANGKENG 21 1,100 26

9 PURWOREJO 16 441 26

10 SENJAYA BUNTU I/52 663 26

11 SRIWIJAYA II/21 723 26

12 SUTAN SYAHRIR 11 451 26

13 TEUKU UMAR 59 1,468 26

WIJAYA I/36 or CIBITUNG

II/36 535

15 WIJAYA III/14 286 26

16 WIJAYA IV/12 392 26

17 FOA 01 556 26

18 FOA 02 713 26

19 FOA 03 602 26

20 FOA 04 533 26

21 FOA 05 545 26

22 FOA 06 390 26

23 FOA 07 574 26

24 FOA 08 509 26

25 FOA 09 610 26

26 FOA 10 525 26

27 FOA 11 1,285 26

28 FOA 12 663 26

29 FOA 13 357 26

30 FOA 14 428 26

31 FOA 15 514 26

32 FOA 16 553 26

33 FOA 17 605 26

34 FOA 18 544 26

35 FOA 19 478 26

36 FOA 20 696 26

37 TS-3 8,106 26

38 TS-4 3,071 26

39 Prapatan Compound 4,403 26

40 Galuh Compound 3,942 26

Total

B.7 THIRD OPTION YEAR PRICES

Services

Unit

Price

Total

1 DIPONEGORO 04 2,558 26

2 DIPONEGORO 18 1,240 26

3 HANG TUAH 18 503 26

4 LATUHARHARY 11 552 26

5 LEMBANG 43A 347 26

6 POLOMBANGKENG 2 904 26

7 POLOMBANGKENG 19 899 26

8 POLOMBANGKENG 21 1,100 26

9 PURWOREJO 16 441 26

10 SENJAYA BUNTU I/52 663 26

11 SRIWIJAYA II/21 723 26

12 SUTAN SYAHRIR 11 451 26

13 TEUKU UMAR 59 1,468 26

WIJAYA I/36 or CIBITUNG

II/36 535

15 WIJAYA III/14 286 26

16 WIJAYA IV/12 392 26

17 FOA 01 556 26

18 FOA 02 713 26

19 FOA 03 602 26

20 FOA 04 533 26

21 FOA 05 545 26

22 FOA 06 390 26

23 FOA 07 574 26

24 FOA 08 509 26

25 FOA 09 610 26

26 FOA 10 525 26

27 FOA 11 1,285 26

28 FOA 12 663 26

29 FOA 13 357 26

30 FOA 14 428 26

31 FOA 15 514 26

32 FOA 16 553 26

33 FOA 17 605 26

34 FOA 18 544 26

35 FOA 19 478 26

36 FOA 20 696 26

37 TS-3 8,106 26

38 TS-4 3,071 26

39 Prapatan Compound 4,403 26

40 Galuh Compound 3,942 26

Total

B.8 FOURTH OPTION YEAR PRICES

Services

Unit

Price

Total

1 DIPONEGORO 04 2,558 26

2 DIPONEGORO 18 1,240 26

3 HANG TUAH 18 503 26

4 LATUHARHARY 11 552 26

5 LEMBANG 43A 347 26

6 POLOMBANGKENG 2 904 26

7 POLOMBANGKENG 19 899 26

8 POLOMBANGKENG 21 1,100 26

9 PURWOREJO 16 441 26

10 SENJAYA BUNTU I/52 663 26

11 SRIWIJAYA II/21 723 26

12 SUTAN SYAHRIR 11 451 26

13 TEUKU UMAR 59 1,468 26

WIJAYA I/36 or CIBITUNG

II/36 535

15 WIJAYA III/14 286 26

16 WIJAYA IV/12 392 26

17 FOA 01 556 26

18 FOA 02 713 26

19 FOA 03 602 26

20 FOA 04 533 26

21 FOA 05 545 26

22 FOA 06 390 26

23 FOA 07 574 26

24 FOA 08 509 26

25 FOA 09 610 26

26 FOA 10 525 26

27 FOA 11 1,285 26

28 FOA 12 663 26

29 FOA 13 357 26

30 FOA 14 428 26

31 FOA 15 514 26

32 FOA 16 553 26

33 FOA 17 605 26

34 FOA 18 544 26

35 FOA 19 478 26

36 FOA 20 696 26

37 TS-3 8,106 26

38 TS-4 3,071 26

39 Prapatan Compound 4,403 26

40 Galuh Compound 3,942 26

Total

B.9 GRAND TOTAL

Base Year Price

First Option Year Price

Second Option Year Price

Third Option Year Price

Fourth Option Year Price

GRAND TOTAL

CONTINUATION TO SF-1449

RFQ NUMBER 191D3226R0013

SCHEDULE OF SUPPLIES/SERVICES, BLOCK 20

1. INTRODUCTION

This firm-fixed price contract is for providing regular mosquito treatment at Government Owned (GO)

Residences in Jakarta Area, in accordance with Section 1 C, below. The work shall be accomplished in a manner that:

• conforms to the intent of all applicable Department of State safety, health, and environmental policies, standards and regulations;

• recognizes and takes all precautions against the documented dangers of pesticide application;

• is done in a manner effective for controlling pests and causes no contamination to other parts of the property and environs;

• endangers none of the property occupants or workers; and

• leaves the areas safe for re-occupancy.

2. GENERAL SCOPE OF WORK

The Contractor shall adequately suppress the mosquito problem by providing regular mosquito treatment based on the Departments Integrated Management Program (IPM). Emphasis is on controlling the conditions that allow pests to breed and exist around the properties, with the following steps:

Initial IPM Inspection:

A Professional Pest Contractor will conduct an initial exterior inspection and provide a written report that identifies problem areas and recommends structural, sanitary, and/or procedural modifications to reduce mosquitoes access water and shelter.

IPM Monitoring Plan:

The Pest Contractor will submit a treatment plan to the Facility Manager/ Post Occupational Safety and

Health Officer (FM/POSHO). The plan will include a detailed proposal of scheduled inspections and treatments at all locations. Treatments will occur bi-weekly. The contractor should make every attempt to schedule the treatment for the same day and time each week except on weekends and holidays. The

Contractor must get approval from the occupant or embassy prior treatment. A list of holidays can be found on attachment 1.

Locations to be treated are: (See Exhibit 4)

IPM services

Treatment services will include:

- Inspection of entire yard, gutters, storm-drains, and ditches along perimeter fence paying special attention to damp and wet soil surfaces and areas with vegetation where adult mosquitoes are likely to rest.

- Inspect openings, cracks, crevices, and other surfaces in the yard, gutters, storm-drains, and ditches along perimeter fence where water can collect.

- The Pest Contractor will use misting methods with compressive air sprayer engine capacity 2.5 kW,

3.3 Hp, Max. air throughput 1.260 m3/h or higher to apply Authorized Professional Pesticides.

- Applying approved pesticides are pyrethroids containing lambda-cyhalothrin or permethrin as specified in attachment 2: “Table 2 Department-Authorized EPA-registered Professional – Use

Pesticides for Common Pests”.

- Communicating findings to the FM/POSHO as outlined in Recordkeeping section.

Service Descriptions:

1. Emphasis on Non-Pesticide Methods

– Standard use of non-pesticide methods should be used as a first and primary means of pest control such as eliminating living and breeding sites.

2. Mosquito Control

– Application of Spray pesticides to Exposed Surfaces:

Fogging is prohibited and the application of spray pesticides to exposed surfaces will be minimized. A The Pest Contractor will obtain approval from the FM/POSHO prior to any application of pesticides to an exposed surface or application of a spray treatment. Use Form 1

Pesticide Application Plan below to obtain approval from the FM/POSHO. The Pesticide

Application Form should be submitted to the FM/POSHO at least 24 hours prior to application.

The Pest Contractor will ensure resident and employee safety and take all necessary precautions for the containment of the pesticide to the application site. No surface application or space spraying will be conducted while resident(s) or personnel are present.

– Schedule:

The Pest contractor must arrange a spray treatment schedule from the beginning of the contract to the end of the contract period and provide it to the FM/POSHO who will obtain approval from the occupants. Spraying is not to be carried out on Saturday, Sunday, and Holiday unless requested by the occupant.

3. Pesticide Use

The Pest Contractor will adhere to the following rules for pesticide use:

- Approved Products:

Only apply pesticide products such as pyrethroids containing lambda-cyhalothrin or permethrin that have been included in “Table 2 Department-Authorized EPA-registered Professional – Use

Pesticides for Common Pests” and approved in writing by the FM/POSHO.

- Prohibited products:

Do not use foggers or bombs, organophosphate or chlorinated hydrocarbons pesticides. Do not use broadcast or baseboard spray applications without authorization from the COR.

- Pesticide Storage:

Do not store any pesticide products at the application sites.

- Minimization of Risk:

When pesticides are used, use only the approved materials, with the most precise application technique, and with the minimum quantity of pesticide necessary to achieve control. Apply pesticides in manner that is safe and inaccessible to residents and pets. Avoid getting any pesticides into natural ponds, ornamental backyard ponds, or swimming pools.

- Notification:

Provide a written notice of the intention to apply pesticide at least 24 hours in advance.

- Personal Protective Equipment (PPE):

The Contractor shall provide their workers and embassy personnel working as a contractor escort

(if any) adequate and proper personal protective equipment (such as safety glasses and chemical mask, etc.) while applying pesticides.

- Emergency Procedures:

If there is a need to deviate from the above procedure in any way, a written request for approval must be submitted to the FM/POSHO or his/her representative.

4. Recordkeeping

- Recordkeeping forms:

The Pest Contractor will submit to the FM/ POSHO a signed and dated checklist for each location visited that will include: a record of the monitoring results, a list of all actions taken, list of threshold information, location, brand name, the active ingredient of any preapproved pesticide product used, and a list of location and problem.

- Permit:

The Pest Contractor will submit to the Embassy security office the documents required to obtain working permits and submit to the FM/POSHO a treatment schedule. The Contractor will work with embassy staff to obtain approval from occupant before treatment.

- Service Updates to FM:

The Pest Contractor will provide a quarterly and annual report that includes a summary of pesticide used, the brand names and active ingredients, progress, and planned activities on each residence. The FM/POSHO will notify Pest contractor if unwanted incident or receive complaint from occupant, neighbor, or security guard related to the treatment. Pest contractor will do any necessary action to response to the incident/complaint in timely manner. These will be included in the quarterly and annual report as well as actions taken.

- Proof of Service Guarantee:

All invoices will be accompanied by proper proof of service, including the date of service, the technician’s time of arrival and departure, a detailed report of all services performed including chemicals/products used and location of use. This proof of service is to be verified and signed by either embassy representative/escort or occupant representative. Invoices will not be paid unless

The Pest Contractor provides acceptable proof of service.

5. Treatment Contract Period

This mosquito treatment work will be a Multiyear Contract for one year (26 treatments / year).

CONTINUATION TO SF-1449, RFQ NUMBER 191D3222R0001

SCHEDULE OF SUPPLIES/SERVICES, BLOCK 20

DESCRIPTION/SPECIFICATIONS/PERFORMANCE WORK STATEMENT

1. DEFINITIONS AND REGULATIONS

a. Definitions.

The following terms as used in this contract are hereby defined as follows:

Aerosol: A system consisting of solid or liquid particles suspended in air.

Clean or Decontaminate: To thoroughly remove pesticide residue from surfaces. In order to accomplish this, refer to the pesticide manufacturer's recommendations for cleaning and decontamination.

Contractor: Shall mean the Pest Control Contractor or authorized representative.

COR: Shall mean Contracting Officer's Representative.

DAPU: Department-authorized professional-use pesticides that are listed on Table 2 of the Department’s

Integrated Pest Management Program document or others that have been authorized (by M/OBO/OM/

SHEM) for a specific application. These pesticides are also listed in Exhibit 2.

DOS: Department of State

Emulsifiable Concentrates: Emulsifiable concentrates permit chemicals which do not dissolve in water, to be suspended in water with water as the extending or diluting material. This is accomplished by dissolving the toxicant in its usual solvent and adding an emulsifying agent to make it possible for small droplets of the solvent, carrying the toxicant to remain dispersed, throughout the water. The emulsion contains water, solvent, pesticide, and emulsifier.

EPA: The U.S. Environmental Protection Agency.

Fumigation: The act of introducing a toxic chemical in an enclosed area in such a manner that it disperses quickly and acts on the target organism in the gaseous or vapor state.

Integrated Pest Management (IPM) Program: IPM is a written, planned program for long-term pest control that employs habitat modification to reduce the prevalence of pests, self-help measures such as traps and consumer pesticides, and, as a last resort, professionally applied Department-authorized pesticides (DAPUs).

Label/ Labeling: All printed material included with a pesticide product that describes how the pesticide may be used and provides directions and precautions. This material may include multiple pages of information in the form of a separate booklet enclosed with the pesticide. All of this information comprises the labeling which users must legally follow.

Log: An official record of all activities that occurred during the term of the contract and identifying the various work locations, Contractor personnel, and other pertinent information.

Monitoring: The process of visually inspecting a specific application of pesticide(s) to determine the proper use and adherence to the labeled instructions as well as general safety precautions.

MSDS: Material safety data sheet that lists hazardous ingredients in a chemical product, such as a pesticide, and provides guidance on safety precautions.

Pest Control Activities: All activities from initiation of work area preparation through successful suppression of the target pest identified within the Initial Inspection Report.

Pest Control Plan (PCP): The Contractor shall develop a written Pest Control Plan after the initial site inspection and submit such plan to the COR for approval. This Plan shall propose measure to reduce the existing pest population and prevent future infestations. Exhibit 1 contains a model Pest Control Plan form.

Pest Control Technicians: Throughout the purchase order's performance, all personnel providing on-site pest control services must meet the requirements of the host country for training, registration, or certification as pest control technicians.

POSHO: Post Occupational Safety and Health Officer.

SHEM – Safety, Health and Environmental Management

Supervisor: An on-site Supervisor and an alternate shall have the Contractor's authority to act on matters pertaining to the performance of services required under this purchase order. This individual shall ensure safety and carry out coordination and continuity of the program routine. The on-site Supervisor and alternate shall both have a working knowledge of this purchase order; the PCP; and Service Schedule for each of the properties. Additionally, the on-site Supervisor and alternate must both be certified as required by the laws and regulations of the host country.

Work Area: The area where a pesticide is being applied. This includes any areas adjacent to which building occupants could be exposed to the pesticide(s) being applied.

b. DOS Policies, Regulations, and Standards.

This sets forth DOS policies, regulations, and standards, which are included in the Safety, Health, and

Environmental Management Resource Guide and others and are incorporated by reference and made part of the specifications.

Requirements include adherence to work practices and procedures stated in applicable codes and regulations. Requirements include obtaining permits, licenses, inspections, releases and similar documentation, as well as payments, statements and similar requirements associated with codes and regulations.

Except to the extent that more explicit or more stringent requirements are written directly into the purchase order documents, all applicable DOS policies, regulations, and standards have the same force and effect (and are made a part of the contract documents by reference) as if copied directly into the purchase order documents, or as if published copies are bound herewith.

Contractor Responsibility: The Contractor shall assume full responsibility and liability for the compliance with all applicable DOS policies, regulations, and standards in their most current form. The

Contractor shall hold the U.S. Government and its representatives harmless for failure to comply with any applicable work, hauling, disposal, safety, health or other regulations on the part of the Contractor, their employees, or subcontractors.

2. DELIVERABLES

The following items shall be delivered under this contract:

Description Delivery Date Deliver to:

Certificate of Insurance (see 4.c. below) 10 days after award Contracting Officer

Pest Control Plan (see 3.b. below) 10 days after initial inspection COR

3. SPECIFIC TASKS

a. Initial Inspection

The Contractor shall conduct a thorough, initial inspection of the property or site within the time specified in the purchase order. The purpose of the initial inspection is for the Contractor to: verify site conditions; identify the insect or organism to be controlled; identify sensitive areas; identify equipment needs; identify structural features, maintenance practices, etc. that are contributing to pest infestations;

and, develop a Pest Control Plan.

Access to building space shall be coordinated with the Contracting Officer's Representative (COR).

The COR will inform the Contractor of any restrictions or areas requiring special scheduling.

b. Develop a Pest Control Plan

Prior to initiation of service, the Contractor shall submit to the COR a Pest Control Plan for each property or site identified in the purchase order within 1 days following the initial inspection. Upon receipt of the Pest Control Plan, the COR will render a decision regarding its acceptability within 1 days.

The Contractor shall be on site to initiate service within 5 days following notice of approval. If aspects of the Pest Control Plan are incomplete or disapproved, the Contractor shall have 1 days to submit revisions.

THE PEST CONTROL PLAN SHALL CONSIST OF THE FOLLOWING PARTS:

1. Proposed methods for control, including name of any pesticide(s) to be used, specimen labels and Material Safety Data Sheets (MSDS sheets) for all pesticides proposed to be used. All professional-use pesticides must be authorized by the Department (see Exhibit 2 for pre-authorized pesticides) and appropriate for the target pest and situation. A list of brand names of rodent bait boxes and any other control devices or equipment should also be included.

2. Methods to be used to ensure the safety of building occupants and visitors to the site including the anticipated period that the premises must be vacated (if applicable).

3. Preparations that must be carried out other than by the contractor prior to implementation of the

Pest Control Plan (e.g. removing pets, covering food handling equipment).

4. A description of conditions conducive to the pest problem and any structural or operational changes that would facilitate the pest control effort.

5. A copy of any local license, if applicable, for every Contractor's representative who will be performing on-site service under this contract.

6. A list identifying the on-site person(s) who will be performing the pest control work. All pertinent information regarding their qualifications, experience, and training must also be provided.

It shall be the Contractor's responsibility to carry out work according to the approved Pest Control

Plan for each property or site. The Contractor shall receive the concurrence of the COR prior to implementing any subsequent changes to the approved Pest Control Plan, including additions or replacements to the pesticide list and to on-site service personnel.

A model Pest Control Plan form is included as Exhibit 1 of this purchase order.

NOTE: THE DEPARTMENT MUST APPROVE ALL PESTICIDES USED BY THE CONTRACTOR.

DEPARTMENT-AUTHORIZED PROFESSIONAL-USE PESTICIDES (DAPU) ARE FOUND IN

EXHIBIT 2. (See Exhibit 2, Department-Authorized EPA-Registered Professional-Use Pesticides for

Common Pests). USE OF NON-CHEMICAL AND SELF-HELP PESTICIDES IN LIEU OF

PROFESSIONAL-USE PESTICIDES IS ENCOURAGED AS APPROPRIATE FOR THE PEST

PROBLEM.

c. Apply Pesticide

General

The Contractor shall only apply pesticides that have been included in the Pest Control Plan and approved in writing by the COR. As a rule, the contractor shall not apply pesticides in any area inside or outside the premises - i.e., in any room, closet, hallway, stairwell, court, driveway, planting bed, and similar locations - unless the Contractor's inspections confirm the presence of pests in that specific area.

The Contractor shall deliver all materials and supplies to the site in the original unopened containers bearing the name of the manufacturer and details for proper mixing, application, storage and disposal.

The Contractor shall apprise all workers, supervisory personnel, and any other contractors who will be at the work site of the seriousness of the hazard and of proper work procedures, which must be followed.

The Contractor shall coordinate any and all pesticide use and activities with the COR prior to actual application. No pesticide application shall occur unless advance preparations have been completed

(Section B item 3). If the COR is not the POSHO, the COR will receive the approval of the POSHO before instructing the Contractor to begin application. The COR shall ensure that he/she has copies of the

Material Safety Data Sheets and pesticide labeling for the pesticides being used and that the Contractor also has copies of said information so that protective measures and/or spills may be properly addressed.

The COR shall provide the Contractor with the following:

- Access to all identified areas for pest control.

- Water and electricity from outside of the work area. The Contractor shall be responsible for the tie-ins to these services.

- A designated space for the Contractor to park vehicles necessary to perform the work, if required.

- The name and phone number of at least one building authority who can be contacted 24 hours a day, if other than the COR.

Insect Control

Pesticide Products and Use: When it is determined that a professional pesticide must be used in order to obtain adequate control, the Contractor shall apply a Department-authorized professional-use pesticide that is appropriate for the target pest and situation. The Contractor shall conduct the application in compliance with all instructions and precautions noted on the specimen label as well as Department specifications, which are a subset of the labeling.

The Contractor shall be responsible for application of pesticides according to the label and

Department specifications (refer to the Department’s Integrated Pest Management Program document).

All pesticides used by the Contractor must be EPA registered and/or authorized by the Department.

Transport, handling, and use of all pesticides shall be in strict accordance with the manufacturer's label instructions; all applicable U.S. Federal laws and regulations; and any applicable international or host country laws and regulations.

The Contractor shall minimize the use of liquid pesticide applications wherever possible. For example, as a general rule pesticide formulations shall be applied indoors only as spot and/or crack, and crevice treatments with application devices specifically designed or modified for this purpose.

Application of pesticide liquid, aerosol, or dust to exposed surfaces, and pesticide space sprays

(including fogs, mists, and ultra-low volume applications), shall be restricted to unique situations where no alternative measures are practical. Special authorization will be required.

If the proposed pesticide is not already authorized in the Department’s Integrated Pest Management

Program document, the Contractor must submit a written request for authorization to the COR prior to any pesticide application. The COR shall render a decision regarding the treatment prior to its application. The Contractor shall take all necessary precautions to ensure tenant and employee safety, and all necessary steps to ensure the containment of the pesticide to the site of application. Other than spot or crack and crevice treatments, no applications of professional-use pesticides shall be made while tenant occupants are present.

d. Inspection and Acceptance

Upon notification to the COR that the service has been provided, the COR shall visually inspect the work area/treated area. If the work is not satisfactory, the COR shall advise the Contractor in writing. The

COR shall repeat the inspection when assured that the work has been completed properly. The COR shall periodically conduct unannounced site visits to observe that the Contractor is implementing all requirements specified in the Pest Control Plan.

When the work has been satisfactorily completed, the COR shall so certify acceptance on the OF-

127, Receiving and Inspection Report.

e. Clean-up of Area

Upon final acceptance by the COR, the Contractor shall remove temporary protective measures (e.g., exhaust fans, tarps placed up for fumigation, and facilities installed for work by the Contractor). Any warning placards shall be removed.

The Contractor shall remove all tools, equipment and supplies from the work area. No pesticides, empty pesticide containers or equipment used for pesticide application shall be left behind in the work area.

The work area shall be free of dirt and/or debris when the project is complete. All holes drilled by the

Contractor shall be patched and covered with standard construction materials or as stated in the Pest

Control Plan.

The Contractor shall comply with the Department of State's cleaning and safety regulations. The

Contractor shall not:

- Burn waste materials.

- Bury debris or excess materials.

- Allow volatile, harmful or dangerous materials to enter the drainage system.

4. OTHER REQUIREMENTS

a. Manner and Time to Conduct Service

The Contractor shall perform routine pest control services that do not adversely affect tenant health or productivity during the regular hours of operation in buildings. When it is necessary to perform work outside of the regularly scheduled hours set forth in the Pest Control Plan, the Contractor shall notify the

COR at least one day in advance.

b. Safety Precautions

The Contractor shall observe all safety precautions throughout the performance of this purchase order and be prepared to clean up any pesticide spills. The Contractor shall provide for proper protection of applicators in accordance with label instructions and local country safety and health requirements. Certain areas within some buildings may require special instructions for persons entering the building. Any restrictions associated with these special areas will be explained by the COR. The Contractor shall adhere to these restrictions and incorporate them into the Pest Control Plan for the specific building or site.

The Contractor shall take appropriate continuous measures as necessary to protect all building occupants from the hazard of exposure to pesticides. The Contractor shall assume full responsibility and liability for compliance with all applicable regulations pertaining to the health and safety of personnel during the execution of work, and shall hold the Government harmless for any action on its part or that of its employees or subcontractors that results in illness or death.

c. Certificate of Insurance

The Contractor shall submit a current certificate of comprehensive general liability insurance on an occurrence basis including bodily injury, personal injury, premises/operations, independent contractors, products and completed operations, contractual liability and broad form property damage. In addition, the Contractor shall furnish evidence of a commitment by the insurance carrier to notify the

Contracting Officer in writing of any material change, expiration or cancellation of any of the insurance policies required not less than thirty (30) days before such change, expiration or cancellation is effective.

When coverage is provided by self-insurer, the Contractor shall not change or decrease the coverage without the Contracting Officer's approval.

The insurance shall include a specific endorsement for the extension of coverage to pest control and pesticide applications. The State Department shall be shown on the certificate as an "additional insured". A copy of the policy shall be provided with any Certificate of Insurance. The certificate shall further provide that the State Department be given thirty (30) days prior notice of cancellation or any change in coverage. Minimum acceptable liability coverage is:

1. Bodily Injury on or off the site stated in US Dollars:

Per Occurrence $2,500.00

Cumulative $5,000.00

2. Property Damage on or off the site in US Dollars:

Per Occurrence $25,000.00

Cumulative $50,000.00

If umbrella excess coverage is used to satisfy these limits, the certificate of insurance shall indicate that it is following the Primary Policy.

d. Contractor Personnel

All Contractor personnel providing on-site pest control service must meet local requirements in the host country where service is actually performed, for training, registration, or certification as may be required by the local laws of the host country for pesticide applicators. Unqualified individuals shall not be permitted to provide service under the terms of this purchase order. In addition, all applicators must review, understand and abide by the pesticide labeling instructions and Department-authorized uses, which are a subset of the labeling instructions.

The COR may request removal of any Contractor personnel from the work site for cause, such as inappropriate behavior, unfit persons not skilled in the work, or lack of appropriate equipment or materials. The Government shall not be responsible for the cost of returning or replacing this person at the work site.

e. Contractor Use of Premises

The Contractor shall confine operations to the areas specified in this purchase order. Portions of the site beyond areas in which work is indicated shall not be disturbed.

The Contractor shall conform to the Post's security rules and regulations affecting the work while engaged in pesticide application or regarding personal behavior.

The Contractor shall keep existing driveways and entrances serving the premises clear and available to Post personnel and the public at all times.

The Contractor shall not unreasonably encumber the site with materials or equipment.

The Contractor shall take all necessary precautions to protect the building or site and its occupants during the application of pesticides. The COR shall provide the occupant(s) of the property(ies) to be treated with a notice of pesticide precautions focusing on whether premises should be vacated and the applicable re-entry requirements. A notification form is included as Exhibit 3 in Section J of this purchase order.

f. Owner Occupancy

Post shall occupy the portions of the buildings not affected by the pest control operations during the period of application. The Contractor shall cooperate fully with the COR to minimize conflicts and to facilitate occupant's usage. The Contractor shall perform the work so as to interfere with Post operations as little as possible.

g. Reporting Accidents

The Contractor shall prepare and submit to the COR and the POSHO reports of significant accidents on site. The Contractor shall record and document data and actions taken in accordance with industry standards. For this purpose, a significant accident is defined to include events where personal injury is sustained, property loss is sustained, or where the event posed a significant threat of loss of property or personal injury. This includes pesticide spills that cause environmental contamination.

h. Unusual Conditions

When an unusual condition of the property or site is discovered during work (e.g., pesticide leaks on the interior of foundations, or any pesticide application which may contaminate a building or overexpose an occupant), the Contractor shall stop work immediately and advise the COR. This should be followed by a special report, if deemed necessary by the COR.

i. Emergencies

The Contractor shall discuss emergency service issues with the COR or other Post personnel to reach a common understanding as to fire, ambulance, or other agencies that service the abatement work site in case of an emergency. The Contractor shall post in the work area the telephone numbers and locations of emergency services including, but not limited to, fire, ambulance, doctor, and hospital.

Any Contractor personnel at the work site shall notify emergency service agencies if necessary.

5. COMPLETION DATE

The contractor shall complete each work required hereunder not later than 5 days after the date COR approved of the monthly Pest Control Plan.

6. DOSAR 652.242-70 CONTRACTING OFFICER'S REPRESENTATIVE (COR) (AUG 1999)

(a) The Contracting Officer may designate in writing one or more Government employees, by name or position title, to take action for the Contracting Officer under this contract. Each designee shall be identified as a Contracting Officer’s Representative (COR). Such designation(s) shall specify the scope and limitations of the authority so delegated; provided, that the designee shall not change the terms or conditions of the contract, unless the COR is a warranted Contracting Officer and this authority is delegated in the designation.

(b) The COR for this contract is Krishnanta Hardhono – APOSHO

7. RECORDKEEPING REQUIREMENTS

The Contractor and the COR shall both maintain a complete and accurate pest management file. The file shall contain as a minimum, the following items:

- A copy of the PCP for each property serviced under this purchase order, including all of the attachments (i.e., labels, Material Safety Data Sheets, and local license).

- Contractor's Service Report forms, documenting arrival and departure time of the Contractor's representative performing the service, and all information on pesticide application required by statute. These report forms may incorporate all of the pest surveillance data.

- Documentation of any complaints from Post personnel or unusual incidents which may have taken place during the visit to the site or pesticide application.

8. Quality Assurance and Surveillance Plan (QASP). This plan is designed to provide an effective surveillance method to promote effective contractor performance. The QASP provides a method for the

Contracting Officer's Representative (COR) to monitor contractor performance, advise the contractor of unsatisfactory performance, and notify the Contracting Officer of continued unsatisfactory performance.

The contractor, not the Government, is responsible for management and quality control to meet the terms of the contract. The role of the Government is to conduct quality assurance to ensure that contract standards are achieved.

Performance Objective PWS Para Performance Threshold

Services.

Performs all mosquito treatment services set forth in the performance work statement

(PWS).

1. thru 6.

All required services are performed and no more than

ONE (1) customer complaints are received per month

8.1. SURVEILLANCE. The COR will receive and document all complaints from Government personnel regarding the services provided. If appropriate, the COR will send the complaints to the Contractor for corrective action.

8.2. STANDARD. The performance standard is that the Government receives no more than two (2) customers complaints per month. The COR shall notify the Contracting Officer of the complaints so that the Contracting Officer may take appropriate action to enforce the inspection clause (FAR 52.212-4, Contract Terms and Conditions-Commercial Items), if any of the services exceed the standard.

8.3 PROCEDURES.

(a) If any Government personnel observe unacceptable services, either incomplete work or required services not being performed they should immediately contact the COR.

(b) The COR will complete appropriate documentation to record the complaint.

(c) If the COR determines the complaint is invalid, the COR will advise the complainant. The COR will retain the annotated copy of the written complaint for his/her files.

(d) If the COR determines the complaint is valid, the COR will inform the Contractor and give the

Contractor additional time to correct the defect, if additional time is available. The COR shall determine how much time is reasonable.

(e) The COR shall, as a minimum, orally notify the Contractor of any valid complaints.

(f) If the Contractor disagrees with the complaint after investigation of the site and challenges the validity of the complaint, the Contractor will notify the COR. The COR will review the matter to determine the validity of the complaint.

(g) The COR will consider complaints as resolved unless notified otherwise by the complainant.

(h) Repeat customer complaints are not permitted for any services. If a repeat customer complaint is received for the same deficiency during the service period, the COR will contact the Contracting Officer for appropriate action under the Inspection clause.

DOCUMENTS, EXHIBITS AND OTHER ATTACHMENTS

Exhibit 1 Model Pest Control Plan Form

Exhibit 2 Department-Authorized EPA Registered Professional-Use Pesticides for Common Pests

Exhibit 3 Pesticide Application Notification

Exhibit 4 List of Building(s)

EXHIBIT 1

NOTE TO THE COR

Prior to resorting to the use of chemical pesticides, the infestation should be confirmed and the effectiveness of self-help and prevalence reduction measures clearly demonstrated. When chemical pesticides are authorized, post should ensure that no substitutions are made with product (s) other than listed on the approved Post Pest Control Plan. The COR will notify occupants of the precautions and schedule to vacate treated space and not to reenter until ___ after the pesticide application (re-entry time depends on pesticide and extent of application and dry time).

Exhibit 2 – Department Autorizhed EPA Registered Proffesional-Use Pesticides for Termite Control

Mosquitoes, outdoors

Larvicide 10% containing Bacillus thuringiensis berliner var israelensis (bti) added to standing water in ponds, bird baths, tires, etc. for sustained release of larvicide

Various including:

Bactimos Briquets – 10% bti

Briquets release bti for a period of 30 days or longer. Break into bits for small containers of water such as potted plant saucers.

Liquid insecticide spray containing 0.015-0.030% lambda cyhalothrin. Apply outdoors as residual spray for on surfaces where adult mosquitoes congregate and the property perimeter.

Surrender (a.k.a.

Demand) Pestab with

Lambda-cyhalothrin (Control Solutions)

Follow mixing and dilution rate instructions on label.

Exhibit 3

PESTICIDE APPLICATION NOTIFICATION

This form is to be used by posts to formally authorize and document the conditions under which a contractor can apply pesticides in Department-owned/leased residences. As requested, an inspection of this property has been conducted and the following treatment plan is authorized.

This form is to be given to residence occupants at least 24 hours before application.

A pesticide applicator has been hired to come to your home or office to treat for pests, which you have been unable to control by other non-chemical means. The vendor has been authorized to use a product that is EPA registered or

Department approved for the specific pest and application. Each pesticide is indicated for certain pests and must be applied according to the manufacturer’s directions. Spraying into cracks and crevices where the pests live is very common. The Department mandates that post only use EPA-registered and Department approved pesticides, which have detailed instructions regarding use of the product. Pesticide labels and other safety related information should be available from the GSO, POSHO or health unit.

All pesticides are poisons and are used judiciously to combat pests, which, in addition to being a nuisance, may pose health risks and/or cause of significant property damage. M/OBO/OM/SHEM does not recommend the use pesticide powders or dusts. Should there be an exception to the general rule, the applicator should remove any residual pesticide, which is accessible to occupants or pets. You can reduce your exposure to pesticides by following the steps indicated below:

• Vacate any location where pesticides are being applied in spray form. This includes any household pets. If you have fish, consider covering the aquarium with plastic if it is too large to move. Some pesticides may be quite toxic to fish or other aquatic life.

• Remove toys from the area to be treated.

• Remove food, dishes, pot, pans and other cooking/eating utensils before treating kitchen cabinets. Pesticides should not be allowed to contact any surface/object that will contact food. Wait until the shelves dry before refilling them. If it’s possible that contact occurred, wash the items thoroughly with soap and hot water before use.

• Allow adequate ventilation following the application of pesticides indoors. When spraying will occur outdoors, close the windows of your home. It may be difficult to predict how long the treated space should be vacated;

however, all sprayed surfaces should be dry. Usually a minimum of one to two hours will be necessary. Although odor is not necessarily the best indicator of exposure, ventilation should be increased in areas where the odor is bothersome.

• Do not use surface sprays to treat entire floors, walls or ceilings even though such “broadcast” applications may be listed on the product label.

• Do not place rodent or insect baits where small children or pets can reach them. Tamper-proof bait stations should be used whenever rodent bait is being used. The granules of bait should never be applied loose since pets or small children may mistake these for food.

• Perform pest prevalence reduction and self-help measures to reduce or eliminate the need for chemical pesticide treatment.

• Follow instructions on the pesticide label.

Exhibit 4 : List of Buildings

No. Address Area / sqm

1 DIPONEGORO 04 2,558

2 DIPONEGORO 18 1,240

3 HANG TUAH 18 503

4 LATUHARHARY 11 552

5 LEMBANG 43A 347

6 POLOMBANGKENG 2 904

7 POLOMBANGKENG 19 899

8 POLOMBANGKENG 21 1,100

9 PURWOREJO 16 441

10 SENJAYA BUNTU I/52 663

11 SRIWIJAYA II/21 723

12 SUTAN SYAHRIR 11 451

13 TEUKU UMAR 59 1,468

14 WIJAYA I/36 or CIBITUNG II/36 535

15 WIJAYA III/14 286

16 WIJAYA IV/12 392

17 FOA 01 556

18 FOA 02 713

19 FOA 03 602

20 FOA 04 533

21 FOA 05 545

22 FOA 06 390

23 FOA 07 574

24 FOA 08 509

25 FOA 09 610

26 FOA 10 525

27 FOA 11 1,285

28 FOA 12 663

29 FOA 13 357

30 FOA 14 428

31 FOA 15 514

32 FOA 16 553

33 FOA 17 605

34 FOA 18 544

35 FOA 19 478

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