W911SA-20-Q-3089 Attachment 5 - Pest Management Application Reporting Form.docx
DOCX document 22 KB Posted
- Attached to
- Grounds Services at KS065 (MS), Great Bend, KS & Bethany, MO Federal contract opportunity
- Solicitation number
- W911SA-20-Q-3089
About this file
This document contains a federal contract solicitation and related application reporting form. The solicitation is for grounds services at a multisite facility located in Great Bend, Kansas and Bethany, Missouri. The contractor will provide all labor, equipment, materials, supervision, and other items necessary to perform grounds services in accordance with the performance work statement and task frequency charts. The period of performance is one year from March 1, 2021 through February 28, 2022 with four additional one-year option periods and a six-month extension option. This procurement is set aside as a woman-owned small business opportunity under NAICS code 561730 with a size standard of $8 million. The related application reporting form provides a template for pest management contractors to report details of each pest control operation such as date, location, type of application, target pest, area treated, pesticide used, and comments.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| W911SA-20-Q-3089 Grounds KS065 Amendment 0001 SF30.docx | DOCX document | |
| W911SA-20-Q-3089 KS065 Grounds Solicitation SF1449.docx | DOCX document | |
| W911SA-20-Q-3089 Attachment 1 - Grounds Price Schedule.xlsx | XLSX spreadsheet | |
| W911SA-20-Q-3089 Attachment 2 - Drawings.pdf | ||
| W911SA-20-Q-3089 Attachment 4 - Grounds Service Ticket.pdf | ||
| W911SA-20-Q-3089 Attachment 6 - SUS Trifold.pdf | ||
| W911SA-20-Q-3089 Attachment 3 - AT OPSEC.pdf |
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 .