W911SA-20-Q-3098 Attachment 4 - Pest Management Application Reporting Form.docx
DOCX document 27 KB Posted
- Attached to
- Grounds Services IL177 (MS), Illinois Federal contract opportunity
- Solicitation number
- W911SA-20-Q-3098
About this file
This document contains a federal contract solicitation for grounds services and a related application reporting form. The solicitation seeks a contractor to provide grounds services at five Illinois locations of the Department of the Army Materiel Command Mission and Installation Contracting Command Fort McCoy. Services include all labor, transportation, equipment, materials and supervision to perform grounds maintenance in accordance with the performance work statement. The period of performance is one base year plus four one-year options and one six-month option, running from April 2021 through September 2022. The NAICS code is 561730 with a $8 million size standard, and it is set aside for woman-owned small businesses. Site visits will be held on specified dates in January 2021. Questions are due by January 15, 2021. The application reporting form requires contractors to document pest management operations with details including date, location, type of application, area treated, pesticide used, and applicator information.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| W911SA-20-Q-3098 Grounds IL177 Amendment 0001 SF30.docx | DOCX document | |
| W911SA-20-Q-3098 Attachment 1 - IL177 Grounds Price Schedule.xlsx | XLSX spreadsheet | |
| W911SA-20-Q-3098 Attachment 3 - AT-OPSEC.pdf | ||
| W911SA-20-Q-3098 Attachment 6 - SUS Trifold.pdf | ||
| W911SA-20-Q-3098 Grounds IL177 SOLICITATION SF1449.docx | DOCX document | |
| W911SA-20-Q-3098 Attachment 5 - Grounds Service Ticket.docx | DOCX document | |
| W911SA-20-Q-3098 Attachment 2 - Drawings.pdf |
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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 .