W911SA-22-Q-3081 Attachment 9 PRS-Deliverables Checklist.xlsx
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- Fort McCoy Herbicide Application Services
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- W911SA-22-Q-3081
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Sheet1
| PRS Inspection Checklist & Summary Report | ||||
| Service Provided: Herbicide Application | ||||
| Contractor Name: | ||||
| Contract Number: | ||||
| Month/Year: | ||||
| Contracting Officer Representative: | ||||
| Tasks | ||||
| SAT | UNSAT | N/A | ||
| 1 | PWS # 1.8. & 4.4. 14 days prior to the contract start date, WDATCP Business and personnel applicator Licenses/Certification must be submitted to the COR. | |||
| COMMENTS: | ||||
| 2 | PWS # 1.9. An ID Badge list shall be submitted by emailed to the COR (NLT) 14 days prior to the contract start date and updated NLT 14 days prior to new employees commencing performance under this contract when personnel changes occur. | |||
| COMMENTS: | ||||
| 3 | PWS # 1.10. All contractor employees to include subcontractor employees, must pass a background check prior to commencing performance under this contract. | |||
| COMMENTS: | ||||
| 4 | PWS # 5.1.1. Objective 1 - The contractor shall provide services for Herbicide Application to approximately 100 acres per year. Treatments conducted shall include the use of blue, red, or green dye so it can easily be seen during and after application. The work may require repeat treatments to ensure at least 95% of target plant species have been treated and at least 90% of current year target plants are killed. | |||
| COMMENTS: | ||||
| 5 | PWS # 5.1.2. Objective 2 - The contractor shall provide services for Herbicide Application to approximately 25 acres per year. Treatments conducted shall include the use of blue, red, or green dye so it can easily be seen during and after application. The work may require repeat treatments to ensure at least 95% of target plant species have been treated and at least 90% of current year target plants are killed. | |||
| COMMENTS: | ||||
| 6 | PWS # 5.1.3. Objective 3 - The contractor shall provide services for Herbicide Application to approximately 30 miles per year. Treatments conducted shall include the use of blue, red, or green dye so it can easily be seen during and after application. The work may require repeat treatments to ensure at least 95% of target plant species have been treated and at least 90% of current year target plants are killed. | |||
| COMMENTS: | ||||
| 7 | PWS # 5.2. Report Accident/Spill immediately to the Fire Desk. Follow on reporting to the COR NLT 24 hours after the Accident/Spill. An accident report (Fort McCoy Form 354-R-E) will be completed and submitted to the Fire Desk within 24 hours. | |||
| COMMENTS: | ||||
| 8 | PWS # 5.3. A written treatment strategy to maximize mortality rates of target species and to minimize impacts to the other resources shall be emailed to the COR for review 14 days prior to treatment of new location(s). All herbicides to be used on Fort McCoy must be on the Fort McCoy Pesticide Use Plan (PUP) list. | |||
| COMMENTS: | ||||
| 9 | PWS # 5.6. Prior to herbicide application, mark application sites with appropriate flagging and sings and remove flagging and signs when completed. | |||
| COMMENTS: | ||||
| 10 | PWS # 5.6.1. The contractor shall remove all signs or flagging after required timeframe of re-entry is authorized based on the chemical label. | |||
| COMMENTS: | ||||
| 11 | PWS # | |||
| COMMENTS: | ||||
| 12 | PWS # | |||
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| 13 | PWS # | |||
| COMMENTS: | ||||
| 14 | PWS # | |||
| COMMENTS: | ||||
| 15 | PWS # | |||
| COMMENTS: | ||||
| 16 | PWS # | |||
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| 17 | PWS # | |||
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| 18 | PWS # | |||
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| 19 | PWS # | |||
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| 20 | PWS # | |||
| COMMENTS: | ||||
| TOTALS | 0 | 0 | ||
| 95.00% - 100.00% Found Acceptable | ERROR:#DIV/0! | |||
| 0.00% - 94.99% Found Unacceptable | ||||
| Deliverables | SAT | UNSAT | N/A | |
| 21 | PWS # 1.7. A list of these key personnel by position, including contact information, shall be submitted by email to the COR no later than (NLT) 14 days prior to the contract start date and updated NLT 14 days prior to new employees commencing performance under this contract when personnel changes occur. | |||
| COMMENTS: | ||||
| 22 | PWS # 1.9. I.D. Badge List submitted NLT 14 days prior to the contract start date and updated NLT 14 days prior to new employees commencing performance. | |||
| COMMENTS: | ||||
| 23 | PWS # 1.10. Background checks prior to contractor employees commencing performance under contract. | |||
| COMMENTS: | ||||
| 24 | PWS # 1.13. An iWATCH training certification for all employees shall be submitted to the COR within 45 calendar days after the contract start date, or within 45 days after new employees commence performance under this contract and annually within 45 days after the start of the option period. | |||
| COMMENTS: | ||||
| 25 | PWS # 1.14. OPSEC Awareness Training required within 45 calendar days after the contract start date, or within 45 days after new employees commence performance under this contract, and annually within 45 days after the start of the option period. | |||
| COMMENTS: | ||||
| 26 | PWS # 5.4. Contact will be made with the COR 30 calendar days, 7 calendar days, and 1 calendar day prior to herbicide application for access to treatment sites to minimize training conflicts. | |||
| COMMENTS: | ||||
| 27 | PWS # 5.5. Monthly application reports shall be supplied to the COR NLT the 1st business day of the following month for the previous months applications. | |||
| COMMENTS: | ||||
| 28 | PWS # 5.7. Report manpower data relating to the performance of service contracts into the system for Award Management (SAM) (https://sam.gov) consistent with existing service contract reporting requirement under the federal acquisition regulation subpart 4.17- Service Contracts Inventory (by NLT September 30th annually). | |||
| COMMENTS: | ||||
| 29 | ||||
| COMMENTS: | ||||
| 30 | PWS # | |||
| COMMENTS: | ||||
| Comments: | ||||
| Contracting Officer Representative signature | ||||
| Name/Signature: Date: | ||||
| Contractor Representative Acknowledge: | ||||
| Name/Signature: Date: |
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