W911SA-24-Q-3082 Attachment 2 - 88th RD Universal Pest Management Application Reporting Form.docx
DOCX document 31 KB Posted
- Solicitation number
- W911SA-24-Q-3082
About this file
This document contains a Universal Pest Management Application Reporting Form and information about a related federal contract opportunity for grounds maintenance services. The reporting form collects details about pest management operations such as date, location, type of control, area treated, pesticide used, applicator information, and comments. It requires a signature and certification number.
The solicitation is for grounds maintenance services at facility OH117 in Trenton, Ohio. It is a request for quotes issued by the Department of the Army Materiel Command Mission and Installation Contracting Command at Fort McCoy. No further information is provided on response dates, award timing, pricing terms, set asides, or incumbent.
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Other files
| File | Type | Posted |
|---|---|---|
| W911SA-24-Q-3082 Attachment 3 - Drawing.pdf | ||
| W911SA-24-Q-3082 Attachment 5 - Sample Service Ticket.docx | DOCX document | |
| W911SA-24-Q-3082 Attachment 1 - Price Schedule - CUI.xlsx | XLSX spreadsheet | |
| W911SA-24-Q-3082 - Solicitation.pdf | ||
| W911SA-24-Q-3082 Attachment 4 - AT-OPSEC.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)____________
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