W911SA-20-Q-3034_Atachment_2_88th_RD_Universal_Pest_Management_Application_Reporting_Form.docx
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- Attached to
- Grounds Maintenance for six locations in Ohio
- Solicitation number
- W911SA20Q3034
About this file
This document contains a universal pest management application reporting form and details of a related federal contract opportunity for grounds maintenance services. The pest management form requires reporting of date, location, type of pest control operation, site description, pest, area treated, applicator name, pesticide/herbicide used including trade name, active ingredient, EPA registration number, formulation, quantity applied, and final concentration applied. Comments and signature of the applicator and certification number are also required.
The grounds maintenance contract opportunity is a non-personnel services contract issued by the Department of the Army Materiel Command Mission and Installation Contracting Command Fort McCoy. The contractor will provide grounds maintenance services at six Army Reserve facilities in Ohio from April 1, 2020 through March 31, 2021 with four option periods and an option for a six month extension.
Attachment 2: 88th RD Universal Pest Management Application Reporting Form
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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 .