W911SA24Q3044 Attachment 2 Deliverable 88th RD Universal Pest Management Application Reporting Form.docx
DOCX document 31 KB Posted
- Solicitation number
- W911SA24Q3044
About this file
This document contains a solicitation for grounds maintenance services at two sites in Kansas and a universal pest management application reporting form template. The solicitation W911SA24Q3044 will be issued on 14 February 2024 through SAM.gov for grounds services at multi-sites in Kansas from 1 April 2024 to 31 March 2025, with four option years to extend. Quotes are due by the solicitation closing date and time and shall be emailed to the listed contracting officer; all required documents must be provided or the quote may not be considered. The pest management form is a template for contractors to report details of each pest control operation, including date, location, type of application, area and pest treated, applicator information, product used, and comments.
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Other files
| File | Type | Posted |
|---|---|---|
| W911SA24Q3044 Solicitation.pdf | ||
| W911SA24Q3044 Attachment 3 Drawings.pdf | ||
| W911SA24Q3044 Attachment 4 AT OPSEC.pdf | ||
| W911SA24Q3044 Attachment 1 Price Schedule CUI.xlsx | XLSX spreadsheet | |
| W911SA24Q3044 Attachment 5 Grounds Service Ticket.docx | DOCX document |
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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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