W911SA24Q3057 Attachment 2 - 88th RD Universal Pest Management Application Reporting Form.docx

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Attached to
Grounds Services at IN075 - Six Locations in Indiana
Solicitation number
W911SA-24-Q-3057
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About this file

This document contains a solicitation for grounds maintenance services at six Army Reserve facilities in Indiana. The requirement is for grounds maintenance from March 1, 2024 to February 28, 2025 with four 12-month option periods and a six-month option to extend services. Quotes are due by the date and time listed on the solicitation in Central Standard Time and must include a signed SF1449, completed supplemental information, completed price schedule, and signed SF30 amendment if applicable. The six locations that require grounds maintenance services are identified as Army Reserve Facilities IN002 in Bloomington, IN004 in Edinburgh, IN005 in Evansville, IN020 in Jeffersonville, IN032 in Scottsburg, and IN036 in Terre Haute, Indiana. No site visit will be held and questions must be submitted by February 15, 2024.

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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 .