W911SA24Q3062 Attachment 4 - 88th RD Universal Pest Management Application Reporting Form.docx
DOCX document 28 KB Posted
- Solicitation number
- W911SA24Q3062
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 requires applicators to provide details of each pest management operation such as date, location, type of control used, area and pests treated, pesticides applied, and comments. It will be used by the 88th Readiness Division to document pest control activities.
The solicitation is a request for quotes from the Department of the Army Materiel Command Mission and Installation Contracting Command Fort McCoy for grounds maintenance services at facility ID008 in Twin Falls, Idaho. Services include maintenance of grounds such as mowing, edging, trimming, fertilizing and pest control. Quotes are due by the date specified in the solicitation. The winning contractor will provide recurring services for one base year with options to extend for additional years.
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Other files
| File | Type | Posted |
|---|---|---|
| W911SA24Q3062 Solicitation.pdf | ||
| W911SA24Q3062 Attachment 3 - AT-OPSEC.pdf | ||
| W911SA24Q3062 Attachment 1 - Price Schedule - CUI.xlsx | XLSX spreadsheet | |
| W911SA24Q3062 Attachment 5 - Sample Service Ticket.docx | DOCX document | |
| W911SA24Q3062 Attachment 2 - Drawing.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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