W911SA24Q3065 Attachment 5 -UT007 Grounds - Pest Management Application Reporting Form.docx
DOCX document 28 KB Posted
- Attached to
- Grounds Maintenance Services at UT007 West Ogden, UT Federal contract opportunity
- Solicitation number
- W911SA24Q3065
About this file
This document contains a federal contract opportunity solicitation and related application reporting form. The solicitation is for grounds maintenance services at an Army Reserve facility in West Ogden, Utah, with a performance period from April 1, 2024 to March 31, 2025 for the base period and four option years. Quotes are due by the date and time listed on the solicitation and must include the completed SF-1449, supplemental information, price schedule attachment, and any amendments. The related application reporting form is a template for contractors to report details of each pest management operation performed under the contract, including date, location, type of application, area treated, pesticide used, and applicator information.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| W911SA24Q3065 Amendment 1 (f) 3-7-24.pdf | ||
| W911SA24Q3065 Attachment 1 - UT007 Grounds - Price Schedule_CUI.xlsx | XLSX spreadsheet | |
| W911SA24Q3065 Attachment 4 -UT007 Grounds - Drawing.pdf | ||
| W911SA24Q3065 Attachment 2 - UT007 Grounds - Service Ticket.docx | DOCX document | |
| W911SA24Q3065 Attachment 3 - UT007 Grounds - AT OPSEC.pdf | ||
| W911SA24Q3065 UT007 Grounds - Solicitation.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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