W911SA24Q3120 Attachment 7 (88th RD Pest Management Reporting Form).docx
DOCX document 30 KB Posted
- Attached to
- Grounds Services Multisite MO081; MO028, MO030 Federal contract opportunity
- Solicitation number
- W911SA-24-Q-3120
About this file
This document is an 88th Readiness Division Universal Pest Management Application Reporting Form. It outlines the requirements for documenting pest management operations, including details such as the date, location, type of pest control, pest type, area treated, pesticide/herbicide used, and applicator information. The form is to be used for each pest management operation conducted.
The related federal contract opportunity is for Grounds Services at multi-site facilities MO081, MO028, and MO030. The solicitation, W911SA-24-Q-3120, will be issued on August 8, 2024 and can be accessed on SAM.gov. The period of performance is anticipated to be September 1, 2024 to August 31, 2025, with four one-year option periods and a six-month extension. Quotes are due by the date/time listed in the solicitation in Central Time. Contractors must submit a signed SF 1449, completed information from the Supplemental Information section, completed Price Schedule Attachment, and any signed amendments. A site visit will be held on August 13, 2024, and written questions are due by August 15, 2024.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| W911SA24Q3120-0001 Solicitation Amdt 1.pdf | ||
| W911SA24Q3120 Attachment 4 (MO030 Drawing).pdf | ||
| W911SA24Q3120 Solicitation.pdf | ||
| W911SA24Q3120 Attachment 2 (AT-OPSEC).pdf | ||
| W911SA24Q3120 Attachment 5 (Grounds Service Ticket).docx | DOCX document | |
| W911SA24Q3120 Attachment 1 (Price Schedule) CUI.xlsx | XLSX spreadsheet | |
| W911SA24Q3120 Attachment 3 (MO028 Drawing).pdf | ||
| W911SA24Q3120 Attachment 6 (DOD Pesticides List).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)____________
File details come from the government source that posted it. Updated .