SBU request.pdf

PDF 11 KB Posted

Attached to
tuck pointing brick exterior facade Federal contract opportunity
Solicitation number
0094
Issued by
General Services Administration Public Buildings Service Region 8

About this file

This document contains a request form and related federal contract opportunity for tuckpointing services. The General Services Administration Public Buildings Service Region 8 is soliciting bids to tuckpoint the exterior brick facade at a federal building in Fargo, North Dakota under solicitation number 0094. Interested contractors must complete and submit the attached Sensitive But Unclassified request form to obtain elevation drawings of the building, and must agree to handle any resulting sensitive information securely and dispose of it properly. The form requests company and point of contact information along with DUNS and EIN numbers to verify contractor identities prior to releasing the drawings.

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Text version

Solicitation No. 47PJ0020R0094

Fargo tuckpointing

Elevation drawings of the building are available by completing the attached Sensitive

But Unclassified request form attached.

REQUEST FOR SENSITIVE BUT UNCLASSIFIED BUILDING (SBU) INFORMATION

Solicitation/Contract Number ________________________________________

The requester shall complete the information below and return the entire Request for Sensitive but Unclassified Building (SBU) Information document to the Contracting Officer or Contract

Specialist. By signature below, the requestor of SBU building information acknowledges the requirement to maintain controls, as stated herein, to safeguard the information, and shall return or destroy the SBU building information as required by this Agreement. The undersigned acknowledges that the requester shall abide by this Agreement and shall only disseminate SBU building information to other authorized users under the conditions set forth herein.

Company Name: _____________________________________________________

Name of Individual and Title: ____________________________________________

Signature: ___________________________________________________

Date: _______________________________________________________

(The Offeror shall attach copy of business license or formation document.)

DUNS Number: _________________________________________

DUNS Number Verified by Government Representative at:

https://www.sam.gov/portal/public/SAM/#1 Yes: ___ No: ___

Employer ID Number/Federal Tax ID Number _______________________________ https://www.sam.gov/portal/public/SAM/#1

Offeror/bidder/contractor information and DUNS number has been verified and release of SBU building information is approved by:

[Contracting Officer's Name] Date

Contracting Officer

DISPOSAL STATEMENT FOR SENSITIVE BUT UNCLASSIFIED BUILDING INFORMATION

Solicitation/Contract Number ________________________________________

I hereby certify that all Sensitive but Unclassified (SBU) building information relative to the referenced solicitation/contract not previously returned to the Government has been destroyed or disposed of by burning or shredding paper copies, physically destroying computer diskettes or permanently deleting/removing/erasing electronic files from computers.

I also certify the no unauthorized physical or electronic copies of such SBU building information were made or are being retained.

Company Name: ______________________________________________

Name of Individual: ____________________________________________

Signature: ___________________________________________________

Title: _______________________________________________________

Date: _________________

File details come from the government source that posted it. Updated .