02 - AF IMT 103 Base Civil Engineering Work Clearance Request.pdf
PDF 97 KB Posted
- Attached to
- Relocate Kirtland Sunshades
- Solicitation number
- FA3099-22-R-0001
About this file
This document contains a Base Civil Engineering Work Clearance Request form and details of a related federal contract opportunity for relocating sunshades at Kirtland Air Force Base in New Mexico.
The form requests clearance to proceed with excavation or utility work, and must be completed and approved prior to starting any work that may disrupt aircraft traffic, base utilities, fire and security systems, or normal base operations. It requires information on the type and location of work, proposed dates, and signatures for approval from various base departments including electrical, steam, water, fire protection, security, safety, and communications.
The related federal contract opportunity is a firm-fixed price solicitation from the Air Force for the removal and reinstallation of two sunshade structures at Kirtland AFB in New Mexico and Laughlin AFB in Texas. The NAICS code is 236220 for construction of commercial and institutional buildings with a small business size standard of $39.5 million. The solicitation will be set aside for small businesses and is available electronically, with proposals due as specified once released. Award is anticipated as a firm-fixed price contract.
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Text version
DATE PREPAREDBASE CIVIL ENGINEERING WORK CLEARANCE REQUEST
(See Instructions on Reverse)
1. Clearance is requested to proceed with work at on Work Order No. , Contract No. , involving excavation or utility disturbance per attached sketch. This area has has not been staked or clearly marked.
2. TYPE OF FACILITY/WORK INVOLVED
G. AIRCRAFT OR VEHICULAR TRAFFIC FLOWA. PAVEMENTS D. FIRE DETECTION & PROTECTION SYSTEMS
H. SECURITYB. DRAINAGE SYSTEMS E. UTILITY OVERHEAD UNDERGROUND
I. OTHERC. RAILROAD TRACKS F. COMM OVERHEAD UNDERGROUND
3. DATE CLEARANCE REQUIRED 4. DATE OF CLEARANCE
5. SIGNATURE OF REQUESTING OFFICIAL
ORGANIZATION REMARKS (Use Reverse for additional REVIEWER'S NAME AND INITIALS
8.
A. ELECTRICAL DISTRIBUTION
B A
S B. STEAM DISTRIBUTION
E
C. WATER DISTRIBUTION
C I
D. POL DISTRIBUTIONV
I L
E. SEWER DISTRIBUTION
E N
F. ENVIRONMENTAL
G
I
G. PAVEMENTS/ GROUNDSN
E
E H. FIRE PROTECTION
R
I
I. ZONEN
G
J. OTHER (Specify)
9. SECURITY POLICE
10. SAFETY
11. COMMUNICATIONS
12. BASE OPERATIONS
13. CABLE TV
14. COMMERCIAL UTILITY COMPANY
TELEPHONE
GAS
ELECTRIC
15. OTHER (Specify)
16. REQUESTED CLEARANCE APPROVED DISAPPROVED
17. TYPED NAME AND SIGNATURE OF APPROVING OFFICER (Chief of Operations Flight or Chief of Engineering Flight) 17a. DATE SIGNED
PREVIOUS EDITIONS ARE OBSOLETE.AF IMT 103, 19940801, V3
7. ORGANIZATION6. TELEPHONE NO.
INSTRUCTIONS
The BCE work clearance request is used for any work (contract or in-house) that may disrupt aircraft or vehicular traffic flow, base utility services, protection provided by fire and intrusion alarm system, or routine activities of the installation. This form is used to coordinate the required work with key base activities and keep customer inconvenience to a minimum. It is also used to identify potentially hazardous work conditions in an attempt to prevent accidents. The work clearance request is processed just prior to the start of work. If delays are encountered and the conditions at the job site change (or may have changed) this work clearance request must be reprocessed.
18. REMARKS. (This section must describe specific precautionary measure to be taken before and during work accomplishment. Specific comments concerning the approved method of excavation, hand or powered equipment, should be included.)
AF IMT 103, 19940801, V3 (REVERSE)
File details come from the government source that posted it. Updated .