09 FCL Verification Certification Template_Final.docx
DOCX document 24 KB Posted
- Attached to
- DCSA Background Investigation Fieldwork Services Federal contract opportunity
- Solicitation number
- HS0021-22-R-0003
About this file
This solicitation requests proposals for background investigation fieldwork services. The Defense Counterintelligence and Security Agency is seeking these services to support personnel security background investigations. Offerors must have an existing Facility Clearance Level that meets or exceeds the level specified in the Performance Work Statement and maintain it throughout the award period and contract performance. Proposals are due by the date and time indicated in this solicitation posting. The North American Industry Classification code for this opportunity is 561611 for Investigation Services.
View the file
Other files for this federal contract opportunity
Show all 40
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
| DCSA BI Fieldwork | CUI | 09 FCL Verification |
| Certification Template | ||
| [This form should be submitted on company letterhead.] |
Date:
Contract or Solicitation Number:
Offeror Company Legal Name:
Offeror Company Physical Address:
Offeror Company CAGE Code:
Offeror Company DUNS:
Offeror Company Facility Security Officer Name:
Offeror Company Facility Security Officer Phone Number:
Offeror Company Facility Security Officer Email:
| |_| Yes |_| No | The Offeror Company is currently a member of the National Industrial Security Program (NISP), has a valid CAGE code, and currently holds a Facility Clearance Level (FCL) granted by the Defense Counterintelligence and Security Agency (DCSA). |
| |_| Yes |_| No | The Offeror Company currently holds the FCL specified in the performance work statement (PWS) at the time of proposal and will maintain it throughout the award process and for the life of the ensuing contract if awarded to the Offeror. |
Current Facility Clearance Level: Granted By: Date Granted:
Current Approved Safeguarding Level: Date Granted:
Current DCSA Cognizant Security Office and address:
Name of DCSA Industrial Security Representative:
Date and assigned Rating from the last two (2) Security Vulnerability Assessments (SVAs) conducted by DCSA:
Date: Rating:
Date: Rating:
The Offeror Company has reviewed the PWS and DD Form 254 contained in the solicitation and meets the security requirements. The signature below indicates Offeror Company’s understanding and certifies that all information provided on this form is current and accurate.
______________________________________________________ Date: _________________ Name of Offeror Company Signatory:
Title of Offeror Company Signatory:
CUI // Source Selection Information. See FAR 2.101 and 3.104.
File details come from the government source that posted it. Updated .