Base Access Request Form_Updated.docx
DOCX document 24 KB Posted
- Attached to
- Garage Cleaning Services
- Solicitation number
- 12259134
- Issued by
-
Defense Health Agency
About this file
The Base Access Request Form is a security document for a site visit related to a Garage Cleaning Services contract with the Defense Health Agency. The form requires individuals seeking base access to provide personal identification details including last name, first name, Social Security Account Number (SSAN), date of birth, driver's license information, vehicle details, organization, destination, start and end dates.
The site visit is scheduled with a submission deadline of 5:00 pm on 6/9/25, with two primary points of contact: Ms. Patricia Treadwell (patricia.r.treadwell.civ@health.mil, 240-612-2250) and Mr. Kevin Morris (kevin.m.morris30.civ@health.mil, 240-857-1123). Due to security protocols at Andrews Base, participants must submit their SSAN and date of birth via encrypted email, with the password to be provided separately by email or phone call. The form specifies a maximum of three representatives per organization are permitted for the site visit.
View the file
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Text version
BASE ACCESS REQUEST FORM
Last name
First Name
SSAN*
Date of Birth*
DL State
DL Number
Veh Disc
State & Tag
Organization
Destination
Start Date
End Date
Last name
First Name
SSAN*
Date of Birth*
DL State
DL Number
Veh Disc
State & Tag
Organization
Destination
Start Date
End Date
Last name
First Name
SSAN*
Date of Birth*
DL State
DL Number
Veh Disc
State & Tag
Organization
Destination
Start Date
End Date
This request form must submit to below POC by 5:00pm 6/9/25 via encrypt email. Please note that maximum of 3 representative from each organization for the site visit:
· Ms. Patricia Treadwell, patricia.r.treadwell.civ@health.mil 240-612-2250 and
· Mr. Kevin Morris, kevin.m.morris30.civ@health.mil 240-857-1123
*Due to security requirements at Andrews Base, we need your Social Security Account Number (SSAN) and Date of Birth. Please submit this information via encrypted email, and then provide the password in a separate email or phone call.
File details come from the government source that posted it. Updated .