Attachment 11 SRS Visitor Badge Request for Site Visit.pdf
PDF 314 KB Posted
- Solicitation number
- 12444124R0001
- Issued by
-
Department of Agriculture Forest Service
About this file
This document contains a badge request form and information about a related federal contract opportunity. The badge request form is for a site visit to the Savannah River Site and requests information such as the visitor's name, employer details, home address, purpose of visit, and dates needed for site access.
The related federal contract opportunity is a multiple service maintenance indefinite delivery/indefinite quantity contract for the Savannah River Site located in South Carolina. The pre-solicitation is being conducted by the Department of Agriculture Forest Service under solicitation number 12444124R0001 and is for services to support the Savannah River Site. The document provides relevant information for a potential site visit to learn more about the contract opportunity.
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Text version
Forest Service - Savannah River Badge Request Form
Type of Badge
Full Name*
Employer Info*
Home Address*
Home Phone*
Date of Birth*
US Citizen*
SSN(N/A for Visitor Badge)*
Gender*
Requesting Staff
Dates Access Needed
GET Training Needed
Purpose of Visit
COR/Program Mgr.
AM Approval
Please fill in sections marked by * only
Privacy Act Notice: The information on this form is required by the USDA Forest Service, Savannah River to complete Department of Energy badge request form OSR-142 or OSR-302 for the purpose of processing and approving a Site security badge that will allow access to the Savannah River Site. Information you provide in response to this request will be treated as confidential and retained in accordance with the Privacy Act of 1974.
Assistant Manager once approved email form to: FS-FSSR Admin Service Request vgolden Highlight
| Contract Officer Rep Name: Site Visit for RFP 12444124R0001 - SRS Multiple Services IDIQ |
| Program Manager Name: Anthony Waiswilos |
| Full Name: |
| Permanent Home Mailing Address: |
| Staff Requesting: [EES] |
| Type of Badge Request: [Select One] |
| SSN: |
| Purpose of Site Visit: |
| Dates Needed for Site Badge: |
| Home Phone Number: |
| Date of Birth: |
| US Citizen: [Select One] |
| Gender: [Select One] |
| Employer Info: Company Name / Address / Phone Number / Email Address |
File details come from the government source that posted it. Updated .