Atch_2_-_Employee_List.docx
DOCX document 14 KB Posted
- Solicitation number
- 1267T019R0001
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Atch 2 - Employee List
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Text version
Contractor and Employee List
COMPANY INFORMATION:
| |_|COMPANY or |_| ORGANIZATION |
| COMPANY NAME |
| DUNS # |
| ADDRESS |
| Contact’s Name |
| CITY |
| Contact’s Phone# |
| STATE |
| ZIP |
CONTRACT INFORMATION:
| |_| CONTRACT OR |_| GRANT |
| Period of Performance |
| CONTRACT # |
| Start Date |
| CONTRACT DESCRIPTION |
| End Date |
|_| Initial Report - |_| Quarterly Report – QTR/YR /
LIST OF EMPLOYEES THAT WILL NEED NEIS PROFILES (Add additional sheets as needed.)
| NAME (Employees fill out corresponding information sheet) |
| PHONE NUMBER |
| This space to be filled out by Government to determine |
TYPE OF ACCESS
| |_| LINCPASS |
|_| PIV-A
|_| SITE BADGE
|_| BACKGROUND CHECK
| |_| LINCPASS |
|_| PIV-A
|_| SITE BADGE
|_| BACKGROUND CHECK
| |_| LINCPASS |
|_| PIV-A
|_| SITE BADGE
|_| BACKGROUND CHECK
| |_| LINCPASS |
|_| PIV-A
|_| SITE BADGE
|_| BACKGROUND CHECK
The CO is considered a Program Sponsor for information into the Non-Employee Identification System (NEIS). You are required to provide information to the NEIS Sponsor (Technical Sponsor) quarterly to update a WO report that is due quarterly. Please provide the following information on all contracts meeting the NEIS requirements (Janitorial, Computer Access) to Brenda Oster by 1st of last month of each quarter.
| CO’S NAME |
| VERIFIED ON |
| Signature |
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