1-_Midway_Atoll_NWR_Travel_Request_Form_Fillable_3.pdf
PDF 113 KB Posted
- Attached to
- MIDWAY ATOLL-(BOS) Base Operation Support Serv2022 Federal contract opportunity
- Solicitation number
- 140F0421R0044
About this file
This document contains a travel request form and related federal contract opportunity notice. The travel request form collects passenger and trip information for travel to Midway Atoll National Wildlife Refuge, including arrival and departure dates, contact details, passport information, luggage details, emergency contact, and lodging and transportation requests. The federal contract opportunity is a pre-solicitation notice for base operation support services at Midway Atoll. Services include facilities support. The anticipated single-award contract will be set aside competitively for 8(a) firms. A mandatory site visit will be required during the solicitation period, with an estimated minimum cost of $4,000 per seat. Interested parties should submit questions and site visit availability to the listed contracting specialist by specified dates in late August and early September 2021.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| DRAFT_Appendix_3.zip | ZIP file | |
| 5-_Midway_Atoll_NWR_Rules__Regulations__and_Policy_Updated_11_24_20_3.pdf | ||
| DRAFT_PWS_-_Midway_BOSS_9_20_21__3.docx | DOCX document | |
| DRAFT_BOSS_SOW_2022_Final_1.docx | DOCX document |
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Text version
Arrival Date (to Midway) (mm/dd/yyyy)
Departure Date (from Midway) (mm/dd/yyyy)
First Name (As it appears on passport)
Last Name (As it appears on passport)
Middle Name (Spell out if done so on your passport)
Billing Address (Street or PO Box)
City
State
Zip
Home Phone
Work or Cell Phone
E-mail Address
Company or Affiliation
Date of Birth (mm/dd/yyyy)
Body Weight (lbs)
Male or Female?
Passport Country of issue
Passport Number
Passport Expiration (mm/dd/yyyy)
Travel Visa Number
Travel Visa Expiration (mm/dd/yyyy)
Permanent Resident Card Number
Are you part of the Visa Waiver Program?
Address while in Honolulu (foreign passports only):
Number of Bags
Total Baggage Weight (50lb max per passenger)
Emergency Contact Name
Emergency Contact Phone
Emergency Contact E-mail
Emergency Contact Relationship
Emergency/Air Evac Insurance company/policy # (if required)
If not already arranged, do you request lodging on
Midway Atoll?
If "yes" to above, do you request a single room or double room?
If in a double room, name of person sharing (required)?
Do you request a bicycle or other transportation rental?
Please list any medical expertise or training (e.g. MD, RN, EMT, etc.) (optional)
Midway Atoll National Wildlife Refuge/Battle of Midway National Memorial Travel Request Form
List any special accommodation requests for FWS consideration.
Travel Dates:
Passenger Information:
Passport Information (current and valid required):
Non-US Citizen Information:
Luggage Information:
Emergency Contact Information:
Billeting & Transportation Information:
*** Please ensure all information is accurate. Inaccurate information could delay or prevent your departure. ***
Revised 10/27/2014
| Arrival Date to Midway mmddyyyy: |
| Departure Date from Midway mmddyyyy: |
| First Name As it appears on passport: |
| Last Name As it appears on passport: |
| Middle Name Spell out if done so on your passport: |
| Billing Address Street or PO Box: |
| City: |
| State: |
| Zip: |
| Home Phone: |
| Work or Cell Phone: |
| Email Address: |
| Company or Affiliation: |
| Date of Birth mmddyyyy: |
| Body Weight lbs: |
| Male or Female: |
| Passport Country of issue: |
| Passport Number: |
| Passport Expiration mmddyyyy: |
| Travel Visa Number: |
| Travel Visa Expiration mmddyyyy: |
| Permanent Resident Card Number: |
| Are you part of the Visa Waiver Program: |
| Address while in Honolulu foreign passports only: |
| Number of Bags: |
| Total Baggage Weight 50lb max per passenger: |
| Emergency Contact Name: |
| Emergency Contact Phone: |
| Emergency Contact Email: |
| Emergency Contact Relationship: |
| EmergencyAir Evac Insurance companypolicy if required: |
| If not already arranged do you request lodging on Midway Atoll: |
| If yes to above do you request a single room or double room: |
| If in a double room name of person sharing required: |
| Do you request a bicycle or other transportation rental: Bicycle |
| Please list any medical expertise or training eg MD RN EMT etc optional: |
| List any special accommodation requests for FWS consideration: |
File details come from the government source that posted it. Updated .