Attachment__J3_-_Personnel_Security_Forms_(Charts_A_-_B).pdf
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- Attached to
- Armed Security Guard Services Federal contract opportunity
- Solicitation number
- 17223SOL0021
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Attachment J3 - Personnel Security Forms (Charts A - B)
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Attachment – J3
Personnel Security Forms (Charts A & B)
CHART A
Mandatory for all on-site contract employees
NON-SENSITIVE
POSITIONS - LEVEL 1
FORM NAME
OBTAIN
FROM
WHEN REQUIRED SUBMIT
TO
DATE
REQUIRED
HHS Form 745 COR.
Sponsorship must be provided by
FDA COR.
All positions on DHHS property or leased space
Food and Drug Administration Office of Security Operations, Policy & Planning Attn: Food and Drug
Administration National Center for Toxicological
Research Safety Office, Building 50, Room
3900 NCTR Road
Jefferson, AR 72079 **Form must be submitted by
Security Rep.
Form must be received prior to making fingerprint appointment.
Contractor’s Commitment to Protect Non-Public Information (NPI) Agreement form
CO All positions with access to non-public privileged, proprietary, or trade secret information
If requested by the government
CO for retention in contract file
Ten (10) calendar days prior to commencement of work
Listing of all contractor employee names, social security #s, gender, dates of birth, former names, and a completed Fair Credit Reporting Act Release
Contractor generated
All positions, including intermittent, per diem or Temporary
When Requested by government
* Food and Drug Administration Attn: Food and Drug
Administration National Center for Toxicological
Research Safety Office, Building 50, Room
3900 NCTR Road
Jefferson, AR 72079 870-543-7473
Ten (10) calendar days prior to commencement of work
SF 85 - Questionnaire for Non-Sensitive Positions
Online via OPM’s e-QIP system
For Non U.S. Citizens only
Non-Sensitive Positions - Level 1
Clearance
*Submit to OPM online via the e-e- QIP system
Ten (10) calendar days upon request of the CO
FDA 258 - Fingerprint Chart (2 Charts Required)
Fingerprinting services available by appointment only.
Call (870) 543-7478
CO Non-Sensitive Positions - Level 1
Clearance When Requested by government
* Food and Drug Administration Attn: Food and Drug
Administration National Center for Toxicological
Research Safety Office, Building 50, Room
3900 NCTR Road
Jefferson, AR 72079 870-543-7473
Ten (10) calendar days prior to commencement of work
*In addition to the submission of these forms, the contractor shall provide a cover letter that includes: contractor’s name, contract number, contractor employees’ names, and name of the CO.
*Upon favorable fingerprint return, contractor will be notified to respond to the badging office for their building pass.
Food and Drug Administration
Attn: Food and Drug Administration National Center for Toxicological Research
Office of Regulatory Compliance and Risk Management Security Specialist 3900 NCTR Road
Jefferson, AR 72079 870-543-7473
CHART B
Public Trust Positions - Levels 5 or 6
FORM NAME
OBTAIN
FROM
WHEN REQUIRED SUBMIT
TO
DATE
REQUIRED
SF 85P - Questionnaire for Public Trust Positions
Online via OPM’s e-QIP system
For non U.S. Citizens only
Public Trust Positions - Level 5 or 6 Clearance
*Submit to OPM online via the e-QIP system
Ten (10) calendar days prior to commencement of work
FDA 258 - Fingerprint Chart (2 Charts Required)
Fingerprinting services available by appointment only.
Call (301) 827-9527
CO Public Trust Positions - Level 5 or 6 Clearance When requested by the government
* Food and Drug Administration Attn: Food and Drug Administration
National Center for Toxicological Research
Safety Office, Building 50, Room 315 3900 NCTR Road
Jefferson, AR 72079 870-543-7473
Ten (10) calendar days prior to commencement of work
HHS Form 745 COR.
Sponsorship must be provided by
FDA COR.
All positions on DHHS property or leased space
Food and Drug Administration Office of Security Operations, Policy & Planning Attn: Food and Drug Administration
National Center for Toxicological Research
Safety Office, Building 50, Room 315 3900 NCTR Road
Jefferson, AR 72079 **Form must be submitted by Security
Rep.
Form must be received prior to making fingerprinting appointment.
Contractor’s Commitment to Protect Non-Public
Information (NPI) Agreement form
CO All positions with access to non-public privileged, proprietary, or trade secret information
If requested by the government
CO for retention in contract file
Ten (10) calendar days prior to commencement of work
Listing of all contractor employee names, social security #s, gender, dates of birth, former names, and a completed Fair Credit Reporting Act Release
Contractor generated
All positions, including intermittent, per diem or temporary If requested by the government
* Food and Drug Administration Attn: Food and Drug Administration
National Center for Toxicological Research
Safety Office, Building 50, Room 315 3900 NCTR Road
Jefferson, AR 72079 870-543-7473
Ten (10) calendar days prior to commencement of work
*In addition to the submission of these forms, the contractor shall provide a cover letter that includes:
contractor’s name, contract number, contractor employees’ names, and name of the CO.
Upon favorable fingerprint return, contractor will be notified to respond to the badging office for their building pass.
Food and Drug Administration Attn: Food and Drug Administration
National Center for Toxicological Research Office of Regulatory Compliance and Risk Management
Security Specialist Building 50, Room 315
3900 NCTR Road Jefferson, AR 72079
870-543-7473
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