RAR Form - 19R0009.docx
DOCX document 31 KB Posted
- Attached to
- Passport Card
- Solicitation number
- 19AQMM20R0009
About this file
This document contains a restricted access request form and details for a federal contract opportunity with the Department of State to procure passport card stock for personalization. The restricted access request form requires companies to provide their legal name, physical address, DUNS number, CAGE code, point of contact who must be corporate legal counsel along with their bar number and state, telephone number and email. By completing and signing the form, corporate legal counsel agrees to safeguard the information in accordance with the distribution restriction statement, which outlines requirements for document handling, duplication and disposal.
The associated federal contract opportunity is a small business set-aside solicitation issued by the Department of State Office of Acquisition Management to procure passport card stock for the Department and Department of Homeland Security. The passport card is a credit-card sized travel document used as an alternative to a traditional passport book at U.S. land and select sea ports of entry within a DHS automated border crossing system. Questions for the solicitation must be submitted by March 19, 2020.
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Text version
Passport Card Production Restricted Access Request
RESTRICTED ACCESS REQUEST – PASSPORT CARD PRODUCTION
19AQMM20R0009
THIS FORM MUST BE FILLED OUT IN ITS ENTIRETY*. INFORMATION SUPPLIED WILL DETERMINE RELEASE.
1. Requester Information
a. Company Name (Must be registered in SAM prior to 2019) ___________________________________________________________________________________
b. Company Address (Physical Address) ___________________________________________________________________________________
c. DUNS No. & CAGE CODE ___________________________________________________________
d. Point of Contact ____________________________________________________________________ (Must be Legal Corporate Counsel providing ABA number/State Bar designation)
e. Telephone No _______________________________________________________
f. E-mail Address ______________________________________________________
2. My interest in this project is as a (please check one):
| a. [ ] | Prime Contractor |
| b. [ ] | Joint Venture Participant |
| c. [ ] | Other (please specify) ___________________________________________ |
3. I, the undersigned (Corporate Legal Counsel), will ensure that Corporate will safeguard this information in accordance with the following distribution restriction statement:
RESTRICTED DISTRIBUTION AGREEMENT
Distribution authorized to legitimate bidders only, contains technical or operation information.
THESE RESTRICTED ACCESS DOCUMENTS 1) MAY NOT BE DUPLICATED NOR 2) SHALL THE HOLDER SUPPLY ANY SECONDARY DISTRIBUTION OF DOCUMENTS AUTHORIZED. ANY AND ALL FIRMS WISHING TO VIEW ANY PART OF THESE DOCUMENTS MUST 3) HAVE BEEN REGISTERED WITH beta.SAM PRIOR TO 2019, 4) AND MUST HAVE COMPLETED AND SIGN THIS FORM. 5) DATA SHALL BE KEPT IN A LOCKED DESK, LOCKED FILING CABINET, OR LOCKED ROOM WHEN NOT IN USE. UPON TERMINATION OF USE, THE HARDCOPY PRINTS AND ANY ELECTRONIC MEDIA SHALL BE 6) DESTROYED BY SHREDDING THE PRINTS AND ANY ELECTRONIC MEDIA PROVIDED. UPON TERMINATION OF USE, 7) ALL MEDIA SHALL BE REMOVED FROM ANY COMPUTERS AND DEGUAZED.
DO NOT COPY, SCAN OR POST ANY PART OF THESE BIDDING DOCUMENTS ON THE INTERNET.
Printed Name:____________________________ Signature:______________________________________
*Completed form may be e-mailed to KagalisL@State.gov Restricted Access Request Page 1SENSITIVE BUT UNCLASSIFIED
File details come from the government source that posted it. Updated .