Attachment 3_RestrictedAccessForm_26R0077.docx
DOCX document 34 KB Posted
- Solicitation number
- 19AQMM26R0077
About this file
This is a Restricted Access Request Form for the U.S. Mission Lome, Togo Overseas Guard Services solicitation (19AQMM26R0077). The form must be completed in its entirety by interested contractors seeking access to restricted bidding documents. Requesters must provide company information including name, address, UEID, CAGE code, and point of contact details. Contractors must indicate their role as either a prime contractor, joint venture participant, or other entity type. The completed form must be emailed to Chantal A. Guetat (GuetatCA@state.gov) and Jenel A. Charles (CharlesJA6@state.gov) for government approval before access to restricted documents is granted.
By signing this form, contractors agree to comply with strict distribution restrictions on all bidding documents. Documents may only be accessed by approved bidders and must be safeguarded in locked storage when not in use. Contractors are explicitly prohibited from copying, scanning, or posting any part of the documents on the internet. Upon completion of use, all hardcopy materials must be destroyed by shredding and all electronic media must be formatted or removed from computers. This form serves as the mandatory access control mechanism for the restricted procurement documents related to overseas guard services at the embassy.
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Text version
US Mission Lome – Overseas Guard Services Restricted Access Request
RESTRICTED ACCESS REQUEST – OVERSEAS GUARD SERVICES
U.S. MISSION LOME, TOGO
19AQMM26R0077
THIS FORM MUST BE FILLED OUT IN ITS ENTIRETY*. ANY INFORMATION NOT SUPPLIED WILL RENDER THIS REQUEST INVALID.
1. Requester Information
a. Company Name _____________________________________________________
b. Company Address ___________________________________________________
c. UEID ______________________________________________________________
d. CAGE CODE _______________________________________________________
e. Point of Contact _____________________________________________________
f. Telephone No _______________________________________________________
g. E-mail Address ______________________________________________________
2. My interest in this project is as a (please check one):
a. a. [ ] Prime Contractor
b. b. [ ] Joint Venture Participant
c. c. [ ] Other (please specify) ___________________________________________
3. I, the undersigned, agree that I 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 MAY NOT BE DUPLICATED NOR IS ANY SECONDARY DISTRIBUTION OF DOCUMENTS AUTHORIZED. ANY AND ALL FIRMS WISHING TO VIEW ANY PART OF THESE DOCUMENTS MUST REGISTER WITH FEDBIZOPS, COMPLETE AND SIGN THIS FORM, AND HAVE THEIR REQUEST APPROVED BY THE GOVERNMENT. 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 DESTROYED BY SHREDDING THE PRINTS AND FORMATTING THE ELECTRONIC MEDIA. UPON TERMINATION OF USE, ALL MEDIA SHALL BE REMOVED FROM ANY COMPUTERS.
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 Chantal A. Guetat at GuetatCA@state.gov and Jenel A. Charles at CharlesJA6@state.gov.
Restricted Access Request Page 1
SBU - CONTRACTING AND ACQUISITIONS
File details come from the government source that posted it. Updated .