About this file

This file is a Short Term Contractors Template CBP Contractor Information Sheet, which serves as an administrative form rather than a substantive contract document. The form is used by the U.S. Customs and Border Protection (CBP) agency to collect and manage information about short-term contractor visitors and their escorts accessing CBP facilities.

The form requires submission of detailed contractor and visitor information at least 72 hours prior to any facility visit, including company details, point of contact information, visitor names, dates of birth, citizenship status, passport and visa information, and identification numbers. All submissions must be directed to the Security Management Division at SMDSECURITYSERVICESBRANCH@cbp.dhs.gov or faxed to 202-344-1860. The form establishes strict security protocols requiring all visitors to present U.S. Government-issued photo identification, check in and out at the Security Desk, and maintain constant escort by designated CBP employees (with a ratio of one escort per four visitors, or one-to-one depending on vetting status). Any unescorted visitors found in CBP space will be immediately removed. This template is designed to facilitate the administrative and security vetting process for contractor access to federal facilities and does not address specific products or services required under the related canine detection solicitation.

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Text version

Short Term Contractors Template

CBP Contractor Information Sheet
Date Submitted:From:
Contract Company InformationCBP Agency Information
Contract Company NameCBP Location Address (Location, Building, Floor, Room #)

Contract Company Address Visitor Escort Full Name (DHS/CBP Employee Only)

Contract Company POC (First & Last Name) Phone Number Email

On Site Contractor POC (First & Last Name) Phone Number Phone Office Mobile Office

Date(s) and
Time(s) of VisitFrom DateTimeTo DateTime
Purpose of Visit:
Provide all below information
#Last Name(s)First NameMiddle NameDOB MM/DD/YYYYU.S. Citizen (Y/N)POB (City, State/ Country)OccupationAddressA NumberExp DateVisa NumberExp DatePassport CountryPassport #Exp DateSocial Security NumberDL State IssuedDrivers

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SUBMISSION: The Office of Professional Responsibility requires a mandatory submission of 72 hours prior to arrival of visitor(s) in order for any visitor to be considered for approval. Email request to SMDSECURITYSERVICESBRANCH@cbp.dhs.gov or fax to the Office of Professional Responsibility, ATTN: Security Management Division at 202-344-1860.

NOTICE: All visitors must present a U.S. Government issued Photo Identification Card. All visitors must check in at the Security Desk upon arrival and check out at the desk upon departure. Visitor escorts are responsible for constant escort of visitors. The designated escort must accompany visitors at all times, to include returning visitors back to the front desk upon departure. Any visitors found in U.S. Customs and Border Protection space without an escort will be immediately reported to security and escortedout of CBP space. One escort must be provided for every four visitors (1-4), depending on Vetting status one escort may be required for evey person (1-1).

PRIVACY ACT NOTICE: This information is provided to PL 93-579 (Privacy Act of 1974). The purpose of this document is provide information necessary for a minimum security check prior tolimited authorized access to U.S. Customs and Border Protection facility. Failure to provide this information may result in denial of access.

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