2. SFS ACL template.docx
DOCX document 35 KB Posted
- Attached to
- Repair Purple Heart Drive Pavement - Dover AFB
- Solicitation number
- FA449725R0001
About this file
This is an Access Control List (ACL) template form for requesting base access to Dover Air Force Base, to be used for contractor site visits related to contract FA449725R0001 for Purple Heart Drive pavement repairs. The form requires sponsor information from TSgt Joshua Brooks (436th SFS/S5B) and allows contractors to request access between 7am-5pm daily, with required personal information including name, date of birth, and driver's license details to be protected under the Privacy Act of 1974.
The associated contract opportunity involves repairs to Purple Heart Drive pavement at Dover AFB, requiring complete contractor services including labor, materials, tools, and equipment. Key work elements include milling 25,477 SY-IN of roadway, reconstructing Section 40 with new pavement sections, milling and overlaying Section 70, performing compaction testing, paving with DelDOT mix asphalt, and restriping 2,250 LF of lines. The period of performance is 104 days from Notice to Proceed, with work to be coordinated with Base Civil Engineering.
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Text version
Date:
MEMORANDUM FOR: 436th SFS/S5B
FROM: 436 CONS/PKA
SUBJECT: Request for Dover AFB Access Control List
1. Sponsor’s Full Name and Grade: Joshua J. Brooks / E-6 Sponsor’s Contact Phone # Military/Home 302-677-5232 Sponsor’s Military/Home Address: 639 Atlantic Street, Dover AFB Email Address: joshua.brooks.14@us.af.mil Sponsor’s Affiliation with Dover AFB: Active Duty: X Reserve:
National Guard: Retired Military Member: DoD Civilian:
Will the sponsor be attending the event? Yes X No
2. Request the below listed individual/personnel be granted entry to:
Dover AFB, DE 19902 Location of event
Contractor Site Visit for work to be conducted on contract FA449725R0001 Reason for request
Access date/time: ; 7am-5pm daily Required access will be from (Inclusive dates and times)
3. The below personal information is provided for individuals requiring access.
All information contained below must be protected under the Privacy Act of 1974 (see AFI33-332). Do not release outside of DoD channels without the consent of the originator's.
LAST NAME, FIRST MI DATE OF BIRTH DRIVER’S LICENSE
//SIGNED//
| JOSHUA BROOKS, TSgt, USAF |
| Administrative Contracting Officer |
Revised: 3 November 2016 Page 1 of 1
File details come from the government source that posted it. Updated .