2025 NCIC Screening Pass Request.pdf

PDF 208 KB Posted

Attached to
Demolition B436 O'Malley Inn Federal contract opportunity
Solicitation number
FA460025Q0065
Issued by
Department of the Air Force Air Combat Command

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The document is a 55th Security Forces Squadron (SFS) Contractor/Vendor NCIC Screening & Pass Request Spreadsheet for accessing Offutt Air Force Base. This multi-page form is designed to collect personally identifying information (PII) for contractors and vendors, including full name, date of birth, driver's license/ID number, work schedule, and citizenship. The form requires completion by contractors seeking base access, with a critical note that all personnel must present a REAL ID ACT compliant driver's license or state ID at the Visitor Control Center. The spreadsheet is linked to a specific federal contract opportunity (Solicitation Number FA460025Q0065) for demolition services at Offutt AFB, which is a 100% Small Business Set-Aside under NAICS Code 238910 for demolishing Building 436 (O'Malley Inn) for the 55th Civil Engineering Squadron.

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Other files for this federal contract opportunity

Other files attached to Demolition B436 O'Malley Inn, newest first.
File Type Posted
Amendment 0001 - OMalley Inn Drawings.pdf PDF
FA460025Q0065 Combined Synopsis Solicitation Document - Oral Amendment 0001 - 26 Aug 2025.pdf PDF
Amendment 0001 - Visiting Officer Quarters Drawings.pdf PDF
Amendment 0001 - Asbestos Tests 1988 - 2004 (compiled).pdf PDF
Amendment 0001 - OMalley Demo Q_A.pdf PDF
B436 OMALLEY INN SITE VISIT SIGN IN SHEET.pdf PDF
FA460025Q0065 - Combined Synopsis Solicitation Document.pdf PDF
FA460025Q0065 - Performance Work Statement (PWS).pdf PDF
SCA Wage Determination 2015-5005 Rev 25.pdf PDF

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Contract#:

Contract Start/End Dates: Unit Commander or Security Manager Sig Block

Full Name Country of Last, First, MI Year Month Day Drivers License/ID # State SSAN Days Hrs Start Date - End Date (MMDDYYYY) Citizenship

Personally Identifying Information (PII) being collected by this form is authorized for collection under provisions of 10 U.S.C. 8013, Secretary of the Air Force, DoD 5200.2R, DoD Personnel Security Program; AFI 33-202, Computer Security, Information will be maintained by local Security Forces Authority while access requirements exist. Information access is restricted to personnel responsible for contract administration, or otherwise needed in the performance of official DoD duties. Information will be properly disposed of when its required use has been concluded.

Providing this information is voluntary; however, failure to provide all of the required data shown on the spreadsheet will result in denial of entry to the installation. This information is exempt from OMB licensing under provisions of AFI 33-324, Information Collections and Reports Management Program; Controlling Internal, Public, and Interagency Air Force Collections, paragraphs 3.16.11 and 3.16.16.3.

55 SFS CONTRACTOR/VENDOR NCIC SCREENING & PASS REQUEST SPREADSHEET

Date of Birth

Offutt AFB Sponsoring Agency / Unit:

Base Sponsor's Name:

Base Sponsor's Phone #:

Request Date:

Work Schedule

Company Name:

Company Address:

Company Representative Name:

Company Representative Phone Number:

NOTE:

Security Manager will ensure all listed personnel are briefed that they must present a REAL ID ACT compliant drivers license, or state ID, or an approved alternate form of photo identification upon arrival at Offutt AFB Visitor Control Center.

Contract Start/End Dates: Unit Commander or Security Manager Sig Block 55 WG/IP Sig Block - Needed For Non U.S. Visitors

Contract Start/End Dates: Unit Commander or Security Manager Sig Block 55 WG/IP Sig Block - Needed For Non U.S. Visitors

Sheet1

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Contract No:

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