21R0146_RestrictedAccessForm.docx

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Local Guard Services - U. S. Mission Tokyo, Japan
Solicitation number
19AQMM21R0146
Issued by

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This document contains a restricted access request form and information on a related federal contract opportunity. The restricted access request form requires contact information and a signature agreeing to safeguard restricted documents for a local guard services contract with the U.S. Department of State in Japan. The related federal contract opportunity is solicitation number 19AQMM21R0146 for local guard services at the U.S. Embassy in Tokyo, Japan. The Department of State requires a contractor to provide security guards and the organizational structure to meet or exceed performance standards. Interested offerors must complete the restricted access request form to receive additional details for proposal submission.

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US Mission Japan– Local Guard Program Restricted Access Request

RESTRICTED ACCESS REQUEST - LOCAL GUARD PROGRAM

U.S. MISSION JAPAN

19AQMM21R0146

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. DUNS No. or CAGE CODE ___________________________________________

d. Point of Contact _____________________________________________________

e. Telephone No _______________________________________________________

f. 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 Kenneth P. Bailey at BaileyKP@state.gov.

Restricted Access Request Page 1

SBU - CONTRACTING AND ACQUISITIONS

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