23 CONS Base Pass Mission Lake.pdf

PDF 373 KB Posted

Attached to
Grassy Ponds Floating Docks Replacement and Repairs Federal contract opportunity
Solicitation number
FA483025Q0007
Issued by
Department of the Air Force Air Combat Command

About this file

This is a base access pass request form used to obtain installation access at Moody Air Force Base for contractors attending a site visit related to solicitation FA483025Q0007 for floating dock replacements and repairs. The form requests contractor personnel information including full names, SSN/DOB, and company details, with passes valid for up to one year.

The associated solicitation requires replacement of three floating docks and repairs to three floating docks at Grassy Pond and Mission Lake for the 23d Force Support Squadron. Key requirements include installing new T-shaped floating docks with galvanized steel framework, composite decking, and poly floats, ranging from 35' to 75' in length. Repairs involve securing loose boards, straightening handrails, adding piling extensions, and replacing hardware. A non-mandatory site visit is scheduled for January 14, 2025 at 9:00 AM EST, with contractors required to submit completed base pass forms by January 13, 2025 at 11:30 AM EST to gain access through the Moody AFB Visitor's Center.

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Text version

FOR OFFICIAL USE ONLY

DEPARTMENT OF THE AIR FORCE

23D CONTRACTING SQUADRON (ACC)

MOODY AIR FORCE BASE GEORGIA

Attack ∙ Rescue ∙ Prevail The information herein is For Official Use Only (FOUO) which must be protected under the Freedom of Information Act of 1996 and Privacy Act of 1974, as amended. Unauthorized disclosure or misuse of this PERSONAL INFORMATION may result in criminal and/or civil penalties

MEMORANDUM FOR 23 SFS/SFOXI

FROM: 23 CONS

SUBJECT: Request for Installation Access Personnel Pass

1. Request pass for the following person(s) to Moody AFB:

2. If you have any questions or concerns, please contact the undersigned:

Contract Number:

Prime Contractor:

Duration of Pass:

(NTE 1 Year)

Purpose:

Full Name Organization/CompanySSN/DOB*

*Write N/A if contractor declined to provide information. Be advised that SSN/DOB information is required for base access.

Security Forces will ask for it at the Visitor's Center if not detailed in this form.

Sponsor Info: Rank, Name; Duty Title; Email; Duty Phone

Date1_af_date: 06-Jan-2025
Contract #: FA483024P0035U00002
Contractor Name: ABCD
Duartion of Pass: 19 May 2022- 19 May 2023
Contract Purpose: Grassy Pond Floating Dock
FullName1: John Doe Jr
FullName2: John Does Sr
FullName3:
FullName4:
FullName5:
SSNDOB1: 123-45-6789/ 1 Jul 2022
SSNDOB2: 678-91-2345/ 1 Jan 2023
SSNDOB3:
SSNDOB4:
SSNDOB5:
Org1: ABCD
Org2: ABCD
Org3:
Org4:
Org5:
SponsorInfo: 2dLt Ryan Trevino, Contract Specialist, ryan.trevino.2@us.af.mil, 257-4739
Clear Form:

File details come from the government source that posted it. Updated .