23R0159_RestrictedAccessForm.docx
DOCX document 33 KB Posted
- Solicitation number
- 19AQMM23R0159
About this file
This document is a restricted access request form for solicitation number 19AQMM23R0159 regarding local guard services at the U.S. Mission in Bamako, Mali. The form requires requesters to provide company information including name, address, UEID, CAGE code, point of contact, and contact details. By completing and signing the form, requesters agree to safeguard restricted documents and information according to the distribution restriction statement, which outlines requirements for document storage, duplication, distribution, and destruction. The related federal contract opportunity is for local guard services at the U.S. Mission in Bamako, Mali, issued by the Department of State Office of Acquisition Management.
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US Mission Bamako - Local Guard Program Restricted Access Request
RESTRICTED ACCESS REQUEST - LOCAL GUARD PROGRAM
U.S. MISSION BAMAKO, MALI
19AQMM23R0159
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. UEID ______________________________________________________________
d. CAGE CODE _______________________________________________________
e. Point of Contact _____________________________________________________
f. Telephone No _______________________________________________________
g. 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 Jenel A. Charles at CharlesJA6@state.gov.
Restricted Access Request Page 1
SBU - CONTRACTING AND ACQUISITIONS
File details come from the government source that posted it. Updated .