(4) Attachment 4 Badge Renewal Form .pdf
PDF 45 KB Posted
- Attached to
- Building 82 Renovation Federal contract opportunity
- Solicitation number
- SP3300-20-B-5002
- Issued by
- Defense Logistics Agency Distribution
About this file
This document contains a badge renewal form and information for the Building 82 Renovation federal contract opportunity with the Defense Logistics Agency Distribution. The solicitation seeks proposals to renovate Building 82 as specified in Invitation for Bid SP3300-20-B-5002 and its attachments. Attachment 4 provides the badge renewal form contractors will use to request construction badges for personnel working on the project. The form collects personal information such as name, social security number, birthdate, physical description and emergency contacts for security and site access purposes. Attachments 2 and 3 to the solicitation are not required for proposal submission but will be used later if a contract is awarded to request badges and gain entry to the work site. Proposals are due as outlined in SP3300-20-B-5002 for the renovation work to be performed at the specified location.
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Text version
ATTACHMENT “D”
BADGE RENEWAL FORM
DDSP SECURITY INFORMATION
CONSTRUCTION CONTRACT PROJECT:
PRIME CONTRACTOR:
SOCIAL SECURITY NUMBER:
LASTE NAME:
FIRST NAME:
MIDDLE INITIAL:
PRIME CONTRACTOR:
SUBCONTRACTOR:
PROJECT NAME/DESTINATION:
LENGTH OF TIME RENEWAL REQUESTED FOR:
OFFICE PHONE AT DDSP:
EMERGENCY REMARKS (Medication, Health Problems, etc.):
ADDRESS:
CITY:
STATE:
ZIP CODE:
HOME PHONE NUMBER:
BIRTH DATE (DD/MM/YY):
BIRTH PLACE (City, State, Country):
EMERGENCY POINT OF CONTACT:
EMERGENCY CONTACT PHONE NUMBER:
SEX: MALE FEMALE
HEIGHT IN INCHES:
WEIGHT IN POUNDS:
EYE COLOR:
HAIR COLOR:
File details come from the government source that posted it. Updated .