3._Photography_Request_Form.doc

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Attached to
AFB FAA RA Refresh & Storage Room Buildout Federal contract opportunity
Solicitation number
47PL0119R0022
Issued by
General Services Administration Public Buildings Service Region 10

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3. Photography Request Form

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PAGE

PHOTOGRAPHY & FILMING REQUEST

ANCHORAGE REGIONAL OFFICE

Date of Visit(s): ______________________________________________________ Project Title:

Company:

FAA Point of Contact/Title: Mike Fleming 271-5393/Lynette Blessie 271-5645 Point of Contact/Title/Contractor: Tikigaq Federal LLC Address:

Phone:

Fax:

TYPE of ACTIVIT: (Choose All That Apply)

Still Photos

Television

Video

Documentary Personal

Commercial

US Govt.

PURPOSE:

FILMING LOCATION: FAA Office areas located on 3rd floor of Anchorage Federal Office Building 222 W. 7th Ave. Anchorage, AK 99513.

AREAS THAT ARE PROHIBITED:

PHOTOGRAPHY RESTRICTIONS: Photography will not be permitted on or within an FAA facility without the permission of the Manager. The only exception is reserve for the Serving Security Element (SSE) when conducting assessments, inspections, investigations, or other official duties.

Rich VanAllman, Acting Regional Administrator

Print Name of Manager/Title

Manager Signature/Date Pam Smith

Print Name of Security Facility Specialist

Security Facility Specialist /Date Office of the Regional Administrator

Alaskan Region

222 West 7th Avenue, #14

Anchorage, Alaska 99513-7587

Phone: (907) 271-5645

Fax: (907) 271-5113�

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