Access_blank_form_full_SSAN.xls
XLS spreadsheet 60 KB Posted
- Attached to
- Janitorial Services /Other Duties Federal contract opportunity
- Solicitation number
- 47PM0817R0011
About this file
Entrance Form
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Instructions_to_Offerors_and_Evaluation_Factors_(1)_(3).docx | DOCX document | |
| signed0007.pdf | ||
| signed0008.pdf | ||
| signedamendment4.pdf | ||
| sf30amend0007.pdf | ||
| additional_questions_and_answers..docx | DOCX document | |
| NAC_2014-2017_Agreement_(2).pdf | ||
| Instructions_to_Offerors_and_Evaluation_Factors_(1)_(3).docx | DOCX document | |
| Questions_Answered_for_NAC_Janitorial_Services_(1).docx | DOCX document | |
| Grounds_Layout.pdf | ||
| map.pdf | ||
| ocidocument.doc | DOC document | |
| National_Custodial_Spec12.19.12.APPROVED.NCRRev.12.27.16NEW.doc | DOC document | |
| 47PM0817R0011__Form_(1)1449.pdf |
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Text version
Personnel
| Personnel Access Request (updated March 2010) | ||||||||
| COMPANY NAME: | New Requests - One (1) week lead time required | |||||||
| DHS POC: | Chris Litseyl/Tom Passagaluppi | Extension Requests - Two (2) weeks lead time required | ||||||
| POC PHONE#: | 202-282-1080 | Please indicate action to be taken | ||||||
| Bldg(s) | DC1432NA Campus Wide | Your office will be notifed of anyone not eligible for access | ||||||
| Privacy Act: | ||||||||
| In accordance with 5 U.S.C. Section 552 and Executive Order 9397 personal data sufficient to identify the individual submitting requests is required. The purpose is to ensure that the records of individuals who are the subject of U.S. Department of Homeland Security systems of records are not wrongfully disclosed by the Department. Failure to furnish this information will result in no action being taken on the request. False information on this form may subject the requester to criminal penalties under 18 U.S.C. Section 1001 and/or 5 U.S.C. 552a (i) (3). Providing your social security number is voluntary. You are asked to provide your social security number to facilitate the identification of records relating to you. Without your social security number, the Department may be unable to admit you onto the NAC Campus. | ||||||||
| LAST | FIRST | MIDDLE | SSN xxx-xx-xxxx | DOB mm/dd/yyyy | SEX | Start Date | End Date | INDICATE ACTION: ADD/EXTEND/ REMOVE |
Vehicle
| Vehicle Access Request | ||||||||||
| COMPANY NAME: | New Requests - One (1) week lead time required | |||||||||
| DHS POC: | John Durrell / Mike Dehart | Extension Requests - Two (2) weeks lead time required | ||||||||
| POC PHONE#: | 202-282-1080 | Please indicate action to be taken | ||||||||
| Personal vehicles (POVs) are not allowed inside parking | ||||||||||
| MAKE | MODEL | YEAR | TAG# | STATE | COLOR | Start Date | End Date | Last Name(s) of Driver(s) | Middle Name(s) of Driver(s) | INDICATE ACTION: ADD/EXTEND/ REMOVE |
Contractor Instructions
| GSA Contractor |
| Processing Guidelines for Guest Worker Requests |
| 1. Company Name should appear in subject line of email. This makes it easier to search should your office require us to look up a request. Also, it will help you to keep track of completed requests |
| 2. Indicate date of first visit. |
| 3. Access length should be for the duration of the contract or 180 days, whichever is shorter. It is advisable to give all workers and vehicles from the same company on the same contract the same expiration date. This makes it easier for you should the time come to request extensions. |
| 4. Action to be taken by this office (Add/Extend/Remove/Deny) must be indicated in status column for each person. Only personnel with an action indicated will be processed. |
| 5. Requests must be submitted not later than one (1) week prior to date/time of visit. Massive lists for extension must be submitted not less than one (2) calendar weeks prior to first date of extension. |
| 6. Employee names should be formatted as follows: Last Name, First Name Middle Name and should be added to the top of the list. No nicknames. |
| 7. Verify all information prior to submitting it to GSA. Improper information will hold up or stop the access process. |
| 8. It is advisable to maintain one master list |
| 9. GSA is to be notified immediately if someone is terminated or quits. |
| 10. Copy others in your office so that they are aware of your submission. This will ensure that our office does not receive duplicate requests. |
File details come from the government source that posted it. Updated .