5. Base Pass Form.pdf

PDF 372 KB Posted

Attached to
Wash Rack
Solicitation number
FA483024Q0060
Issued by

About this file

This document is a Request for Installation Access Personnel Pass for Moody Air Force Base. It outlines the process for requesting access passes for contractor personnel to enter the base for a contract with the Department of the Air Force Air Combat Command.

The key details include the contract number FA483024Q0060, the prime contractor ABCD, the duration of the passes (not to exceed 1 year), and the purpose of the site visit. The form requests the full names, social security numbers/dates of birth, organizations, and sponsor information for the personnel requiring access. The federal contract opportunity is for replacing the existing wash rack station at Moody AFB, with specific requirements around dimensions, cleaning capabilities, and equipment to be washed. The evaluation factors include technical capability, lowest price technically acceptable, and past performance.

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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: 24-Jul-2024
Contract #: FA483024Q0060
Contractor Name: ABCD
Duartion of Pass: Thursday, 1 August 2024
Contract Purpose: Contractor Site Visit
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: Austin H. Collins, Contract Specialist, austin.collins.2@us.af.mil, 257-2053
Clear Form:

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