Attachment J006_Contract_On-Boarding_Off-Boarding Checklist_v1.0_DFA_updated 71719.pdf

ATTACHMENT J006- CONTRACTOR ON-BOARDING/OFF-BOARDING CHECKLIST

1. Contract Employee’s Full Name 2. Badge No. 3. COR Name 4. COR Routing Symbol

5. Contract Number 6. Contract Company’s Name 7. Contract Local Phone

8. Action New Hire Resignation Transfer To: Other:

9. Office Location Address: City/State: Zip #:

10. Instructions: Each item subject to activation or clearance must be signed by the appropriate signing official. If an item is not required in an employee’s position, the cognizant Contracting Officer’s Representative may indicate “not applicable” and sign in the “Signature of Official” block.

Bldg/Rm Action Items Subject To Activation/Clearance Date

301 Hangar 1st Flr Ops Area - 56984

CONTRACT

EMPLOYEE Government Issued Keys

CONTRACTOR

PROJ/PROG MGR

VAP Action Submitted, FAA Form 1600.25, Security Termination Statement (if applicable)

CONTRACTOR

PROJ/PROG MGR

Government Issued Accountable Property (property card) and/or Government Furnished

Property/Information (GFP)

CONTRACTOR

PROJ/PROG MGR

Electronic & Paper Federal Records/FAA Owned Non-record Materials (Including drafts, duplications, and copies) and/or Government Furnished Information (GFI)

CONTRACTOR

PROJ/PROG MGR

Government Emails Delete all Personal and Non-record Emails from Government Email System Print and file remaining emails

320 Security Operations Center

CONTRACTOR

PROJ/PROG MGR

DELIVER TO COR

Electronic key (Tech Center badge), Parking Decal(s), Handicap Parking Placard or

Designated Parking space (if applicable) FAA Servicing Security

59865 (AC)

77423(DC)

CONTRACTOR

PROJ/PROG MGR

DELIVER TO COR

PIV Card

IT Support 1-844-322-6948

Helpdesk@faa.gov

COR

Network Access (Print copy of confirmation email of cancellation/deletion from IT Support) Attach email for IT Support

Telecomm Grp 54085/59206/54357

COR Phone number 411 information

11. Certification Of Employee:

I certify that I have received or returned all government property entrusted to me.

Signature Date

12. Certification Of Contract Project Manager:

I certify that to the best of my knowledge and belief, all government property, records, and indebtedness entrusted and/or issued to the above employee have been either received or returned , except as noted.

Signature Date

13. Certification of Contracting Officer Representative:

I certify to the best of my knowledge and belief, all GOV property, records, and indebtedness entrusted and/or issued to the above employee have been accounted for and computer access and passwords have been deleted, except as noted.

Signature Date

Notes:

1. Sign in the appropriate signature space if all items are received/ returned. If any items are not accounted for, provide detail in the space below or provide details as an attachment to this form.

2. Completed form shall be given to the Contracting Officer’s Representative by the Contractor Project/Program Manager.

3. This form shall be maintained in the Contracting Officer Representative’s official contract file.

Additional Information:

Attachment JXXX_v1.0 Electronic Version (Adobe)

Note: Recommend print emails to PDF or for MS Outlook users create a PST folder and save on shared drive per office file plan. Guidance on creating PST folders is available at http://dotnet.dot.gov/technology/OCIO_rma_toolkit.html

Signature of Official http://dotnet.dot.gov/technology/OCIO_rma_toolkit.html mailto:nsc@faa.gov

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NG_Form_3370-1_(07-16).pdf

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