Attachment 4 - Rev 1 Site Visit Registration Form.pdf

697DCK-18-R-00238

Attachment #4

CONTRACTOR SITE VISIT REGISTRATION FORM

INSTRUCTIONS: Please complete and return this form to Karen McIvor via email Karen.CTR.McIvor@faa.gov no later than June 22, 2018 at 12:00 Pacific Time

Name & Address of Firm: ________________________________

Point of Contact: ______________________________________________

E-Mail Address:

Phone No.: _________________ Fax No.:____________

Number of individuals to attend the contractor site visit: _____________

Drivers License # w/state issued

Name:

1.___________________________________________________________

2.___________________________________________________________

3.___________________________________________________________

Sites visit (Put an “x” by the site or sites):

1. Kona ATCT & Base building _________

2. Hilo ATCT & Base building _________

3. Maui OGG ATCT, TOWB, _________

ESU Bldg, NWS