70FBR621Q00000033 Solicitation.pdf

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

2. CONTRACT NO.

7. FOR SOLICITATION

► INFORMATION CALL:

9. ISSUED BY

FEMA REGION 06

DEPARTMENT OF HOMELAND

l

a. NAME Sandra

EFFECTIVE DATE I

3.AWARD/ r· ORDER NUMBER

Shanks

CODE I70FBR6

SECURITY

FEDERAL EMERGENCY MANAGEMENT AGENCY

REGION VI

800 NORTH LOOP 288

DENTON TX 76209-3606

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

1K] SEE SCHEDULE

15. DELIVER TO

DHSFEMA

DR-4332-TX

11000 I-35N

AUSTIN TX 78753

17a. CONTRACTOR/ CODE

OFFEROR

TELEPHONE NO.

12. DISCOUNTTERMS

CODE I DR-4332-TX

I

FACILITY! CODE

□ 17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

19. 20.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES

This is a combined synopsis/solicitation

1. REQUISITION NUMBER

I

PAG

OF

I 40

5. SOLICITATION NUMBER r· SOLICITATION

70FBR621Q00000033 ISSUE DATE

09/02/2021 l

b. TELEPHONE NUMBER (No col/eel calls)

· OFFER DUE DATE/LOCAL TIME

303-501-0051 09/08/2021 1200 CT

10. THIS ACQUISITION IS □ UNRESTRICTED OR IBJ SET ASIDE: 100.00 %FOR:

[Kl SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

□ (WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

□ HUBZONE SMALL SMAI I RIJSINFSS PRO�RAM

BUSINESS □ EDWOSB

□ SERVICE-DISABLED □ B(A)

VETERAN-OWNED

SMALL BUSINESS

13b. RATING D 13a. THIS CONTRACT IS A

NAICS:4 84210

SIZE STANDARD:

RATED ORDER UNDER 14. METHOD OF SOLICITATION DPAS (15 CFR 700)

16. ADMINISTERED BY

DR-4332-TX

DR-4332-TX

11000 I-35N

AUSTIN TX 78753

18a. PAYMENT WILL BE MADE BY

OORFQ □ IFB □ RFP

CODE IDR-4332-TX

CODE I

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW

IS CHECKED □SEE ADDENDUM

21. 22. 23. 24.

QUANTITY UNIT UNIT PRICE AMOUNT

for

$30.0 commercial items prepared in accordance with the format in Subpart 12.6 and Part 13 - Simplified

!Acquisition Procedures -as supplemented with additional information included in this notice.

This announcement constitutes the only solicitation; proposals are being requested and a written solicitation will not be issued.

This solicitation, 70FBR621Q00000033, is issued as a Request for Quotation, This solicitation

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

IX] 27a. SOLICITATION INCORPORATES BY REFERENCE FAR52.212- 1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA IXIARE

□ ARE

□ ARE NOT ATTACHED.

□ 27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA □ ARE NOT ATTACHED.

IKl 28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN 1

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

30a. SIGNATURE OF OFFEROR/CONTRACTOR

30b. NAME AND TITLE OF SIGNER (Type or print)

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

I 30c. DATE SIGNED

□ 29. AWARD OF CONTRACT: __ _ _ _ _ __ _ _ _ OFFER

DATED __ _ _ _ __ . YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

HEREIN, IS ACCEPTED AS TO ITEMS:

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

31b. NAME OF CONTRACTING OFFICER (Type or print)

Sandra Shanks I 31c. DATE SIGNED

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA• FAR (48 CFR) 53.212 Page 1 of 40

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

incorporates provisions and clauses in effect through Federal Acquisition Circular (FAC)

2021-06.

Funds are not yet obligated, and no award will be made until funds are certified/obligated. The solicitation number is RFQ #70FBR621Q000000033.

The North American Industrial Classification

System (NAICS) code for this procurement is

484210 Used Household and Office Goods Moving.

Offerer's Representations and Certifications must indicate this NAICS code in their entity registration in the System of Award Management

(SAM.gov) to be considered.

DISASTER AREA SET-ASIDE

This requirement is issued as a 100 % Small

Business / Local Disaster Area Set-Aside under

Presidentially Declared Disaster DR-4332-TX and the Robert T. Stafford Disaster Relief and

Emergency Assistance Act, as Amended.

https://www.fema.gov/disaster/stafford-act

Offerers must reside, or primarily do business in, the following DR-4332-TX Texas Counties of:

Aransas, Austin, Bastrop, Bee, Bexar, Brazoria, Continued ...

32a. QUANTITY IN COLUMN 21 HAS BEEN

21. 22.

QUANTITY UNIT

0 RECEIVED 0 INSPECTED 0 ACCEPTED AND CONFORMS TO THE CONTRACT EXCEPT AS NOTED·

23.

UNIT PRICE

24.

AMOUNT

32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE I

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED 36. PAYMENT 37. CHECK NUMBER

CORRECT FOR

0 COMPLETE □ PARTIAL 0 FINAL

0 PARTIAL 0 FINAL

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41 a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 42a. RECEIVED BY (Print)

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42b. RECEIVED AT (Location)

42c. DATE REC'D (YYIMMIDD) 142d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 2/2012) BACK

REFERENCE NO. OF DOCUMENT BEING CONTINUED

CONTINUATION SHEET

?0FBR62lQ00000033

NAME OF OFFEROR OR CONTRACTOR

ITEM NO.

(A)

SUPPLIES/SERVICES

(B)

Burleson, Caldwell, Calhoun, Chambers, Colorado, Comal, Dallas, DeWitt, Fayette, Fort Bend, Galveston, Goliad, Gonzales, Grimes, Guadalupe, Hardin, Harris, Jackson, Jasper, Jefferson, Jim

Wells, Karnes, Kleberg, Lavaca, Lee, Liberty, Madison, Matagorda, Milam, Montgomery, Newton, Nueces, Orange, Polk, Refugio, Sabine, San

Augustine, San Jacinto, San Patricio, Tarrant, Travis, Tyler, Victoria, Walker, Waller, Washington, Wharton

DESCRIPTION OF REQUIREMENT

The Federal Emergency Management Agency's Texas

Recovery Office (TRO) has an immediate need for the pickup, disassembly, packing, palletizing, and delivery of office furniture and supplies that have been donated to FEMA through Other

Government Agencies in San Antonio, Texas.

Inventory pickup will occur in San Antonio, Texas to be delivered to Austin, Texas.

The service performed will include the disassembly of office furniture, packing/wrapping, palletizing, loading, transporting, and unloading of office furniture and supplies. The offeror shall provide all personnel, equipment, transportation, expertise, and supplies to fulfill this requirement.

Furniture shall be delivered without damage. The details are provided in the Statement of Work

(SOW) that has been incorporated into this

Solicitation, to include all attachments to the sow.

Attachment 1: Statement of Work

Attachment la: Probate Court Furniture Inventory

List

Attachment lb: Pretrial Furniture Inventory List

Attachment le: Facility Access Information

Attachment ld: Certification Vaccination On-Site

Contractors and Visitors

SITE VISIT

Continued ...

NSN 7540-01-152-8067

QUANTITY UNIT

(C) (D)

UNIT PRICE

(E)

OF

AMOUNT

(F)

OPTIONAL FORM 336 (4-l!6)

Sponsored by GSA

FAR (48 CFR) 53.110

?0FBR62lQ00000033

NAME OF OFFEROR OR CONTRACTOR

ITEM NO.

(A)

SUPPLIES/SERVICES

(B)

The only site visit will be offered on Friday, September 3, 2021 at 9:00 am, Central Time at the site location in San Antonio, Texas. All attendees must RSVP.

To attend the site visit, provide your contact information and an attendee list to FEMA Point of

Contact Sandra Edwards-Woods.

Email: Sandra.Edwards@fema.dhs.gov

SITE ACCESS:

Site Access is RSVP only, and Offerers who desire to attend must provide to the Contracting Officer

Representative (COR) an employee name list (legal names, no nicknames) requiring access to the sites preferably 72-hours in advance, but not less than 24-hours in advance. All employees accessing the locations must provide a valid

Government issued identification, such as a State issued driver's license or passport. All contract employees will be escorted by a

Government employee at all times while performing on site location.

FEMA POC for Site Visit is Sandra Edwards-Woods.

Email: Sandra.Edwards@fema.dhs.gov

COVID GUIDELINES FOR SITE ACCESS:

Contractors:

a) If visiting this facility for any purpose, you must have completed and possess the government provided Certification of Vaccination form and present the completed form to the Protective

Security Officer (PSO) when going through facility security screening.

b) If you are not fully vaccinated, you must have in your possession documentation of a negative

COVID-19 test result from within the last 72 hours to show the agency you are visiting.

c) While in the facility, follow the workplace safety plans and protocols that you are visiting.

d) Any requests for a medical or religious accommodation from being vaccinated should be directed to the agency you are visiting.

Continued ...

NSN 7540-01-152-8067

QUANTITY UNIT

(C) (D)

UNIT PRICE

(E)

OF

AMOUNT

(F)

OPTIONAL FORM 336 (4-l!6)

Sponsored by GSA

70FBR62lQ00000033

NAME OF OFFEROR OR CONTRACTOR

ITEM NO.

(A)

SUPPLIES/SERVICES

(B)

* Attachment le - Facility access information

* Attachment ld - Certification Vaccination

On-Site Contractors and Visitors

Additional guidance is provided at the Government

Wide Point of Entry at SAM.gov. (Click on the link to access this information).

https://sam.gov/opp/f7d3c66892a54e9499af36c2d12799 ad/view

DELIVERY SCHEDULE

PICKUP: PICKUP OF ITEMS SHALL OCCUR NO LATER THAN

SEPTEMBER 10, 2021

DELIVERY: DELIVERY OF ITEMS SHALL OCCUR NOT

LATER THAN 72-HOURS AFTER PICKUP

QUESTIONS CONCERNING THIS RFQ:

All questions regarding this RFQ shall be submitted in writing, via email, to the

Contracting Officer. Questions and Answers will be posted to Beta.Sam.gov in the solicitation announcement. The deadline for questions is

September 7, 2021 at 12 pm CT.

Sandra Shanks, Contracting Officer

Sandra.Shanks@fema.dhs.gov

IMPORTAN DATES:

Site Visit Friday, September 3, 2021 9:00 a.m.

Central Time

Questions for Solicitation: Deadline Tuesday, September 7, 2021 12 pm Central Time

Quotation Deadline: Wednesday, September 8, 2021

12 pm Central Time

Continued ...

NSN 7540-01-152-8067

QUANTITY UNIT

(C) (D)

UNIT PRICE

(E)

OF

AMOUNT

(F)

OPTIONAL FORM 336 (4-l!6)

Sponsored by GSA

?0FBR62lQ00000033

NAME OF OFFEROR OR CONTRACTOR

ITEM NO.

(A)

SUPPLIES/SERVICES

(B)

Delivery: 09/10/2021

Period of Performance: 09/09/2021 to 09/14/2021

Pickup, disassembly, packing, palletizing, and delivery of office furniture and supplies.

Product/Service Code: N071

Product/Service Description: INSTALLATION OF

EQUIPMENT- FURNITURE

Department of Labor Wage Determinations Apply and may be located on the Beta.Sam.gov website.

Service Contract Act WO#: 2015-5253

Service Contract Act WO#: 2015-5215

NSN 7540-01-152-8067

QUANTITY UNIT

(C) (D)

1 EA

UNIT PRICE

(E)

OF

AMOUNT

(F)

OPTIONAL FORM 336 (4-l!6)

Sponsored by GSA

LIST OF ATTACHMENTS

Attachment 1 – Statement of Work Page 23 – 25 Attachment 1a – Probate Court Furniture Inventory List

Page 26- 31

Attachment 1b – Pretrial Furniture Inventory List Page 32 – 35 Attachment 1c – Facility Access Information Page 36 Attachment 1d – Certification of Vaccination Page 37 – 40

Statement of Work Furniture Transfer

Federal Emergency Management Agency (FEMA) September 01, 2021

1. INTRODUCTION

Federal Emergency Management Agency (FEMA) is seeking to transfer furniture from the Probation and

Pretrial Courts in San Antonio, Texas to FEMA Texas Recovery Office (TRO) Austin facility. (Specific location listed below under work location).

2. PROJECT PURPOSE

The purpose of this contract is to solicit a proposal from qualified moving services that will result in a Contract available to federal governmental agencies. The overarching objectives are: (1) to remove free-standing furniture, partitions, and modular furniture from existing locations, (2) transport items to TRO Austin and (3) place the furniture in FEMA warehouse/facilities in Austin TRO.

3. SCOPE OF WORK

1. Contractor shall provide all labor, supervision, material, supplies, tools, equipment, and expertise necessary to transfer furniture. (See attachments 1 and 2)

2. Contractor shall disassemble furniture (to include modular furniture), palletize, wrap, load, and transport furniture to destination and offload in identified spaces at location. No unwrap/depalletize or reassembly required at destination.

3. Pickup and movement out of the Probation and Pretrial Courts building in San Antonio shall be completed No Later Than (NLT) Friday, September 10th, 2021. (see attachments 1 and 2)

4. Contractor shall be responsible for delivering/placing pallets at the TRO in Austin NLT 72 hours after pick-up from the Probation and Pretrial Courts in San Antonio on Friday, September 10th, 2021.

5. Contractor shall provide a list of names of contractor personnel that will be entering each facility prior to start date of contract with a copy of each person(s) driver’s license. (Note: If for some reason a contractor personnel will be out, the replacement contractor personnel name and driver license shall be submitted for building entry).

6. Contractor shall comply with all applicable laws, rules, and regulations.

7. The relevant Points of Contact (POC) are identified below.

4. WORK LOCATION, POINT OF CONTACT (POC), DROP OFF LOCATION, HOURS OF

OPERATION

Pickup Location Point of Contact Drop off Location

Probation and Pretrial Courts 727 E. Cesar E Chavez Blvd., Various rooms San Antonio, TX 78206

Sandra Edwards-Woods

(202) 718-1619 Laurie Petri

(210) 606-7427 Victoria Tarin

(210) 371-7436

TRO – Austin Warehouse 11000 North I-35 Hwy Austin, TX 78753

Contracting Officer (CO) POC: Sandra Shanks | Phone number will be provided upon contract being awarded.

Contracting Officer Representative (COR) POC: Sandra Edwards-Woods

5. PERIOD OF PERFORMANCE

The period of performance for pick-up and removal from Probation and Pretrial Courts is Thursday, 9 September, and Friday, 10 September 2021. Delivery to the Austin TRO will be no later than 72 hours after pick-up from Probation and Pretrial Courts.

6. DAMAGES

This section applies to damages caused by the Contractor at any time while performing contracted services (during breakdown, packing, transport and/or moving). The responsibility to “repair, replace, or otherwise correct” the damaged property lies with the Contractor. The property must be restored to its pre-damaged condition or replaced with a new item of equal estimated value. The estimated value will be determined as identified herein.

1. If the property can be repaired, the amount of damages can be set at the amount it costs to repair the property.

2. If the cost to repair the property turns out to be more than the fair market value of the property, before the loss, the damages may be limited to the fair market value.

7. CLEAN-UP

During the performance of this contract, contractor shall ensure trash/debris, packing material, etc. shall be removed from each Federal facility upon completion at each Federal Facility.

8. SAFETY REQUIREMENTS

Contractors:

1. If visiting this facility for any purpose, you must have completed and possess the government provided Certification of Vaccination form and present the completed form to the Protective Security Officer (PSO) when going through facility security screening. (see attachments 3 and 4)

2. If you are not fully vaccinated, you must have in your possession documentation of a negative COVID-19 test result from within the last 72 hours to show the agency you are visiting.

3. While in the facility, follow the workplace safety plans and protocols that you are visiting.

4. Any requests for a medical or religious accommodation from being vaccinated should be directed to the agency you are visiting.

9. SECURITY REQUIREMENTS

The FEMA TRO Austin office and the Probation and Pretrial Courts in San Antonio is a secure area. A list of personnel/names entering the building daily shall be provided to Security prior to contract start date to gain daily access to Federal buildings. Personnel requiring access must provide government-issued photo identification, such as a state driver’s license when they arrive every day. Onsite access during the project shall be coordinated through the Contract Officer Representative (COR).

10. DELIVERABLES

The contractor shall prepare and submit to the CO/COR daily progress reports detailing Contract activities. The report shall be submitted the end of each business day. The daily Progress Report must include, at a minimum, the following data elements; and they are as follows:

• Requesting agency name

• Date of service

• Purchase Order number

• Originating address

• Destination address

• Identify Items to be transferred from Probation and Pretrial Courts (see attachments 1 and 2)

• Identify Items transferred to Austin TRO (see attachments 1 and 2)

ATTACHMENTS

Attachment 1a – Probate Court Furniture Inventory List, 727 E. Cesar E Chavez Blvd., Various Rooms, San Antonio, TX 78206 Attachment 1b – Pretrial Furniture Inventory List, 727 E. Cesar E Chavez Blvd., Room 636, San Antonio, TX 78206

Attachment 1c – Facility Access Information

Attachment 1d – Certification Vaccination On-site Contractors and Visitors

(END OF STATEMENT OF WORK)

ASSET ID DESCRIPTION ROOM

12465 SUSPO/Executive task Chair San Antonio L405

14406 Wardrobe San Antonio L405

14895 Lounge sofa San Antonio L405

23291 Wardrobe San Antonio L405

23292 Desk San Antonio L405

23293 Credenza w/Hutch San Antonio L405

23295 3 ft coffee table San Antonio L405

100264 Lounge chair San Antonio L405

100265 Lounge chair San Antonio L405

9738 Guest chair San Antonio D425

9739 Guest chair San Antonio D425

9740 End table San Antonio D425

9742 U-shaped desk w/Hutch San Antonio D425

9743 SUSPO/Executive task chair San Antonio D425

9744 3 Shelf bookcase w/storage San Antonio D425

9745 3 Shelf bookcase w/storage San Antonio D425

9709 3 Shelf bookshelf w/storage San Antonio A429A

9710 Lounge couch San Antonio A429A

9712 2 ft End table San Antonio A429A

9713 Guest chair San Antonio A429A

9714 Guest chair San Antonio A429A

9715 Guest chair San Antonio A429A

9716 Guest chair San Antonio A429A

9717 Desk San Antonio A429A

9719 Credenza w/Hutch San Antonio A429A

9720 2 Drawer lateral file cabinet San Antonio A429A

100235 3 ft Coffee table San Antonio A429A

102478 End table San Antonio A429A

9796 Storage Cabinet San Antonio A429E

9797 Storage Cabinet San Antonio A429E

9657 Paper stock assorter San Antonio A429F

100201 5 Shelf metal shelving San Antonio A429F

100202 5 Shelf metal shelving San Antonio A429F

9694 4 Drawer lateral file cabinet San Antonio A407E

9695 Guest chair San Antonio A407E

9696 Guest chair San Antonio A407E

9697 U-shape desk San Antonio A407E

9700 2 Drawer lateral file cabinet San Antonio A407E

14342 Task Chair San Antonio A407E

9671 2 ft End table San Antonio A407D

9688 4 Drawer lateral file cabinet San Antonio A407D

9693 U-shape desk w/hutch San Antonio A407D

100301 4 Drawer lateral file cabinet San Antonio A407D

102414 2 Drawer lateral file cabinet San Antonio A407D

9555 Guest chair San Antonio A407G

Probate Court Furniture Inventory - 3rd & 4th Floor

ATTACHMENT 1A Probate Court Inventory List

9556 Guest chair San Antonio A407G

9679 U-shape desk w/hutch San Antonio A407G

9680 2 Drawer vertical file cabinet San Antonio A407G

9681 3 Shelf bookcase w/storage San Antonio A407G

9682 4 Drawer lateral file cabinet San Antonio A407G

9683 4 Drawer lateral file cabinet San Antonio A407G

100095 Task chair San Antonio A407G

9558 4 Drawer Lateral File Cabinet San Antonio A407I

9559 Desk San Antonio A407I

9590 Credenza w/Hutch San Antonio A407I

100236 Guest chair San Antonio A407I

100237 Guest chair San Antonio A407I

102476 2 shelf printer stand San Antonio A407I

102477 White dry erase board San Antonio A407I

9557 Task chair San Antonio A407J

9642 5 shelf bookcase San Antonio A407J

9643 Credenza w/Hutch San Antonio A407J

9647 Desk San Antonio A407J

9648 3 shelf bookcase with storage San Antonio A407J

9649 Guest chair San Antonio A407J

9650 Guest chair San Antonio A407J

100102 Work table San Antonio A407J

102904 Regrigerator San Antonio HR 411 break rm

102905 Breakroom chair San Antonio HR 411 break rm

102906 Breakroom chair San Antonio HR 411 break rm

102907 Breakroom chair San Antonio HR 411 break rm

102908 Breakroom chair San Antonio HR 411 break rm

102909 Breakroom chair San Antonio HR 411 break rm

102910 Breakroom chair San Antonio HR 411 break rm

102911 Breakroom chair San Antonio HR 411 break rm

102912 Breakroom chair San Antonio HR 411 break rm

102913 Breakroom table San Antonio HR 411 break rm

102914 Breakroom table San Antonio HR 411 break rm

102893 End table San Antonio HR Lobby

24484 L-shape Desk San Antonio HR401

24485 Credenza w/Hutch San Antonio HR401

102873 Guest chair San Antonio HR401

102874 Guest chair San Antonio HR401

102875 Guest chair San Antonio HR401

102876 Guest chair San Antonio HR401

102877 4 ft Conference table San Antonio HR401

102878 Task chair San Antonio HR401

102879 End table San Antonio HR401

100252 Conference chair San Antonio HR402 conference

100253 Conference chair San Antonio HR402 conference

100254 Conference chair San Antonio HR402 conference

100255 Conference chair San Antonio HR402 conference

100256 Conference chair San Antonio HR402 conference

100257 Conference chair San Antonio HR402 conference

100258 3 Shelf bookcase w/storage San Antonio HR402 conference

100259 Conference table San Antonio HR402 conference

100291 3 Shelf bookcase w/storage San Antonio HR402 conference

102880 U-shape Desk San Antonio HR403

102881 4 shelf bookcase w/glass doors San Antonio HR403

102882 Task chair San Antonio HR403

24469 Guest chair San Antonio HR404

24470 Guest chair San Antonio HR404

102883 U-shaped desk San Antonio HR404

102884 Task chair San Antonio HR404

102885 4 shelf bookcase w/glass doors San Antonio HR404

100261 2 Shelf printer stand San Antonio HR405 copy rm

102886 3 drawer vertical file cabinet w/casters San Antonio HR405 copy rm

102887 Console table San Antonio HR405 copy rm

102888 Stool w/casters San Antonio HR405 copy rm

100281 Guest chair San Antonio HR406

100282 Guest chair San Antonio HR406

102889 U-shaped desk w/Hutch San Antonio HR406

102890 Console table San Antonio HR406

102891 3 shelf bookcase w/door and lateral drawers San Antonio HR406

100286 U-shaped desk w/Hutch San Antonio HR407

100290 Wardrobe San Antonio HR407

102894 Guest chair San Antonio HR407

102895 Guest chair San Antonio HR407

102896 Task chair San Antonio HR407

100283 Task chair San Antonio HR408

100284 Guest chair San Antonio HR408

100285 Guest chair San Antonio HR408

102897 U-shaped desk San Antonio HR408

102898 Bookcase w/doors and lateral drawers San Antonio HR408

102899 Desk return section San Antonio HR408

24462 Guest Chair San Antonio HR409

100250 SUSPO/Executive task Chair San Antonio HR409

100251 U-shaped desk w/Hutch San Antonio HR409

100289 Guest Chair San Antonio HR409

24461 U-shape desk w/Hutch San Antonio HR410

24464 Wardrobe San Antonio HR410

102900 3 foot worktable San Antonio HR410

102901 Task chair San Antonio HR410

102902 Guest chair San Antonio HR410

102903 Guest chair San Antonio HR410

3RD FLOOR

13776 2 drawer vertical file cabinet San Antonio B304C

14256 Wardrobe San Antonio B304C

14260 U-shaped desk w/Hutch San Antonio B304C

14261 SUSPO/Executive task chair San Antonio B304C

14262 Guest chair San Antonio B304C

14263 Guest chair San Antonio B304C

100030 Sofa table San Antonio B304C

102647 Dry erase board San Antonio B304C

102648 Conference table San Antonio B304C

102649 Guest chair San Antonio B304C

102650 Guest chair San Antonio B304C

102651 Guest chair San Antonio B304C

102652 Guest chair San Antonio B304C

102653 Credenza San Antonio B304C

14569 5 Shelf bookcase San Antonio B304A

14571 Guest chair San Antonio B304A

14572 Guest chair San Antonio B304A

14573 U-shaped desk w/Hutch San Antonio B304A

24251 Task chair San Antonio B304A

100024 5 Drawer vertical file cabinet San Antonio B304A

14511 Desk San Antonio B302K

102861 Guest chair San Antonio B302K

14280 U-shaped desk w/Hutch San Antonio B302I

14281 Task chair San Antonio B302I

14282 Guest chair San Antonio B302I

14283 Guest chair San Antonio B302I

14284 5 Shelf bookcase San Antonio B302I

29931 2 Drawer vertical file cabinet San Antonio B302I

14285 Storage Cabinet San Antonio B302F

14286 Guest chair San Antonio B302F

14287 Guest chair San Antonio B302F

14288 U-shaped desk w/Hutch San Antonio B302F

14289 2 Drawer vertical file cabinet San Antonio B302F

14290 5 Drawer vertical file cabinet San Antonio B302F

29930 Task chair San Antonio B302F

14604 Breakroom chair San Antonio B302E

14605 Breakroom chair San Antonio B302E

14606 Breakroom chair San Antonio B302E

14607 Breakroom chair San Antonio B302E

14608 Break room chair San Antonio B302E

14609 Breakroom chair San Antonio B302E

14610 Breakroom chair San Antonio B302E

14611 Breakroom chair San Antonio B302E

14612 Breakroom chair San Antonio B302E

14613 Breakroom chair San Antonio B302E

14614 Breakroom chair San Antonio B302E

14615 Breakroom chair San Antonio B302E

14616 Breakroom chair San Antonio B302E

14617 Breakroom chair San Antonio B302E

14618 Breakroom chair San Antonio B302E

14619 3 ft Breakroom table San Antonio B302E

14620 3ft Breakroom table San Antonio B302E

14621 3 ft Breakroom table San Antonio B302E

14399 U-shaped desk San Antonio B302D

14401 Guest chair San Antonio B302D

14403 Guest chair San Antonio B302D

14585 5 Shelf bookcase San Antonio B302D

100093 Task chair San Antonio B302D

10407 2 Drawer vertical file cabinet San Antonio B302B

14292 5 Shelf bookcase San Antonio B302B

14293 Guest chair San Antonio B302B

14294 Guest chair San Antonio B302B

14295 U-shaped desk w/Hutch San Antonio B302B

14296 Task chair San Antonio B302B

14297 5 Drawer vertical file cabinet San Antonio B302B

13860 Guest chair San Antonio B302A

13861 Guest chair San Antonio B302A

14298 U-shaped desk w/Hutch San Antonio B302A

14305 5 Shelf bookcase San Antonio B302A

24382 Task chair San Antonio B302A

100116 Television w/stand San Antonio B302M

14306 5 Shelf bookcase San Antonio A301A

14307 Guest chair San Antonio A301A

14308 Guest chair San Antonio A301A

14309 U-shaped desk w/Hutch San Antonio A301A

14310 5 Drawer vertical file cabinet San Antonio A301A

14311 Task chair San Antonio A301A

14312 U-shaped desk with hutch San Antonio A301B

14313 Task Chair San Antonio A301B

14315 5 Drawer vertical file cabinet San Antonio A301B

14316 Guest chair San Antonio A301B

14317 Guest chair San Antonio A301B

100019 2 Drawer vertical file cabinet San Antonio A301B

100318 5 Shelf bookcase San Antonio A301B

14318 5 Shelf bookcase San Antonio A301C

14319 5 Drawer vertical file cabinet San Antonio A301C

14320 Guest chair San Antonio A301C

14321 Guest chair San Antonio A301C

14322 U-shaped desk w/Hutch San Antonio A301C

14323 Task chair San Antonio A301C

100018 5 Drawer vertical file cabinet San Antonio A301C

14324 U-shaped desk w/Hutch San Antonio A301D

14326 5 Drawer vertical file cabinet San Antonio A301D

14327 Guest chair San Antonio A301D

14328 Guest chair San Antonio A301D

29928 Task chair San Antonio A301D

100015 5 Shelf bookcase San Antonio A301D

14344 5 Drawer vertical file cabinet San Antonio A303C

14347 U-shaped desk San Antonio A303C

14349 5 Shelf bookcase San Antonio A303C

14465 Guest chair San Antonio A303C

14466 Guest chair San Antonio A303C

100094 Task chair San Antonio A303C

14350 5 Shelf bookcase San Antonio A303D

14351 Conference chair San Antonio A303D

14352 Conference chair San Antonio A303D

14353 Conference chair San Antonio A303D

14354 Conference chair San Antonio A303D

14355 Conference chair San Antonio A303D

14356 Conference chair San Antonio A303D

14357 Conference Table San Antonio A303D

14358 5 Drawer vertical file cabinet San Antonio A303D

14359 U-shaped Desk with hutch San Antonio A303D

14360 SUSPO/Executive task Chair San Antonio A303D

14361 Guest Chair San Antonio A303D

14362 Guest Chair San Antonio A303D

100014 Storage Cabinet San Antonio A303D

14348 Task Chair San Antonio 3rd flr CL 1

14737 Printer stand San Antonio 3rd flr CL 1

14738 3ft Work table San Antonio 3rd flr CL 1

14747 Cubicle station San Antonio 3rd flr CL 1

100017 Cubicle station San Antonio 3rd flr CL 4

102852 5 drawer lateral file cabinet San Antonio 3rd flr CL 4

102853 5 drawer lateral file cabinet San Antonio 3rd flr CL 4

102854 Mobile printer stand San Antonio 3rd flr CL 4

14680 Task chair San Antonio 3rd flr CL 5

14704 Cubicle station San Antonio 3rd flr CL 5

29876 Task chair San Antonio 3rd flr CL 6

29877 Cubicle station San Antonio 3rd flr CL 6

14678 Task chair San Antonio 3rd flr CL 7

14691 Cubicle station San Antonio 3rd flr CL 7

N/A Greenery décor 17 ea.

N/A Coatrack 9 ea.

N/A Trash can 26 ea.

N/A Wall décor 49 ea.

N/A Wall décor pictures 46ea.

N/A Wall calendar board 12 ea.

N/A Desktop paper tray 15ea.

ASSET ID DESCRIPTION ROOM

101246 Coat Rack 636

101248 Chair, Guest, Blue 636

101249 Workstation, Officer 636

101254 Cabinet, File, 2-Drawer, Lateral 636

101258 Coat Rack 636

101261 Workstation, Officer 636

101264 Chair, Guest, Blue 636

101275 Chair, Guest, Green Leaf 636

101276 Chair, Guest, Green Leaf 636

101288 Coat Rack 636

101330 Chair, Guest, Green 636

101331 Chair, Guest, Green 636

101332 Chair, Guest, Gold-Burgundy, Blue-Green Leaves 636

101333 Chair, Guest, Gold-Burgundy, Blue-Green Leaves 636

101357 Chair, Stool, Blue 636

101358 Chair, Stool, Blue 636

101359 Chair, Guest, Blue 636

101360 Chair, Guest, Blue 636

101396 Coat Rack 636

101400 Workstation, Officer 636

101404 Chair, Guest, Maroon 636

101405 Chair, Guest, Maroon 636

101412 Cabinet, File, 2-Drawer, Lateral 636

101429 Table, Conference 636

101437 Podium 636

101449 Board, Visual, w/Door (disassembling required) 636

101452 Microwave, Sharp, Carousel 636

101497 Chair, Guest, Purple/Green Print 636

101505 Workstation, Officer 636

101508 Chair, Guest, Maroon 636

101509 Chair, Guest, Maroon 636

101510 Bookcase, 5-Shelf 636

101514 Chair, Guest, Fairfield, Paprika 636

101515 Chair, Guest, Fairfield, Paprika 636

101529 Desk, Administrative 636

101543 Bookcase, 5-Shelf 636

101544 Chair, Guest, Green 636

101545 Chair, Guest, Green 636

101547 Chair, Guest, Mauve Leaf 636

101548 Chair, Guest, Mauve Leaf 636

101554 Typewriter, Brother, EM-630 636

101557 Chair, Guest, Tan and Mauve 636

101558 Chair, Guest, Tan and Mauve 636

101559 Table, End 636

101562 Chair, Guest, Tan and Mauve 636

Pretrial Furniture Inventory - 3RD Floor

ATTACHMENT 1 b - PRETRIAL INVENTORY LIST

101566 Chair, Guest, Blue 636

101567 Chair, Guest, Blue 636

101568 Desk, Officer 636

101569 Cabinet, File, 2-Drawer, Lateral 636

101570 Bookcase, 4-Shelf 636

101625 Cabinet, File, 2-Drawer, Lateral 636

101648 Shredder, Destroyit, Ideal 4002,Cross Cut, SN-2886396 636

101656 Chair, Guest, Parsley, Dark Green 636

101657 Chair, Guest, Parsley, Dark-Green 636

101658 Chair, Guest, Parsley, Dark-Green 636

101659 Chair, Guest, Parsley, Dark-Green 636

101660 Chair, Guest, Parsley, DarkGreen 636

101661 Chair, Guest, Parsley, Dark Green 636

101662 Chair, Guest, Parsley, Dark Green 636

101663 Chair, Guest, Parsley, Dark Green 636

101664 Chair, Guest, Parsley, Dark Green 636

101665 Chair, Guest, Parsley, Dark Green 636

101666 Chair, Guest, Basil, Light Green 636

101667 Chair,Guest, Basil, Light Green 636

101668 Chair, Guest, Basil, Light Green 636

101669 Chair, Guest, Basil, Light Green 636

101670 Chair, Guest, Basil, Light Green 636

101680 Table, Round 636

101681 Table, Console 636

102014 Typewriter, Brother 636

102025 Cabinet, File, Lateral, 2-Drawer 636

102026 Bookcase, 4-Shelf, Open 636

102098 Table, Conference, Small 636

102288 Cabinet, Storage, 2-Doors, Beige,24"d x 36"w x 84"h 636

102290

Cabinets, Wall, 2-Door & 1-Door, Cabinets, Base, 2-Door, 1-Door, 4-Drawers, Countertop 25 x 72 636

102346 Sofa, Loveseat, Benton, Kiwi Color, Wooden Arms & Legs 636

102438

Chair, Managerial, Mid Back, Swivel Tilt, Vinyl, Black, The Hon

Co. 636

102439

Chair, Managerial, Mid Back, Swivel Tilt, Vinyl, Black, The Hon

Co. 636

102440

Chair, Managerial, Mid Back, Swivel Tilt, Vinyl, Black, The Hon

Co. 636

102441

Chair, Managerial, Mid Back, Swivel Tilt, Vinyl, Black, The Hon

Co. 636

102442

Chair, Managerial, Mid Back, Swivel Tilt, Vinyl, Black, The Hon

Co. 636

102443

Chair, Managerial, Mid Back, Swivel Tilt, Vinyl, Black, The Hon

Co. 636

102444

Chair, Managerial, Mid Back, Swivel Tilt, Vinyl, Black, The Hon

Co. 636

102445

Chair, Managerial, Mid Back, Swivel Tilt, Vinyl, Black, The Hon

Co. 636

102446

Chair, Managerial, Mid Back, Swivel Tilt, Vinyl, Black, The Hon

Co. 636

102447

Chair, Managerial, Mid Back, Swivel Tilt, Vinyl, Black, The Hon

Co. 636

102448

Chair, Managerial, Mid Back, Swivel Tilt, Vinyl, Black, The Hon

Co. 636

102449

Chair, Managerial, Mid Back, Swivel Tilt, Vinyl, Black, The Hon

Co. 636

102450

Chair, Managerial, Mid Back, Swivel Tilt, Vinyl, Black, The Hon

Co. 636

102451

Chair, Managerial, Mid Back, Swivel Tilt, Vinyl, Black, The Hon

Co. 636

102452

Chair, Managerial, Mid Back, Swivel Tilt, Vinyl, Black, The Hon

Co. 636

102453

Chair, Managerial, Mid Back, Swivel Tilt, Vinyl, Black, The Hon

Co. 636

102454

Chair, Managerial, Mid Back, Swivel Tilt, Vinyl, Black, The Hon

Co. 636

102455

Chair, Managerial, Mid Back, Swivel Tilt, Vinyl, Black, The Hon

Co. 636

102456

Chair, Managerial, Mid Back, Swivel Tilt, Vinyl, Black, The Hon

Co. 636

102457

Chair, Managerial, Mid Back, Swivel Tilt, Vinyl, Black, The Hon

Co. 636

102532 Chair, Stack, Global 636

102533 Chair, Stack, Global 636

102534 Chair, Stack, Global 636

102535 Chair, Stack, Global 636

No Tag Cabinet 636

No Tag Chair, Stool, Blue 636

No Tag Conference room wall unit (disassembling required) 636

No Tag Credenza 636

No Tag Guest Chair 636

No Tag Guest Chair 636

No Tag Locker 636

No Tag Metal Shelving unit 636

No Tag Metal Shelving unit 636

No Tag Metal Shelving unit 636

No Tag Metal Shelving unit 636

No Tag Metal Shelving unit 636

No Tag Metal Shelving unit 636

No Tag Metal Shelving unit 636

No Tag Metal Shelving unit 636

No Tag Metal Shelving unit 636

No Tag Metal Shelving unit 636

No Tag Metal Shelving unit 636

No Tag Rolling computer stand 636

No Tag Shredder, Destroyit, Ideal 4002,Cross Cut 636

No Tag Shredder, Destroyit, Ideal 4002,Cross Cut 636

No Tag Standard Fridge 636

No Tag Whiteboard 636

No Tag Wooden desk 636

No Tag 15 desk mats 636

No Tag Modular Walls Admin Office (disassembling required) 636

No Tag Storefront Modular Walls (disassembling required) 636

In accordance with Executive Order 13991, Office of Management and Budget Memorandum M-21- 15, and guidance from the Safer Federal Workforce Task Force, the follow conditions and requirements must be met for entry into this facility:

FEDERAL EMPLOYEES

1. Show proof of fully vaccination statue or documentation of a negative COVID-19 test result from within the last 72 hours to show entry screener.

2. While in the facility, follow agency workplace safety plans and protocols.

3. Any requests for a medical or religious accommodation from being vaccinated should be directed through ERO.

FEDERAL CONTRACTORS

1. Ensure you have completed and possess the agency provided Certification of Vaccination form and present the completed form to the Protective Security Officer (PSO) when going through facility security screening.

2. If you are not fully vaccinated, have in your possession documentation of a negative COVID-19 test result from within the last 72 hours to show your agency.

3. While in the facility, follow workplace safety plans and protocols.

4. Any requests for a medical or religious accommodation from being vaccinated should be directed to your employer.

VISITORS [Those who do not possess a valid Federal Government Personal Identity Verification (PIV) Card]

1. If visiting this facility to seek a public service or benefit, you are NOT required to provide information about your vaccination status or negative COVID-19 test results; however, you MUST abide by masking and social distancing requirements.

2. If visiting this facility for any other purpose, you must have completed and possess the government provided Certification of Vaccination form and present the completed form to the Protective Security Officer (PSO) when going through facility security screening.

3. If you are not fully vaccinated, you must have in your possession documentation of a negative COVID-19 test result from within the last 72 hours to show the agency you are visiting.

4. While in the facility, follow the workplace safety plans and protocols that you are visiting.

5. Any requests for a medical or religious accommodation from being vaccinated should be directed to the agency you are visiting.

NEW Facility Access Requirements and Restrictions

ATTACHMENT 1c Facility Access Information http://pngimg.com/download/25679 https://creativecommons.org/licenses/by-nc/3.0/ http://pngimg.com/download/25679 https://creativecommons.org/licenses/by-nc/3.0/ http://pngimg.com/download/25679 https://creativecommons.org/licenses/by-nc/3.0/ http://pngimg.com/download/25679 https://creativecommons.org/licenses/by-nc/3.0/ http://pngimg.com/download/25679 https://creativecommons.org/licenses/by-nc/3.0/ https://creativecommons.org/licenses/by-nc/3.0/

OMB Control No. 3206-0277 Exp. Feb. 5, 2022

Certification of Vaccination The purpose of this form is to take steps to prevent the spread of COVID-19, to protect the health and safety of all Federal employees, onsite contractors, visitors to Federal buildings or Federally controlled indoor workspaces, and other individuals interacting with the Federal workforce. If you fail to submit this signed attestation or any required negative COVID-19 test, you may be denied entry to a Federal facility.

My Vaccination Status By checking the box below, I declare that the following statement is true:

I am fully vaccinated.1

1 The Centers for Disease Control and Prevention considers an individual fully vaccinated if they are:

• 2 weeks after their second dose in a 2-dose series, such as the Pfizer or Moderna vaccines, or

• 2 weeks after a single-dose vaccine, such as Johnson & Johnson’s Janssen vaccine

If you don’t meet these requirements, regardless of your age, you are not fully vaccinated.

I am not yet fully vaccinated.2

2 Either I have received my first dose of Moderna or Pfizer, and my second appointment is scheduled, or I received my final dose less than two weeks ago.

I have not been vaccinated.3

3 If you are not vaccinated due to medical or religious reasons, please check either “I have not been vaccinated” or “I decline to respond.”

I decline to respond.

I understand that if I decline to respond or am not fully vaccinated, I must comply with the following safety protocols while in a Federal facility:

• Wear a mask regardless of the level of community transmission;

• Physically distance; and

• Provide proof of having received a negative COVID-19 test from within the previous 3 days if I am a visitor or I am an onsite contractor who is not enrolled in an agency’s testing program.

I sign this document under penalty of perjury that the above is true and correct, and that I am the person named below. I understand that a knowing and willful false statement on this form can be punished by fine or imprisonment or both (18 U.S.C. 1001). Checking “I decline to respond” does not constitute a false statement. I understand that if I am a Federal employee or contractor making a false statement on this form could result in additional administrative action, including an adverse personnel action up to and including removal from my position or removal from a contract.

Your printed name here:

Your signature here:

Date:

Directions and notice to Federal employees Consistent with guidance from the Centers for Disease Control and Prevention (CDC) and the Safer Federal Workforce Task Force, has established specific safety protocols for fully vaccinated people and not fully vaccinated people, respectively. You may be asked to submit this completed form to your employing agency.

In areas of low or moderate transmission, as defined by CDC, fully vaccinated people generally can safely participate in most activities, indoor or outdoor, without needing to wear a mask or maintain physical distance, and do not need to undertake regular testing—please note that consistent with CDC guidance, agencies may have different protocols for fully vaccinated people in specific work settings, such as healthcare settings. In areas of high or substantial transmission, everyone, including fully vaccinated people, must wear a mask consistent with Federal requirements.

Employees who disclose that they are fully vaccinated will comply with agency guidance for fully vaccinated individuals. Employees who are unvaccinated, are not fully vaccinated, or who choose not to provide vaccine information are required to comply with CDC and agency guidance for not fully vaccinated individuals, including wearing masks regardless of the transmission rate in a given area, physical distancing, regular testing, and adhering to applicable travel restrictions.

These requirements are to prevent the spread of COVID-19 to protect the health and safety of our workforce. Making a false statement on this form could result in an adverse personnel action against you, up to and including removal from your position.

Pursuant to 5 U.S.C. § 552a(e)(3), this Privacy Act Statement informs you of why you are being asked to provide this information.

Authority: We are authorized to collect the information requested on this form pursuant to Executive Order 13991, Protecting the Federal Workforce and Requiring Mask-Wearing (Jan. 20, 2021), Executive Order 12196, Occupational Safety and Health Program for Federal Employees (Feb. 26, 1980), and 5 U.S.C. chapters 11 and 79.

Purpose: This information is being collected and maintained to promote the safety of Federal buildings and the Federal workforce consistent with the above-referenced authorities, the COVID-19 Workplace Safety: Agency Model Safety Principles established by the Safer Federal Workforce Task Force, and guidance from the Centers for Disease Control and Prevention and the Occupational Safety and Health Administration.

Routine Uses: While the information requested on this form is intended to be used primarily for internal purposes, in certain circumstances it may be necessary to disclose this information externally, for example to disclose information to: a Federal, State, or local agency to the extent necessary to comply with laws governing reporting of communicable disease or other laws concerning health and safety in the work environment; to adjudicative bodies (e.g., the Merit System Protection Board), arbitrators, and hearing examiners to the extent necessary to carry out their authorized duties regarding Federal employment; to contractors, grantees, or volunteers as necessary to perform their duties for the Federal government; to other agencies, courts, and persons as necessary and relevant in the course of litigation, and as necessary and in accordance with requirements for law enforcement; or to a person authorized to act on your behalf. A complete list of the routine uses can be found in the system of records notice associated with this collection of information, OPM/GOVT-10, Employee Medical File System of Records, 75 Fed. Reg. 35099 (June 21, 2010), amended 80 Fed. Reg. 74815 (Nov. 30, 2015).

Consequence of Failure to Provide Information: Providing this information is voluntary.

However, if you fail to provide this information, you will be treated as not fully vaccinated for purposes of implementing safety measures, including with respect to mask wearing, physical distancing, testing, travel, and quarantine.

Please contact with questions. Please return this form to .

Directions and notice to Federal contractors In areas of low or moderate transmission, as defined by CDC, fully vaccinated people generally can safely participate in most activities, indoor or outdoor, without needing to wear a mask or maintain physical distance, and do not need to undertake regular testing—please note that consistent with CDC guidance, agencies may have different protocols for fully vaccinated people in specific work settings, such as healthcare settings. In areas of high or substantial transmission, everyone, including fully vaccinated people, must wear a mask consistent with Federal requirements.

You may be asked to show this form and/or information from a health screening upon entry to a Federal building or Federally controlled indoor worksites, and/or to a Federal employee who is supervising or managing your work on Federal premises. Please maintain this form during your time on Federal premises.

Please contact with questions.

https://www.federalregister.gov/documents/2010/06/21/2010-14838/privacy-act-of-1974-update-and-amend-system-of-records https://www.federalregister.gov/documents/2015/11/30/2015-30309/privacy-act-of-1974-routine-use-implementation-system-of-records

Directions and notice to visitors In areas of low or moderate transmission, as defined by CDC, fully vaccinated people generally can safely participate in most activities, indoor or outdoor, without needing to wear a mask or maintain physical distance, and do not need to undertake regular testing—please note that consistent with CDC guidance, agencies may have different protocols for fully vaccinated people in specific work settings, such as healthcare settings. In areas of high or substantial transmission, everyone, including fully vaccinated people, must wear a mask consistent with Federal requirements.

You may be asked to show this form and/or information from a health screening upon entry to a Federal building or Federally controlled indoor worksites. Please maintain this form during your visit. You may be asked to show this form as part of your in-person participation in a Federally hosted meeting, event, or conference. If you are entering to obtain a public service or benefit and are not fully vaccinated, you must comply with all relevant CDC guidance, including mask wearing and physical distancing requirements, however this form and the requirement to show a negative COVID-19 test do not apply to you.

Public burden information Public burden reporting for this collection of information is estimated to average 2 minutes per response, including time for reviewing instructions and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to PRA@opm.gov. The OMB clearance number 3206-0277, is currently valid.

may not collect this information, and you are not required to respond, unless this number is displayed.

mailto:PRA@opm.gov