JBCC Vetting Form.pdf

PDF 180 KB Posted

Attached to
HVAC Cleaning Services - Cape Cod
Solicitation number
70Z08425QDL950012
Issued by

About this file

The document is a JBCC Event - Project Roster form designed for access control and background checks for an event or project. The form requires comprehensive personal information for participants, including last name, first name, state/country code, driver's license or passport number, date of birth, and Real ID compliance. Key requirements include:

Submission Instructions: The roster must be electronically submitted to Access Control/Pass & ID 3-5 working days prior to arrival for background checks. All parties must agree to DCJIS/NCIC/III checks, and as of May 7th, 2025, all applicants must be Real ID compliant. The originating agency contact is Brian O'Kane from the US Coast Guard, with contact email brian.c.o'kane@uscg.mil and phone number 508-968-6993. The form is marked for official use only and includes spaces for event details, sponsor information, and administrative tracking.

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70Z08425QDL950012-2.2.1-Attachment 3.txt TXT text file
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Text version

JBCC EVENT - PROJECT ROSTER- OFFICIAL USE ONLY

Event/Project Name:

Destination:

Start & End Dates:

Sponsor

Name/Phone:

Company/POC/Phone:

Date Submitted:

CJIS Clerk:

POC called:

CJIS Roster:

CJIS Date:

COMPLETE ALL BLOCKS RETURN TO ACCESS CONTROL/PASS & ID, 3-5 WORKING DAYS PRIOR TO ARRIVAL FOR BACKGROUNDS

MUST BE TYPED & SENT ELECTRONICALLY TO ACCESS CONTROL/PASS & ID FOR TRACKING PURPOSES

Last Name First Name, MI State/

Ctry Code OLN/Passport NO. DOB Real

ID REF

Access Status

ALL PARTIES ABOVE AGREE TO DCJIS/NCIC/III CHECKS

CJIS Clerk Signature:

rev: 04/24/2025

NCIC APPROVAL:

Originating Agency Contact Information:

Comments:

As of May 7th 2025, all applicants must be real ID compliant.

christopherliptak Highlight christopherliptak Highlight thomas.m.monti Cross-Out

THOMAS.M.MONTI3

Highlight

THOMAS.M.MONTI3

Highlight

EventProject Name:
Destination:
Start End Dates:
Sponsor NamePhone:
CompanyPOCPhone:
Last NameRow1:
LEGAL First NameRow1:
Drivers License Row1:
USA CitizenRow1:
IGateRow1:
Last NameRow2:
LEGAL First NameRow2:
Drivers License Row2:
USA CitizenRow2:
IGateRow2:
Last NameRow3:
LEGAL First NameRow3:
Drivers License Row3:
USA CitizenRow3:
IGateRow3:
Last NameRow4:
LEGAL First NameRow4:
Drivers License Row4:
USA CitizenRow4:
IGateRow4:
Last NameRow5:
LEGAL First NameRow5:
Drivers License Row5:
USA CitizenRow5:
IGateRow5:
Last NameRow6:
LEGAL First NameRow6:
Drivers License Row6:
USA CitizenRow6:
IGateRow6:
Last NameRow7:
LEGAL First NameRow7:
Drivers License Row7:
USA CitizenRow7:
IGateRow7:
Last NameRow8:
LEGAL First NameRow8:
Drivers License Row8:
USA CitizenRow8:
IGateRow8:
Last NameRow9:
LEGAL First NameRow9:
Drivers License Row9:
USA CitizenRow9:
IGateRow9:
Text3:
Text4:
Text5:
Text6:
Originating Agency Contact Information: BRIAN O'KANE / BRIAN.C.O'KANE@USCG.MIL 508-968-6993
NCIC Approval: [Yes]
Comments:
Text7:
CUS Row 1:
CUS Row 2:
CUS Row 3:
CUS Row 4:
CUS Row 5:
CUS Row 6:
CUS Row 7:
CUS Row 8:
CUS Row 9:
StateRow1:
StateRow2:
StateRow3:
StateRow7:
StateRow8:
StateRow9:
StateRow4:
StateRow5:
StateRow6:
TEXT3:
TEXT1:
TEXT2:
TEXT4:
TEXT5:
TEXT6:
TEXT7:
TEXT8:
TEXT9:

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