12c Attachment - Amendment 00001 - Base Boston Access Request.pdf

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Attached to
REPLACE UNDERWATER MEMBERS - COVERED MOORINGS
Solicitation number
70Z0G124BBBOS0078
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About this file

This document contains an access request list template and details of a federal contract opportunity notice for structural repairs to a covered mooring floating dock. The access request list template requires contractors to provide name, gender, date of birth, driver's license or passport information, citizenship, home address, work dates and hours, and sponsor information for base access. The federal contract opportunity is solicitation number 70Z0G124BBBOS0078 from the Department of Homeland Security US Coast Guard. It requires contractors to furnish all labor, material, equipment, transportation, and supervision to perform a complete inspection and structural repairs to underwater steel bracings, bolt connections and brackets of the Covered Mooring Floating Dock outboard of Wharf 4 at US Coast Guard Base Boston. All work must be accomplished according to attached specifications and drawings.

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Text version

ACCESS REQUEST LIST

Name M or F DOB Driver’s License

(Include State) or Passport#

Citizenship

Home Address City & State Only Start Date End Date Work/ Event

Hours

Example: John Doe M 08/17/1991

MA# 123456789 U.S. Boston, MA 10/17/23 10/20/23 0700-1500

Access Start Date End Date Company/Agency: ________

Purpose of visit: _ Location on Base______________________

Sponsor Print: Sponsor Signature: Sponsor Phone #: _______________

Email completed form to Ms. Caitlin Foos Caitlin.Q.Foos@uscg.mil & ME1 Gage Hunt Gage.c.hunt@uscg.mil *By signing this request, I certify that I have reviewed the information provided to me by the vendor’s company and the above is true and accurate to the best of my knowledge.

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