Acitve Barrier Maintenace Site Visit Access List.pdf

PDF 99 KB Posted

Attached to
Active Vehicle Barriers Maintenance Federal contract opportunity
Solicitation number
FA460025Q0045
Issued by
Department of the Air Force Air Combat Command

About this file

Written by GovTribe AI ·

This document is an Active Barrier Maintenance Site Visit Entry Authority List for Offutt Air Force Base, designed to track and authorize personnel entry for a specific site visit on 05/08/2025. The form allows for listing up to 18 guests, requiring detailed personal information including legal name, gender, date of birth, driver's license number, and U.S. citizenship status. The site visit is scheduled from 1300-1500 hours and will cover all active barrier locations, with Benjamin Hudson (CIV) serving as the sponsor and contact number 402-232-5279.

The entry list is part of a larger federal contract opportunity (Solicitation Number FA460025Q0045) for Active Vehicle Barriers Maintenance at Offutt Air Force Base. The contract requires a contractor to provide personnel, equipment, and services for vehicle barrier system maintenance, complying with commercial and military standards. Key dates include a site visit on 8 May 2025, questions due by 14 May 2025, and offers due by 30 May 2025 at 1:00 PM CDT. The solicitation is managed by the Department of the Air Force Air Combat Command, with primary contact points being Mr. Casey Hupton and 2d Lt Ryan Brewster.

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FOUO OFFUTT AIR FORCE BASE ENTRY AUTHORITY LIST

Page of 55 SFS Form 31 (10 Apr 2015)

Event Name

Start and End Time for Each Day of Event Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Date(s) of Event (Expires Immediately After Event ) Location of Event

Sponsor Name and Rank Sponsor Phone Number(s)

PRIVACY ACT STATEMENT

Authority: 10 U.S.C. 8013 and Executive Orders 13478 and 9397 as amended.

Purpose: Information collected by Security Forces personnel will be used to authorize installation entry to persons shown on the entry authority listing for the specific purpose provided by the sponsor. Information will also be used to notify person(s) designated as the visitor sponsor of arrival and other pertinent information relating to entry on the installation.

Routine Uses: Records may be disclosed to applicable Federal, State, or local agency charged with the responsibility of investigating or prosecuting a violation or enforcing/implementing a statute, rule, regulation, order issued pursuant thereto.

Disclosure: Disclosure of requested information is voluntary. Failure to provide all or parts of information requested can result in denial of installation entry. System of records number F031 AF SF B, Security Forces Management Information System (SFMIS), Defense Biometric Identification Systems (DBIDS) applies.

**DO NOT MODIFY FORMAT**

Approval Stamp (55 SFS Use Only)

Signature of Authenticator (55 SFS Use Only)

Legal Name of Guest:

(Last, First, MI)

Gender:

(M/F)

DOB:

(1962 Jan 11)

Driver’s License# State Issued

(M19GO62BLU / MI)

United States Citizen

(Yes / No)

Tuesday:
Wednesday:
Thursday: 1300-1500
Friday:
Saturday:
Sunday:
Sponsor Name and Rank: Benjamin Hudson CIV
Name 1:
Gender 1:
DOB 1:
DL 1:
Citizen 1:
Name 2:
Gender 2:
DOB 2:
DL 2:
Citizen 2:
Name 3:
Gender 3:
DOB 3:
DL 3:
Citizen 3:
Name 4:
Gender 4:
DOB 4:
DL 4:
Citizen 4:
Name 5:
Gender 5:
DOB 5:
DL 5:
Citizen 5:
Name 6:
Gender 6:
DOB 6:
DL 6:
Citizen 6:
Name 7:
Gender 7:
DOB 7:
DL 7:
Citizen 7:
Name 8:
Gender 8:
Citizen 8:
DOB 8:
DL 8:
Name 9:
Gender 9:
DOB 9:
DL 9:
Gender 10:
DOB 10:
DL 10:
Citizen 10:
Name 10:
Citizen 9:
Name 11:
Gender 11:
DOB 11:
DL 11:
Citizen 11:
Name 12:
Gender 12:
DOB 12:
DL 12:
Citizen 12:
Name 13:
Gender 13:
DOB 13:
DL 13:
Citizen 13:
Name 14:
Gender 14:
DOB 14:
DL 14:
Citizen 14:
Gender 15:
DOB 15:
Citizen 15:
Name 15:
Name 16:
Gender 16:
DOB 16:
DL 15:
Citizen 16:
DL 16:
Name 17:
Gender 17:
DOB 17:
DL 17:
Citizen 17:
Gender 18:
Name 18:
DOB 18:
DL 18:
Citizen 18:
Monday:
Sponser Phone Number: 402-232-5279
Event Name: Active Barrier Maintenance Site Visit
Date of Event: 05/08/2025
Location of Event: All Active Barrier Locations

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