AF Form 2586 Flightline Driving Request.pdf
PDF 94 KB Posted
- Attached to
- Civil Engineering Multiple Award Construction Contract III, IDIQ Federal contract opportunity
- Solicitation number
- FA8501-22-R0023
About this file
This document provides details for the Civil Engineering Multiple Award Construction Contract III (CEMACC III) indefinite delivery, indefinite quantity (IDIQ) contract opportunity. The Air Force Sustainment Center through the AFSC/PZIOC Infrastructure Support Branch at Robins AFB, GA is seeking proposals from service-disabled veteran owned small businesses for construction services including maintenance, repair, alteration, mechanical, electrical, heating/air conditioning, demolition, painting, asbestos remediation, paving, and earth work for industrial/office buildings and infrastructure at Robins AFB. The combined maximum value of the multiple award IDIQ is $300 million over a five-year period of performance comprising a one-year base period and four one-year options. Task orders will range from $150,000 to $2 million. Lowest price with special standards of responsibility will be used for award to multiple awardees. The NAICS code is 236220 with a $36.5 million small business size standard. The solicitation will be posted at https://beta.sam.gov/ and paper copies will not be available.
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Text version
PREVIOUS EDITIONS ARE OBSOLETE.AF IMT 2586, 19 9 81001, V2
UNESCORTED ENTRY AUTH ORIZATION CERTIFICATE
PRIVACY ACT STATEMENT
I. IDENTIFICATION
II. CERTIFICATION OFREQUESTING OFFICIAL
III. DUTY
IV. RESTRICTED/CONTROLLED AREA COORDINATION
NAME
ORGANIZATION OR FIRM
GRADE ControlNumber(Last, First, MiddleInitial)
AUTH O RITY:
PRINCIPALPURPOSE(S):
ROUTINE USE(S):
10 U.S.C. 8013, 44 U.S.C. 3101, andEO 9 39 7.
TorecordpersonalinformationonanindividualwhosedutyperformancerequiresentryintoAirForcerestrictedandcontrolledareasin ordertocoordinatewiththeappropriateofficialanddeterminewhenandwhattypeofentrycredentialtouse.
ControlNumberisusedforindividualidentification. (Mustbefrom government-issuedID suchasCAC, driverlicense, passport, etc.)
None.
DISCLO SURE: Disclosureisvoluntaryhowever, failuretodiscloseinformationandSSN wouldresultinnotbeingallowedentryintotheseareas.
IcertifythattheindividualwhosenameappearsabovehasbeenthesubjectofafavorableinvestigationwhichmeetstherequirementsofAFIs31-101, 31-209 and
31-501, whenapplicable, forunescortedentryintorestrictedorcontrolledareas. Ifurthercertify, intheeventtheabovenamedindividualisanon-US national, that noUS nationalscanbemadeavailabletofillthispositionduringtheperiodindicatedabove, andthatthegrantingofunescortedentryrepresentsanexceptional requirementessentialtotheproperexecutionoftheCommand'smission. SuchunescortedentrywillnotinfringeupontheprohibiteddutiesoutlinedinAFPD 31
-seriesdirectives, andisclearlyconsistentwiththeinterestofnationalsecurity.
CAMPBELL, MARVIN G
78TH CIVIL ENGINEER GROUP
CONTRACTOR
COLOR H AIR
BLACK
CO LO R EYES
BROWN
W EIGH T
H EIGH T
5'10"
CITIZENSH IP (CheckOne)
(Describedutiesthatrequireunescortedentryintotheareasindicated)
US CITIZEN ALIEN IMMIGRANT NON-US NATIONAL
NAME, GRADE AND TITLE (Typed)
LOUIS BOUFFARD, SECURITY MANAGER
COMPANY NAME: XXXXXX
CONTRACT NUMBER:XXXXXX
PERFORMANCE START DATE:
PERFORMANCE END DATE:
PROGRAM MANAGER: TERRY R STINSON
PM OFFICE SYMBOL:78 CEG/CENME
PM DUTY PHONE:478-258-2507
PM BUILDING#280
DATE
05/16/2016
SIGNATURE
NUMBER OFFICIAL
AREA
LASSITER.TONYA.M.1284045382
ESCO RT
TYPE AREA
CONCUR
DATE
OFFICIAL'S SIGNATURE
COORDINATING/APPROVING
YES NO
NAME (Last, First, MiddleInitial)NAMENAME
H EIGH T W EIGH T CO LO R EYES COLOR H AIR
AFIMT2586, 19 9 81001, V2 (REVERSE)
IV. RESTRICTED/CONTROLLED AREA COORDINATION
V. RESTRICTED/CONTROLLED AREA BADGE ISSUE
NUMBER OFFICIAL
AREA
TRANSACTION
BASIC BADGE
EXCH ANGE BADGE #1
EXCH ANGE BADGE #2
CARD NUMBERFO RM TYPE BADGE NUMBER
ESCO RT
TYPE AREA
CONCUR
DATE
OFFICIAL'S SIGNATURE
COORDINATING/APPROVING
YES NO
EXCH ANGE BADGE #3
REISSUE #1
REISSUE #2
REISSUE #3
REISSUE #4
REISSUE #5
BADGE ISSUING OFFICIAL
REMARK S
(TypedNameandSignature) APPLICANT VERIFYING RECEIPT OF BADGE DATE(Signature)
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