Appendix D - NSSC Contractor Request For -.docx
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- Solicitation number
- W911QY-23-R-1021
About this file
This document contains a contractor access request form and instructions for submitting the form to gain entry onto the Natick Soldier Systems Center (NSSC). The form requests individual visitor information such as name, date of birth, address history, and identification details. It specifies that all U.S. visitors over 18 and foreign visitors must be vetted before entry according to Department of the Army guidance. The form can be submitted via encrypted email or fax at least 24 hours before the planned visit. Visitors will be added to the daily access roster if vetting is successful. Those vetted within 90 days will be on the visitor access roster. The point of contact will only be notified if entry is not authorized. Questions should be directed to the listed Natick police department phone number. A waiver process is available for those denied access.
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Text version
NSSC Contractor Access Request Form
Company Name: __________________________ Bldg/Area working: ____________ NSSC Point of Contact (POC): _________________ POC Phone #:__________________
| Last Name |
| First Name |
| Date of Birth |
| State ID or Drivers License # |
| DL |
State
| Current Address |
| States Resided In |
During Past 5 Years
· Per U.S. Army Directive-Type Memorandum (DTM) 09-012, all of the above information is required for unescorted access. The POC will only be notified if the visitor is not authorized entry onto the installation.
· All U.S. visitors 18 years of age and older must be vetted prior to entry to NSSC. Foreign visitors (both official and unofficial) must be vetted through the appropriate Foreign Disclosure Officer based on the organization he/she is coming to see.
· To protect PII, there are two methods of submitting this form. This form can be emailed encrypted to “USARMY Natick SSC IMCOM List NATI-PoliceVistorAccess-SSC” at email address usarmy.natick.imcom.list.nati-policevistoraccess-ssc@mail.mil Alternatively, this form can be faxed to (508) 206-4009.
· Requests must be received by USAG Natick Police at least 24 hours prior to the visitor’s arrival. Upon successful vetting, the visitor will be added to the Daily Access Roster for the date of the visit. The Daily Access Roster is maintained at the Main Gate.
· If a visitor has been vetted within the last 90 days, their information will be on the appropriate Visitor Access Roster. For those personnel not on the Visitor Access Roster or who have recently expired, then send an email request to the above address at least 24 hours prior to the visitor’s arrival. Include the visitor’s full name, date of visit, time of visit and POC.
· If a visitor has derogatory information found when vetted, a call will go to the POC only and not allowed on Installation.
· Contact the USAG Natick Police Desk at 508-206-4007, to verify whether or not a visitor has been vetted within the last 90 days.
· Please direct any questions regarding this process to the USAG Natick Police Desk at 508-206-4007.
· Note: If individual has been denied access a Waiver Request and instructions can be obtained from USAG Natick Police Desk.
FOUO
In compliance with the Privacy Act of 1974, this information is Personal Data and must be protected from disclosure.
USAG Form 402 image1.gif
File details come from the government source that posted it. Updated .