Att 2 - NCIC Screening_Pass Request.pdf
PDF 250 KB Posted
- Solicitation number
- FA460026R0002
About this file
This is a Contractor/Vendor NCIC Screening & Pass Request Spreadsheet for Offutt Air Force Base (55 SFS - Security Forces Squadron). The form is classified as Controlled Unclassified Information (CUI) and is used to process background screening and base access passes for contractor and vendor personnel working at Offutt AFB.
The spreadsheet requires submission of contractor and vendor company information, including company name, address, and designated representative contact details. For each personnel member requiring base access, the form collects full name, date of birth, driver's license or state ID number, Social Security number, work schedule (days and hours), employment start and end dates, and country of citizenship. The form includes fields for contract number and contract start/end dates, and requires signature approval from the Unit Commander or Security Manager. For non-U.S. visitors, additional approval from 55 WG/IP (55th Wing Intelligence/Protection) is required. All listed personnel must present a REAL ID ACT-compliant driver's license, state ID, or approved alternate form of photo identification upon arrival at the Offutt AFB Visitor Control Center. The point of contact for CUI-related matters is Mr. Gregory Derkatch at (402) 232-7339.
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| HEMP Q and A.pdf | ||
| CDRL Listing Ex A.pdf | ||
| Att 4 PWS Feb 2026.pdf | ||
| Solicitation Amendment - FA460026R00020002.pdf | ||
| Site Visit Sign In Sheet.pdf | ||
| FA460026R00020001.pdf | ||
| FA460026R0002.pdf | ||
| Att 3 Price Model Final.xlsx | XLSX spreadsheet | |
| CDRL Listing ExA.pdf | ||
| Att 7 Wage Determination.pdf | ||
| Att 5 HDBK 423 5-15-93.pdf | ||
| Att 6 SB_Subcontracting Plan Review Checklist.xlsx | XLSX spreadsheet | |
| Att 4 PWS Jan 2026.pdf | ||
| Att 1 - NDA - Solicitation.pdf |
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Text version
Contract#:
Contract Start/End Dates: Unit Commander or Security Manager Sig Block
NOTE:
Security Manager will ensure all listed personnel are briefed that they must present a REAL ID ACT compliant driver’s license, or state ID, or an approved alternate form of photo identification upon arrival at Offutt AFB Visitor Control Center.
CUI
55 SFS CONTRACTOR/VENDOR NCIC SCREENING & PASS REQUEST SPREADSHEET
CUI
Contractor/ Vendor NCIC Screening & Pass Request Spreadsheet contain “CONTROLLED UNCLASSIFED INFORMATION” (CUI) which must be protected under the Freedom of Information Act (5 U.S.C. 552) and/or the Privacy Act of 1974 (5 U.S.C. 552a). Unauthorized disclosure or misuse of this PERSONAL INFORMATION may result in disciplinary action, criminal and/or civil penalties. Further distribution is prohibited without the approval of the author of this message unless the recipient has a need to know in the performance of official duties. CONTROLLED BY: 55SFS/MAP/CUI CATEGORY: PRVCY/DISTRIBUTION/DISSEMINATION CONTROL: FEDCON POC: MR.
DERKATCH, GREGORY (402) 232-7339.
Offutt AFB Sponsoring Agency / Unit: Company Name:
Base Sponsor's Name: Company Address:
Base Sponsor's Phone #: Company Representative Name:
Request Date: Company Representative Phone Number:
Full Name Date of Birth Work Schedule Country of Last, First, MI Year Month Day Drivers License/ID # State SSAN Days Hrs Start Date - End Date (MMDDYYYY) Citizenship
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Contract Start/End Dates: Unit Commander or Security Manager Sig Block 55 WG/IP Sig Block - Needed For Non U.S. Visitors
Contract Start/End Dates: Unit Commander or Security Manager Sig Block 55 WG/IP Sig Block - Needed For Non U.S. Visitors
File details come from the government source that posted it. Updated .