Attach_5_PCL Template.docx

DOCX document 44 KB Posted

Attached to
NGA Solicitation for Behavioral Support Science Services
Solicitation number
HM047626Q0018
Issued by

About this file

This is a Personnel Security Clearance Information template used for source selection purposes. The document serves as a standardized format for collecting and presenting security clearance data on key personnel proposed for a federal contract. It contains personally identifiable information marked as UNCLASSIFIED//FOUO and includes fields for recording individual names, dates of birth, places of birth, Social Security numbers, investigation types, clearance close dates, SCI eligibility dates, and government sponsors. The template demonstrates the type of clearance documentation that contractors must provide when responding to the NGA Solicitation for Behavioral Support Science Services (Solicitation Number HM047626Q0018), which seeks non-personal services to support the National Geospatial Intelligence Agency's Security and Installation Directorate Counter Insider Threat Office and its Behavioral Science Team. Personnel security clearances are a critical requirement for work involving sensitive government functions, particularly in security and counterintelligence roles.

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UNCLASSIFIED//FOUO

SOURCE SELECTION INFORMATION – SEE FAR 2.101 & 3.104

SOURCE SELECTION INFORMATION – SEE FAR 2.101 & 3.104

Personnel Security Clearance Information (Template)

Full Name (Last, First Middle)

DOB
POB
SSN
Type of Investigation/

Close Date

SCI Eligibility Date
Govt. Sponsor
YYYYYY, Jane Ann
05/06/1970
Washington, DC
666-66-2345
SSBI-PR
01/20/2019
02/25/2019
DIA
XXXXX, John Henry
02/01/1981
San Diego, CA
777-77-7890
SSBI
07/26/2021
08/30/2021
NGA

Note: This document contains personally identifiable information and is for official use only. Unauthorized dissemination or use of personally identifiable information is a violation of Federal law. Individuals in violation may be subject to fines, disciplinary actions or both (P.L. 93-579)

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